Abstract
The purpose of this study was to find out the longitudinal impact of inter-household caregiving on adult children’s mental health. The research question formulated was the wear and tear of the adult children’s mental health (the longer the care given the greater the psychological impact). The samples subjects were chosen from 112 households that had elderly impaired parents and care was provided by an adult child in that family. The study was done for a duration of 14 weeks. The parameters used to measure mental health were depression, subjective caregiving stress, and subjective caregiving effectiveness. At the end of the study, it is suggested that more research should be done based on other types of caregivers.
Introduction
The research done by Townsend et al, clearly states the purpose of the study as it seeks to examine the effect of caregiving by adult children caring for their elderly parents. The longer a person is involved in caregiving, the more the effect it has on their mental health. This is important since the results of the study can be used in implementing different health policies that relate to caregiving in various households. This research paper reviews previous studies that have been done and is a review of a paper presented at the Annual Psychological Association, New York in August 1987(American Psychology Association, 2009). Other previous researches include research done by Harris (2005) on the mental health of spouses that were taking care of elderly people with Alzheimer’s disease.
The study is appropriate because there has been a lack of data on longitudinal research on this issue. There has been cross-sectional but not longitudinal research on the mental health of adult children taking care of their elderly parents. The hypothesis has been clearly stated in this particular research. It states that the wear and tear of the mental health of an adult caregiver are increased with longer periods of giving care to the impaired parent. To support the hypothesis, the study shows that the mental deterioration of the caregiver increases with time and is occasioned by depression and reduced immunity (Seyle, 1976). It also shows that the amount of stress at the initial stages increases with the duration it has had an effect on the caregivers. To counter the hypothesis, some studies show that after a long period of taking care of the impaired parent, the caregivers adapt and have reduced stress and strain. The hypothesis, therefore, explains the uncertainty being solved and also the purpose of the study.
Method
Samples for this research were chosen by Margaret Blenkner Research Center at the Benjamin Rose Institute in Cleveland Ohio. The samples have been stated but it’s not clear especially concerning the elderly parents. However, the samples were taken from white family units with elderly (60 years and above) impaired parents. These parents needed at least assistance on 6 caregiving chores to qualify for this research. The sampling procedure used was personalized and individual interviews with the caregivers and elderly parents were done. There were also referrals from community agencies and informal community groups.
The study protocol dealt with the development of a study plan that was based on the research question. The outline of the study provides a detailed list of the elements of the study that acts as a checklist for the researcher. With this in mind, 160 families were selected and eligible at the start of the data collection but with various factors, only 112 remained on the criteria that they needed help for the next 14 months. Some were also eliminated on the basis that the elderly parents were institutionalized and no longer need their care in the course of the study. If no data was available at the first and second data collection, the families were disqualified. The instruments used in the research are well described and measured the content intended.
The instruments used were the social demographic data that classified the adult children’s characteristics and the elderly parents’ characteristics. With this information, one is able to determine what category of caregivers is affected by what level of impairment in the parents. Another measure used was parental care needs, and the parents who had limited functionality were said to have affected their other responsibilities. This instrument can be used to measure the mental health of the caregivers. The instruments used were able to measure the concepts they intended; these concepts are mental health of the adult children caregivers, duration of the caregiving and subjective stress & effectiveness. To measure mental health, the researcher used the Zung (1965) instrument which measures the frequency of depressive episodes in a person. The scores were lower at the 1st point of data collection than the second. The investigators also used the Bradburn (1969) affect balance scale which measures the occurrence of positive and negative feelings that happen for long durations.
To measure the duration of care giving, the caregivers were asked to state how long they had being taking care of their impaired parents’ needs. Subjective stress and effectiveness measurements used the Klein & Hills (1979) model that seeks to establish the relationship between family problems and solving effectiveness was put into play. The need for care by the impaired parents is viewed as a family problem, and being able to meet the needs was subjective to effectiveness. The design selected is longitudinal research and was appropriate for the research of the wear and tear of the mental health of the care givers.
