Formal and family caregiver protective factors in systems of care: A systematic review with implications toward a resilience model for aging veterans.

Abstract

Increased longevity of veterans and the continuing increase overall in numbers of veterans over age 65 are likely to increase the numbers of informal caregivers (i.e., family) and the need for formal caregivers beyond current rates associated with typical aging, as well as increasing the challenges of both those caregiving roles. The study objective was to identify protective factors for veteran and family outcomes in the veteran caregiving matrix as a basis for future development of a resilient caregiving model for trauma-exposed aging veterans. An exploratory systematic review was performed to identify which care matrix patterns are perceived by all 3 parties (formal caregiver, informal/family caregiver, and aging veteran care recipient) as optimal for resilient outcomes for the veteran and family caregiver. Of 747 research reports identified, 8 met study inclusion criteria. Data were extracted by 2 independent coraters, and were synthesized to identify caregiving matrix protective factors from literature with implications for aging veterans in need of care. Identified elements of a resilient caregiving matrix had relevance for trauma-exposed aging veterans receiving care whether from veteran or private health delivery systems/providers. Future research is needed to develop a model incorporating these findings and addressing additional matrix factors such as the gender of the caregivee and caregiver and the balance between formal and informal caregiving.

Loneliness, Resilience, Mental Health, and Quality of Life in Old Age: A Structural Equation Model

“…The level of generalized self-esteem is a factor that is interrelated with the dimension of well-being in its physical, emotional, and psychological components (Smith et al, 2000 ; Bandura, 2004 ; Fry and Debats, 2010 ). Longitudinal studies support the view that resilience traits, like self-efficacy, are protective in the later life stage (Smith-Osborne and Felderhoff, 2016 ) and that these beliefs are linked to stress resistance in the face of minor distress (i.e., anxiety and loneliness; e.g., Fry, 2001 ; Fry and Debats, 2006 , 2010 ). As pointed out by the American Psychological Association ( 2004 ) and Bonanno ( 2004 ), resilience is configured as a common response to losses and conditions of severe stress during the lifecycle.…”

“…In the general population, people with a low sense of self-efficacy are subject to an increased risk of physical and mental health issues (Marshall, 1991 ; Krause, 1994 ; Smith-Osborne and Felderhoff, 2016 ). In the elderly, loneliness dissatisfaction can significantly contribute to reduce self-evaluations of perceived self-efficacy (i.e., Fry and Debats, 2002 ).…”