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Families Caring for Elders in Residence: Issues in the Measurement of Burden
Abstract
This paper examines the concept of caregiving burden and urges a multidimensional perspective in which burden is viewed as a mediating force between the elders' impairments and the impact that caregiving has on the lives of caregivers and their families. The analysis underscores the need to apply the concept of burden to subjective interpretations by caregivers of the elders' different kinds of impairments including impairment of activities of daily living, cognitive incapacity, disruptive behavior, and lack of sociability. The analysis also demonstrates that a variety of less subjective effects of caregiving are important and measureable. These issues are elaborated and illustrated using data and findings from the Benjamin Rose Institute's survey of 614 families in which impaired elders resided with and were provided care by family members.
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“This psychological morbidity is strongly associated with caregivers’ coping strategies [12, 13], such that support and healthy coping strategies are associated with less stress and burden [14–16].”
From Feasibility and acceptability of an acceptance and commitment therapy intervention for caregivers of adults with Alzheimer’s disease and related dementias (2021) · cites this paper as [14]
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DiBartolo, M. C. (2000) · Journal of Gerontological Nursing · doi:10.3928/0098-9134-20000601-08 · Cited by 23
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Scharlach, A. E. (1989) · Research on Aging · doi:10.1177/0164027589112005 · Cited by 23
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Clark, M. C., & Standard, P. L. (1997) · Issues in Mental Health Nursing · doi:10.3109/01612849709010326 · Cited by 22
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Mui, A. C. Y.-S., & Morrow-Howell, N. L. (1993) · Research on Aging · doi:10.1177/0164027593151003 · Cited by 22
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May, K. M., & Hu, J. (2000) · Public Health Nursing · doi:10.1046/j.1525-1446.2000.00273.x · Cited by 21
Incongruent Perceptions of Older Adult/Caregiver Dyads
Zweibel, N. R., & Lydens, L. (1990) · Family Relations · doi:10.2307/584950 · Cited by 21
The Revised Caregiver Burden Scale: A Preliminary Evaluation
Gupta, R. (1999) · Research on Social Work Practice · doi:10.1177/104973159900900406 · Cited by 20
“The occurrence of burden among caregivers of the elderly in the United States is a well-documented American social phenomenon (Lawton, Rajagopal, Brody, & Kleban, 1992; Poulshock & Deimling, 1984).”
BackgroundMethodMoon, H. E., Townsend, A. L., Dilworth‐Anderson, P., & Whitlatch, C. J. (2016) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317516653819 · Cited by 20
Refinement of the Shared Care Instrument-Revised: A Measure of a Family Care Interaction
Sebern, M. (2008) · Journal of Nursing Measurement · doi:10.1891/1061-3749.16.1.43 · Cited by 20
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MethodInfluentialThe Perceived Caregiver Burden Scale for Caregivers of Elderly People in India
Gupta, R. (2007) · Journal of Applied Gerontology · doi:10.1177/0733464806297685 · Cited by 20
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BackgroundMexican American elders' use of home care services
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“Burden in this study has two dimensions: caregivers’ assessment of elders’ impairment and caregivers’ perceptions of burden (Poulshock & Deimling, 1984).”
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Beliefs about elderly people among social workers and the general public in Hong Kong
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Scharlach, A. E., Runkle, M. C., Midanik, L. T., & Soghikian, K. (1994) · Journal of Aging and Health · doi:10.1177/089826439400600304 · Cited by 16
Illness and Impairment in Elderly Couples: Implications for Marital Therapy
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Family Caregivers' Burden, Quality of Life, and Health following Patients' Renal Transplantation
Wicks, M. N., Milstead, E. J., Hathaway, D., et al. (1998) · Progress in Transplantation · doi:10.1177/090591999800800308 · Cited by 16
