William E Haley

University of South Florida | USF · School of Aging Studies

A stress and coping model was used to study predictors of individual differences in caregiver adaptation. A total of 54 family caregivers of elderly dementia patients completed interviews and questionnaires assessing the severity of patient impairment and caregiving stressors; caregiver appraisals, coping responses, and social support and activity;...

Considerable research and public discourse on family caregiving portrays it as a stressful and burdensome experience with serious negative health consequences. A landmark study by Schulz and Beach that reported higher mortality rates for strained spouse caregivers has been widely cited as evidence for the physical health risks of caregiving and is...

Significance Family caregiving has been proposed as a type of chronic stress that may lead to health risks through increased systemic inflammation. However, most previous studies of caregiving and inflammation have used small convenience samples and compared caregivers with poorly characterized noncaregiving controls. In this prospective investigat...

BACKGROUND/OBJECTIVES Few studies have rigorously examined the magnitude of changes in well‐being after a transition into sustained and substantial caregiving, especially in population‐based studies, compared with matched noncaregiving controls. DESIGN We identified individuals from a national epidemiological investigation who transitioned into ca...

Background Stroke commonly leads to disability and depression. Social connection and engagement can be protective against functional decline and depression in the general population. We investigated the effects of social connection and engagement on trajectories of function and depressive symptoms in stroke. Methods Participants were 898 individua...

General and workplace discrimination have been studied extensively in the general population, with Black/AA individuals consistently reporting more discrimination than White individuals. However, the intersection of race, employment, and caregiving has rarely been studied. We applied stress process and minority stress theories to address these issu...

Recent studies have shown that social connection and engagement can serve as protective factors against depression. Buffering effects are sometimes found, suggesting greater protective effects for people experiencing high levels of stress. We examined whether social connection and engagement had a greater protective effect for depressive symptoms i...

While hearing loss and dementia are highly concurrent conditions, there is a lack of studies examining its impact on dementia caregiving. Hearing loss has been identified as an unmet need among older adults living with dementia, as it contributes to communication challenges. Using Round 12 (2022) of the linked National Health and Aging Trends Study...

Advance care planning (ACP) is a necessary first step to meeting care preferences at the end of life and an important aspect of palliative care provision. ACP in assisted living (AL) is lacking for older adults living with dementia. A palliative care educational intervention found that only 12% of residents in AL living with dementia at baseline ha...

The University of South Florida is a public research university in Tampa, FL with approximately 50,000 students across three campuses. The School of Aging Studies is one of several departments throughout the university that offers interdisciplinary undergraduate degree programs. However, like many gerontology programs across the country, the School...

Family caregiving may affect purpose in life, defined as the sense that life has meaning and intentionality. Few studies have compared caregivers to non-caregivers or examined the characteristics of caregivers associated with purpose in life. Using data from the Caregiving Transitions Study ( n = 486), we conducted multiple linear regression analys...

Objectives We examined how the association between cognitive performance and cognitive health appraisal would be moderated by vision and/or hearing impairment. Methods Data were collected from 315 older Korean–American residents in subsidized senior housing in Los Angeles ( M age = 79.4 years). Linear regression models examined the direct and inte...

Background The Framework for Reporting Adaptations and Modifications–Enhanced (FRAME) is a tool that systematically guides decision-making and reporting of adaptations made to evidence-based interventions. Using FRAME, we documented the process and outcomes of adapting the Savvy Caregiver Program (SCP) for Korean American dementia caregivers. Meth...

Dementia caregivers in ethnic minority communities have often been excluded from access to caregiver interventions and their benefits because of linguistic and cultural barriers. In pursuit of equal treatments for all, it is imperative to make evidence-based interventions available and accessible to ethnic minority dementia caregivers, and linguist...

Advance care planning among persons with dementia, their family members and staff in assisted living (AL) communities can facilitate meeting care preferences. In a recent NIH Stage 1a feasibility cluster randomized trial in AL communities (N=118 residents with dementia, 23 staff; k=10 ALs). The Palliative Care Education in Assisted Living for Demen...

