Biomedical subjects

M M Seltzer

Publications and source records attributed to M M Seltzer.

At least 19 recordsLinked to original sources

PubMed2005

Adults with autism living at home or in non-family settings: positive and negative aspects of residential status.

BACKGROUND: Very little is known about the context of caregiving by parents of adults with autism or about the perceived impacts of continued patterns of co-residence vs. out-of-family living. In the present study, maternal assessments of residential status, involvement with adult children living in a non-family setting, and the impacts on mothers of their residential arrangements were examined. METHODS: Mothers from 133 families of adults (aged 22 years and older) with autism spectrum disorder (ASD) completed questionnaires as part of a longitudinal study on family caregiving. Mothers completed open-ended questions regarding the positive and negative aspects of their child's residential arrangement. Mothers also completed scaled questions regarding their satisfaction with their child's residential arrangement, the different ways in which people's lives change after a relative moves from the home, and the frequency of contact with their son or daughter. RESULTS: Mothers found co-residing with their adult child to be of greatest positive benefit to the family while those living apart found this residential arrangement of greatest benefit to the son or daughter with ASD. The greatest negative consequences for co-residing mothers were understood to fall on families, while mothers felt the majority of negative consequences for those that lived apart. There was a high level of contact and maternal involvement between the mother and adult child with ASD even after out-of-home placement. CONCLUSIONS: Residential status, as appraised by mothers, has varying impacts on the individual with ASD, on the family, and on mothers as individuals and caregivers. The present analysis suggests the multifaceted and highly contingent maternal experience associated with where her child with ASD lives. Among families whose children live elsewhere, there is an impressive amount of continued contact between these families and their son/daughter.

Adolescent↗

PubMed2001

Quality of life of adults with mental retardation/developmental disabilities who live with family.

In this paper, we review the literature related to the quality of life of adults with mental retardation/developmental disabilities (MR/DD) who live at home with their families. We examine the nature of the relationships between adults with MR/DD and their parents and siblings, the social worlds of adults with MR/DD, age-related functional and health issues that affect their quality of life, the range of services and supports provided to them, and familial efforts to plan for their continued well-being when parental care is no longer viable. Individual characteristics associated with these dimensions and/or more compromised quality of life profiles are identified. The paper concludes with recommendations for expanded research on the quality of life of adults with MR/DD who live in the parental home, a topic which has received markedly less attention than the quality of life of adults who live in publicly supported residential settings. MRDD Research Reviews 7:105-114, 2001.

Adult↗

PubMed2001

Continuity or discontinuity of family involvement following residential transitions of adults who have mental retardation.

Family involvement with adults who have mental retardation following a residential transition to a nonparental living situation was examined. We found that aging mothers were highly involved in the relocation process and had frequent contact and continued emotional involvement with their adult child. Mothers became increasingly satisfied with their level of contact with their child over time, less worried about the future, and had decreasing levels of direct caregiving and contact with residential staff. Adult siblings reported improved sibling relationships over time. Siblings whose brother or sister moved out of the parental home increased their shared activities and felt less pessimistic about the future. Findings address a critical gap in knowledge about the life course roles of families of persons with mental retardation.

Adult↗

PubMed2001

Life course impacts of parenting a child with a disability.

We contrasted parents who had a child with a developmental disability, a serious mental health problem, and a normative comparison group with respect to parental attainment and well-being at mid-life. Data are from the Wisconsin Longitudinal Study, collected when the respondents were 18, 36, and 53 or 54, on average. Although similar at age 18, group patterns of attainment and well-being diverged thereafter. Parents of a child with a developmental disability had lower rates of employment, larger families, and lower rates of social participation but were similar to parents without a child with a disability in educational and marital status, physical health, and psychological well-being. Parents whose child had a serious mental health problem had normative patterns of educational and occupational attainment and marriage, but elevated levels of physical symptoms, depression, and alcohol symptoms at mid-life.

Child↗

PubMed2000

The dynamics of caregiving: transitions during a three-year prospective study.

This prospective study (n = 476) examined 3 types of caregiving transitions experienced by wives and daughters of older persons: entry, institutionalization, and bereavement. Daughters were more likely to enter the caregiving role than wives, but the impact of entering the role was more pronounced for wives. After becoming a caregiver, wives decreased in their participation in leisure activities, perceptions of quality of family relations, and marital satisfaction. Daughter caregivers were more likely than wives to place their care recipient in an institution, and they increased in social participation and decreased in subjective burden after placement. Roughly the same percentage of wife and daughter caregivers were bereaved during the study period, and for wives bereavement was accompanied by an increase in social involvement and personal growth. The results underscore the highly dynamic nature of the caregiving career and the importance of the kinship relationship between caregiver and care recipient in conditioning the effects of caregiving transitions.

Bereavement↗

PubMed2000

Brothers and sisters of adults with mental retardation: gendered nature of the sibling relationship.

