Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
Gerontologist. 2024 Feb 1;64(2). doi: 10.1093/geront/gnad040.
Family caregivers of older people with health needs often provide long-term, intensive support. Caregivers are, in turn, shaped by these caregiving experiences. According to the narrative identity framework, self-narratives from lived experiences influence self-beliefs and behaviors. We assert that family caregiving experiences, filtered through individuals' memory systems as self-narratives, provide substantial scaffolding for navigating novel challenges in late life. Self-narratives from caregiving can guide positive self-beliefs and behaviors, leading to constructive health-focused outcomes, but they also have the potential to guide negative self-beliefs or behaviors, causing adverse consequences for navigating late-life health. We advocate for incorporating the narrative identity framework into existing caregiving stress models and for new programs of research that examine central mechanisms by which caregiving self-narratives guide self-beliefs and behavioral outcomes. To provide a foundation for this research, we outline 3 domains in which caregiving self-narratives may substantially influence health-related outcomes. This article concludes with recommendations for supporting family caregivers moving forward, highlighting narrative therapy interventions as innovative options for reducing the negative consequences of maladaptive caregiving self-narratives.
有健康需求的老年人的家庭照顾者通常提供长期、密集的支持。反过来,照顾者也受到这些照顾经验的影响。根据叙述身份框架,来自生活经历的自我叙述会影响自我信念和行为。我们断言,家庭照顾经验通过个人的记忆系统过滤为自我叙述,为晚年应对新挑战提供了重要的支撑。来自照顾的自我叙述可以引导积极的自我信念和行为,从而产生建设性的以健康为重点的结果,但它们也有可能引导消极的自我信念或行为,从而对晚年健康的应对产生不利后果。我们提倡将叙述身份框架纳入现有的照顾压力模型,并开展新的研究计划,以研究照顾自我叙述指导自我信念和行为结果的核心机制。为了为这项研究提供基础,我们概述了照顾自我叙述可能会极大地影响与健康相关的结果的 3 个领域。本文最后提出了支持家庭照顾者的建议,强调叙事疗法干预是减少适应不良的照顾自我叙述的负面影响的创新选择。