Individuals’ health and well-being are often shaped by significant others in their lives in that spousal relationships are particularly important. In dyadic studies among older couples, few studies have examined cognitive health as an outcome variable. Considering the lack of couple research on cognition especially among older immigrant population,...

Background Hearing loss and hearing health are underrecognized public health urgencies affecting over 70% of adults aged 70 and older. Untreated hearing loss has its association with higher prevalence of adverse physical and cognitive health outcomes. Current literature reveals racial disparities in hearing aid utilization. Based on the Health Beli...

The University of South Florida has more than 50,000 students. The School of Aging Studies first offered an MA in Gerontology in 1967. We currently offer many undergraduate General Education courses, two undergraduate majors, online graduate certificate and master’s programs, and a PhD in Aging Studies. Accountability and addressing university metr...

This study investigated stressors and strains, resources, and well-being among Black working caregivers (BWC) and White working caregivers (WWC) who participated in the Midlife in the United States study (Black: n = 49, White: n = 250). Comparisons were made between BWC and WWC for primary caregiving stressors, secondary strains, resources, and wel...

This study examined how different living/eating arrangements were associated with loneliness and depressive symptoms among older Korean immigrants. We examined gender differences considering: (1) patterns of living/eating arrangements and their relations with loneliness and mental distress and (2) indirect effect of living/eating arrangements on me...

Chronic stress is associated with negative health outcomes, including poorer cognition. Some studies found stress from caregiving associated with worse cognitive functioning; however, findings are mixed. The present study examined the relationship between caregiving, caregiving strain, and cognitive functioning. We identified participants in the Re...

Background: Stroke commonly leads to disability and depression. Social connection and engagement can be protective against functional decline and depression in the general population. We investigated the effects of social connection and engagement on trajectories of function and depressive symptoms in stroke. Methods: This is a longitudinal stud...

Background and objectives: Disaster preparedness is an urgent concern, particularly for caregivers of persons with dementia. Developing and executing plans for oneself and another person who needs care can be difficult when the care recipient is cognitively impaired. We sought to better understand caregivers' disaster preparedness for the purpose...

Introduction Caregivers often exhibit unhealthy/dampened cortisol profiles and sleep problems due to high stress. Grandparent caregivers (GP-CG) may be particularly vulnerable with caregiving burden and age-related changes in sleep/health. Yet there is lack of empirical evidence examining baseline cortisol and reactivity in GP-CG and how they are a...

Background and objectives: Alzheimer's disease or related dementia are a major cause of death in the United States. While effective interventions have been developed to deliver palliative care to nursing home residents with ADRD, little work has identified effective interventions to reach assisted living (AL) residents with dementia. Research des...

Building on the importance of family and friends as sources of social connectedness in later years of life, we conducted a contextual examination of their independent and interactive roles in predicting mental health, using a compensatory social convoy model. In a sample of older Korean Americans, we anticipated that friend networks would be a more...

There is a need for improved communication in assisted living communities (ALCs) for staff and family caregivers of persons with dementia. This study is a cluster randomized trial in 10 ALCs (N=23 nurses and administrators; N= 122 residents with dementia) of a PC education (PCEAL) program for dementia care providers facilitated by hospice nurse edu...

Of the more than 800,000 assisted living (AL) residents in the U.S. approximately 25% remain until the end of life and can benefit from palliative care (PC) and hospice care. Although the AL population is the fasting-growing segment of hospice care, increasing by 40% in the past five years, ALs still have special challenges in providing quality end...

Emergency preparedness for disasters such as hurricanes is critical. A common feature of disasters is their disruption of daily life, which is magnified for persons living with Alzheimer’s disease and related dementias (ADRD). It is critically important to understand more about disaster preparedness for those with ADRD and the informal caregivers r...

Background Limited English proficiency (LEP) of dementia caregivers poses a critical barrier to these caregivers’ access to evidence-based interventions. In an effort to make such interventions available and accessible to dementia caregivers with LEP, in the present study we use Barrera and colleagues’ (2011) three-step model of cultural adaptation...

