Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-20T05:34:56.925Z Has data issue: false hasContentIssue false
  • English
  • Français

Becoming an older caregiver: A study of gender differences in family caregiving at the end of life

Published online by Cambridge University Press:  19 March 2021

Roberta Spatuzzi Open the ORCID record for Roberta Spatuzzi [Opens in a new window] ,
Maria Velia Giulietti ,
Francesca Romito ,
Giorgio Reggiardo ,
Carmela Genovese ,
Michele Passarella ,
Letizia Raucci ,
Marcello Ricciuti ,
Fabiana Merico  and
Gerardo Rosati
...Show all authors
Roberta Spatuzzi*
Affiliation:
Department of Mental Health, UOSD CSM Vulture-Melfese, ASP Basilicata, Potenza, Italy
Maria Velia Giulietti
Affiliation:
Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
Francesca Romito
Affiliation:
Unit of Psycho-Oncology, National Cancer Research Center Istituto Tumori Giovanni Paolo II Bari, Bari, Italy Grumo Appula Hospice – ASL Bari, Bari, Italy
Giorgio Reggiardo
Affiliation:
Biostatistics and Data Management Unit, Medi Service S.r.l., Genova, Italy
Carmela Genovese
Affiliation:
Cystic Fibrosis Italian League, Potenza, Italy
Michele Passarella
Affiliation:
Fondazione ANT Italia ONLUS, Potenza, Italy
Letizia Raucci
Affiliation:
Palliative Care Unit, “San Carlo” Hospital, Potenza, Italy
Marcello Ricciuti
Affiliation:
Palliative Care Unit, “San Carlo” Hospital, Potenza, Italy
Fabiana Merico
Affiliation:
Palliative Care Center Hospice “Casa di Betania”, Tricase (Lecce), Italy
Gerardo Rosati
Affiliation:
Medical Oncology, “San Carlo” Hospital, Potenza, Italy
Luigi Attademo
Affiliation:
Department of Mental Health, Hospital Psychiatric Service of Diagnosis and Care at “San Carlo” Hospital, ASP Basilicata, Italian NHS, Potenza, Italy
Anna Vespa
Affiliation:
Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
*
Address correspondence: Roberta Spatuzzi, Department of Mental Health, UOSD CSM Vulture-Melfese, ASP Basilicata, Potenza, Italy. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Older people are not traditionally expected to become caregivers. For this reason, the experience of caregiving in older persons has not been explored adequately in the research on gender differences. The objective of this study was to assess the caregiver burden among older family members who care for cancer patients facing the end of their lives, in order to compare their differences according to gender (male vs. female).

Methods

This is a cross-sectional study. A total of 102 older caregivers (aged ≥65 years) of hospice patients were interviewed through the Caregiver Burden Inventory (CBI). The sample group was divided into two gender subgroups.

Results

Compared with male caregivers, the older female group reported significantly higher scores in the CBI–physical subscale (P = 0.028), and in the CBI, the overall score (P = 0.0399) confirmed by the generalized linear model (multivariate) evaluation that included possible predictors in the model. There were no significant differences in the other CBI subscale scores (time-dependent, developmental, social, and emotional).

Significance of results

Older female caregivers are at higher risk of experiencing burden and worse physical health compared with men. Further research is needed in modern palliative care to assess the role of gender differences in the experience of caregiving when the caregiver is an older person.

Keywords

BurdenCancerGenderOlder caregiver
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 1 , February 2022 , pp. 38 - 44
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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.)

