Although most women find it difficult to provide care to an older family member, some women face additional challenges and health risks because the care recipient is abusive or aggressive toward them. This study tested a 12-week psychoeducative nursing intervention intended to decrease the frequency and intensity of physical and verbal/psychological aggression toward older caregiving wives and daughters by care recipients and improve selected abuse-related outcomes. The intervention, which focused on pattern identification, advocacy counseling, reframing of the caregiving situation, and nonconfrontational caregiving strategies, was individualized and highly interactive with emphasis placed on mutual problem solving and mutual planning. Subjects included women older than 50 who provided care to elders older than 55. Subjects were randomly assigned to group (intervention, N = 38; control, N = 45) and data collectors were “blinded” to group assignment. Findings indicated the intervention significantly reduced frequency of verbal/psychological aggression, and feelings of anger for caregivers providing care to fathers or husbands. It was not effective for caregivers providing care to mothers, and it did not reduce burden. Implications for nursing include raising awareness about the special vulnerabilities of older caregivers, providing provocative new information about the gender-based power dynamics in caregiving situations and underscoring the need for nurses to assume a stronger leadership role in building science with regard to family caregiving.
School of Nursing, University of California, Los Angeles.
Corresponding Author: Linda Ree Phillips, PhD, RN, FAAN, FGSA, School of Nursing, University of California, 700 Tiverton Avenue Factor Bldg 5-133a, Los Angeles, CA 90005 (firstname.lastname@example.org).
Research reported here was supported by a grant from the National Institutes of Aging in collaboration with the National Institute of Justice and National Institute of Drug Abuse, grant #1RO1 DA/AG 1115.
The contributions of the following members of the research team in the implementation of this project are gratefully acknowledged: Anne Woodtli, PhD, RN, FAAN, Professor of Nursing Emeritus; JoAnne Glittenberg, PhD, RN, FAAN, Professor of Nursing Emeritus; Esperanza Torres de Ardon, MSN, RN, Project Director; Barbara B. Brewer, PhD, RN; Socorro Dominquez, PhD, RN; and Martha Ayres, MS, RN, formerly Graduate Research Associates, College of Nursing, University of Arizona. The editorial suggestions of Barbara Bates-Jensen, PhD, RN, Assistant Professor, UCLA School of Nursing, are also appreciated.