MsW Students’ perceptions of and preparedness for stress and coping of family caregiving

1. MsW Students’ perceptions of and preparedness for stress and coping of family caregiving Erin Batchelor California State University, Long Beach May 2013

2. Introduction • It is estimated that by the year 2050 more than 100,000 professional social workers will be needed to meet the demands of the aging population. • As the older adult population increases, there will be an increasing need to prepare social work students to work with older adults and their families (Faria, Dauenhauer, & Steitz, 2010). • In order to provide the needed support to the increasing number of family caregivers, the sources of caregiver stress needs to be better identified through clinically useful assessment protocols which can thereby allow for further development of much needed support services (Montgomery & Kosloski, 2009). • The purpose of this qualitative study was to explore MSW students’ perceptions of and preparedness for providing care to an aging family member as well as their preparedness to support and advocate for family caregivers in a professional capacity. Knowing the responses of this essential group provides insight for future studies on stress and coping in family caregiving and helps determine further needs for gerontological education in social work programs. • The research addressed the following questions: • How prepared are MSW students for their future caregiver role? • How prepared are MSW students to help others in the caregiver role?

3. Social Work Relevance • Researchers report that there is an alarming shortage of social workers with basic competence of gerontological practice and only 4% of social workers specialize in geriatrics (Kaplan & Berkman, 2011). • In recognizing the need to expand social workers’ awareness and knowledge, the NASW recently developed the NASW Standards for Social Work Practice with Family Caregivers of Older Adults (2010) to help social workers work more effectively with family caregivers. • Social workers are guided by the NASW Code of Ethics to help identify and reduce stress. Families who provide care to older adults are at risk of increased stress and a decreased sense of well-being (Savla et al., 2008). • It is important for social workers to recognize the stressors of caregiving and provide appropriate interventions that help promote good mental health and increase quality of life for caregivers and their families.

4. Cross-Cultural Relevance • It is important for professionals to recognize conflicts between cultural norms and practical considerations facing family caregivers . • The NASW (2010) suggests that social workers consider cultural values, beliefs, and practices of family caregivers especially the ways in which “culture influences perceptions and practices related to aging, illness, and disability; physical and psychosocial pain; health care treatments; providing care to or receiving care from family members; help-seeking behaviors; healthcare, financial and other decision making; and death and dying” (p. 26).

5. Methods • This study utilized an exploratory qualitative design conducting in-depth, face-to-face interviews with participants who met the study criteria. • An open-ended semi-structured interview format was used to allow participants to describe their individual perceptions of family caregiving, their personal preparedness for family caregiving, and their professional preparedness to provide support to family caregivers. • The study utilized non-probability convenience sampling of 22 MSW students in their final year of studies at California State University, Long Beach (CSULB). • To participate in this study, the participants met the criteria of: (a) a current MSW student enrolled in their final year of school and (b) anticipating a future family caregiver role. • Audio taped interviews were transcribed verbatim. The researcher observed similarities and dissimilarities of the respondents in order to identify patterns and themes. The data analysis focused on the subjects’ perceptions of family caregiving, their personal preparedness for family caregiving, and their professional preparedness to provide support to other family caregivers. • Demographic attributes were analyzed through numerical frequencies and percentages. The researcher formed categories as commonalities were identified. Tables were created and tentative conclusions were formed. Direct quotes from participants were used to support the conclusions.

6. Methods (continued) Participants were asked to provide answers to the following questions: The first section discussed participants’ perceptions of and preparedness to care for an aging family member: • If today it became necessary for you to become a primary caregiver for an aging family member, how prepared would you be adopt this role? • Please identify some of the tasks that you perceive would be required of you as the primary caregiver to an older family member. • What aspects of caregiving do you perceive would be the most stressful? • What aspects of caregiving do you perceive would be the most rewarding? • Describe what your cultural expectations are about family caregiving. • Describe how your culture has prepared you for family caregiving. • How has your education and field experience prepared you to become a family caregiver? • What would help future MSW students prepare for a family caregiver role? This section discussed participants’ preparedness to provide support to family caregivers in a professional capacity: • How has your education and field experience prepared you to work with family caregivers in a professional capacity? • How has your education and field experience prepared to you work with a culturally diverse population of family caregivers? • What would you have wanted to learn in your MSW program about family caregiving? • What would help future MSW students prepare to work family caregivers in a professional capacity? The last question was a general question: • Please identify some coping skills that you believe would be useful to help avoid burnout and stress in family caregiving.

