Wife Caregivers of Frail Elderly Veterans: Correlates of Caregiver Satisfaction and Caregiver Strain

This study investigated correlates of satisfaction and strain in 80 wife caregivers of frail elderly veterans. The study focused on the background and context of stress, stressors, and cognitive appraisal of self-efficacy and social/institutional support. Support from spouse was the strongest positive predictor of satisfaction with caregiving and the strongest negative predictor of caregiver strain. Confidence in ability to manage caregiving tasks (self-efficacy) was the strongest positive predictor of caregiver life satisfaction. During the next two decades, older veterans will represent a large and growing proportion of all males aged 65 and older. Two out of three of all males aged 65 and older will be eligible for Department of Veterans Affairs medical care by the year 2000 (Weiler, 1988). The population served by Department of Veterans Affairs Medical Centers (VAMCs), the largest multihospital system in the United States, is likely to be older, of lower than average income, and in need of more care and supportive services than the general population (Department of Veteran Affairs, 1992; Weiler, 1988; Wilson, Moore, Rubin, & Bartels, 1990). Yet, relatively little research has focused on the caregivers of frail elderly veterans and hardly any has focused on wife caregivers (Toseland, Labrecque, Goebel, & Whitney, 1992), who are the most frequent providers of care (Horowitz, 1985; Soldo & Myllyluoma, 1983; Stoller & Earl, 1983). Wives caring for chronically ill or disabled husbands are at particular risk for physical, emotional, and financial strain. Caregiving wives live in the same household as the care receiver, tend to be older and in poorer health than their noncaregiving counterparts, and generally do not have a child living at home to help (Cantor, 1983; George & Gwyther, 1986; Hoyert & Seltzer, 1992; Noelker & Wallace, 1985). Caregiving wives have been identified as that group of caregivers who are most burdened by the rigors of providing care (Hoyert & Seltzer, 1992; Noelker & Wallace, 1985; Pruchno & Resch, 1989; Toseland et al., 1992). Wives caring for frail elderly veterans may be particularly burdened by providing care because functionally disabled elderly veterans receive less community-based long-term care services than does the rest of the elderly population; furthermore, only a small minority of those veterans receives any paid home care (Department of Veterans Affairs, 1992). The situation and experiences of wives caring for frail elderly veterans may, therefore, be different from those of other wife caregivers and, thus, merit empirical investigation. In making recommendations for setting the agenda for the White House Conference on Aging, Pillemer, Moen, Krout, and Robison (1995) noted the importance of considering the needs of specific subpopulations of the elderly, including veterans. Less attention has been given in the literature to the satisfactions of caregiving than to the strains of caregiving. Some of the literature has suggested that caregivers may experience satisfactions or rewards in providing care (Farran, Keane-Hagerty, Salloway, Kupferer, & Wilken, 1991; Given & Given, 1990; Horowitz, 1985; Kramer, 1993). Personal satisfaction may be derived from providing help to an ill or disabled spouse, from meeting the challenges of caregiving, or from gaining respect or recognition from others (Brody, 1985; Chenoweth & Spencer, 1986; Gatz, Bengston, & Blum, 1990; Motenko, 1989). The purpose of the present study was to investigate factors related to satisfaction and strain in wife caregivers of frail elderly veterans. No previous research has investigated correlates of both satisfaction and strain among wives caring for frail elderly veterans in the same study. By examining satisfaction and strain, the present study was able to assess positive as well as negative outcomes of the caregiving experience. In this study, satisfaction was conceptualized as a subjective sense of well-being (Campbell, Converse, & Rodgers, 1976) and strain as a perception of enduring problems that are a threat to one's wellbeing (Pearlin & Schooler, 1978; Robinson, 1983). …