Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-20T13:28:37.793Z Has data issue: false hasContentIssue false
  • English
  • Français

Older Adult Spouses with Multiple Chronic Conditions: Challenges, Rewards, and Coping Strategies

Published online by Cambridge University Press:  28 March 2017

Shelley Peacock ,
Bharati Sethi ,
Allison Williams ,
Wendy Duggleby ,
Melanie Bayly ,
Jenny Swindle ,
Jenny Ploeg  and
Maureen Markle-Reid
Shelley Peacock*
Affiliation:
College of Nursing, University of Saskatchewan
Bharati Sethi
Affiliation:
King’s College, Western University
Allison Williams
Affiliation:
Aging and Community Health Research Unit, McMaster University
Wendy Duggleby
Affiliation:
Faculty of Nursing, University of Alberta
Melanie Bayly
Affiliation:
College of Nursing, University of Saskatchewan
Jenny Swindle
Affiliation:
Faculty of Nursing, University of Alberta
Jenny Ploeg
Affiliation:
Aging and Community Health Research Unit, McMaster University
Maureen Markle-Reid
Affiliation:
Aging and Community Health Research Unit, McMaster University
*
†La correspondance et les demandes de tire-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Shelley Peacock, Assistant Professor College of Nursing, University of Saskatchewan Health Sciences Building, E-wing 4340 104 Clinic Place Saskatoon, SK, S7N 2Z4 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne’s interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.

Résumé

Un manque de recherche explore comment les conjoints des personnes âgées avec de multiples affections chroniques confèrent un sense à leur expérience de la prestation de soins. Dans le cadre de cette étude, nous avons posé la question suivante: Quelle est l’expérience des aidants naturels pour les personnes atteintes de maladies chroniques multiples? Nous avons appliqué l’approche descriptive interprétative de Thorne, en interviewant 18 conjoints qui ont fourni une riche description de leurs expériences de soins; les entrevues ont été transcrites textuellement et analysées thématiquement. Les thèmes ont été catégorisés en fonction des difficultés rencontrées, des récompenses obtenues et des stratégies de soutien employées par les participants à la prestation de soins pour les conjoints souffrant de maladies chroniques multiples. Les résultats uniques portent sur les défis inhérents à la prise de décision dans le contexte de maladies chroniques multiples. Cet article commence à combler l’écart dans la littérature sur l’expérience des soins dans le contexte de multiples maladies chroniques.

Keywords

agingfamily caregivingmultiple chronic conditionsinterpretive descriptionvieillissementsoins familialesmaladies chroniques multiplesdescription intérpretative
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 36 , Issue 2 , June 2017 , pp. 209 - 222
Check for updates
Copyright
Copyright © Canadian Association on Gerontology 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors thank Maha Kumaran, Health Sciences librarian at the University of Saskatchewan, for providing support with searching the literature. Also, a sincere “thank you” to the participants who so willingly shared their stories.

