Research That Matters (January 17 - 20, 2008)

Family caregivers provide the majority of long-term care for persons with chronic illnesses and disabilities in the U.S. Although some caregivers report the experience to be uplifting and meaningful, a large body of literature now documents significant negative social, psychological, and physical health consequences. At the same time, an extensive body of work on caregiver outcomes shows wide variations, not only in the tasks that caregivers undertake, but also in the costs they incur and the benefits they perceive as a consequence of their caregiving role. For some caregivers, caregiving is a difficult experience that has serious negative consequences, while other caregivers who assume similar responsibilities are able to cope well and report little impact or even positive outcomes. According to Montgomery and Kosloski's caregiver identity theory (in press), such variations in the experience of caregiving burden is simultaneously influenced by the care receiver's functional level and the caregiver's identity standards, which are largely influenced by cultural norms and established familial roles. The current study investigated the extent to which filial norms (i.e., norms guiding the relationship between an adult-child and a parent) influence multiple constructs of burden (objective, relationship and stress burdens) and uplifts (positive aspect of caregiving) among adult-child caregivers. First, we conducted exploratory factors analyses to examine the measurement structure of 46 items related to filial identity (identified from the literature on adult-child and parent relationship and identity) among adult-child caregivers who participated in a caregiver registry and completed a series of caregiving surveys (N=307). Second, we conducted multiple regression (step-wise) analyses to examine the relationships between identified factors of filial identity and three dimensions of burden (objective, relationship, and stress) and uplifts among a sub-sample of adult-child caregivers (n=166). Exploratory factor analyses revealed a three-factor structure of filial identity: (a) positive interaction (8 items, alpha=.92; (b) confidant (4 items, alpha=.85); and (c) deference (4 items, alpha=.86). Results from multiple regression analyses controlling for care recipient functioning, problem behavior, caregiving demands, and caregiver depression showed that all three factors of the filial identity are significantly and differentially associated with the three dimensions of burden and uplifts. Confidant and deference were significantly associated with objective burden: confident significantly reduced objective burden (B= -.26, p = .001) while deference increased objective burden (B= .21, p = .05). Positive interaction significantly increased stress burden (B= .16, p=.05) and uplifts (B= .37, p = .001). The findings indicate that multiple dimensions of caregiving burden and uplifts are experienced differentially across adult-child caregivers with different filial norms. Further, the study findings suggest that the caregiver identity theory is a useful framework for social workers as they seek to understand factors related to caregiver burden. Social work practice with caregiver clients may be improved by giving increased attention to values and norms governing the relationship between caregivers and care recipients such as filial norms.