Friday, 14 January 2005 - 8:00 AM

This presentation is part of: Family Caregiving

From Caregiving to Bereavement: Mental Health Trajectories of Wife and Daughter Caregivers

PURPOSES

This study has two purposes: (1) examine the trajectories of depressive symptoms of wife and daughter caregivers during the time when they are providing care as well as after their care recipients die; (2) examine whether the trajectories vary between wife and daughter caregivers.

METHODS

Sample: Data came from a 4-wave study of wives and daughters caring for their elderly relatives in Wisconsin. Each wave was 18 months apart. Data collection continued even if the care recipients had died. 43 wives and 104 daughters who had experienced bereavement by Wave 4 were the sample used in this analysis.

Variables: The outcome variable was depressive symptoms, measured by the Center for Epidemiology Scale for Depression (CES-D; Radloff, 1977). Caregiving relationship, wife or daughter, was the predictor. A variable “time” was created by subtracting the date of interview and the date of death of the care recipient.

Analysis: 2-level hierarchical linear modeling, using the HLM software (Raudenbush, Bryk, Cheong, & Congdon, 2000), was conducted. The repeated measures of depressive symptoms were conceived as a function of individual change parameters plus errors at Level-1. These individual change parameters were modeled as a function of caregiving relationship plus errors associated with individuals at Level-2. Combining the Level 1 and 2 models results in a mixed model with fixed and random effects.

RESULTS

With time centered at the time of death of care recipients, the trajectory of depressive symptoms of caregivers exhibited a curvilinear shape, with the rates of change accelerating before bereavement and decelerating after. The deceleration during the bereavement period was more rapid than the acceleration during the caregiving period. While wives had more depressive symptoms than daughters at all time, their patterns of change in depressive symptoms before and after bereavement were similar.

IMPLICATIONS

Levels of depression of wife and daughter caregivers are at their peak level in the two years before care recipients die, which suggest that social work interventions may be particularly needed during this period. Wife caregivers are at a higher risk of depression than daughter caregivers, and are especially vulnerable when their husband’s death is imminent. Social workers should have heightened awareness of the mental health status of wife caregivers. While bereavement is commonly conceived as a stressful experience, to wife and daughter caregivers, it may also be a relief and an opportunity for mental health recovery. Social workers may need to affirm positive changes in their mental health following the death of their care recipients.

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