I'm So Glad You're Here: Positive Aspects of Informal Caregiving

To the Editor: Informal caregivers are essential for an aging population.1, 2 Unpaid care, usually provided to older family members, allows care recipients to remain in the community, thereby alleviating demands on formal health systems.2, 3 The preponderance of research focuses on the negative biopsychosocial and financial outcomes of caregiving (e.g., strain, burnout).4 Although these consequences are frequently experienced, the affirming attributes of informal caregiving are currently underrepresented in the literature and in practice.5 As such, this study explored first-person accounts of positive aspects of informal caregiving. Using principles of qualitative description,6 participants were recruited through purposive and convenience sampling. Recruitment announcements were advertised university-wide at Dalhousie University (Halifax, Nova Scotia, Canada) through online forums and a caregiver support group. Participation was open to faculty and staff members who were informal caregivers. Eleven female family caregivers participated, ranging in age from 46 to 58. Nine were married or common-law partners, and two were divorced; 10 were white, and one was mixed ethnicity; and three had postsecondary diplomas, five had bachelor degrees, and three had graduate degrees. Open-ended in-person interviews lasting 36–77 minutes were conducted. Interviews were facilitated using a piloted semistructured guide that included questions such as: What have been your positive experiences as a caregiver? How have these positive experiences influenced you? Interviews were transcribed, and the authors conducted thematic analysis7 of the responses to ensure trustworthiness. Five themes emerged. Participants experienced a number of positive emotions, such as joy (P8). They felt privileged (P9), lucky (P6, P11), and grateful (P1) for the opportunity to provide informal care to their family member. One participant stated, “I treasure these times with my father” (P9). The intrinsic value of being highly committed to something (P4) was emphasized. Participants noted better time management and task-prioritizing skills. For example, “I'm better organized than I was” (P5), and “I can make choices that are right for me … then focus on what those priorities are and really stick to them. That's a source of happiness” (P7). Participants also became more patient (P3, P10) with care recipients and others in times of stress (e.g., coping with changes in parent–child dynamics and care recipient health status). Participants developed stronger relationships with their care recipients through caregiving. One participant stated, “You go in, and they light up and say, ‘I'm so glad you're here!’ It's that moment of, ‘Oh, I've made you feel better, and you know you can count on me. I'm going to be there for you.’ It's giving them security that is a real positive thing” (P3). Participants highlighted that relationships with siblings were strengthened through negotiating responsibilities of care for their older parent(s). “We all really appreciate what each of us are doing” (P1), and “I think that it has brought us closer together” (P6). Participants described enhanced capabilities of expressing empathy with care recipients, other caregivers, and people in general. This result was due to critical reflection and greater appreciation for the challenges that others may face. Participants said, “anybody I talk to about caregiving has their own story” (P4), “it's made me aware of individuals in different ways … if they're saying or doing something and I'm like, ‘Oh my God, where did that come from?’ Maybe he's not having a good day” (P2), and “it helps me keep things in perspective” (P11). Based on their caregiving experience, some participants were motivated to promote the rights and dignities of older people. For example, “our population is aging, and if you're going to have a lot of people in nursing homes or assisted living, we better do something now … I've looked at the regulations and policies and laws that govern these places, and it makes you want to stand up and shout, ‘This has got to get better!’ … It makes me wish that I could be a part of a group that stands for better seniors' care” (P7). Informal caregiving generates numerous, diverse, positive intrapersonal, interpersonal, and community-level experiences. The affirming attributes generated from caregiving help improve and sustain the caregiver–care recipient relationship, support caregivers’ abilities to survive the stresses of caregiving, and provide them with resources in times to thrive. Practitioners with patients who have, or are, informal caregivers can help attenuate the health-related consequences of caregiving while simultaneously endorsing the affirming qualities—the latter may contribute to the prior. Having a more-equal balance between negative and positive aspects of informal caregiving may improve not only caregivers’ lives, but also the quality of life and care that older adults receive outside formal health systems. Conflict of Interest: None. Author Contributions: Both authors had a role in developing the study concept and design, recruitment of participants, collection and analysis of data, interpretation of findings, and preparation of the manuscript. Sponsor's Role: No sponsor.

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