FAMILY RELATIONSHIPS BETWEEN TWO SAMPLES OF FRAIL ELDERLY INDIVIDUALS

A staged causal model was used to examine the nature of the family relationships between two groups of frail elderly subjects who resided at home and were cared for by a related caregiver. The purpose of the study was to determine the effect of (1) the subject's and caregiver's characteristics; (2) the elderly person's perceptions of the relationship; (3) the elderly person's role perception; and (4) the elderly person's expectations and perceptions of the caregiver on the nature of the caring situation and on the subject's affective tone. One group in this study was composed of individuals whose relationships with their caregivers were judged to be "Good" (N = 44) and the other group was composed of individuals whose relationships with their caregivers were judged to be "Abusive and/or Neglectful" (N = 30) by a referring public health nurse. Using elements of intrafamily violence theory and the child abuse literature, the variables that were predicted to impact on abuse and/or neglect and on neglative mood states were identified in a theoretical model. The sample was selected from individuals who were defined as frail elderly by virtue of physical or psychological disabilities. In addition, each subject met other criteria including: was over sixty years of age, was Anglo-American, was not confused, and was English speaking. A blind interview technique was used and each subject was interviewed in his home setting. Data were analyzed in several phases. First, descriptive data were analyzed to determine the characteristics of the two groups of subjects and to determine the similarities between the two groups. The descriptive analysis included consideration of the subjects, their caregivers, the relationships between the two, and the refusers in the study. Second, the reliability and validity of the tools were tested. Third, the casual hypotheses were tested using regression analysis testing full and reduced models for both groups. The dependent variables included anger, tension, depression, and abuse. An empirical model was generated and tested as well. Last, a comparison between the groups using difference of the means tests were completed for the major variables. The results of this study demonstrated that there were significant differences between the two groups in the causal models, the amount of explained variance, and three major variables: social supports, expectations of the caregivers, and perceptions of the caregivers. A number of descriptive variables were statistically significant as well. Among the most important study outcomes were the identification of issues involved in the study of abuse and/or neglect among the elderly, the identification of issues involved in the study of older individuals, the identification of potential areas for future study, and the identification of the implications of this type of study for nursing and for health care of older people in general