Caring for a parent with dementia: The psychological well-being of adult children.

BACKGROUND: Caregiving for a parent with dementia has both positive and negative influences on psychological well-being of adult children and perceived social support plays an essential role in dementia caregiving process. OBJECTIVES: We examined how the degree of caregiving intensity influences mental health among Chinese adult children then further explored how perceived social support influences the relationship between intensity and psychological well-being. RESEARCH DESIGN AND SETTING: Cross-sectional study in Kunming, mainland China between November 2022 and January 2023. METHODS: We interviewed 320 adult dementia child caregivers. Linear regression and multiple mediation analysis using Hayes' process model were used to assess the relationship between caregiving intensity and psychological well-being, as well as the mediating role of perceived social support. RESULTS: The study found that caregiving intensity was positively associated with depression and negatively associated with life satisfaction. A lack of perceived social support exacerbated these effects for the adult children. Specifically, the caregivers reported higher caregiving intensity when they perceived less family support, which is in turn associated with greater depression and lower life satisfaction among the caregivers. Likewise, those who reported higher caregiving intensity was reported lower friend support, which was in turn associated with greater depression. CONCLUSIONS AND IMPLICATIONS: The findings emphasize the importance of social support, especially family support, and the necessity for health practitioners to provide targeted interventions on both negative and positive aspects of psychological well-being among dementia caregivers and to strengthen caregivers' resources for social support to enhance their well-being. While these findings are cross-sectional, it is logical to assume that those who perceive less support feel that their caregiving responsibilities are more intense, and that intensity could cause the caregiver to withdraw from friends.

The mediating role of coping strategies between caregiving burden and pre-death grief among Chinese adult-child caregivers of dementia patients.

AIMS: The objective of this study was to examine the relationship between caregiving burden and pre-death grief, with a specific focus on adult-child caregivers in mainland China. Additionally, the study explored whether coping strategies played a mediating role in this correlation. METHODS: A convenience sample of 320 adult-child caregivers of older parents with dementia from Kunming, mainland China, was recruited for the study. Data were collected using the Chinese version of the Marwit-Meuser Caregiver Grief Inventory-Short Form, the Burden Scale for Family Caregivers, and the Ways of Coping Checklist-Revised. RESULTS: Results using linear regression and multiple mediation analysis with Hayes' process model indicated that caregiving burden was positively related to pre-death grief and that active coping mediated the relationship between them. In the female group, active coping partially mediated the association between caregiving burden and pre-death grief, but in the male group, this mediating effect did not exist. CONCLUSION: The study found evidence supporting the link between caregiving burden and pre-death grief among adult-child caregivers of older parents with dementia in mainland China. Furthermore, the caregiving burden prevented the use of active coping, and this decrease in coping increased the perception of pre-death grief. These associations only existed in the female group. IMPLICATIONS: This paper presented the importance of active coping skills in the dementia caregiving process. IMPACT: The findings of this study emphasize the necessity for health practitioners to provide targeted interventions regarding pre-death grief among dementia caregivers and strengthen caregivers' active coping strategies to reduce their pre-death grief. Community-based and personal care support services should be promoted to alleviate their caregiving burden. REPORTING METHOD: We have adhered to the transparent reporting of evaluations with quantitative design statements and the corresponding checklist was followed. PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

The Profile of Stress and Coping Related to Successful Aging Among Chinese Migrant and Nonmigrant Grandparents.

BACKGROUND AND OBJECTIVES: Around eight million older adults have internally migrated to take care of grandchildren in China. This study aimed to explore how Chinese migrant and nonmigrant grandparents perceived successful aging and how they coped with challenges to successful aging. RESEARCH DESIGN AND METHODS: Based on ecological systems theory, semistructured interviews were conducted among 21 grandparents (12 migrants, median age = 59 years old) from urban areas in China who provided noncustodial grandchild care. Deductive content analysis was employed to examine the data pertaining to the definition of successful aging, the stressors encountered, and coping strategies employed by both groups. RESULTS: Findings revealed that both migrant and nonmigrant grandparents placed a higher emphasis on family prosperity than their own physical health, in their definitions of successful aging. Although both groups experienced common stressors in the microsystem (e.g., intergenerational conflicts), migrant grandparents uniquely encountered stressors in the mesosystem (e.g., hardships in their close relationships) and in the macrosystem (e.g., uncertainty in aging preparation). In terms of coping, migrant grandparents exhibited a distinctive pattern of utilizing avoidant coping strategies when navigating intergenerational conflicts and planning for their later life, compared to nonmigrant grandparents. DISCUSSION AND IMPLICATIONS: Our findings suggested that although migration was not associated with grandparents' definition of successful aging, migrant grandparents encountered specific challenges in achieving successful aging. This highlights the necessity of providing more support to grandparents through the family, community, or state, particularly to those who are migrants.

Does intergenerational support affect older People's social participation? An Empirical study of an older Chinese population.

As a means of social support, intergenerational support plays an essential role in encouraging older people to participate in society. Data on 3142 older adults were collected from the China Survey of Elderly Health Influencing Factors (CLHLS), and logistic regression models were used to determine the effects of several types of intergenerational support on social participation and whether self-rated health and life satisfaction mediated the associations between intergenerational support and social participation. Among all the three types of intergenerational support, the results showed that financial support and emotional support were positively associated with the social participation of the older Chinese in our sample. We observed rural-urban differences in the effects of financial support and emotional support on social participation, which were significant in the urban groups. Gender differences also exist in these relationships. The effects of emotional support on social participation were significant in both groups and the impact of financial support was obvious only in the female group. Regarding the mediating effect, financial support was found to improve the participants' self-rated health, which enhanced their social participation. Emotional support increased the participants' life satisfaction, which led to higher levels of social participation. Based on the findings of this study, policymakers should advocate to strengthen financial and emotional support from adult children in the community.