Gender differences among Canadian spousal caregivers at the end of life

Authors

  • Kevin Brazil PhD,

    1. Department of Clinical Epidemiology and Biostatistics & Division of Palliative Care, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada,
    2. St. Joseph's Health System Research Network, Hamilton, ON, Canada,
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  • Lehana Thabane PhD,

    1. Department of Clinical Epidemiology and Biostatistics & Division of Palliative Care, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada,
    2. Biostatistics Unit, Father Sean O'Sullivan Research Centre & Centre for Evaluation of Medicines, St Joseph's Healthcare, Hamilton ON, Canada,
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  • Gary Foster PhD,

    1. Biostatistics Unit, Father Sean O'Sullivan Research Centre & Centre for Evaluation of Medicines, St Joseph's Healthcare, Hamilton ON, Canada,
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  • Michel Bédard PhD

    1. Public Health Program, Lakehead University, Thunder Bay, ON, Canada, and
    2. Division of Human Sciences, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
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Kevin Brazil
Department of Clinical Epidemiology and Biostatistics
105 Main St., E., Level P1
Hamilton, ON
Canada L8N 1G6
E-mail: brazilk@mcmaster.ca

Abstract

The purpose of this study was to examine gender differences in spousal caregiving at the end of life. The primary research question was to determine gender differences in caregiver strain among spousal caregivers. Secondary research questions investigated included (i) the presence of gender differences among spousal caregivers in the duration of care provided; (ii) gender differences among spousal caregivers in formal service use and unmet service needs; and (iii) whether support to care recipients in activities of daily living varied according to the gender of the spousal caregiver. The study was conducted over a 2-year period (2000–2002) in south-central Ontario, Canada. The study sample included 283 informal spousal caregivers (198 females, 85 males) each of whom were caring for a terminally ill spouse at the time they participated in a cross-sectional telephone survey. The analysis showed that females reported a significantly greater level of caregiving strain than males (t = –2.12, d.f. = 281, P = 0.035). When considering source of support in activities of daily living for the care recipient, differential assistance was noted on the basis of caregiver gender. Female caregivers had almost twice the odds of providing support in toileting-related tasks than male caregivers (odds ratio (OR) = 1.98, 95% confidence interval (CI) = 1.01–3.85, P = 0.044), while male caregivers had approximately twice the odds of providing support in mobility-related tasks (OR = 0.41, 95% CI = 0.21–0.81, P = 0.011). Care recipients who had a female caregiver had lower odds of receiving support from family and friends in tasks associated with personal care (OR = 0.17, 95% CI = 0.05–0.53, P = 0.002). To address gender differences in caregiving, a realistic home-based palliative care approach must take into account the importance of informal caregivers.

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