The Influences of Gender and Religiousness on Alzheimer Disease Caregivers' Use of Informal Support and Formal Services

Abstract

Objective-This study explored how male and female family caregivers of Alzheimer's disease (AD) patients differ in their use of formal services and informal support and how religiousness may affect such differences.Methods-Data were from a sample of 720 family caregivers of AD patients who participated in the Resources for Enhancing Alzheimer's Caregiver Heath (REACH I) study sites in Birmingham, Boston, Memphis, and Philadelphia.Results-Female caregivers were less likely to use in-home services than males (M = 0.83 vs. M = 1.06, p < .01) but reported more use of transportation services (21.6% vs. 12.7%, p < .01) and more use of informal support (M = 13.9 vs. M = 10.7, p < .01). Mediation tests suggested that three measures of religiousness helped explain the relationship between gender and use of formal services and informal support.Discussion-These findings highlight the necessity to assess AD caregivers' religiousness to better understand their circumstances. Keywordsgender; Alzheimer's caregiving; religiousness; service use Women have had a long history as the primary caregivers in American society. With medical advances and increased longevity, this has increasingly included care of older adults. These same factors have also resulted in an increase in the number of males providing care to adults, most often spouses. Males, however, have not had the same tradition of and experiences with caregiving that females have had and thus might approach the task somewhat differently (Calasanti & Bowen, 2006).A substantial proportion of current female AD caregivers was born in the first third of the 20th century and formed many of their views on caregiving during the 1930s and 1940s. Caregiving, both of children and adults, during this time was largely a family/friend matter. Day care was Please address correspondence to Fei Sun, Social Work Department, Arizona State University, #3251, 4701 W. Thunderbird Road, Glendale, AZ, 85306-4908; sun011@bama.ua.edu. NIH Public AccessAuthor Manuscript J Aging Health. Author manuscript; available in PMC 2010 February 10. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript not readily available, elder care programs were nonexistent, and the proportion of married women who worked outside the home was low (Velkoff & Lawson, 1998). Consequently, care systems were largely informal.Beyond the family, the primary institution that provided support and help to individuals was the church. Mothers, perhaps because they had primary responsibility for the socialization of their children, were more heavily involved with the church and thus could, at least on occasion, find support and assistance from the church community (Levitt, 1995). Males from this same era had primary responsibility for providing financially for the family and had less involvement in direct care of children or, in those cases where it occurred, adult care. They also generally had less involvement with the church, at least as a system of social support (Francis, 1997).The biographical context ...

The Male Face of Caregiving

“…With the exception of one study (Sun et al, 2008) all employed qualitative methods. The findings will be reported in relation to four subthemes: men's constructions of caregiving as men's work, the "man-made" challenges of caregiving, men's help-seeking experiences, Gender-based social networks highly influenced the men's masculine identities.…”

Meeting the Needs of Male Caregivers by Increasing Access to Accountable Care Organizations

“…However, men have reported the use of some types of formal support (e.g., homemaking, transportation) (Brazil et al, 2009; Schwartz, 2013; Sun, Roff, Klemmack, & Burgio, 2008). To the authors’ knowledge, the help-seeking behaviors of men couched in contemporary understandings of the socialization of gender and the meaning of masculinity remain understudied, and are warranted to gain a more holistic picture of men’s acceptance of formal supports.…”

Appalachian Caregivers of Persons with Dementia Non Use of Services

“…The review of literature for measures of caregiver use of resources identified three theories used in studying caregiver's use or non-use of services. The theories were Pearlin's Coping Stress Model (Sun, Roff, Klemmack, & Burgio, 2008), Andersen's Behavioral Model of Service Use (Phillipson et al, 2014), and the Theory of Planned Behavior with Andersen's Behavioral Model of Service Use (Phillipson et al, 2013). Andersen's model was APPCGNONUSESERVICES 28 chosen to guide this study because this theory addressed the characteristics that could potentially impact service use or non-use in Appalachian healthcare systems.…”

“…The SPS was the most frequently used instrument to assess CG use of resources in the recent literature (Robinson, Buckwalter et al, 2005;, however the scale was not adequate for assessing all variables of interest in Andersen's model, or identifying important information suggested from the review of literature (Brown, Chen, Mitchel, & Province, 2007;Johnston et al, 2011;O'Connell et al, 2012;Phillipson et al, 2014;Phillipson et al, 2013;Phillipson & Jones, 2012;Phillipson & Jones, 2011;Ploeg et al, 2009;Robinson, Buckwalter et al, 2005;Robinson et al, 2012;Robinson et al, 2013;Stockwell-Smith et al, 2010;Sun et al, 2008). Table 4 in Appendix F connects the literature review to the expanded SPS questions.…”

“…Quantitative Studies. Sun et al, (2008) analyzed existing data from African American and Caucasian CG (N= 720, n=165 male, and n= 555 female), from the Resources for Enhancing Alzheimer's CG Health I (REACH I) project sites in Birmingham, Memphis, Philadelphia, and Boston. The dependent variables were use of formal services and use of informal support (Sun et al).…”