Differences and similarities between brothers and sisters of adults with mental retardation with respect to the instrumental (caregiving, companionship) and affective (positive affect, emotion) aspects of the sibling relationship were examined. Sisters scored higher than brothers in the caregiving, companionship, and positive affect aspects of the sibling relationship. Brothers' sibling relationships were conditioned by the gender of the sibling with mental retardation. Brothers of brothers with mental retardation had a more favorable emotional response than did brothers of sisters. Two-wave longitudinal data showed that sibling involvement and closeness increased over time, but was dependent upon changes in the health of the mother. The findings are discussed in relation to normative patterns in the sibling relationship across the life course.

Adult↗

PubMed1999

Change in depressive symptoms among daughter caregivers: an 18-month longitudinal study.

This longitudinal study investigates, over an 18-month period, the caregiving experience of a probability sample of 115 daughters who provided care to an aging parent. The levels of depressive symptoms manifested by these daughters were relatively low, with only 23.5% scoring in the clinical range during the study. Nevertheless, there was substantive change in depressive symptoms among the daughters during the 18 months. Daughters with higher levels of mastery were more likely to use problem-focused coping strategies, which led to reductions in depression, whereas daughters with lower levels of mastery were more likely to use emotion-focused coping, which led to increased levels of depression. Mastery was higher when the caregiving role was shared with a sibling: it was lower if the daughter had other caregiving responsibilities and if the parent care recipient had elevated levels of behavior problems.

Adaptation, Psychological↗

PubMed1999

Siblings of adults with mental illness or mental retardation: current involvement and expectation of future caregiving.

OBJECTIVE: The study examined the factors associated with the involvement of siblings in the life of a brother or sister who has mental illness or mental retardation. Involvement was defined as the current provision of instrumental and emotional support as well as the expectation of future caregiving responsibility. METHODS: A mailed questionnaire was used to collect data from 61 siblings of adults with serious mental illness and 119 siblings of adults with mental retardation. The sample was drawn from two ongoing longitudinal studies. RESULTS: The two groups of siblings showed striking differences in their expectations about their responsibility for future caregiving. Almost 60 percent of the siblings of adults with mental retardation expected to assume primary caregiving responsibility in the future, but only one-third of the siblings of adults with mental illness held this expectation. For both groups, competing family responsibilities limited the involvement of siblings, whereas closeness to the family of origin led to greater sibling involvement. CONCLUSIONS: The extent of current and future involvement by siblings of adults with disabilities is a function of the demands and constraints of midlife as well as the degree of closeness with the family of origin. The findings highlight the importance of clinicians' work to support and strengthen family relationships, which loom large in determining the extent to which siblings are involved in the care of a brother or sister with disabilities.

Adult↗

PubMed1999

Patterns of respite use by aging mothers of adults with mental retardation.

Use of respite services by 275 aging families of adults with mental retardation was examined over a 4.5-year period. Although more than twice as many families used respite in 1993 compared to 1988, over half never used respite during this period. Most families using respite received in-home services, in moderate amounts, and with high levels of satisfaction. In an analysis of predictors of respite use, the only significant predictor in 1988 was poorer functional abilities of the adult with mental retardation. By 1993, respite use was predicted by three characteristics: poorer functional abilities, better health in the adult with mental retardation, and greater maternal caregiving burden. These findings reflect variability in aging families' needs for support and changing respite policies.

Adult↗

PubMed1999

Differences in coping effectiveness and well-being among aging mothers and fathers of adults with mental retardation.

In this longitudinal study, we examined stress and coping processes among 133 married mothers (age 59 to 83) and fathers (age 56 to 84) of adults with mental retardation (age 19 to 53). There were no differences between mothers and fathers with respect to their frequency of use of emotion-focused coping, but mothers used significantly more problem-focused coping strategies than did their husbands. For mothers, greater use of problem-focused coping strategies and lower use of emotion-focused coping buffered the impacts of caregiving stress on their psychological well-being. However, for fathers, no buffering effects of coping were detected. The implications of gender differences in coping effects were examined in the context of the impact of lifelong caregiving.

Adult↗

PubMed1997

Distinctive late-life challenges: implications for coping and well-being.

Two distinctive late-life challenges, community relocation and caring for an adult child with mental retardation, were studied to determine their influence on coping and well-being. These challenges differ in terms of their normativeness, duration, and whether they were expected. Data from 2 ongoing longitudinal studies (N = 449) were used to test the hypotheses that women experiencing residential relocation would report higher well-being and use problem-focused coping more frequently than women with long-term caregiving responsibilities. As predicted, more positive changes in well-being across time were reported by the relocation sample, which also showed more problem-focused coping. Women in the caregiving sample, however, showed stronger relationships between coping and well-being, underscoring possible gains in expertise that accompany challenges of lengthy duration.

