Although predictors of nursing home placement have attracted a good deal of attention in gerontological research, the type and amount of family assistance offered to caregivers prior to institutionalization has not been extensively examined. This study analyzed the impact of family help on the timing of placement among cognitively impaired care recipients. Using longitudinal data from the Adult Day Care Collaborative Study, an event-history analysis was performed to determine the effects of family help after sociodemographic characteristics, caregiving stressors, and indicators of caregiver well-being were taken into account. Results showed that caregivers were far less likely to institutionalize their relatives when family members provided overnight help and assisted with activities of daily living care. These findings suggest that specific types of family help play an important role in delaying nursing home placement among older adults suffering from dementia.

This paper compares employed and non-employed caregivers of cognitively impaired elderly family members. Using two competing positions derived from role theory, role conflict and role expansion, we explored whether holding the positions of both caregiver and worker led to greater role overload and psychological role conflict, or provided an outlet that helps caregivers better manage the demands placed on them. We found no differences between employed and non-employed caregivers on measures of role overload, worry and strain, and depression. For working caregivers, however, greater conflict on the job was associated with higher role overload and worry and strain while beneficial work experiences were only weakly associated with lower role overload and worry and strain. There was an interaction effect between positive work experiences and role overload when predicting depressive symptoms. These results provide some support for role conflict, but also suggest that caregivers may vary considerably in how they adapt to multiple roles.

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This study tests the hypothesis that verbal routines and expansions increase generalized child mean length of utterance (MLU). Verbal routines were built through repeated interaction with the same picture book across several intervention sessions. The subjects were four young children with developmental delay. One of the subjects experienced two rounds of the intervention (i.e., two intervention phases with two different books) to provide the opportunity for more replication and extension of the effects. Generalization sessions were conducted with a different adult, different modality of material (i.e., objects), and different interaction style than were used during the intervention. The pattern of the results provides strong evidence that the intervention increased generalized MLU in children in the first stage of language development more than in children in a later language stage. The secondary analyses support the notion that verbal routines and expansions were responsible for the effects. Future research is needed to determine why the intervention was not effective for the developmentally older cases but was effective for the developmentally younger cases.

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