Work

Through the Burden: A Model of Self-Transcendence in in Family Caregivers of NH Residents

Year: 2025

Type: article

Abstract: Background Family caregivers of nursing home (NH) residents with advanced dementia often experience high emotional and logistical burden. While most models emphasize stress and coping, fewer address meaning-making and personal growth. This study applies Reed’s Self-Transcendence (ST) Theory to explore how caregiving may foster adaptation and meaning after placement. Objective To examine whether perceptions of family-centered care predict caregiver burden and ST. Methods Using a cross-sectional survey of 232 family caregivers of NH residents with advanced dementia, we examined the relationships between “Perception of Family-Centered Care” (basic care, symptom management, communication, trust, shared decision-making, and recognition of personhood), in NH staff, burden, and ST. Results Structural equation modeling revealed that Perception of Family-Centered Care significantly predicted lower caregiver burden (β = –.611, p < .001). In turn, lower burden was associated with higher ST (β = –.52, p = .002). The direct path from Perception of Family-Centered Care to ST was nonsignificant (β = –.154, p = .218). However, the indirect effect from Perception of Family-Centered Care to ST through caregiver burden was significant (β = .67, 95% CI [.214 – 2.253], p = .000), indicating full mediation. Conclusions Findings highlight the transformative nature of family caregiving in the NH setting. Recognizing family caregiving as a dynamic, transformative process can guide interventions that help family caregivers move through the burden-transcend toward meaning and connection. NH policies should consider integrating structured communication, family engagement, and decision-making support to reduce burden while fostering resilience, meaning-making, and role adaptation.

Source: Innovation in Aging

DOI: 10.1093/geroni/igaf122.4240

Authors: Dalit Zaguri-Greener, Ruth Lopez, Anna Zisberg

Institutions: University of Haifa, MGH Institute of Health Professions, Massachusetts General Hospital

Language: English

Topic: Geriatric Care and Nursing Homes

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,977