The design used in the study in the complex issue was based on the hypotheses that the research was seeking to investigate. The design of this study is appropriate as the mental health of the care givers is the dependent variable and the others being the subjective stress and effectiveness. The design selected is able to get the right answers which respond to the research question. During the study there were threats to internal and external validity inherent in the design of the study; there is the difference between the actual and intended a sample, where the sample group of 160 people was originally selected but with various reasons coming into play the number reduced to 112 and with more elimination based on various criteria. Another threat would be a wrong format of the questionnaires and that results in the subjects ticking the wrong boxes therefore providing the wrong information. There various errors that would also be a threat to the validity include random errors (caused by chances) and systematic errors caused by biases. The author of the research coped with the threats to internal and external factors by use of smaller sample sizes. Bigger sample sizes give bigger margins for errors.
Discussion
The researcher compares the present findings with previous works. Increased subjective stress levels increased depression which is consistent with a study done earlier by Montgomery et al, (1985) and Zarit et al, (1980).Other findings in the study were that; longer periods of care giving lead to more subjective stress, greater subjective effectiveness and more depression which was seen at the initial stages of data collection. Another group’s findings were that; longer duration of care giving didn’t mean deterioration in the mental health of the care giver in that some of these children actually adapt to the situation and their depression is greatly lowered resulting in good mental health. Duration of time spent care giving to the parents had little co-relation with the subjective stress level/effectiveness or mental health.
Some subjects experienced more subjective effectiveness and more depression with prolonged periods of care giving. The relationship between the care giver and the parent had no significant impact on the subjective stress levels, efficiency and mental health. It is clear that the purpose of the study was to test the wear and tear hypotheses of the mental health of adult care takers of impaired parents (Hulley, et al., 2006). The findings this particular study are related to the purpose of the study by viewing the data collected in relation to the set parameters of the study which are mental health, subjective stress and effectiveness.
The hypothesis is contrary to the findings in that the mental health of an adult care taker does not deteriorate with pronged care giving. In subjects, the stress levels increased but effectiveness decreased resulting to very poor mental health. To add on this is that, the implications of the research has been discussed in the paper.The answers to the research question show that caretakers need help at the beginning of the care giving since the findings show that initial stages have higher subjective stress levels. At the same time, the depression is decreased with prolonged periods especially when the caregivers are happy that they are able provide care to their elderly parents. They adapt to the situation and start to experience satisfaction for being able to meet the needs of the parent (Saunders, 2006)
Conclusion
The results of this research can be used in future research in various ways as explained here; the use of the wear and tear hypotheses while focusing on other categories of caregivers for example, spouses taking care of impaired spouses, since the study has established that most caregivers adapt and their stress decreases with increased effectiveness. A future research study could be done to show which factors that can cause variability in these care givers. Some of the caretakers may want to put their impaired parents in institutions.
Another thing to be noted is that the research has been consistent and there are no leaps of logic. The paper starts with the statement of the hypothesis thus one understands what the research is all about. After the establishment of the research question, there is the determination of the importance of the research followed by the design of the study while at the same time the outline and study protocol is established (Pan, 2008). To establish the hypothesis of the wear and tear on the longitudinal impact on adult children’s mental health of inter household care giving to impaired elderly parents, subjects are selected that fit the criteria of elderly impaired parent (above 60 years and beyond that require help with more than six personal care activities).
The criteria of the subjects also cover caregivers who are adult children of the elderly impaired and are either widowed or married parent. Sampling is done with the subjects being interviewed together or apart from each other and the researcher making his own observations for the duration of the study. After the gathering of the data the findings are analyzed and tested against the hypothesis which can be either for or against the hypothesis. In this particular research there where findings that were consistent with the hypothesis and others contrary to the hypothesis. These cases, previous works of similar studies are compared with the present findings and from the results of the study; future research questions can be generated.
References
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