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Bridging the Family Care Gap explores expected future shortages of family caregivers of older persons and identifies potential solutions. The book examines the sustainability and availability of care management models and whether they can be effectively scaled up to meet community needs. It identifies newly emerging policy initiatives at local, state, and federal levels. The book addresses the state of family caregiving science, dissemination and implementation of promising programs and supports, technological innovations, and other strategies to offset the family care gap. This edited volume also explores lay healthcare workers as guides, interpreters, and advocates in healthcare systems that provide continuity of contact for family caregivers. Details threats to family caregiving-sociodemographic, chronic disease, and socioeconomic challenges Presents solutions to the caregiving gap in a systematic, synthesized manner Addresses the intersection of family caregiving and technology Discusses chronic disease management to offset and reduce the need for family caregiving Describes models of caregiver support in work settings Reimagines the delivery of long-term services and supports with novel initiatives

Family Caregiving in the New Normal discusses how the drastic economic changes that have occurred over the past few years have precipitated a new conversation on how family care for older adults will evolve in the future. This text summarizes the challenges and potential solutions scientists, policy makers, and clinical providers must address as they grapple with these changes, with a primary focus given to the elements that may impact how family caregiving is organized and addressed in subsequent decades, including sociodemographic trends like divorce, increased participation of women in the workforce, geographic mobility, fewer children in post-baby boom families, chronic illness trends, economic stressors, and the current policy environment. A section on the support of caregivers includes technology-based solutions that examine existing models, personal health records, and mobile applications, big data issues, decision-making support, person-centered approaches, crowd-sourced caregiving such as blogs and personal websites that have galvanized caregivers, and new methods to combine paid and unpaid forms of care. Provides a concise "roadmap" of the demographic, economic, health trends, and policy challenges facing family caregivers Presents potential solutions to caregiving so that scientists, policymakers, and clinical providers can best meet the needs of families and communities in the upcoming decades Includes in-depth, diverse stories of caregivers of persons with different diseases who share perspectives Covers person-centered care approaches to family caregiving that summarize effective community-based services of psychosocial intervention models Examines how existing efficacious models can more effectively reach and serve individual families

Using statewide data from Oregon (N= 596 at baseline), this study compares informal help received by assisted living (AL) and nursing home (NH) residents over a 1‐year period. The analysis also identifies predictors of informal help among AL and NH residents with an expanded version of the Behavioral Model. Instrumental assistance (i.e., help with shopping, appointments, transportation) was more prevalent in the AL setting throughout the analysis. Regression models found multiple predictors of informal help among AL and NH residents (i.e., predisposing, enabling, and need characteristics). The results imply that the AL setting facilitates informal help provision; however, predictors of support are varied and require greater attention in future research.

The Spectrum of Family Caregiving for Adults and Elders with Chronic Illness is written for individuals in the helping professions who are in roles that interface with or serve family caregivers who are supporting an adult or elder with a chronic condition.

The Spectrum of Family Caregiving for Adults and Elders with Chronic Illness is written for individuals in the helping professions who are in roles that interface with or serve family caregivers who are supporting an adult or elder with a chronic condition.

Abstract

Objectives
This qualitative descriptive study explored the perceptions of dementia, dementia care, and caregiving within the African immigrant community.


Methods
Six community conversations (focus groups) were held with 24 participants. Three conversations were led by project advisory board members and utilized a 12-question conversation guide. The recorded conversations were transcribed and analyzed using thematic analysis.


Results
Of the 24 African immigrants who participated, 52% were 55-75 years old, 67% identified as female, and 39% were married or cohabitating. Twenty percent were currently providing care to a relative with dementia and 40% had provided care to a relative with dementia in the past. Four themes were identified. These included 1) attitudes towards mental health, illnesses, and poor health, 2) community attitudes towards dementia, and dementia caregiving, 3) barriers to dementia care and caregiving, and 4) current dementia care resources in the African immigrant community.


Discussion
The findings show that African immigrant cultural beliefs significantly shape dementia care and caregiving attitudes, preferences, and behavioral practices. African immigrants' cultural backgrounds influence (or have the potential to influence) timely access and engagement in dementia care. And, depending on how deeply held these cultural beliefs are, they could impact dementia care and caregiving both positively and negatively. With the rapidly growing immigrant older adult population, there is a need for systemic strategies to facilitate affordable and culturally responsive dementia care for African immigrants and other minoritized older adults.

This study tested the hypothesis that various components of the stress process model were related to negative outcomes (depression, guilt, negative health) in cancer caregivers. This study also tested the hypothesis that psychosocial resources (mastery, socioemotional support) mediated the relationship between the various domains of the stress process model and negative outcomes. A total of 238 cancer caregivers were recruited from radiation medicine clinics at the University of Maryland Greenebaum Cancer Center ( n = 186) and the University of Minnesota Cancer Center ( n = 52). A comprehensive interview battery was administered. A multivariate regression found that primary subjective stressors were the strongest predictors of depression and negative health impact. A path analysis indicated that mastery mediated the relationship between role captivity and negative health impact. These results emphasize the importance of multidimensional assessment in cancer caregiving. The findings also suggest refinements to the stress process model when examining family cancer care.

The direct exposure to physical or psychological trauma from torture or war leads to well-documented individual health consequences. Less understood are the inclusive and intergenerational effects of war trauma on family systems and youth adjustment. The purpose was to examine mechanisms in war-affected families that explained the significant emotional and behavioral consequences of intergenerational trauma in youth through the use of multiple methods. Quantitative assessments of maternal and paternal caregivers and youth characterized associations between parent torture, parent mental health distress, parent physical health problems, family functioning, and youth adjustment. Narrative statements further contextualized processes through which the trauma of a parent impacted youth and family systems. The research was conducted in partnership with local, refugee-serving community-based organizations. The study sample included parents and youth in 96 Karen families, originating from Burma in Southeast Asia, who had been resettled to the United States through the U.S. Refugee Admissions Program. Path analysis results indicated that parent torture (β = −0.173) had statistically significant negative direct effects on youth adjustment. Parent torture had a negative indirect effect on youth adjustment through the mental health (β = −0.345) and physical health problems of parents (β = −0.305), and youth gender (β = 0.126) and trauma exposure of youth (β = −0.048). Family functioning type demonstrated a positive direct effect on youth adjustment (β = 0.449). Family type had an indirect effect on youth adjustment through youth gender (β = 0.142), youth trauma exposure (β = −0.165), parent physical health problems (β = −0.202), and parent mental health (β = 0.509). The current study developed and tested the first model of intergenerational trauma's effects on the adjustment of Karen refugee youth. Results emphasize that individual recovery from torture must be accompanied by adjunct interventions focused on family systems and youth adjustment, to holistically address intergenerational sequala of trauma.