Friday, 14 January 2005 - 8:00 AM

This presentation is part of: Families Coping with Severe Mental Illness

Siblings of Persons with Schizophrenia: Expectations About Future Caregiving Roles

Purpose: Since few persons with schizophrenia marry, their parents are often the mainstay of support. However, many of these parents are in their aging years. It is commonly assumed that siblings will take on a caregiving role when the parents become disabled or die. However, very little is known about the willingness of siblings to assume this role. The purpose of this study was to begin to fill this gap in our knowledge by examining the extent to which siblings expect to take on a caregiving role, the factors influencing their future caregiving expectations, and the programs that might facilitate the transition into a caregiving role.

Methods. The data come from a large scale NIMH funded longitudinal study of aging mothers of adults with schizophrenia. Mothers were asked to identify the sibling who would most likely be involved in the care of their brother or sister with schizophrenia when the parents became disabled or died. Letters were sent to 151 siblings, and 119 (78.8%) agreed to participate. The sibling participants had a mean age of 44.5 years, about three-fourths were married, and half were college graduates.

Results: Approximately three-fourths of the siblings expected to oversee their brother or sister’s care by helping with household chores, transportation, monitoring medications, money management, and being available in times of a crisis. However, few (13%) expected to live with their sibling with mental illness. Almost all the siblings expected to remain involved with their sibling with schizophrenia by visiting frequently (88.2%), including the sibling in social events (81.5%) and family holidays (92.4%).

A regression analysis examining the predictors of future sibling involvement revealed that sisters expected to be more involved than brothers, and that younger and married siblings expected to be more involved than those siblings who were older and not married. Current levels of sibling involvement and the quality of the current sibling relationship were significant predictors of future expectations of involvement. Siblings who perceived their brother or sister as having control over their symptoms and behaviors were less likely to expect to be involved in the future.

Few siblings (22.7%) reported having contact with their sibling’s mental health providers and approximately half expressed the need for more information about schizophrenia and its treatment. Almost 75% reported that the availability of printed materials on schizophrenia, a workshop specially designed for siblings, or a support group would make it easier for them to assume a future caregiving role.

Implications. Although the great majority of siblings in this study expected to be involved in helping their sibling with schizophrenia when their parents became disabled or died, few had an adequate understanding of their sibling’s illness and treatment. Social workers have a role in helping siblings of adults with mental illness prepare for this future role through educational workshops and support groups specially designed for adult siblings of persons with mental illness. A newly designed workshop for siblings of persons with mental illness will be discussed.

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