Adaptation, Psychological↗

PubMed1997

Social support and depressive symptoms: differential patterns in wife and daughter caregivers.

This cross-sectional study examined how three types of social support-social participation, emotional support, and caregiving support-were related to depressive symptoms in wives caring for their elderly husband and daughters caring for their elderly parent. We investigated whether different dimensions of social support affect mental health via different mechanisms and whether the context in which the support is needed and received will temper its effects. We found that social participation had a main effect on depressive symptoms for daughters but not for wives. Emotional support buffered the stress emanating from the husband's behavior problems for wives. For daughters, emotional support buffered the stress emanating from both the behavior problems and the ADL/IADL limitations of the parent care recipient. Using caregiving as the example, our data suggested that social support does not have uniform effects; rather, the type of stressor, the type of social support, and the individual context interact to result in the specific effect of support.

Activities of Daily Living↗

PubMed1997

Aging parents' residential plans for adult children with mental retardation.

Future residential plans and placement preferences of 340 mothers of adult children with mental retardation living at home were examined and findings from a 3-year follow-up discussed. Four subgroups of families were compared based upon residential plans and preferences for continued home residence for the next 2 years. Significant group differences were found for background characteristics, maternal psychological well-being, and support systems. Less than 50% had made residential plans, and the majority believed their child would still be at home in 2 years. At 3-year follow-up, 22% of the families with short-term residential plans had achieved a placement compared to 14% among families without a plan who wanted a placement.

Adult↗

PubMed1997

Residential transitions of adults with mental retardation: predictors of waiting list use and placement.

Predictors of residential planning and placement among 461 families of adults with mental retardation living at home were examined prospectively over a 4.5-year period. Factors predicting whether an adult's name would be put on a waiting list for residential placement were a diagnosis of Down syndrome, higher unmet service needs, smaller parental support networks, and better maternal health. Predictors of residential placement were being on a waiting list, poorer maternal health, and older age of the adult child. Result from qualitative analyses of parental reasons for use of the waiting list or of placement were also presented. Findings were interpreted using stress and coping, family life cycle, and postponed launching models.

Adult↗

PubMed1996

The transitions of caregiving: subjective and objective definitions.

We examined two indicators of the temporal trajectory of caregiving: (a) duration of caregiving and (b) the perception that caregiving is a new role, an ongoing role, or a role that will end soon. The association between the two depended on the type of onset of the caregiving role (abrupt or gradual) and the type of kinship relationship with the care recipient (wife or daughter). Daughters in later stages of caregiving had a more distant relationship with the care recipient and more subjective burden than daughters in the earlier stages. Wives evidenced the opposite pattern, as those who had been providing care for a longer duration of time reported less burden, and those who perceived themselves to be in the later stages of caregiving reported a closer relationship with their husband.

Activities of Daily Living↗

PubMed1996

Binding ties: the roles of adult siblings of persons with mental retardation.

Current relationship patterns and future role expectations of 140 adult siblings of a brother or sister with mental retardation still living in the parental home were examined. Results showed that siblings maintained regular and personal contact, provided emotional support, and felt knowledgeable about the varied needs of their brother or sister with mental retardation. Of the siblings who had firm plans for the future, 36% intended to co-reside with their brother or sister with mental retardation, whereas 64% intended to live apart. Factors differentiating groups included gender (of both the sibling and the brother or sister with retardation), mother's health, level of mental retardation, and frequency of activities shared by the siblings during the past year.

Adult↗

PubMed1995

A comparison of coping strategies of aging mothers of adults with mental illness or mental retardation.

Differences in coping by 105 aging mothers of adults with mental illness and 389 similar mothers of adults with mental retardation were investigated. Although no differences in problem-focused coping were found, mothers of adults with mental illness used more emotion-focused coping, which predicted greater maternal depression. For mothers of adults with retardation, depressive symptoms were a function of their child's behavior problems, although this source of stress was buffered by coping. For mothers of adults with mental illness, depression was a function of caregiving demands, but coping did not buffer the effects of stress. Explanations for findings include maternal perceptions of the context of care, of her control over the disability, and her caregiving efficacy.

Adaptation, Psychological↗

PubMed1995

Cross-national comparisons of ageing mothers of adults with intellectual disabilities.

Ageing (55+ years) mothers of adults with intellectual disabilities in the Republic of Ireland, Northern Ireland and the United States were compared with respect to three general issues. Firstly, to what extent do the adults in these three countries differ in their level of reliance on their mothers? Secondly, do the mothers differ in the extent to which they have made plans for the future care of their son or daughter with intellectual disabilities? Thirdly, do the mothers differ in physical, social and psychological well-being? These cross-national comparisons were undertaken to examine the extent to which lifelong caregiving has either a common influence on mothers across national boundaries, or, alternatively, whether the cultural context exerts a unique influence on mothers in each country. Findings supported the latter explanation, even when background characteristics were statistically controlled.

Adult↗