Dissertations, Theses, and Capstone Projects

Date of Degree

9-2023

Document Type

Dissertation

Degree Name

Ph.D.

Program

Social Welfare

Advisor

Nancy Giunta

Committee Members

Rufina Lee

Paul Attewell

Subject Categories

Health Policy | Social Welfare | Social Work | Statistical Methodology

Keywords

Informal caregivers, spouses, Alzheimer’s disease and related dementia, stress process, structural equation modeling

Abstract

Applying Structural Equation Modeling to Better Understand the Relationship Between Stressors, Social Support and Wellbeing in the Lives of Spouse Dementia Caregivers considers the utility of Pearlin et al.’s (1990) stress process model in understanding the needs of spouse caregivers. Data were drawn from eight biennial waves of the University of Michigan Health and Retirement Study (HRS) and analyzed using structural equation modeling. The final study sample comprised 774 spouses, average age 73, who were categorized based on Alzheimer’s Disease and Related Dementia (ADRD) and non-ADRD caregiver status. Results showed that for the study sample as a whole, social support mediated the negative effects of family conflict on both life satisfaction and loneliness experienced by caregivers. Social support did not, however, moderate caregiver strain. Economic problems were by far the most influential contextual factor for spouse caregivers. For ADRD caregivers, increased social support resulted in a much greater increase in life satisfaction compared to their non-ADRD counterparts. However social support did not reduce loneliness for ADRD caregivers (though it did for non-ADRD caregivers). The dominant source of secondary stress for ADRD caregivers was social constriction, whereas for non-ADRD spouse caregivers family conflict was the main source of secondary stress. These findings have useful implications for how informal caregiver support is arranged. For example, by developing interventions that capitalize on the role of social support in mediating the relationship between family conflict and caregiver wellbeing, and by more proactively addressing economic problems when implementing caregiver support interventions. These findings also indicate productive opportunities for future research, including longitudinal work to explore the relationship between stress, social support and caregiver wellbeing over time, and understanding more about differences in the experience of social constriction and family conflict between ADRD and non-ADRD caregivers.

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