Perceived control and adaptation in elderly caregivers

Abstract

<p>This study examined the mediating effects of perceived control on the adaptation of elderly caregivers. Perceived control, or the perception that salient or valued aspects of one's life are manageable, was hypothesized as mediating between: (a) the subjective and objective contexts of caregiving and caregiver adaptation and (b) the subjective and objective demands of caregiving and caregiver adaptation. Adaptation was measured as life satisfaction, depression, and subjective symptoms of stress. Objective measures of stress were measured as urinary cortisol, norepinephrine, and epinephrine. Sixty older caregivers were interviewed and twenty-four hour urine samples were obtained from thirty-nine caregivers. Data were obtained from interview self-report questionnaires in the caregivers' homes. Path analyses revealed that only the objective demands of caregiving predicted perceived control. The hypothesis that perceived control mediated between the objective and subjective contexts, and the objective and subjective demands of caregiving, and caregiver adaptation was not supported. Perceived control directly predicted life satisfaction and depression but not subjective symptoms of stress. Perceived control influenced subjective symptoms of stress indirectly through its effect on wishful thinking coping. Perceived control was not associated with the objective biochemical measures of stress. Wishful thinking coping was the only coping strategy that predicted adaptation; it was associated positively with depression and subjective symptoms of stress and inversely with life satisfaction. In terms of the objective measures, cortisol was significantly related to subjective symptoms of stress. The relationship between cortisol and depression was positive but did not achieve significance. Both cortisol and epinephrine were significantly associated with the length of caregiving, suggesting the potential physiological impact of long-term caregiving. The study supports the importance of perceived control for life satisfaction and depression; discusses issues related to model respecification; raises issues related to the importance of the context of caregiving; and suggests that the subjective environment of caregiving directly affects caregiver adaptation. Results from the study also support the multidimensionality of adaptation and suggests that future studies consider more than one dimension of adaptation in elderly caregivers.</p>