The Occupation of Caregiving: Moving Beyond Individualistic Perspectives

The overall aim of this research was to illuminate and describe caregiving as an occupation, informed by perspectives from older adult care partners and occupational therapists. An additional aim was to integrate and inform study findings with theoretical constructs that inform occupational therapy practice through occupational science and public health perspectives. Although caregiving was the main construct under consideration, the specific focus was on care situations involving older adults. Study 1 considered the narratives of 3 older adult women serving as informal (unpaid) caregivers to friends and family members. All of the women were over the age of 65 and of varied racial/ethnic backgrounds. Data were elicited through story prompts embedded in repeated semi-structured interviews and analyzed using a storyboarding approach and poetic transcription. Study 2 was an ethnographic case study considering how care dyads take part in community mobility, a common instrumental activity of daily living, with a particular focus on how the caregiver supports the participation of the care recipient. 3 care dyads (6 participants) over the age of 65 were consented into the study. The researcher employed participant observation, field note journaling and semi-structured interviews followed by thematic qualitative analysis to illuminate strategies used by these care dyads to remain active in community mobility in the context of their care situation. Study 3 used a constructivist grounded theory approach to explore the perspectives of occupational therapists regarding their interactions with older adult caregivers. Repetitive focus groups with 11 occupational therapy practitioners, researcher memos and individual reflections from 2 additional participants provided multifaceted data that the researchers analyzed through several levels of coding to construct a grounded theory of occupational therapist-caregiver interactions. Study 4 consisted of secondary data analyses of a national survey of adult caregivers conducted in the United States in 2014-2015. Data specific to 482 caregivers age 65+ and older and their care recipients were extracted from the overall sample and considered in relationship to responses to questions regarding support received from healthcare providers. Descriptive and inferential statistical analyses were employed to develop a profile of older adult care situations and predict inquiries of support from healthcare providers based on care situation