References

Applebaum, AJ, Farran, CJ, Marziliano, AM, et al. (2014) Preliminary study of themes of meaning and psychosocial service use among informal cancer caregivers. Palliative and Supportive Care 12(2), 139–148.Google Scholar
Applebaum, AJ, Kulikowski, JR and Breitbart, W (2015) Meaning-centered psychotherapy for cancer caregivers (MCP-C): Rationale and overview. Palliative and Supportive Care 13(6), 1631–1641.CrossRefGoogle ScholarPubMed
Balducci, L (2019) Geriatric oncology, spirituality, and palliative care. Journal of Pain and Symptom Management 57(1), 171–175.CrossRefGoogle ScholarPubMed
Berger, JM, Levant, R, McMillan, KK, et al. (2005) Impact of gender role conflict, traditional masculinity ideology, alexithymia, and age on men's attitudes toward psychological help seeking. Psychology of Men & Masculinity 6(1), 73–78.Google Scholar
Breitbart, W, Poppito, S, Rosenfeld, B, et al. (2012) Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of Clinical Oncology 30(12), 1304–1309.Google Scholar
Breitbart, W, Rosenfeld, B, Pessin, H, et al. (2015) Meaning-centered group psychotherapy: An effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology 33(7), 749–754.Google Scholar
Carstensen, LL (2006) The influence of a sense of time on human development. Science 312(5782), 1913–1915.CrossRefGoogle ScholarPubMed
Caserta, MS, Lund, DA and Wright, SD (1996) Exploring the Caregiver Burden Inventory (CBI): Further evidence for a multidimensional view of burden. International Journal of Aging and Human Development 43(1), 21–34.CrossRefGoogle ScholarPubMed
Davies, E (2003) What are the Appropriate Services and Support to Address the Palliative Care Needs of Older People? Report to the Health Evidence Network. Copenhagen: WHO Regional Office for Europe.Google Scholar
Del-Pino-Casado, R, Millàn-Cobo, MD, Paolomino-Moral, PA, et al. (2014) Cultural correlates of burden in primary caregivers of older relatives: A cross-sectional study. Journal of Nursing Scholarship 46, 176–186.Google Scholar
Eagly, AH (2009) The his and hers of prosocial behavior: An examination of the social psychology of gender. American Psychologist 64(8), 644–658.CrossRefGoogle ScholarPubMed
Ettema, EJ, Derksen, LD and van Leeuwen, E (2010) Existential loneliness and end-of-life care: A systematic review. Theoretical Medicine and Bioethics 31(2), 141–169.CrossRefGoogle ScholarPubMed
Fromme, EK, Drach, LL, Tolle, SW, et al. (2005) Men as caregivers at the end of life. Journal of Palliative Medicine 8(6), 1167–1175.Google Scholar
Goldzweig, G, Schapira, L, Baider, L, et al. (2019) Who will care for the caregiver? Distress and depression among spousal caregivers of older patients undergoing treatment for cancer. Supportive Care in Cancer 27(11), 4221–4227.Google Scholar
Ketcher, D, Trettevik, R, Vadaparampil, ST, et al. (2020) Caring for a spouse with advanced cancer: Similarities and differences for male and female caregivers. Journal of Behavioral Medicine 43(5), 817–828.Google Scholar
Kluge, F, Zagheni, E, Loichinger, E, et al. (2014) The advantages of demographic change after the wave: Fewer and older, but healthier, greener, and more productive? PLoS One 9(9), e108501.Google Scholar
Marvardi, M, Mattioli, P, Spazzafumo, L, et al. (2005) Study group on brain aging, Italian society of gerontology and geriatrics. The Caregiver Burden Inventory in evaluating the burden of caregivers of elderly demented patients: Results from a multicenter study. Aging Clinical and Experimental Research 17(1), 46–53.Google Scholar
Masterson, MP, Hurley, KE, Zaider, T, et al. (2015) Toward a model of continuous care: A necessity for caregiving partners. Palliative and Supportive Care 13(5), 1459–1467.Google Scholar
Menaca, A, Evans, N, Andrew, EV, et al. (2012) End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal. Critical Reviews in Oncology/Hematology 82, 387–401.CrossRefGoogle Scholar
