Research That Matters (January 17 - 20, 2008)

Background and Purpose: There is considerable variability in family caregivers' experience of burden across their caregiving careers. Caregiver identity theory proposes that individuals experience burden when they appraise their behaviors as incongruent with their expectations for their relationship identity. Using spouse caregivers, this study investigated the extent to which role discrepancies mediated the relationships between illness-related stressors (problem behaviors and functional decline) and three dimensions of burden: stress, demand and objective burden.

Method: Two inventories on identity standards for spouse and caregiver roles and behaviors were developed and administered to 358 spouse caregivers. Participants also completed measures of functional decline, problem behavior, and caregiver burden.

Results: Analyses using structural equation modeling provided support for role discrepancies as mediators of the relationships between functional decline and stress and demand burden. Although role discrepancies mediated the relationship between functional decline and objective burden, there were also direct relationships between the two constructs. Similarly, although role discrepancies mediated the relationships between problem behaviors and all forms of burden, there were strong direct relationships between problem behaviors and burden. Finally, the relationship between role discrepancy and burden suggests that participants who exceeded their relationship identity standards experienced higher levels of stress, demand, and objective burden.

Conclusions and Implications: The results provide direct support for caregiver identity theory. Namely, they suggest that functional declines of the care-recipient are only burdensome for caregivers when they highlight that their own behaviors are inconsistent with their expectations for their relationship identity. However, unpredictable stressors such as problem behaviors are both inherently burdensome and highlight role discrepancies. By examining these role discrepancies, social workers can better understand how caregivers interpret the impact of illness-related stressors on their relationship with their spouses.