Caregiver Identity Theory: Exploring the Links between Stressors and Burden
Marie Y. Savundranayagam, PhD, University of Wisconsin-Milwaukee and Jeannine M. Rowe, MSW, University of Wisconsin-Milwaukee.
Despite extensive research in family caregiving, little consistency has emerged concerning the factors linked to the experience of burden. For some family members, caregiving is a difficult experience that has serious negative consequences. Yet, other caregivers who have similar responsibilities are able to cope well with little impact of the experience on their well being or even experience positive outcomes. Because some caregivers fare better than others, researchers have sought to map the factors that influence caregiver outcomes. Many researchers suggest that stress is a subjective response that is an outcome of life events that challenge one's identity. In the context of caregiving, stress results from an involuntary transformation of a familial relationship that is closely tied to one's identity. The transformation of the relationship is often influenced by changes in the care receiver's functional ability or frequency in the amount of problem behaviors. To explain the link between stressors and burden, Montgomery and Kosloski's (in press) caregiver identity theory proposes that caregivers experience burden when they are engaged in care activities that are inconsistent with their familial identity. The present study investigates the extent to which the care receiver stressors (problem behaviors and functional level) serve as threats to caregiver's relationship identity. Additionally, this study considers whether identity discrepancy mediates the relationship between stressors and three dimensions of caregiver burden. The present study involved 120 spouse caregivers who completed assessments of care receiver stressors, caregiver burden, and identity discrepancy. Analyses using structural equation modeling were conducted to test components of caregiver identity theory. In support of the theory, identity discrepancy was predicted by functional decline. Specifically, caregivers assisting spouses with high levels of functional decline reported that were not meeting their identity standards. Moreover, caregivers who exceeded their role expectations experienced both stress and relationship burden. In addition, functional decline directly predicted objective and relationship burden, whereas problem behaviors was a direct predictor of stress and relationship burden. The findings indicate that the caregiver identity theory is a useful framework for social workers as they seek to understand factors related to caregiver burden. When social workers understand caregiver sources of stress, they are better equipped to determine appropriate interventions that can support family caregivers.