Pre-liminal |
(1) Pivotal event |
(a) Recognition of illness or health crisis in a “family” member (Insidious versus abrupt) |
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(2) Commitment to the care recipient |
(b) Dedication to a sick “family” member (obligation versus closeness/love) |
Liminal |
(3) Role ambiguity |
(c) Redefining relationship with care recipient (losing a partner versus gaining a role) |
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(d) Redefining relationships with others (being seen as a couple, reconstruct role in the family) |
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(e) Possible experience of stigma (perceptions of discrimination) |
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(4) Social changes |
(f) Taking on new responsibilities (new routines) |
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(g) Interfacing with health care system (alone or with assistance) |
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(h) Reduced participation in life (isolation) |
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(5) Uncertainty regarding future goals and aspirations |
(i) Unpredictable illness trajectory (i.e. treatment response, recovery, acute changes) |
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(j) Motivation for caregiving (self-efficacy/empowerment versus lack of enthusiasm) |
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(k) Uncertain prognosis (roller coaster of chronic illness versus death) |
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(6) Suffering as a way of life |
(l) Stress and burden of caring (emotional pain, grief, guilt that leads to negative adaptation) |
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(m) Makes life “sweeter”, when life is good (positive adaptation, hope, constructing a positive recovery for care recipient) |
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(n) Spirituality and self-reflection (finding peace) |
Post-liminal |
(7) Reincorporation and the new normal |
(o) Role delineation (can change again with institutionalization or death) |
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(p) Uncertainty may continue indefinitely (increases, stays the same, or decreases) |
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(q) Suffering may continue indefinitely (burden/stress versus growth/meaning/purpose and transcendence) |