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Psychological distress in sons as resident carers of older mothers in Japan

Published online by Cambridge University Press:  01 September 2022

Haruna Tanaka Open the ORCID record for Haruna Tanaka [Opens in a new window]  and
Chieko Greiner
Haruna Tanaka
Affiliation:
Department of Nursing, Graduate School of Health Sciences, Kobe University, Kobe, Japan Faculty of Global Nursing, Otemae University, Osaka, Japan
Chieko Greiner*
Affiliation:
Department of Nursing, Graduate School of Health Sciences, Kobe University, Kobe, Japan
*
*Corresponding author. Email: greiner@harbor.kobe-u.ac.jp
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Abstract

In Japan, care-giving sons are noted for their high rates of abuse of care recipients. This study revealed, for the first time, the difficulties unique to sons caring for their mothers. All sons used long-term care insurance services. However, they provided care that could not be covered by such public services while harbouring psychological distress. In this study, we interviewed 13 sons living with their older mothers as the primary carer and conducted a thematic analysis focusing on their psychological distress. As part of our study findings, we have identified nine themes during analysis: uncomfortable feelings that cannot be mitigated as a son; feeling of futility in being unrecognised as a carer; fear of losing something important; a strong sense of responsibility for one's mother's life; disappointment in being unable to obtain understanding and co-operation from one's siblings in providing care; irritation and anger towards one's wayward mother; guilt about treatment of one's mother; sense of exhaustion due to demanding care; and experiencing hopelessness and despair. Thus, it is important to understand what psychological distress carers experience and to consider possible approaches for their support. The study findings provide suggestions for long-term care support in regions, such as East Asia, where the numbers of son carers are increasing inevitably owing to declining birth rates and ageing population, as in Japan.

Keywords

psychological distresscarerscare-givingthematic analysisqualitativesons
Type
Article
Information
Ageing & Society , Volume 44 , Issue 6 , June 2024 , pp. 1410 - 1434
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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References