References

Alvira, M. C., Risco, E., Cabrera, E., Farré, M., Hallberg, I. R., Bleijlevens, M. H. C., … Zabalegui, A. (2014). The association between positive-negative reactions of informal caregivers of people with dementia and health outcomes in eight European countries: A cross-sectional study. Journal of Advanced Nursing, 71(6), 1417–1434. doi: 10.1111/jan.12528 Google Scholar
Bayliss, E. A., Edwards, A. E., Steiner, J. F., & Main, D. S. (2008). Processes of care desired by elderly patients with multimorbidities. Family Practice, 25(4), 287–293. doi: 10.1093/fampra/cmn040 CrossRefGoogle ScholarPubMed
Broemeling, A. M., Watson, D. E., & Prebtani, F. (2008). Population patterns of chronic health conditions, co-morbidity and healthcare use in Canada: Implications for policy and practice. Healthcare Quarterly, 11(3), 70–76. doi: 10.12927/hcq.2008.19859 CrossRefGoogle ScholarPubMed
Burton, A. M., Sautter, J. M., Tulsky, J. A., Hoff Lindquist, J., Hays, J. C., Olsen, M. K., … Steinhauser, K. E. (2012). Burden and well-being among a diverse sample of cancer, congestive heart failure, and chronic obstructive pulmonary disease caregivers. Journal of Pain and Symptom Management, 44(3), 410–420. doi: 10.1016/j.jpainsymman.2011.09.018 CrossRefGoogle ScholarPubMed
Centre for Chronic Disease Prevention, Public Health Agency of Canada. (2014). Chronic disease and injury indicator framework: 2014 edition. Retrieved from http://infobase.phac-aspc.gc.ca/cdif/ Google Scholar
Chappell, N. L., Dujela, C., & Smith, A. (2014). Spouse and adult child differences in caregiving burden. Canadian Journal on Aging, 33(4), 462–472. doi: 10.1017/S0714980814000336 CrossRefGoogle ScholarPubMed
Charmaz, K. (2006). Constructing grounded theory. Thousand Oaks, CA: Sage.Google Scholar
Davis, L. L., Gilliss, C. L., Deshefy-Longhi, T., Chestnutt, D. H., & Molloy, M. (2011). The nature and scope of stressful spousal caregiving relationships. Journal of Family Nursing, 17(2), 224–240. doi: 10.1177/1074840711405666 CrossRefGoogle ScholarPubMed
de Bruin, S. R., Versnel, N., Lemmens, L. C., Molema, C. C. M., Schellevis, F. G., Nijpels, G., & Baan, C. A. (2012). Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review. Health Policy, 107, 108–145. doi: 10.1016/j.healthpol.2012.06.006 CrossRefGoogle ScholarPubMed
Denton, F. T., & Spencer, B. G. (2010). Chronic health conditions: Changing prevalence in an aging population and some implications for the delivery of health care services. Canadian Journal on Aging, 29(1), 11–21. doi: 10.1017/S0714980809990390 CrossRefGoogle Scholar
Donnellan, W. J., Bennett, K. M., & Soulsby, L. K. (2015). What are the factors that facilitate or hinder resilience in older spousal dementia carers? A qualitative study. Aging & Mental Health, 19(10), 932–939. doi: 10.1080/13607863.2014.977771 Google Scholar
Freid, V. M., Bernstein, A. B., & Bush, M. A. (2012). Multiple chronic conditions among adults aged 45 and over: Trends over the past 10 years. NCHS data brief, no. 100. Hyattsville, MD: National Center for Health Statistics.Google ScholarPubMed
Garlo, K., O’Leary, J. R., Van Ness, P. H., & Fried, T. R. (2010). Burden in caregivers of older adults with advanced illness. Journal of the American Geriatrics Society, 58(12), 2315–2322. doi: 10.1111/j.1532-5415.2010.03177.x Google Scholar
Goodman, R. A., Posner, S. F., Huang, E. S., Parekh, A. K., & Koh, H. K. (2013). Defining and measuring chronic conditions: Imperatives for research, policy, program, and practice. Preventing Chronic Disease, 10, E66. doi: 10.5888/pcd10.120239 Google Scholar
Harris, G. M., Allen, R. S., Dunn, L., & Parmelee, P. (2013). “Trouble won’t last always”: Religious coping and meaning in the stress process. Qualitative Health Research, 23(6), 773–781. doi: 10.1177/1049732313482590 CrossRefGoogle ScholarPubMed
