Making the best of it: an emerging grounded theory of caring for an older person with mental health problems



Dodd, Lydia
Making the best of it: an emerging grounded theory of caring for an older person with mental health problems. Master of Philosophy thesis, University of Liverpool.

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Abstract

Aim This study aims to develop a substantive grounded theory of the informal care of older people with acute functional mental health problems in the community, using data from qualitative interviews with informal carers and classic grounded theory methodology. Results The theory presented is based on field notes and memos from in depth interviews conducted with 11 informal carers of people aged 65 and over with a functional mental illness. The participants include carers of people with depression and anxiety (n=8), bipolar disorder (n=2) and schizophrenia (n=1). Many of the people cared for also had physical co-morbidities. Most patients had longstanding mental illnesses with equally longstanding caring arrangements. The age range of carers was 40 to 93 years, and of patients was 65 to 88 years. Five of the carers were female, and six male. Eight patients were female, and three male. Carers were related to patients as husband (n=5), wife (n=3), daughter (n=2) or son (n=1). Most carers lived with the person they cared for (n=9). The theory explains, predicts and interprets how carers of older people with longstanding functional mental health problems who have received mental health service input attempt to resolve the tensions that they face as part of caring through making the best of it. Making the best of it consists of three inter-related dimensions: aspirational optimization, adjustment and keeping going. Aspirational optimization is the carer’s desire for the best for the person they care for, and their desire to do their best for them. The six aspects of adjustment are dependency adjustment, identity adjustment, expectation adjustment, illness adjustment, adjustment resourcing and balancing priorities. Making the best of it explains how many carers of older people with longstanding functional mental health problems who have received mental health service input continue to live with unresolved tensions, keeping going despite the fluctuating demands placed upon them, while carrying out corresponding adjustments, which are resourced internally and externally. Making the best of it is discussed in relation to the concepts of family burden, coping, obligation, adaptation and identity. The theory shows how carers of older people with longstanding functional mental health problems who have received mental health service input manage the challenges and the rewards that accompany caring on a daily basis in the decisions, sacrifices and prioritizations they make. It is useful for health and social care practitioners and researchers, as well as contributing to the body of extant classic grounded theories.

Item Type: Thesis (Master of Philosophy)
Additional Information: Date: 2010-11 (completed)
Uncontrolled Keywords: aging, caregivers, caregiving, coping and adaptation, families, caregiving, grounded theory, mental health and illness, older people, relationships, parent-child relationships, primary partner
Subjects: ?? RC0321 ??
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Divisions: Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 23 Aug 2011 09:09
Last Modified: 16 Dec 2022 04:34
DOI: 10.17638/00001485
Supervisors:
URI: https://livrepository.liverpool.ac.uk/id/eprint/1485