Remarriage as Context for Dementia Caregiving

by Jacquelyn Benson on November 9, 2012

Due to the growing population of older adults and high, sustained rate of divorce, repartnering in later life is expected to increase. Repartnering in older adulthood yields complex marital and family histories, as repartnered older adults may be required to balance their time and attention toward the needs of what may appear like and function as two, separate families. At the same time, as the health care needs of older adults increase with advancing age, it is important to understand how the potentially complex family and marital histories of remarried older adults may impact the caregiving experience.

Research on repartnering in later life is limited. The majority of this research has centered on remarriage — as opposed to cohabitation or living-apart-together relationships — with analyses focused on comparing the health effects of remarriage to marriage and unmarried adults. We know that remarriage can result in decreased intergenerational support exchange, especially for fathers. Adult children also feel fewer obligations to provide support to stepparents than biological or adoptive parents. Only one study has been conducted examining caregiving among remarried wives. The findings from this study suggest that family members often did not provide approval or support for the remarriage and the remarried wives, in general, did not endorse a sense of “family” with stepfamily members. The study reviewed here is an extension of this work, specifically examining how positive and negative forms of caregiving-specific support are experienced within remarriage for women caring for their husbands with a dementia diagnosis.

The data from this study were qualitative and were collected from 60 remarried wife caregivers. Interviews took from one and one-half to two hours and were conducted via telephone. Participants were asked questions developed to elicit their subjective appraisals of positive (e.g., emotional, instrumental) and negative (e.g., lack of support, interfering, actively negative/critical) support from family and stepfamily members. The average age of participants was 66 years (45 to 87 years). Seventy-seven percent of women were in a second marriage, and 23 percent were in higher order remarriages. The majority of husbands were in the midstage of disease progression, with an average of four years since dementia diagnosis.

Results indicated that participants felt supported by their own family members, but experience either active interference from stepfamily members, or a total lack of support or assistance. Sixty-eight percent of caregivers reported receiving emotional support from family members, with the majority (81 percent) coming from the participant’s own family members. Only 19 percent were received from a stepfamily member. Only 28 percent of caregivers reported receiving instrumental support from a family member, with 76 percent of that support coming from the participant’s own family members and only 23 percent coming from a stepfamily member. A majority of participants (81 percent) reported a lack of support or active negativity from stepfamily members. Lack of support was manifested in three ways: denial, divestment from care responsibilities, and empty promises. Active negativity was manifested in two ways: intrusive and critical involvement, and overt conflict. Participants contributed their stress, weight gain, depression, and physical decline due to the lack of support, intrusiveness, and active negativity received from stepfamily members.

The implications of this study are many. First, this study supports the notion that remarriage often results in confusion regarding social norms and expectations for roles and behaviors within stepfamilies. Second, although older adulthood is characterized as a time when individuals focus more on positive, close family relationships as opposed to negative or estranged relationships, this research sheds light on the fact that family illness in the context of complex family arrangements and dynamics can bring negative family relationships to the fore, resulting in unique stressors and caregiver demands. Finally, this research helps push the public health policy debate surrounding family caregiving. Current policies are still premised on the “nuclear family,” yet this research suggests the need for additional research and policy reform that considers the complex family systems that comprise American families today.

Source:

Sherman CW. Remarriage as context for dementia caregiving: Implications of positive support and negative interactions for caregiver well-being. Research in Human Development (2012); 9, 165-182.

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