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Erder, M. H., Wilcox, T. K., Chen, W.-H., O’Quinn, S., Setyawan, J., & Saxton, J. A. (2012) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317512456449 · Cited by 16
“The degree of caregiver burden is a function of objective demands, such as the amount of time spent providing care and, perhaps more importantly, the caregiver’s subjective appraisal of the demands imposed relative to their own capacity, the patient’s status, and the caregiving environment.(15-22) Assessment of caregi…”
BackgroundEffects of a nursing intervention program on disabled patients and their caregivers
Hung, L.-C., Liu, C.-C., Hung, H.-C., et al. (2003) · Archives of Gerontology and Geriatrics · doi:10.1016/s0167-4943(02)00170-x · Cited by 15
Ó’Caoimh, R., Cornally, N., Svendrovski, A., Weathers, E., Fitzgerald, C., HEALY, E., O’Connell, E., O’Keeffe, G., O’Herlihy, E. A., GAO, Y., et al. (2016) · The Journal of Frailty & Aging · doi:10.14283/jfa.2016.86 · Cited by 15
Elder Caregiving in South-Asian Families in the United States and India
Gupta, R., & Pillai, V. K. (2012) · Social work & society · Cited by 16
The Effect of Video-Based Interventions on Self-Care
Clark, M. C., & Lester, J. (2000) · Western Journal of Nursing Research · doi:10.1177/019394590002200805 · Cited by 15
Spousal Care of Alzheimer's Disease Patients in Nursing Home versus In-Home Settings
Barber, C. E. (1993) · Clinical Gerontologist · doi:10.1300/j018v12n04_02 · Cited by 15
Alzheimer's Disease: Caregivers' Perceptions of Burden
Jenkins, T. S., Parham, I. A., & Jenkins, L. R. (1985) · Journal of Applied Gerontology · doi:10.1177/073346488500400206 · Cited by 15
The Contribution of Long Term Economic Costs to Predicting Strain Among Employed Women Caregivers
Keefe, J. M., & Medjuck, S. (1997) · Journal of Women & Aging · doi:10.1300/j074v09n03_02 · Cited by 15
A follow‐up study of psychogeriatric day hospital patients with dementia
Woods, J. P., & Phanjoo, A. L. (1991) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.930060312 · Cited by 15
Adaptive Coping of Older Caregiving Spouses
(1989) · Social Work · doi:10.1093/sw/34.5.415 · Cited by 15
DEVELOPMENTAL PROCESS: Family Caregivers of Demented Japanese
Kobayashi, S., Masaki, H., & Noguchi, M. (1993) · Journal of Gerontological Nursing · doi:10.3928/0098-9134-19931001-05 · Cited by 15
Family Counseling and Legal Issues in Alzheimer’s Disease
Levine, J., & LAWLOR, B. A. (1991) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(18)30314-9 · Cited by 15
Kausar, R., & Powell, G. E. (1996) · Clinical Rehabilitation · doi:10.1177/026921559601000213 · Cited by 15
The Burden of Care in Instances of Chronic Non-communicable Disease
González, G. M. C., Herrera, B. S., Barrera-Ortíz, L., Chaparro-Díaz, L., & de Colombia, U. N. (2013) · Aquichan · doi:10.5294/aqui.2013.13.2.10 · Cited by 13
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BackgroundManthorpe, J., & Bowling, A. (2016) · ePrints Soton (University of Southampton) · Cited by 14
Reinardy, J. R., Kane, R. A., Huck, S. M., et al. (1999) · Research on Aging · doi:10.1177/0164027599211005 · Cited by 14
Recent Developments in Gerontopsychiatric Research on Age-Associated Dementia in Japan
Homma, A., & Hasegawa, K. (1989) · International Psychogeriatrics · doi:10.1017/s1041610289000049 · Cited by 13
Exploring Self-Efficacy and Hardiness in Spousal Caregivers of Individuals with Dementia
DiBartolo, M. C. (2002) · Journal of Gerontological Nursing · doi:10.3928/0098-9134-20020401-07 · Cited by 14
Working Conditions in Home Care: Comparing Three Groups of Workers
Neysmith, S. M., & Nichols, B. (1994) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980800006000 · Cited by 14
Changes in Carers’ Capacity and Motivation to Provide Care
Wells, Y., & Kendig, H. L. (1996) · Journal of Family Studies · doi:10.5172/jfs.2.1.15 · Cited by 14
Multidimensional Caregiving Burden of Female Family Caregivers in Korea
Lim, Y. M., Ahn, Y. H., & Ahn, J. Y. (2015) · Clinical Nursing Research · doi:10.1177/1054773815591472 · Cited by 13
“…refer to caregiver’s feelings of oppression, discomfort, and distress arising both from the elder’s disruptive behavior (i.e., yelling or swearing at people) and from the elder’s difficulties with social functioning (i.e., not being friendly or sociable toward people; Poulshock & Deimling, 1984).”