7. ResultsThe majority of participants (n = 20, 91%) were female, their ethnicities were predominately Asian/Pacific Islander (n = 7, 32%), Latino/Hispanic (n – 6, 27%), and Caucasian (n = 6, 27%). All participants were in their last year of graduate school and approximately half of them were enrolled in the OAF concentration (n = 12, 55%) and the other half (n = 10, 45%) were enrolled in the CYF concentration. Demographic Characteristics of Participants (N = 22) Characteristics f % Gender Female 20 91 Male 2 9 Age 20-25 7 32 26-30 11 50 31-35 3 14 36-40 1 4 Marital Status Single 16 73 Married 5 23 Divorced 1 4 Ethnicity * Asian/Pacific Islander 7 32 Latino/Hispanic 6 27 White/Caucasian 6 27 Other 3 14 African American 1 4 MSW Program Concentration Older Adults and Families 12 55 Child Youth and Families 10 45 • More than one response given

8. Results (continued) • Q1: the majority of participants felt they could not handle the role right now. • Q2: the majority of participants identified transportation as a primary caregiver task. • Q3: the majority of participants felt the physical demands of caregiving would be the most stressful. • Q4: the majority of participants felt that most rewarding aspects of caregiving would be just being there for them. • Q5: the majority of participants felt their culture expects them to take on the caregiver role. • Q6: the majority of participants felt their culture has prepared them for the caregiver role. • Q7: the majority of participants felt their education has prepared them to take on a caregiver role. • Q8: the majority of participants suggested more coursework to help future MSW students prepare for the caregiver role. • Q9: the majority of participants felt their field experience has helped them learn to work with caregivers. • Q10: the majority of participants felt their field experience has helped them work with culturally diverse caregivers. • Q11: the majority of participants felt they would have liked to have learned more about interventions for caregivers. • Q12: the majority of participants suggested more coursework to help future MSW students prepare to work with caregivers. • Q13: the majority of participants identified respite care and self-care as coping mechanisms to avoid stress and burnout.

9. Discussion • In answering the first question regarding participants’ preparedness for a future caregiver role, the majority of participants indicated that they are currently unprepared for family caregiving because of the major responsibilities that come along with the role. • Sixty-eight percent of the participants indicated that the physical demands of caregiving would be the most stressful. Many felt that providing care to an aging family member while trying to maintain their own life would be very stressful. • In answering the second question regarding participants’ preparedness to support other family caregivers in a professional capacity, the majority of participants indicated that they felt their education and field experience had prepared them to work with family caregivers. • Some participants indicated that they felt less prepared educationally mainly because of the program concentration they were in but that their field experiences had prepared them to work with families in general. • What was significant was that many participants felt that their life experiences and cultural expectations had contributed to their knowledge about family caregiving. • It is important for future social workers to consider the importance of gaining further education, experience, and an understanding of cultural expectations in family caregiving.

10. References Faria, D., Dauenhauer, J. A., & Steitz, D. W. (2010). Fostering social work gerontological competencies: Qualitative analysis of an intergenerational service-learning course. Gerontology & Geriatrics Education, 31(1), 92-113. doi:10.1080/02701960903578378 Kaplan, D. B., & Berkman, B. (2011). Dementia care: A global concern and social work challenge. International Social Work, 54(3), 361-373.doi:10.1177/0020872 810396255 Montgomery, R. V., & Kosloski, K. (2009). Caregiving as a process of changing identity: Implications for caregiver support. Generations, 33(1), 47-52. National Association of Social Workers. (2010). NASW standards for social work practice with family caregivers of older adults. Washington, DC: NASW Press. Available at http://www.socialworkers.org/practice/standards/NASWFamilyCaregiverStandards.pdf Savla, J., Almeida, D. M., Davey, A., & Zant, S. H. (2008). Routine assistance to parents: Effects on daily mood and other stressors. Journals of Gerontology Series B:Psychological Sciences & Social Sciences, 36B(3), S154-S161