Morgan, T, Williams, LA, Trussardi, G, et al. (2016) Gender and family caregiving at the end-of-life in the context of old age: A systematic review. Palliative Medicine 30(7), 616–624.CrossRefGoogle ScholarPubMed
Mystakidou, K, Parpa, E, Panagiotou, I, et al. (2013) Caregivers’ anxiety and self-efficacy in palliative care. European Journal of Cancer Care 22, 188–195.Google Scholar
Naldini, M, Pavolini, E and Solera, C (2016) Female employment and elderly care: The role of care policies and culture in 21 European countries. Work. Employment and Society 30(4), 607–630.CrossRefGoogle Scholar
Navaie-Waliser, M, Spriggs, A and Feldman, PH (2002) Informal caregiving: Differential experiences by gender. Medical Care 40(12), 1249–1259.CrossRefGoogle ScholarPubMed
Novak, M and Guest, CI (1989) Application of a multidimensional Caregiver Burden Inventory. The Gerontologist 29(6), 798–803.CrossRefGoogle ScholarPubMed
Novak, M and Guest, C (1992) A comparison of the impact of institutionalization on spouse and nonspouse caregivers. Journal of Applied Gerontology 11(4), 379–394.CrossRefGoogle ScholarPubMed
O'Hara, RE (2010) Impact on caregiver burden of a patient-focused palliative care intervention for patients with advanced cancer. Palliative and Supportive Care 8(4), 395–404.CrossRefGoogle ScholarPubMed
Parker Oliver, D, Albright, DL, Washington, K, et al. (2013) Hospice caregiver depression: The evidence surrounding the greatest pain of all. Journal of Social Work in End-of-Life & Palliative Care 9(4), 256–271.Google Scholar
Pinquart, M and Sörensen, S (2006) Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 61(1), 33–45.CrossRefGoogle ScholarPubMed
Postmes, T and Speares, R (2002) Behavior online: Does anonymous computer communication reduce gender inequality? Personality and Social Psychology Bulletin 28, 1073–1083.CrossRefGoogle Scholar
Prentice, DA and Carranza, E (2002) What women and men should be, shouldn't be, are allowed to be, and don't have to be: The contents of prescriptive gender stereotypes. Psychology of Women Quarterly 26, 269–281.CrossRefGoogle Scholar
Read, T and Wuest, J (2007) Daughters caring for dying parents: A process of relinquishing. Qualitative Health Research 17, 932–944.CrossRefGoogle ScholarPubMed
Russell, R (2007) The work of elderly men caregivers: From public careers to an unseen world. Men and Masculinities 9(3), 298–314.CrossRefGoogle Scholar
Schrank, B, Ebert-Vogel, A, Amering, M, et al. (2015) Gender differences in caregiver burden and its determinants in family members of terminally ill cancer patients. Psychooncology 25(7), 808–814.Google Scholar
Sharma, N, Chakrabarti, S and Grover, S (2016) Gender differences in caregiving among family – Caregivers of people with mental illnesses. World Journal of Psychiatry 6(1), 7–17.CrossRefGoogle ScholarPubMed
Shetty, P, Mane, A, Fulmali, S, et al. (2018) Understanding masked depression: A clinical scenario. Indian Journal of Psychiatry 60, 97–102.Google Scholar
Washington, KT, Pike, K, Demiris, G, et al. (2015a) Gender differences in caregiving at end of life: Implications for hospice teams. Journal of Palliative Medicine 18(12), 1048–1053.Google Scholar
Washington, KT, Demiris, G, Pike, KC, et al. (2015b) Anxiety among informal hospice caregivers: An exploratory study. Palliative and Supportive Care 13(3), 567–573.Google Scholar
Williams, SW, Dilworth-Anderson, P and Goodwin, PY (2003) Caregiver role strain: The contribution of multiple roles and available resources in African-American women. Aging and Mental Health 7(2), 103–112.CrossRefGoogle Scholar
Williams, LA, Giddings, LS, Bellamy, G, et al. (2017) Because it's the wife who has to look after the man: A descriptive qualitative study of older women and the intersection of gender and the provision of family. Palliative Medicine 31(3), 223–230.Google Scholar
Wool, CA and Barsky, AJ (1994) Do women somatize more than men? Gender differences in somatization. Psychosomatics: Journal of Consultation and Liaison Psychiatry 35(5), 445–452.CrossRefGoogle ScholarPubMed