Introduction: Research on carers of people with eating disorders (ED) is limited and on carers of people with severe and enduring eating disorders (SEED) almost nonexistent. Nearly 40% of carers of people with ED experience clinical level mental health difficulties. The current aims investigated wellbeing in carers of people with ED and specifically, carers of people with SEED; investigated gender differences; and compared data with wellbeing studies investigating carers of people with other long-term conditions. The Stress Process Model (SPM) (Pearlin, Mullan, Semple, & Skaff, 1990) was used to better understand predictors of wellbeing. Method: Carers (28 male, 76 female) were recruited from ED carer support groups. Carers were stratified using duration (since diagnosis) of their recipient’s ED (0-2 years, 2-6 years, over 6 years). The “over 6 years” category was classified as SEED. Comparison data were drawn from carers of people with dementia, brain injury, ED and psychosis. Standardised questionnaires measured wellbeing (SF-36), experiences of caregiving (ECI), perceived caregiver competence (MoCC), sense of personal mastery (MoPM) and expressive support (MoES). Results: Carers of people with SEED were not significantly different on reported wellbeing to the whole sample of carers of people with ED. However, carers of people with ED reported significantly less wellbeing than community norms, carers of people with brain injury and dementia. Perceived dependency, carer gender and sense of personal mastery accounted for 29% of the variance in mental wellbeing scores. Differences in reported positive experiences of caregiving were identified. Discussion: The mental wellbeing of carers of people with SEED and ED appears poorer than carers of other conditions. Further research on carers of people with SEED is needed. The SPM is a helpful framework to use. Clinical implications include ensuring that perception of dependency and the positive experiences of caregiving are addressed in workshops and support groups.

Background and objectives Research into carers of people with young onset dementia (YOD) has highlighted that carers may experience more distress than late onset dementia (LOD) carers (e.g. Freyne, Kidd, Coen & Lawlor, 1999), and have specific needs which differ from those of LOO carers (e.g. Svanberg, Spectar & Slott, 2011). Difficulties with employment has been raised as a particular issue for this population (e.g. van Vliet, de Vugt, Bakker, Koopmans & Verhey, 2010), yet no qualitative study has examined the factors influencing carers' experience of employment. This study aimed to explore such factors and how these impact on carers' ability to cope with their caring roles. Method A qualitative grounded theory approach was used to study the experiences of employment using in-depth semi-structured interviews. Ten YOD carers with experience of employment, who were living with, and caring for, someone who had been diagnosed with dementia before the age of 65, were recruited through carer support groups using purposive sampling. Results Nine theoretical categories were identified, including: dealing with the challenges of the caring role, appraisal, attributing responsibility, support, benefitting from working, transferring work skills, mutual interference of work and home, needing flexibility to continue working and being motivated to seek work. by a need for space and identity. Conclusions These findings expand current theoretical knowledge of how YOD carers may manage employment alongside their caring role. Findings suggest carers may experience employment as personally beneficial, and that it may directly and indirectly influence their ability to cope with their caring role. YOD carers' vocational needs, and their coping resources may need to be explicitly addressed in clinical assessments, and explored and incorporated into psychological interventions. Further research is warranted to validate the findings empirically with a larger sample of YOD carers.

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Abstract Background: Carers and families have a key role in supporting adults with intellectual disabilities to make lifestyle behaviour changes. This study explores paid and family carers’ motivation to support change and their attributions around physical activity choices in the individuals that they support. Methods: A between subjects questionnaire design, using two questionnaires adapted specifically for this study, was used to investigate carers’ motivation to support behaviour change and explore how this related to their attributions of physical activity choices. The influence of gender, age and level of intellectual disabilities of the individual that the carer supports were examined. Results: 18 carers participated in the study. There was evidence to suggest that carers’ motivation to support change and attributions were correlated. In addition, motivation and attributions were related to age and level of intellectual disabilities of the individual supported by the carer. Conclusion: Carer attributions might present a barrier to motivation to support change. This may indicate a training need for carers. Further research is required to further explore carer attributions and to further examine the utility of the questionnaire measures adapted for this study.

When an individual is cared for from within the household, this care-giver is most likely to be their spouse or partner. Research to date has explored the impact of life-limiting illness on spouses and partners, as well as other family members. Studies have described some of the ways in which a life-limiting illness can impact on a spouse or partner physically and emotionally; and the role changes that they may face. Often research publications have grouped together participants who differ from one another in terms of age and gender, and it can be argued that there is value in focusing more narrowly on specific groups; in order to gain a detailed, in-depth appreciation of their distinct experiences. The initial part of this thesis critically evaluates recent research investigating the impact on individuals who have a family member with a life-limiting illness. This includes identifying key themes arising across studies which highlight the multitude of ways in which life-limiting illness can affect family members. This is followed by an empirical paper detailing a piece of idiographic qualitative research which sought to explore the experiences of older women living with a husband or partner who have a life-limiting illness. Six over-arching themes emerged from the interviews which described these experiences.