Amirkhanyan, AA and Wolf, DA (2006) Parent care and the stress process: findings from panel data. Journals of Gerontology: Series B 61, 248–255.CrossRefGoogle ScholarPubMed
Ar, Y and Karanci, AN (2019) Turkish adult children as caregivers of parents with Alzheimer's disease: perceptions and caregiving experiences. Dementia 18, 882–902.CrossRefGoogle ScholarPubMed
Boss, P (1999) Ambiguous Loss: Learning to Live with Unsolved Grief. Cambridge, MA: Harvard University Press.Google Scholar
Boyatzis, R (1998) Transforming Qualitative Information: Thematic Analysis and Code Development. Thousand Oaks, CA: Sage.Google Scholar
Cabinet Office, Government of Japan (2013) Report of National Council of Reform of Social Security on the Roadmap of Passing Down the Sustainable Social Security System for the Next Generations. Available at http://www.kantei.go.jp/jp/singi/kokuminkaigi/pdf/houkokusyo.pdf. (in Japanese)Google Scholar
Campbell, LD (2010) Sons who care: examining the experience and meaning of filial caregiving for married and never-married sons. Canadian Journal on Aging 29, 73–84.CrossRefGoogle ScholarPubMed
Chee, YK and Levkoff, SE (2001) Culture and dementia: accounts by family caregivers and health professionals for dementia-affected elders in South Korea. Journal of Cross-cultural Gerontology 16, 111–125.CrossRefGoogle ScholarPubMed
Coutinho, J, Oliveira-Silva, P, Mesquita, AR, Barbosa, M, Perrone-McGovern, KM and Goncalves, OF (2017) Psychophysiological reactivity in couples during a marital interaction task. Applied Psychophysiology and Biofeedback 42, 335–346.CrossRefGoogle ScholarPubMed
Donorfio, LM and Sheehan, NW (2001) Relationship dynamics between aging mothers and caregiving daughters: filial expectations and responsibilities. Journal of Adult Development 8, 39–49.CrossRefGoogle Scholar
Duggleby, WD, Swindle, J, Peacock, S and Ghosh, S (2011) A mixed methods study of hope, transitions, and quality of life in family caregivers of persons with Alzheimer's disease. BMC Geriatrics 11, 88.CrossRefGoogle ScholarPubMed
Funk, LM (2010) Prioritizing parental autonomy: adult children's accounts of feeling responsible and supporting aging parents. Journal of Aging Studies 24, 57–64.CrossRefGoogle Scholar
Harris, PB (1998) Listening to caregiving sons: misunderstood realities. The Gerontologist 38, 342–352.CrossRefGoogle ScholarPubMed
Harris, PB (2002) The voices of husbands and sons caring for a family member with dementia. In Kramer, BK and Thompson, EH (eds), Men as Caregivers. New York, NY: Springer Publishing, pp. 213–233.Google Scholar
Hashizume, Y (2000) Gender issues and Japanese family-centered caregiving for frail elderly parents or parents-in-law in modern Japan: from the sociocultural and historical perspectives. Public Health Nursing 17, 25–31.CrossRefGoogle ScholarPubMed
Hayder, D and Schnepp, W (2008) Urinary incontinence – the family caregiver's perspective. Zeitschrift für Gerontologie und Geriatrie 41, 261–266.CrossRefGoogle Scholar
Health and Welfare Bureau for the Elderly, Ministry of Health, Labour and Welfare (2016) Long-term Care Insurance System of Japan. Available at https://www.mhlw.go.jp/english/policy/care-welfare/care-welfare-elderly/dl/ltcisj_e.pdf.Google Scholar
Jones, GW (2019) Ultra-low fertility in East Asia: policy responses and challenges. Asian Population Studies 15, 131–149.CrossRefGoogle Scholar
Karantzas, GC and Simpson, JA (2015) Attachment and aged care. In Simpson, JA and Rholes, WS (eds), Attachment Theory and Research: New Directions and Emerging Themes. New York, NY: Guilford Press, pp. 319–345.Google Scholar
Kramer, BJ and Thompson, EH (eds) (2002) Men as Caregivers. New York, NY: Springer Publishing.Google Scholar
Kwak, M, Indersoll-Dayton, B and Kim, J (2012) Family conflict from the perspective of adult child caregivers: the influence of gender. Journal of Social and Personal Relationships 29, 470–487.CrossRefGoogle Scholar
Lai, DWL (2010) Filial piety, caregiving appraisal, and caregiving burden. Research on Aging 32, 200–223.CrossRefGoogle Scholar
Lashewicz, B and Keating, N (2009) Tensions among siblings in parent care. European Journal of Ageing 6, 127–135.CrossRefGoogle ScholarPubMed
Lee, KS (2016) Conflicting views on elder care responsibility in Japan. Social Science Research 57, 133–147.CrossRefGoogle ScholarPubMed
Lee, J, Sohn, B, Lee, H, Seong, SJ, Park, S and Lee, JY (2018) Attachment style and filial obligation in the burden of caregiver of dementia patients. Archives of Gerontology and Geriatrics 75, 104–111.CrossRefGoogle ScholarPubMed
Lin, MC and Giles, H (2013) The dark side of family communication: a communication model of elder abuse and neglect. International Psychogeriatric 25, 1275–1290.CrossRefGoogle ScholarPubMed
Lin, JP and Yi, CC (2013) A comparative analysis of intergenerational relations in East Asia. International Sociology 28, 297–315.CrossRefGoogle Scholar
Lin, WF, Chen, LH and Li, TS (2013) Adult children's caregiver burden and depression: the moderating roles of parent–child relationship satisfaction and feedback from others. Journal of Happiness Studies 14, 673–687.CrossRefGoogle Scholar
Liu, Y, Fu, R, Roberto, AK and Savla, J (2019) Depressive symptoms among adult children caregivers in China: moderating effects of working status and gender. Aging & Mental Health 23, 1391–1399.CrossRefGoogle Scholar
Lopez-Anuarbe, M and Kohli, P (2019) Understanding male caregivers’ emotional, financial, and physical burden in the United States. Healthcare 7, 72.CrossRefGoogle ScholarPubMed
McAuliffe, L, Ong, B and Kinsella, (2020) Mediators of burden and depression in dementia family caregivers: kinship differences. Dementia 19, 2234–2250.CrossRefGoogle ScholarPubMed
McCusker, MG and Galupo, MP (2011) The impact of men seeking help for depression on perceptions of masculine and feminine characteristics. Psychology of Men & Masculinity 12, 275–284.CrossRefGoogle Scholar
McDonnell, E and Ryan, AA (2014) The experience of sons caring for a parent with dementia. Dementia 13, 788–802.CrossRefGoogle ScholarPubMed
