Mother-daughter relationships and adult daughters' commitment to caregiving for their aging disabled mothers.

Abstract

This investigation examined the relationship between mother-daughter attachment, mother-daughter conflict, mothers' level of disability and adult daughters' commitment to caregive for their disabled mothers for the first time. In addition, employment and living arrangements were hypothesized as mediating variables in the equation. The theoretical framework was based on Rogers' model of unitary human beings, feminist theory, and family caregiving research. Both cross-sectional and longitudinal analyses as well as quantitative and qualitative methods were utilized. Ninety-eight daughters caring for their mothers were identified from a larger sample of first time family caregivers. Data were collected from an initial screening interview, a Wave 1 interview within one month after screening, and a Wave 2 interview 3 months after the Wave 1 interview. In addition, eight daughters participated in a qualitative interview approximately one year into caregiving. Cross-sectional findings at Wave 1 using a path analysis model, indicated that mother-daughter relationships (attachment and conflict), predicted daughters' affective commitment to caregiving (positive and negative beliefs about caregiving), while mothers' level of disability and mother-daughter attachment predicted instrumental commitment (number of hours of direct and supervisory care). Living arrangements functioned as a mediator in the model while employment did not. Employment had a direct effect on both instrumental and affective commitment. Wave 2 path analysis findings were limited due to a drop in the number of cases, although the trend of the results mirrored Wave 1 findings. Longitudinal findings indicated that mother-daughter attachment and conflict remained stable during the transition to caregiving. Logistic regressions were used to predict three patient caregiving outcomes: (1) no longer requires care; (2) remains in care; and (3) died. Supervisory care, not direct care, was found to predict the odds of remaining in care and dying versus improving at Wave 2. Magnitude of mothers' limitation at Wave 1 was negatively related to mother improving at Wave 2. Finally, qualitative interviews supported and augmented quantitative findings especially those regarding living arrangements and the onerous responsibilities of supervisory care; they also enriched data on mother-daughter relationships during the transition to caregiving.