BackgroundMethodResultInfluentialThe Mid/Late Life Generation Gap: Adult Children with Aging Parents
Myers, J. E. (1988) · Journal of Counseling & Development · doi:10.1002/j.1556-6676.1988.tb00880.x · Cited by 13
Victoroff, J., Nielson, K. A., & Mungas, D. (1997) · International Psychogeriatrics · doi:10.1017/s1041610297004316 · Cited by 13
New Diagnosis : Caregiver Role Strain
Burns, C., Archbold, P. G., Stewart, B., et al. (1993) · International Journal of Nursing Terminologies and Classifications · doi:10.1111/j.1744-618x.1993.tb00088.x · Cited by 13
Phillips, L. R. (2008) · Advances in Nursing Science · doi:10.1097/01.ans.0000319566.06879.e8 · Cited by 12
Activity Restriction and Well-Being in Middle-Aged and Older Caregivers
Loucks‐Atkinson, A., Kleiber, D. A., & Williamson, G. M. (2006) · Topics in Geriatric Rehabilitation · doi:10.1097/00013614-200610000-00003 · Cited by 12
Causes of Strain Affecting Relatives of Swedish Oldest Elderly
Herlitz, C. A., & Dahlberg, L. (1999) · Scandinavian Journal of Caring Sciences · doi:10.1111/j.1471-6712.1999.tb00524.x · Cited by 12
Family care of the elderly with dementia in Hong Kong
Chu, I. P. L. (1991) · International Social Work · doi:10.1177/002087289103400405 · Cited by 12
Caregiver Burden among African-American and Anglo-American Family Caregivers
Allen‐Kelsey, G. J. (1998) · Topics in Geriatric Rehabilitation · doi:10.1097/00013614-199809000-00008 · Cited by 12
THE EFFECTS OF CAREGIVING FOR THE DEMENTED ELDERLY
Flicker, L. A. (1992) · Australian Journal on Ageing · doi:10.1111/j.1741-6612.1992.tb00554.x · Cited by 12
Caregiver Burden and the Continuum of Care
Miller, B. H., & McFall, S. L. (1992) · Research on Aging · doi:10.1177/0164027592143005 · Cited by 12
Sobrecarga vivenciada por cuidadores de idosos na comunidade
Gratão, A. C. M. (2010) · doi:10.11606/t.22.2010.tde-14012011-092744 · Cited by 12
Dyadic interventions in older people with chronic diseases: An integrative review
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Preliminary Efficacy of Let’s Talk Tech: Technology Use Planning for Dementia Care Dyads
Berridge, C. W., Turner, N. R., Liu, L., Fredriksen‐Goldsen, K. I., Lyons, K. S., Demiris, G., Kaye, J. A., & Lober, W. B. (2023) · Innovation in Aging · doi:10.1093/geroni/igad018 · Cited by 16
Burgener, S. C., Marsh-Yant, S., & Nega, K. K. (2010) · Research in Gerontological Nursing · doi:10.3928/19404921-20100504-01 · Cited by 11
“…as measured by the Relatives Stress Scale (RSS; Greene, Smith, Gardiner, & Timbury, 1982); and relationship with the person with dementia, 69Research in Gerontological Nursing • Vol. 4, No. 1, 2011 as measured by the Elder-Caregiver-Family Relationship scale (ECFR; Poulshock & Deimling, 1984).”
MethodThe Use of Personal Assistance Services by Persons With Spinal Cord Injury
Nosek, M. A., Führer, M. J., Rintala, D. H., et al. (1993) · Journal of Disability Policy Studies · doi:10.1177/104420739300400105 · Cited by 11
Relatives of Persons Suffering from Dementia: Differences in the Burden
Duijnstee, M. S. H. (1994) · Ageing and Society · doi:10.1017/s0144686x00001884 · Cited by 11
“This inconsistency renders the concept of burden a kind of 'umbrella concept', covering a multitude of concepts (Poulshock and Deimling 1984).”
BackgroundA New Direction for Intervention with Depressed Caregivers to Alzheimer's Patients
Kosloski, K., Young, R. F., & Montgomery, R. J. V. (1999) · Family Relations · doi:10.2307/585244 · Cited by 11
Hemophilia from the partners' perspective: Burden and impact on their lives
Triemstra, M., van der Ploeg, H. M., Smit, C., & Rosendaal, F. R. (1999) · Psychology and Health · doi:10.1080/08870449908407317 · Cited by 10
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Ferraro, K. F., & Schafer, M. H. (2008) · The Journals of Gerontology Series B · doi:10.1093/geronb/63.1.s3 · Cited by 10
Conceptualizing Stress, Coping, and Illness Management in Heart Disease Caregiving
Young, R. F., & Kahana, E. (1987) · The Hospice Journal · doi:10.1080/0742-969x.1987.11882593 · Cited by 10
Recreation Programs for Caregivers of Older Adults
Bedini, L. A., & Phoenix, T. L. (1999) · Activities Adaptation & Aging · doi:10.1300/j016v24n02_02 · Cited by 10
“To measure social participation, the authors developed the Social Life Restriction Scale (modified from Poulshock & Deimling, 1984) which included recreation and leisure participation.”
