The purpose of this study was to examine the effects short-term respite care had on caregivers of elderly and brain-impaired adults. The study also sought to examine the role that social support plays in determining satisfaction with respite care.

This study addressed gaps in the literature on caregiver burden involving lack of information about the multiple strains of caregiving families, their coping patterns, and positive as well as negative aspects of caregiving. The primary objective was to examine the relationship among caregiving strains, patterns of coping responses employed, and the resulting objective and subjective burden. A model describing the relationship of these variables guided the study. The design was a mail survey of 97 caregivers living in Southwestern Virginia who were caring for a sick or disabled family member, age 60 or older (response rate=81%). Family strain was correlated with both subjective and objective burden. Only one coping pattern that dealt with understanding the medical situation was marginally correlated with objective burden at p < .10. No coping patterns were correlated with subjective burden. Based on stepwise multiple regression analysis, the variables that were significant in explaining the variance in objective burden were health of the caregiver and family strain. The presence of home health services and family strain were significant in explaining the variance in subjective burden. Qualitative analysis identified major themes of positive and negative aspects of caregiving, with the majority of caregivers reporting both. Implications of these findings for future research include the importance of examining family strain when studying caregiver burden, assessing problems with the conceptualization of coping, evaluating the effectiveness of different measures of coping patterns, and investigating the balance of costs and rewards related to caregiving. Implications for practice include the importance of health workers considering multiple sources of strain in the family. Caregivers need optimistic but realistic information about the situation. Staff members should promote the caregiver's confidence in the management of the medical situation. Governmental and service agencies need to assist caregivers in relieving problems with restrictions on time and activities, and provide an opportunity for the exchange of information about managing home care. Future researchers need to study the influence of home health services on caregiving by comparing the coping patterns and subjective and objective burden of caregivers who receive this service and those who do not. / Ph. D.

Respite Care programs for the elderly and their families are being recognized and developed within Long Term Care systems. Research on these programs is sparse and focused on outcome studies. Very little work has been published that addresses grounded theory building or exploratory needs assessments in the definition of need and objectives for respite care. This exploratory study addresses the issue of need for respite from two perspectives. Within an urban Canadian center, focused interviews were conducted with a sample of family caregivers in high risk situations. Case scenario questionnaires were distributed and focused interviews conducted with Long Term Care case Managers, content analysis was used to identify themes and issues from all data sources. The themes and categories that emerged from the data are discussed in relation to a system stimulation model and locus of control perspective as applied to understanding need and establishing program objectives and delivery patterns. Implications for needs assessments, program design, intervention, and future research are presented. / Arts, Faculty of / Social Work, School of / Graduate

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