The roles of adult daughters in long-term care facilities: alternative caregiver career paths
Although our understanding of issues faced by community-based caregivers has been expanding rapidly over the past decade, our understanding of the roles of family members within long-term care settings is quite limited. The research that does exist tends to conceptualise the term "role" as a uni-dimensional concept, to treat diverse caregiver samples as homogeneous groups, and fails to take into account the broader context within which family member roles are played out. Employing a multi-dimensional conceptualisation of the term "role", and guided by a symbolic interactionist approach and the conceptual framework of the caregiving career, the purpose of this study was to gain a deeper and more comprehensive understanding of the roles of adult daughters in long-term care facilities from their perspectives. Specific techniques of the grounded theory approach combined with in depth, active interviews and personal logs were used as the primary research design procedures. The analysis revealed that adult daughters' perceptions of their roles fell into five distinct yet not mutually exclusive "family caregiving role manifestations". Active Monitors, Regular Visitors, Indirect Supporters, Unaccepting Relinquishers, and Accepting Relinquishers. Key factors which help explain these role manifestations include temporal phase in the caregiving career, amount and nature of involvement within the facility, meaning or definition of the role, interpretations of their parent's "thereness" or psychological presence, pressure to be involved in care, the presence of both parents, satisfaction with care, the ability to accept the situation, and the experiences in the role. Common to all of the role manifestations was the inherent "changeability" of the caregiving role as well as the stresses and demands of the role and resourcefulness of the caregivers. An integration of a number of the above factors is used in the development of a substantive grounded theory on the alternative family member caregiving career paths in long-term care facilities. The dominant paths in this model are the "Coping Through Protection of Self Path", the "Focus on Other Path", and the "Growth Through Acceptance Path". Drawing on McCubbin and Patterson's Family Adjustment and Adaptation Response Model, a dialectic conceptualisation of caregiving career paths is presented.