Dementia Caregiving in the Context of Late‐Life Remarriage: Support Networks, Relationship Quality, and Well‐being

Caregiving research has not accounted for increasingly diverse and complex marital and family histories of older Americans. The authors examined social relations and care-specific positive and negative support networks among late-life remarried wife dementia caregivers (N = 61) to determine associations among network structure, relationship quality with and support received from network members, and global assessments of family and stepfamily disagreement on caregiver well-being. Own family and friends predominated in the social relations and positive networks. Although over half (54%) of respondents included a stepfamily member in their positive networks, stepchildren comprised the largest group (35%) in the negative networks. Larger negative networks and actively negative interactions were related to greater caregiver burden, and more global disagreement with stepfamily was associated with greater depression and burden. The findings illustrate the complex nature of support and the value of targeted examinations of caregiving support dynamics among late-life remarried older adults and stepfamilies facing health demands.Key Words: aging, caregiving, dementia, remarriage, social support, stepfamily.Older adults and families are experiencing more complex marital and stepfamily transitions over the life course (Manning & Brown, 2009; Teachman, Tedrow, & Crowder, 2000). Over one third (38%) of all marriages in the United States are remarriages for one or both partners (Deal, 2011), resulting in 35 million remarried Americans. Furthermore, nearly 500,000 adults over age 65 remarry every year (U.S. Census Bureau, 2006). This trend of older adults repartnering through legal remarriage, cohabitation, or other arrangements is a new reality of aging (Brown, Bulanda, & Lee, 2005; de Jong Gierveld, 2004).Americans are also living longer, with increasing levels of chronic disease and disability. In particular, Alzheimer's disease (AD) and related dementias are the sixth leading cause of death in the United States. Currently, one in eight older Americans has AD/dementia, and rates are expected to triple by 2050 (Hebert, Scherr, Bienias, Bennett, & Evans, 2003). Health policy in the United States relies heavily on family and close ties to provide the long-term care required by adults with dementia (Bookman & Kimbral, 2011). Currently, more than 15 million Americans provide such care for a family member with AD (Alzheimer's Association, 2012). Moreover, aging Baby Boomers are expected to have fewer people to care for them compared to prior cohorts of older adults (Ryan, Smith, Antonucci, & Jackson, 2012). This situation may be exacerbated in cases of remarriage and stepfamily, with potentially adverse effects for remarried older adults. Furthermore, the significant physical and psychological challenges of providing spousal dementia caregiving are well documented (Fratiglioni, Wang, Ericsson, Maytan, & Winblad, 2000; Gaugler, Davey, Pearlin, & Zarit, 2000; Pearlin, Mullan, Semple, & Skaff, 1990; Zarit, Femia, Kim, & Whitlatch, 2010). It is, therefore, critical to understand the availability and nature of social support networks of older caregivers living in complex family structures.The present study focused on the spousal dementia caregiving experiences of late-life remarried wives (n - 61). Late-life remarriage was defined in this study as a second (or higher order) marriage occurring after children from prior relationships were 18 years of age or older. A primary aim of this study was to document remarried wife caregivers' general social relations convoys as well as to document their caregiving-specific support networks. These care-specific support networks were conceptualized as two separate networks, including those individuals who provided positive caregivingrelated support (i.e., positive caregiving support network) and those who demonstrated negativity with respect to care support (i. …