relations with stepchildren can compound the burdens a wife feels while caring
for her husband with Alzheimer's disease or other forms of dementia, a new
learned from women in the study that those with higher levels of care-related
disagreements with stepfamily members felt a significantly greater burden and
feelings of depression related to care," said lead author Carey Wexler
Sherman of the University of Michigan's Institute for Social Research in Ann Arbour.
Approximately one-third of all American
marriages are remarriages for at least one partner, according to the US Census
Bureau. Previous research has shown that divorce rates among adults 50 and
older doubled between 1990 and 2010.
nearly 5% of the US population, more than 15 million Americans, cares for a
dementia patient, according to the Alzheimer's Association, which helped to
fund the new research.
study, Sherman and her colleagues focused only on wives in later-life remarriages
that occurred after child-rearing years, and recruited 61 remarried wife care-givers
from across the country. Between 2008 and 2010, the participants, whose average
age was 66, completed questionnaires about their social networks, their levels
of depression and their caregiver burdens.
participants were white, middle-class and 85% of them had been divorced prior
to remarriage; the rest were widows. The average length of the women's current
marriages was 17 years, though one quarter of them had been remarried for 10
years or less.
had the women draw a diagram of their social networks and place their
acquaintances into three categories, including "social network",
"positive network", or "negative network", with little
overlap. The women's own family and friends dominated the social network and
positive network categories. And more than half of the participants included
one stepfamily member in their "positive" network. But, at 35%,
stepchildren comprised the largest proportion of what wives considered a
"negative" group related to caretaking.
two-thirds of the caregivers' social network categories, stepchildren were
completely absent. The remarried wives also reported that adult stepchildren
and other stepfamily members were more likely to question care-related
decisions, offer unwanted advice, interfere or criticise.
common complaints from women in the study included stepchildren not being
present during the care giving process or promising to help but never following
through. Some participants reported substantial family conflicts with adult
stepchildren and other stepfamily members over money, inheritance concerns and
medical decisions. When the researchers looked at what factors affected the
caregivers' well-being, levels of family disagreement over care giving issues
had the strongest impact on the women's levels of depression and sense of
in older age in general haven't been researched," Merril Silverstein, the
Cantor Professor of Ageing Studies at Syracuse University in New York, told
Reuters Health. Silverstein invited Sherman's group to publish the study in a
special stepfamily section of the Journal of Marriage and Family, but he was
not involved in the research. "Baby boomers are entering old age with
complicated family structures – unlike their parents," Merril said.
couples remarry less often with age and US remarriage rates have declined over
the past two decades, but co-habitation and other non-traditional arrangements
are less studied, he said.
In 2010, the remarriage rate among men age 65
and older was 12 per 1000 and among women the same age only 2 per 1000,
according to the National Centre for Family & Marriage Research.
people remarry later in life, it means they may have relatively few
opportunities to bond with adult stepchildren," said Lawrence Ganong,
professor of human development and family studies at the University of Missouri
of the reasons children take care of their parents is that they feel they've
been taken care of and feel obliged to return the favour," Ganong, who
was not involved in the study, said. "We are getting into a new era of
older families and couples where unprecedented numbers of divorces and
remarriages have happened," he added.
first intervention that everyone can do in their own life is discuss with
family members how health issues and care giving will be handled," Sherman
said. She and her colleagues are working to develop tailored instructions
designed for remarried spouses and stepfamily members.
do not want to sit down and have these conversations because they are
difficult, Ganong said.
The Georgia-based Rosalynn Carter Institute
for Care giving offers evidence-based intervention options for dementia caregivers,
including cognitive-behavioural therapy, communication training and online
acknowledge that their study was small and suggest that future research should
follow participants for a longer time and include caregivers more representative
of the general population's diversity.
Despite her study's results, Sherman thinks
this added burden on caregivers can be lightened. "It's important to note... that stepfamilies can do this successfully," she said.