Ministry of Health, Labour and Welfare (2013) Comprehensive Survey of Living Conditions. Available at https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa13/dl/05.pdf.Google Scholar
Ministry of Health, Labour and Welfare (2018) Survey Results for the State of Treatment Based on the ‘Act on the Prevention of Elder Abuse, Support for Caregivers of Elderly Persons and Other Related Matters’ of the Ministry of Health, Labour and Welfare. Available at https://www.mhlw.go.jp/content/12304250/000584234.pdf.Google Scholar
Ministry of Health, Labour and Welfare (2019) Comprehensive Survey of Living Conditions. Available at https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa19/dl/05.pdf.Google Scholar
Ministry of Health, Labour and Welfare (2020 a) Basic Survey of Gender Equality in Employment Management. Available at https://www.mhlw.go.jp/toukei/list/dl/71-r01/07.pdf p.38.Google Scholar
Ministry of Health, Labour and Welfare (2020 b) About the Situation Surrounding the Long-term Care Field. Available at https://www.mhlw.go.jp/content/12300000/000608284.pdf p.3.Google Scholar
Nakatani, H (2019) Population aging in Japan: policy transformation, sustainable development goals, universal health coverage, and social determinates of health. Global Health & Medicine 1, 3–10.CrossRefGoogle ScholarPubMed
O'Brien, BC, Harris, LB, Beckman, TJ, Reed, DA and Cook, DA (2014) Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine 89, 1245–1251.CrossRefGoogle ScholarPubMed
Ophir, A and Polos, J (2022) Care life expectancy: gender and unpaid work in the context of population aging. Population Research and Policy Review 41, 197–227.CrossRefGoogle ScholarPubMed
Ridner, SH (2004) Psychological distress: concept analysis. Journal of Advanced Nursing 45, 536–545.CrossRefGoogle ScholarPubMed
Riffin, C, Van Ness, PH and Wolff, JL (2017) Family and other unpaid caregivers and older adults with and without dementia and disability. Journal of the American Geriatric Society 65, 1821–1828.CrossRefGoogle ScholarPubMed
Robinson, CA, Bottorff, JL, Pesut, B, Olliffe, JL and Tomlinson, J (2014) The male face of caregiving: a scoping review of men caring for a person with dementia. American Journal of Men's Health 8, 409–426.CrossRefGoogle ScholarPubMed
Saito, M (2017) Current issues regarding family caregiving and gender equality in Japan: male caregivers and the interplay between caregiving and masculinities. Japan Labour Review 14, 92–111.Google Scholar
Sambasivam, R, Liu, J, Vaingankar, JA, Ong, HL, Tan, ME, Fauziana, R, Picco, L, Chong, SA and Subramaniam, M (2019) The hidden patient: chronic physical morbidity, psychological distress, and quality of life in caregivers of older adults. Psychogeriatrics 19, 65–72.CrossRefGoogle ScholarPubMed
Santini, S, Andersson, G and Lamura, G (2016) Impact of incontinence on the quality of life of caregivers of older persons with incontinence: a qualitative study in four European countries. Archives of Gerontology and Geriatrics 63, 92–101.CrossRefGoogle ScholarPubMed
Son, J, Erno, AE, Shea, DB, Femia, EE and Zarit, SH (2007) The caregiver stress process and health outcomes. Journal of Ageing and Health 19, 871–887.CrossRefGoogle ScholarPubMed
Sugihara, Y, Sugisawa, H, Shibata, H and Harada, K (2008) Productive roles, gender, and depressive symptoms: evidence from a national longitudinal study of late-middle-aged Japanese. Journals of Gerontology: Series B 63, 227–234.CrossRefGoogle ScholarPubMed
Takagi, E and Silverstein, M (2006) Intergenerational coresidence of the Japanese elderly: are cultural norms proactive or reactive? Research on Aging 28, 473–492.CrossRefGoogle Scholar
Takagi, E, Silverstein, M and Crimmins, E (2007) Intergenerational coresidence of older adults in Japan: conditions for cultural plasticity. Journals of Gerontology: Series B 62, S330–S339.CrossRefGoogle ScholarPubMed
Tatangelo, G, McCabe, M, Macleod, A and Konis, A (2018) I just can't please them all and stay sane: adult child caregivers’ experience of family dynamics in care-giving for a parent with dementia in Australia. Health and Social Care in the Community 26, 370–377.CrossRefGoogle ScholarPubMed
Tokunaga, M, Hashimoto, H and Tamiya, N (2015) A gap in formal long-term care use related to characteristics of caregivers and households, under the public universal system in Japan: 2001–2010. Health Policy 119, 840–849.CrossRefGoogle ScholarPubMed
Tsutsui, T, Muramatsu, N and Higashino, S (2013) Changes in perceived filial obligation norms among coresident family caregivers in Japan. The Gerontologist 54, 797–807.CrossRefGoogle ScholarPubMed
Twigg, J (2000) Carework as a form of bodywork. Ageing & Society 20, 389–411.CrossRefGoogle Scholar
Van Wijngaarden, E, Van der Wedden, H, Henning, Z, Komen, R and The, AM (2018) Entangled in uncertainty: the experience of living with dementia from the perspective of family caregivers. PLOS ONE 13, e0198034.CrossRefGoogle ScholarPubMed
Vasileiou, K, Barnett, J, Barreto, M, Vines, J, Atkinson, M, Lawson, S and Wilson, M (2017) Experiences of loneliness associated with being an informal caregiver: a qualitative investigation. Frontiers in Psychology 8, 585.CrossRefGoogle ScholarPubMed
Wawrziczny, E, Duprez, C and Antoine, P (2020) Predictors of caregiver distress among spouses, adult children living with the person with dementia, and adult children not living with the person with dementia. Psychogeriatrics 20, 594–601.CrossRefGoogle Scholar
Weiss, RS (1973) Loneliness: The Experience of Emotional and Social Isolation. Cambridge, MA: MIT Press.Google Scholar
Ziemba, RA and Lynch-Sauer, JM (2005) Preparedness for taking care of elderly parents: ‘first, you get ready to cry’. Journal of Women Aging 17, 99–113.CrossRefGoogle ScholarPubMed
Zuzelo, PR (2012) Evidence-based nursing and qualitative research: a partnership imperative for real-world practice. In Munhall, PL (ed.), Nursing Research: A Qualitative Perspective, 5th Edn. Sudbury, MA: Jones & Bartlett, pp. 533–552.Google Scholar