Hawranik, P. G., & Strain, L. A. (2007). Giving voice to informal caregivers of older adults. Canadian Journal of Nursing Research, 39(1), 156–172. Retrieved from http://digital.library.mcgill.ca/cjnr/ Google ScholarPubMed
Hayes, J., Boylstein, C., & Zimmerman, M. K. (2009). Living and loving with dementia: Negotiating spousal and caregiver identity through narrative. Journal of Aging Studies, 23(1), 48–59. doi: 10.1016/j.jaging.2007.09.002 Google Scholar
Hodge, D. R., & Sun, F. (2012). Positive feelings of caregiving among Latino Alzheimer’s family caregivers: Understanding the role of spirituality. Aging & Mental Health, 16(6), 689–698. doi: 10.1080/13607863.2012.678481 Google Scholar
Hollander, M. J., Liu, G., & Chappell, N. L. (2009). Who cares and how much? The imputed economic contribution to the Canadian healthcare system of middle-aged and older unpaid caregivers providing care to the elderly. Healthcare Quarterly, 12(2), 42–49. doi: 10.12927/hcq.2009.20660 CrossRefGoogle Scholar
Jeon, Y. H., Jowsey, T., Yen, L., Glasgow, N. J., Essue, B., Kljakovic, M., … Aspin, C. (2010). Achieving a balanced life in the face of chronic illness. Australian Journal of Primary Health, 16, 66–74. doi: 10.1071/PY09039 Google Scholar
Koch, G., Wakefield, B. J., & Wakefield, D. S. (2015). Barriers and facilitators to managing multiple chronic conditions: A systematic literature review. Western Journal of Nursing Research, 37(4), 498–516. doi: 10.1177/0193945914549058 Google Scholar
Kuluski, K., Gill, A., Naganathan, G., Upshur, R., Jaakkimaimen, R. L., & Wodchis, W. P. (2013). A qualitative descriptive study on the alignment of care goals between older persons with multi-morbidities, their family physicians and informal caregivers. BMC Family Practice, 14, 133–143. doi: 10.1186/1471-2296-14-133 Google Scholar
Limpawattana, P., Theeranut, A., Chindaprasirt, J., Sawanyawisuth, K., & Pimporm, J. (2012). Caregivers burden of older adults with chronic illnesses in the community: A cross-sectional study. Journal of Community Health, 38(1), 40–45. doi: 10.1007/s10900-012-9576-6 CrossRefGoogle Scholar
Lloyd, J., Patterson, T., & Muers, J. (2014). The positive aspects of caregiving in dementia: A critical review of the qualitative literature. Dementia. doi: 10.1177/1471301214564792 Google ScholarPubMed
Mackenzie, A., & Greenwood, N. (2012). Positive experiences of caregiving in stroke: A systematic review. Disability & Rehabilitation, 34(17), 1413–1422. doi: 10.3109/09638288.2011.650307 Google Scholar
Márquez-González, M., López, J., Romero-Moreno, R., & Losada, A. (2012). Anger, spiritual meaning and support from the religious community in dementia caregiving. Journal of Religion and Health, 51(1), 179–186. doi: 10.1007/s10943-010-9362-7 Google Scholar
Peacock, S., Forbes, D., Markle-Reid, M., Hawranik, P., Morgan, D., Jansen, L., … Leipert, B. (2010). The positive aspects of the caregiving journey with dementia: Using a strengths-based perspective to reveal opportunities. Journal of Applied Gerontology, 29, 640–659. doi: 0.1177/0733464809341471 Google Scholar
Peacock, S., Hammond-Collins, K., & Forbes, D. (2014). The journey with dementia from the perspective of bereaved family caregivers: A qualitative descriptive study. BMC Nursing, 13, 42–52. doi: 10.1186/s12912-014-0042-x Google Scholar
Pinquart, M., & Sörensen, S. (2011). Spouses, adult children, and children-in-law as caregivers of older adults: A meta-analytic comparison. Psychology and Aging, 26(1), 1–14. doi: 10.1037/a0021863 CrossRefGoogle ScholarPubMed
Poulin, M. J., Brown, S. L., Ubel, P. A., Smith, D. M., Jankovic, A., & Langa, K. M. (2010). Does a helping hand mean a heavy heart? Helping behavior and well-being among spousal caregivers. Psychology and Aging, 25(1), 108–117. doi: 10.1037/a0018064 CrossRefGoogle Scholar
Quinn, C., Clare, L., & Woods, R. T. (2012). What predicts whether caregivers of people with dementia find meaning in their role? International Journal of Geriatric Psychiatry, 27, 1195–1202. doi: 10.1002/gps.3773 Google Scholar
