Care Pairs: Exploring Relationships between Caregivers & Patients

Using interviews, researchers investigated how to maintain supportive relationships between older adults with multiple chronic conditions and their informal caregivers.

This study focused on relationships in which an older adult care recipient was managing multiple chronic conditions, was not cognitively impaired, and received care from an informal caregiver such as a relative or friend. The patient and caregiver of each dyad were interviewed together in the patient’s residence. Patients were asked about how they manage their chronic conditions and about their attitudes toward receiving care. Caregivers responded to their patient’s answers and explained their attitudes toward giving care.

These interviews revealed two general types of relationships: supportive relationships and conflicted relationships. Supportive relationships were characterized by mutual agreement and understanding between the patient and caregiver. For these relationships, it was important for dyads to not only agree on the level of involvement by the caregiver, but to have confidence in one another’s abilities to perform disease management tasks. It was also important for caregivers to understand the challenges patients face and acknowledge the care recipient’s efforts to reduce caregiver demands. Collaborative decision-making also helped dyads agree on treatment plans that took both individuals’ needs into account, including the employment of a paid caregiver or a move to assisted living if necessary.

Characteristics of conflicted relationships were centered around disagreement, distrust, and underappreciation. In these situations, patients often felt the caregiver was too involved, incapable of delivering appropriate care, and expected too much of the patient. Whereas caregivers did not have faith in the patient’s ability to manage their own conditions and felt underappreciated for their work. The addition of paid caregiving in these relationships often resulted from distrust and was used to reduce tension between the caregiver and patient.

Considering these results, health care providers should be aware of signs of conflicted relationships, such as distrust or disagreement in treatment plans. Caregiving is a stressful experience for everyone involved, so focusing on mutual understanding and appreciation may be helpful in not only reducing stress but in enhancing management of conditions.


Riffin C, Van Ness PH, Iannone L, and Fried T. Patient and caregiver perspectives on managing multiple health conditions. American Geriatrics Society (2018); 66(10): 1992-7.


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