The increasingly important role of the family in providing home care for a relative diagnosed with dementia has become a recognised feature of contemporary heahh care. Few studies exist, however, that have examined the relationship these carers develop with the professional assigned to help them undertake care-giving. The relationship held with a key-worker may significantly influence their ability and motivation to undertake the tasks and lifestyle changes necessary for this role. This study's aim was to examine this relationship in detail and generate a theoretical explanation allowing a clearer understanding of the influential factors associated with creation and enhancement of this relationship. Grounded theory was considered the methodology best suited to this aim. Its principal advantage is that it allows the researcher to generate rather than simply test theory and it also provides the necessary degree of flexibility essential for such an exploratory study. In order to meet ethical approval requirements a purposive, rather than theoretical, sampling approach was used for the selection of carers. Approach into the carer sample was through the consultant psychiatrist who forwarded research packs to potential participants via the person with dementia. Eighteen carers met the entry requirements and were subsequently included within the study; along with their chosen key-workers who numbered eleven in total. The key-worker group were all front line workers from either a health or social care background. Nine of this key-worker group were qualified and registered worregistered workers while the remaining two were unqualified care workers working under the direct supervision of a registered social or health care professional. The carerlkey-worker pairs were interviewed in tandem and all interviews recorded. These were then analysed using the constant comparative method, a process helped by the use of NUD*IST computer software. The analysis progressed from initial data categories through to the final core category that provided an explanation of all subordinate data. This core category became the title for the theoretical framework that eventually emerged. Subsequently, a theoretical explanation of the relationship's development was generated along with how it impacted upon the care-giving environment. The theory began with the major category 'The Enhanced Relationship Drivers', which highlighted that while characteristics associated with this relationship were often obscure, there were significant qualities and actions that clearly enhanced the relationship. Once these were engaged both parties moved towards the closer 'therapeutic alliance' contained within the second major category area, 'Models of Action'. Here shared qualities and attributes were more successfully directed towards the care of the person with dementia. A direct outcome of this alliance was a potentially closer and more productive working relationship for both the carer and key-worker. This could result in the creation of an improved therapeutic milieu, minimising the more negative interpretations associated with care-giving. These more negative perceptions of care-giving were highlighted within the third major category 'Impact upon the World of Caring'. However, when the enhancing influences of the preceding major categories were enacted, a more 'Rewarding Care Experience' was possible. External mediators could impinge upon the relationship, either impeding or enhancing its development. These included factors such as the management style of the key-worker's employing authority, the availability of alternative support networks for the carer, as well as the educational/life experience of both members of this dyad. The derived theory has been diagrammatically represented to provide a clear demonstration of all theoretical links between codes and categories, facilitating a better understanding of the developed theory. The study provided a clear insight into the interpersonal processes associated with the carerlkey-worker relationship and how this relationship may more effectively be initiated, managed and strengthened. This theory has important implications for future research into similar psychosocial aspects of care-giving. These findings have ramifications for carer training as well as education and training courses preparing professionals to work more effectively with carers. It has implications for health and social care managers in terms of their level of awareness of the importance of this relationship and the need for investment in it. lt is important that this theory is exposed to more rigorous empirical study allowing for a more confident prediction that its propositions will produce the direct benefits for this relationship that this theory suggests.

This thesis presents a retrospective critique of the social and political construction of 'informal care' within community care policy from the period of the late 1970s to the mid 1990s. The thesis considers the question of the degree of 'choice' available to informal carers to say 'no' to caring, or aspects of caring, within the reforms' positioning of informal care as the first line of support for adult dependants. The critique focuses on subjectivity, difference, agency and choice. A theoretical and methodological synthesis is developed between feminist post-structuralism, feminist critiques of mainstream social policy, and feminist theory and research, within which a qualitative in-depth interview study with informal carers is situated. The critique is then expanded through the development of a 'Q' Methodology study with a larger cohort of informal carers. The research identified gendered generational differences between the carers, and a 'burden' of care imposed as an outcome of consecutive governments' attempts to residualise welfare. The older carers' levels of agency and choice were severely curtailed. However, the younger female carers were more able to resist the drive of the community care reforms, their counter discourses being based on a new emergent notion of 'rights'. The direction of community care policy was found to be out of step with how the carers within this study perceived their responsibilities and 'obligations'. The thesis argues that whilst post-modernism may have constrained the capacity of governments and reconstituted our understanding of 'care', it has not done so to the extent that we are no longer prepared to make demands for 'care' from and by the state.

Thesis (LLM.) -- University of Limpopo, 2019 / This mini-dissertation seeks to evaluate the best interests of the child as a separate factor that influences the sentencing of a primary caregiver. When a parent is in conflict with the law, the child stands to be affected sentence that the court may impose on the caregiver. A custodial sentence has the potential of affecting the child’s right to parental care. Therefore, in the event where a custodial sentence is appropriate, alternative care of the child by other persons become a possible option. The author recommends that after applying the principles articulated in S v M and making use of a child impact report; the right of the child to parental care should carry more weight. Thus, courts should duly consider the best interest of the child as an independent factor when negative effects to the child are associated with the sentence. Where appropriate, with either a non-custodial sentence or adequate alternative care (in the case of imprisonment).