Retrum, J. H., Nowels, C. T., & Bekelman, D. B. (2013). Patient and caregiver congruence: The importance of dyads in heart failure care. The Journal of Cardiovascular Nursing, 28(2), 129–136. doi: 10.1097/JCN.0b013e3182435f27 Google Scholar
Roth, D. L., Fredman, L., & Haley, W. E. (2015). Informal caregiving and its impact on health: A reappraisal from population-based studies. The Gerontologist, 55(2), 309–319. doi: 10.1093/geront/gnu177 CrossRefGoogle Scholar
Sandelowski, M. (1986). The problem of rigor in qualitative research. Advances in Nursing Science, 8(3), 27–37.Google Scholar
Sanders, S., & Power, J. (2009). Roles, responsibilities, and relationships among older husbands caring for wives with progressive dementia and other chronic conditions. Health & Social Work, 34(1), 41–51. doi: 10.1093/hsw/34.1.41 Google Scholar
Savundranayagam, M. Y. (2013). Receiving while giving: The differential roles of receiving help and satisfaction with help on caregiver rewards among spouses and adult-children. International Journal of Geriatric Psychiatry, 29, 41–48. doi: 10.1002/gps.3967 Google Scholar
Savundranayagam, M. Y., Montgomery, R. J. V., & Kosloski, K. (2011). A dimensional analysis of caregiver burden among spouses and adult children. The Gerontologist, 51(3), 321–331. doi: 10.1093/geront/gnq102 CrossRefGoogle ScholarPubMed
Schoen, C., Osborn, R., Squires, D., Doty, M., Pierson, R., & Applebaum, S. (2011). New 2011 survey of patients with complex care needs in eleven countries finds that care is often poorly coordinated. Health Affairs, 30(12), 2437–2448. doi: 10.1377/hlthaff.2011.0923 Google Scholar
Shim, B., Barroso, J., & Davis, L. L. (2012). A comparative qualitative analysis of stories of spousal caregivers of people with dementia: Negative, ambivalent, and positive experiences. International Journal of Nursing Studies, 49, 220–229. doi: 10.1016/j.ijnurstu.2011.09.003 CrossRefGoogle ScholarPubMed
Shim, B., Barroso, J., Gilliss, C. L., & Davis, L. L. (2013). Finding meaning in caring for a spouse with dementia. Applied Nursing Research, 26(3), 121–126. doi: 10.1016/j.apnr.2013.05.001 Google Scholar
Sinha, M. (2013). Spotlight on Canadians: Results from the General Social Survey – Portrait of caregivers, 2012 (catalogue no. 89-652-X — No. 001). Retrieved from Statistics Canada website: www.statcan.gc.ca Google Scholar
Thorne, S. (2008). Interpretive description. Walnut Creek, CA: Left Coast Press.Google Scholar
Tinetti, M. E., Fried, T. R., & Boyd, C. (2012). Designing health care for the most common chronic condition – multimorbidity. The Journal of the American Medical Association, 307(23), 2493–2494. doi: 10.1001/jama.2012.5265 Google Scholar
Valderas, J. M., Starfield, B., Sibbald, B., Salisbury, C., & Roland, M. (2009). Defining comorbidity: Implications for understanding health and health services. Annals of Family Medicine, 7(4), 357–363. doi: 10.1370/afm.983 Google Scholar
Washington, K. T., Meadows, S. E., Elliott, S. G., & Koopman, R. J. (2011). Information needs of informal caregivers of older adults with chronic health conditions. Patient Education and Counseling, 83, 37–44. doi: 10.1016/j.pec.2010.04.017 Google Scholar
Wolfs, C. A. G., de Vugt, M. E., Verkaaik, M., Haufe, M., Verkade, J., Verhey, F. R. J., & Stevens, F. (2012). Rational decision-making about treatment and care in dementia: A contradiction in terms? Patient Education and Counseling, 87(1), 43–48. doi: 10.1016/j.pec.2011.07.023 Google Scholar
Zulman, D. M., Asch, S. M., Martins, S. B., Kerr, E. A., Hoffman, B. B., & Goldstein, M. K. (2014). Quality of care for patients with multiple chronic conditions: The role of comorbidity interrelatedness. Journal of General Internal Medicine, 29(3), 529–537. doi: 10.1007/s11606-013-2616-9 Google Scholar