Doctoral Dissertations

Janet Witucki

Date of Award

5-2000

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Martha Raile Alligood

Committee Members

Carol Seaver, Debra Wallace, Jean Skinner

Abstract

The purpose of this study was to gain an understanding of patterns of help seeking by older wife caregivers of demented husbands. Essential to an understanding of service utilization is an understanding of the more basic process of help-seeking.Research to date has largely concentrated on help-seeking as a variable, rather than as an independent entity.Grounded theory methodology with a nursing perspective of health as expanding consciousness, was used to explore interactions, thoughts and feelings associated with patterns of help-seeking by eleven older wife caregivers and allowed for a more holistic view of the process of help-seeking by these older women. This methodology led to discovery of a new substantive theory entitled "Help-seeking choices: Taking one day at a time" which was grounded in reality as experienced by the participants and illuminates help-seeking for this group of caregivers. The core category of reaching out/reaching within described the main phenomena of wives reaching out to involve both informal and formal sources and reaching within themselves to manage care and seek help on a day-to-day basis. Wives made choices to employ strategies of avoiding,shouldering and facing to accomplish continuing to provide care at home for the husbands. These choices were influenced by a myriad of facilitating and hindering intervening conditions.Understanding obtained from the study indicates that earlier screening and intervention are essential to assisting with identification of dementia and to help caregivers realize that a problem exists. Further suggestion is for more comprehensive case management across health care settings for this group, and a recognition of the impact of previous experiences on future health choices by these caregivers. The Importance of pattern recognition which enables caregivers to view, seek, and manage their husbands' health care in creative ways is also indicated. Understanding gained may lead ultimately to the development of interventions which can increase the effectiveness of help-seeking patterns, result in more appropriate utilization of formal and informal resources, reduce burden and stress associated with the caregiving role, and assist women to sustain the caregiving role.

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