BackgroundMethodChen, I., Sung, J., & Wang, W. (2025) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.70080 · Cited by 9
Carretero, S., Ferrer, J. G., & Ródenas, F. (2015) · Cited by 9
Wang, Y., & Luo, P. (2022) · Sustainability · doi:10.3390/su141911847 · Cited by 9
“…the time, money and labor spent on meeting the daily needs of the elderly and caring for them when they are ill, while from the perspective of the young caregiver, this refers to the psychological experience of stress, worry, anxiety, distress, etc., associated with providing care services [5,6].”
Horwitz, M. E., & Rosenthal, T. C. (1994) · The Journal of Rural Health · doi:10.1111/j.1748-0361.1994.tb00240.x · Cited by 9
Salguero, R. H., Kohn, R., Salguero, L. F., et al. (1998) · Journal of Cross-Cultural Gerontology · doi:10.1023/a:1006534521253 · Cited by 9
Taranrød, L. B., Eriksen, S., Pedersen, I., & Kirkevold, Ø. (2020) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s268818 · Cited by 9
‘Misplacement’ of elderly people in the caring organisation: reasons and alternatives
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“, 1992a,b), burden (Poulshock and Deimling, 1984), living situation (Severson et al.”
BackgroundPaquet, M. (1996) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980800005870 · Cited by 9
“…que d'autres avant (Matthews, 1988; Montgomery, 1989; Montgomery, Gonyea, & Hooyman, 1985; Montgomery, Stull, & Borgatta, 1985; Novak & Guest, 1989; Poulshock & Deimling, 1984; Vitaliano, Young, & Russo, 1991) demontrent l'interet des chercheurs a faire du fardeau un concept: "scientifically…”
Ambiguity of Loss, Anticipatory Grief, and Boundary Ambiguity in Caregiver Spouses and Parents
Rider, J. (1993) · University of North Texas Digital Library (University of North Texas) · Cited by 9
Long Term Care in Health Services
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Wu, J., Liu, M., Chen, M., Xue, J., Zou, Y., Deng, Z., Zhao, S., & Yang, X. (2025) · Medicine · doi:10.1097/md.0000000000041275 · Cited by 9
“Poulshock and Deimling [11] argued that caregiver burden arises from the psychological, physical, and social dimensions of the difficulties that caregivers face as a result of their caregiving activities.”
김용희, & 안정신 (2012) · Korean Journal of Gerontological Social Welfare · doi:10.21194/kjgsw..57.201209.161 · Cited by 8
“Tipping point” concept analysis in the family caregiving context
Crist, J. D., Liu, J., Shea, K. D., Peterson, R. L., Martin‐Plank, L., Lacasse, C. L., May, J. T., Wyles, C. L., Williams, D. K., Slebodnik, M., et al. (2019) · Nursing Forum · doi:10.1111/nuf.12373 · Cited by 10
Investigating Caregiver Distress with the Parental Bonding Instrument (PBI)
Daire, A. P. (2004) · Dementia · doi:10.1177/1471301204039326 · Cited by 9
“Other measures used in caregiver research and practice include Caregiver Stress Scale (Pearlin, Mullan, Semple, & Skaff, 1990), Poulshock and Deimling Scale (Poulshock & Deimling, 1984), and the Screen for Caregiver Burden (Vitaliano, Russo, Young, & Becker, 1991) to present a few.”
MethodChaix, B., Navaie‐Waliser, M., Viboud, C. G., Parizot, I., & Chauvin, P. (2006) · European Journal of Public Health · doi:10.1093/eurpub/cki094 · Cited by 8
Metadata
- Authors
- Poulshock, S. W., & Deimling, G. T.
- Affiliations
- Benjamin Rose Institute on Aging (US)
- Case Comprehensive Cancer Center (US)
- ORCID
- Deimling, G. T.
- Venue
- Journal of Gerontology
- Publisher
- Oxford University Press (OUP)
- Published
- 1984-03-01
- Volume
- 39
- Issue
- 2
- Pages
- 230-239
- ISSN
- 0022-1422 (ISSN-L)
- OpenAlex
- W2016101351
- Cited by
- 582
- References
- 0
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 8 · 2017: 9 · 2016: 12 · 2015: 6 · 2014: 12 · 2013: 13 · 2012: 9
- FWCI
- 50.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Gerontology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Social Sciences › Life-span and Life-course Studies › Aging, Elder Care, and Social Issues
- Keywords
- caregiver burden, family caregivers, older adults, activities of daily living, cognitive impairment, disruptive behavior, sociability, family caregiving
- MeSH terms
- Activities of Daily Living, Aged, Attitude, Behavior, Cognition, Family, Home Nursing, Humans
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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