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American Journal of Alzheimer's Disease and Other Dementias®
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Discourse-derived perspectives: Differentiating among spouses' experiences of caregiving

Kenneth Hepburn, PhD

Department of Family Practice and Community Health, University of Minnesota, Minneapolis, Minnesota.

Marsha L. Lewis, PhD, RN

School of Nursing, University of Minnesota, Minneapolis, Minnesota.

Suzanne Narayan, PhD, RN

School of Nursing, Metropolitan State University, Minneapolis, Minnesota.

Jane B. Tornatore, PhD

Health Services Research and Development, VA Puget Sound Health Care System, Seattle, Washington.

Karin Lindstrom Bremer, MA

Carey Wexler Sherman, MA

Department of Family Practice and Community Health, University of Minnesota, Minneapolis, Minnesota.

A method of constant comparative analysis was used to code open-ended interviews with 132 spouse caregivers regarding their experiences in caregiving. Results of this analysis yielded 69 qualitative code categories. We used these categories to compare the caregivers on several groupings that the literature has identified as providing meaningful ways to differentiate among caregivers. We used the qualitative responses to compare the caregivers by caregiver gender, care-recipient dementia severity, and duration of caregiving. Results partly confirmed previous findings that wife caregivers are more distressed than husbands, but the results also indicated these caregivers were more similar than dissimilar. The other analyses likewise indicated greater similarities than dissimilarities in the caregiving experience. We next continued the analysis and, using the coding categories as a springboard, identified four distinct patterns for construction of the meaning of the caregiving experience in the caregivers’ discourse. These discourse-derived framing categories, applicable in about three-quarters of the caregivers, offered other ways to distinguish among caregivers. Further analysis of these robust groupings showed important differences among the groups. These framing categories suggest ways to differentiate among caregivers, based on their perception of their role in the caregiving situation, ways that might point the way to intervention strategies for each of the groupings.

Key Words: caregiving • dementia • discourse-derived analysis • qualitative research • spousal caregivers

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 17, No. 4, 213-226 (2002)
DOI: 10.1177/153331750201700409


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