title: Conceptual challenges in the study of caregiver-care recipient relationships.
abstract: BACKGROUND
  In the literature on family caregiving, care receiving and caregiving are generally treated as distinct constructs, suggesting that informal care and support flow in a unidirectional manner from caregiver to care recipient. Yet, informal care dynamics are fundamentally relational and often reciprocal, and caregiving roles can be complex and overlapping.
  
  
  OBJECTIVE
  To illustrate ways care dynamics may depart from traditional notions of dyadic unidirectional family caregiving and to stimulate a discussion of the implications of complex relational care dynamics for caregiving science.
  
  
  METHODS
  Exemplar cases of informal care dynamics were drawn from three ongoing and completed investigations involving persons with serious illness and their family caregivers. The selected cases provide examples of three unique, but not uncommon, care exchange patterns: (a) care dyads who are aging, are chronically ill, and who compensate for one another's deficits in reciprocal relationships; (b) patients who present with a constellation of family members and other informal caregivers, as opposed to one primary caregiver; and (c) family care chains whereby a given individual functions as a caregiver to one relative or friend and care recipient to another.
  
  
  CONCLUSIONS
  These cases illustrate such phenomena as multiple caregivers, shifting and shared caregiving roles, and care recipients as caregivers. As caregiving science enters a new era of complexity and maturity, there is a need for conceptual and methodological approaches that acknowledge, account for, and support the complex, web-like nature of family caregiving configurations. Research that contributes to, and is informed by, a broader understanding of the reality of family caregiving will yield findings that carry greater clinical relevance than has been possible previously.
authors.affiliation: Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261, USA. linglerjh@upmc.edu
authors.forename: Jennifer Hagerty
authors.initials: JH
authors.lastname: Lingler
authors.forename: Paula R
authors.initials: PR
authors.lastname: Sherwood
authors.forename: Margaret H
authors.initials: MH
authors.lastname: Crighton
authors.forename: Mi-Kyung
authors.initials: MK
authors.lastname: Song
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Happ
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural; D017028:Caregivers / Q000523:psychology*; D003299:Cooperative Behavior; D017281:Cost of Illness; D004645:Empathy; D005190:Family / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006701:Home Nursing / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D036301:Qualitative Research; D012380:Role; D012944:Social Support
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