The food-related role shift experiences of spousal male care partners and their wives with dementia
Introduction
The number of men acting as primary care providers for persons with dementia is increasing due to the growing older adult population and the shift in the provision of long-term care from institutions to the community. Traditionally, care work has been described as a “woman's work” and most research on caregiving has focussed on the challenges and hurdles women care partners face. Currently, there's a growing interest in the experiences of male care partners especially husbands caring for wives with dementia who make up the majority of the male care partners (McFarland and Sanders, 1999, Siriopoulos et al., 1999). Interestingly, male care partners report less burden or stress compared to female care partners (McFarland & Sanders, 1999); however they struggle with cooking and food shopping. These studies report that the gender scripting of roles left spousal male care partners unprepared and lacking adequate skills and knowledge to take up food purchase and preparation tasks. None of these studies took into account the experiences of wives with dementia.
The Eating Together (Phase 1) study is unique in that it explores the mealtime experiences of persons with dementia living in the community and their primary care partners. Analysis of the first 2 years of data from this study revealed that husbands and their wives with dementia faced unique challenges honouring identity and maintaining connections as they transitioned through food role changes. This necessitated the need to further examine the experiences of husbands and their wives with dementia as they re-negotiated and gave meaning to food-related role changes. Therefore in this current analysis, we examined the food-related role change experiences of spousal male care partners and their wives with dementia using 3 years of data collected through the Eating Together (Phase 1) study.
Section snippets
Mealtimes in families living with dementia
Relatively little research has been conducted on mealtimes in families living with dementia. Positive interactions at mealtimes are associated with increased food intake for persons with dementia (Amella, 2002). On the other hand, aversive mealtime behaviours (i.e. spilling of food, refusal to eat, etc.) sometimes exhibited by persons with dementia causes care partner stress resulting in unpleasant mealtime experiences (Aselage & Amella, 2009). These incidents further lead to malnutrition and
Methodology
This study was a qualitative inquiry using grounded theory methodology with the aim of capturing the inner experiences of participants (husbands and their wives with dementia), and the meanings formed through these experiences (Corbin & Strauss, 2008).
The sliding into food role process
Analysis of data revealed that spousal male care partners and their wives with dementia dealt with food role changes by sliding into food roles as they sought ways to honour identity and stay connected. Sliding into food roles is described as the gradual transition from wives doing most of the food preparation to doing less while husbands do a bit more, until a point in time is reached when wives participate minimally and husbands have fully taken over food roles. Husbands and their wives with
Discussion
There's a growing interest in understanding the relationship between persons living with dementia and their care partners, especially spousal couples. The limited studies in this area have identified a “multi-dimensional and dynamic inter-relationship” between spousal couples living with dementia (Whitlach, 2001). This is consistent with findings in this current study which also suggest that the nature of this dynamic relationship affects how these couples adjust to living with dementia. The
Study strengths and limitations
This work bridges a gap in the literature on the experiences of spousal male care partners and wives with dementia. Most studies consider the account of only the person with dementia or the spousal care partner (Hellström et al., 2007). Beyond filling this void, this study is unique in that it provides important insights into the dynamic nature of the food-related role experiences of these spousal couples living with dementia. For the first time, the longitudinal nature of this study allows for
Implications of this research
Findings from this study have implications for research and practice. This study re-emphasizes the importance of adopting a relationship-centered approach when conducting research studies on spousal couples living with dementia. Inferences drawn from this study indicate that spousal couples living with dementia continually strive to maintain and develop their marital relationship, and this shapes how they adapt to changes due to dementia. Therefore recognizing them as a dyadic unit instead of
Conclusion
This study provides unique perspectives on how spousal male care partners and their wives with dementia experience food-related role changes. Examining the experiences of spousal couples over a three year period provides insights into the evolving life changes that occur when wives' ability to perform food roles is impaired due to dementia. This study challenges researchers, health care practitioners and other professionals to adopt a relationship-centered approach when designing and delivering
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