Veterans’ Informal Caregivers in the “Sandwich Generation”: A Systematic Review Toward a Resilience Model

Abstract

Social work theory advanced the formulation of the construct of the sandwich generation to apply to the emerging generational cohort of caregivers, most often middle-aged women, who were caring for maturing children and aging parents simultaneously. This systematic review extends that focus by synthesizing the literature on sandwich generation caregivers for the general aging population with dementia and for veterans with dementia and polytrauma. It develops potential protective mechanisms based on empirical literature to support an intervention resilience model for social work practitioners. This theoretical model addresses adaptive coping of sandwich- generation families facing ongoing challenges related to caregiving demands.

The Impact of Parental Operational Stress Injury on Child Mental Health and Well-Being: A Scoping Review

“…There is a scarcity of international research to inform programming, interventions, and policy; and within the existing research is little methodological rigor (Campbell et al, 2011;Catani, 2010;Cederbaum et al, 2014;Chandra & London, 2013;Cozza, 2011;Cozza, Haskins, et al, 2013;Lester & Flake, 2013;McFarlane, 2009;Milburn & Lightfoot, 2013;Park, 2011;Ray & Heaslip, 2011;Sherman, 2014).…”

“…The literature strongly reports that exclusive focus on the individual living with OSI is problematic (Arata-Maiers & Stafford, 2010;Brannen, Grandia, Stewart, Zahradnik, & McGrath, 2008;Catani, 2010;Cozza, Haskins, et al, 2013;Dinshtein et al, 2011;Gorman et al, 2010;Holmes et al, 2013;Kelley & Jouriles, 2011;Lester, 2012;Park, 2011;Smith-Osborne & Felderhoff, 2014). It is critical that the focus shift toward a familycentered service delivery system (Cohen et al, 2011;Cozza, 2011;Cozza, Holmes, et al, 2013;Danish & Antonides, 2013;Dinshtein et al, 2011;Gorman et al, 2010;Lambert et al, 2014;Lester et al, 2010;McFarlane, 2009;Walsh et al, 2014) that can provide parallel services to individuals, spouses, couples, and children (Boricevic Mar sanic, Aukst Margetic, Jukic, et al, 2014;Boricevic Mar sanic, Aukst Margetic, Zecevic, et al, 2014;Cozza, 2011;Esposito-Smythers et al, 2011;Guzman, 2014;Holmes et al, 2013;Pearrow & Cosgrove, 2009;Pedras & Pereira, 2014;Sammons & Batten, 2008).…”

“…The complex interplay of factors within the family dynamic makes it difficult to unequivocally determine a causal relationship between the parental OSI and levels of child distress (Gorman et al, 2010;Lambert et al, 2014), with some evidence that genetic, physiological, and environmental exposure factors are involved (Cozza, 2011;Smith-Osborne & Felderhoff, 2014). Nevertheless, these disruptions typically lead to interrelated family stress such that the OSI may be further exacerbated by family or child dysfunction, creating a vicious circle (Boricevic Mar sanic, Aukst Margetic, Jukic, et al, 2014;Campbell et al, 2011;Cozza, Holmes, et al, 2013;Danish & Antonides, 2013;Gorman et al, 2010;Janke-Stedronsky et al, 2016;Walsh et al, 2014).…”

“…It is critical that the focus shift toward a familycentered service delivery system (Cohen et al, 2011;Cozza, 2011;Cozza, Holmes, et al, 2013;Danish & Antonides, 2013;Dinshtein et al, 2011;Gorman et al, 2010;Lambert et al, 2014;Lester et al, 2010;McFarlane, 2009;Walsh et al, 2014) that can provide parallel services to individuals, spouses, couples, and children (Boricevic Mar sanic, Aukst Margetic, Jukic, et al, 2014;Boricevic Mar sanic, Aukst Margetic, Zecevic, et al, 2014;Cozza, 2011;Esposito-Smythers et al, 2011;Guzman, 2014;Holmes et al, 2013;Pearrow & Cosgrove, 2009;Pedras & Pereira, 2014;Sammons & Batten, 2008). No singular strategy for addressing the needs is recommended; instead, optimally, there would be a spectrum of services with a variety of access and interface options (Cozza, Haskins, et al, 2013;Dinshtein et al, 2011;Kudler & Porter, 2013;Smith-Osborne & Felderhoff, 2014). For example, use of peer support for youth has been identified as a preferred service delivery feature (Esposito-Smythers et al, 2011;Guzman, 2014;Harrison et al, 2014;Pearrow & Cosgrove, 2009).…”

Long Distance Military and Civilian Relationships: Women's Perceptions of the Impact of Communication Technology and Military Culture

“…This study's findings suggest that women's access to and initiative in using communications technology and its impact on long-distance relationships may be influenced in complex and often ambiguous ways by several factors, including control of the resources that pay for the technology, acceptance or rejection of traditional gender roles, and the effects of institutional cultural norms and values (Byrne & Findlay, 2004;Horstmanshof & Power, 2005;Pettigrew, 2007;Smith-Osborne & Felderhoff, 2014;Wei, 2007). Emergent themes from this study suggest that when male partners controlled access to the means of communication and the initiative in their use, behaviors that were reinforced both by the military's institutional social norms and the men's economic dominance, they also controlled, limited, and were more active in defining the couple's long-distance relationship (Shipman & Kay, 2009;Sprecher, 1985).…”