Objective Project VITAL At Home aimed to combat social isolation and loneliness in family caregivers of people with dementia through purposeful engagement and connection. This project examined the effects of technology on caregiver loneliness and well-being, as well as their technology experiences, during the COVID-19 pandemic. Methods Family care...

Objectives We identified types of family relationships of older Korean Americans and examined how the mental health benefit of friend networks might be conditioned by family type. Methods Data were from 2,070 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants aged 60 and older (Mage = 73.3, SD = 8.01). T...

Telomere length (TL) is widely studied as a possible biomarker for stress-related cellular aging and decreased longevity. There have been conflicting findings about the relationship between family caregiving stress and TL. Several initial cross-sectional studies have found associations between longer duration of caregiving or perceived stressfulnes...

Objectives Higher inflammation has been linked to poor physical and mental health outcomes, and mortality, but few studies have rigorously examined whether changes in perceived stress and depressive symptoms are associated with increased inflammation within family caregivers and non-caregivers in a longitudinal design. Design Longitudinal Study....

Circulating levels of inflammatory biomarkers may be influenced by chronic psychological stressors such as those experienced by family caregivers. However, previous studies have found mostly small and inconsistent differences between caregivers and control samples on individual measures of systemic inflammation. Latent variables of inflammation wer...

Objectives The spousal relationship is one of the most important social contexts in old age and the loss of a spouse/partner is associated with stress and cognitive decline. In the present study, we examined whether social relationships can buffer potential negative effects of spousal loss on cognition. We examined the role of social network, socia...

Positive aspects of caregiving (PAC) are positive appraisals that caregivers report about their role such as feeling appreciated or important, and may increase with caregiver adaptation over time. We aimed to examine differences in PAC by caregiving duration and social engagement, controlling for measures of distress. A total of 283 African America...

An increase in life expectancy and an aging population has resulted in increased risks and prevalence of age-related diseases. Previous studies have shown that factors, such as chronic stress, are associated with shorter telomere length. When telomeres become critically short, cells enter a state of senescence, which is a hallmark of aging. Several...

This study examined possible effects of COVID-19 on students’ appraisals, coping, and responses to completing advance directives (ADs). We used the transactional model of stress and coping to explore 93 undergraduate students’ responses to an AD assignment completed in an undergraduate course during COVID-19. Students watched a recorded lecture, re...

Structural isolation such as living alone poses a mental health risk in diverse groups of older adults, including older immigrants. Given that those living with others might also be disengaged, the present investigation included eating alone as another source of isolation and examined the impact of the combination of living and eating alone. The pr...

Objectives The influence of childhood sexual abuse (CSA) may be seen immediately or across the life course. CSA is also associated with increased HIV-risk behavior, and greater likelihood of an HIV/STI diagnosis. The aim of this study was to explore the perspectives of CSA among older adults living with HIV. Methods Twenty-four adults living with...

Objectives Positive caregiver adaptation over time may be associated with reports of positive aspects of caregiving (PAC). We examined differences in PAC by caregiving duration and social engagement, controlling for measures of distress. Methods Participants included 283 African American or White caregivers from the Caregiving Transitions Study wi...

Objectives : Responding to racial/ethnic disparities in dementia diagnosis and care, we examined the role of race/ethnicity in the correspondence between subjective and objective ratings of cognitive impairment. Our examination focused on the two types of discordance: (1) positive ratings in the presence of cognitive impairment and (2) negative rat...

Objective Studies investigating hearing interventions under-utilise and under-report treatment fidelity planning, implementation, and assessment. This represents a critical gap in the field that has the potential to impede advancements in the successful dissemination and implementation of interventions. Thus, our objective was to describe treatment...

Nativity status is related to stress, health and well-being, but the literature is scant concerning whether these effects differ by race/ethnicity for older adults. We examined direct and indirect effects of nativity status on stress, coping resources, health, and depression/anxiety for the three largest racial/ethnic groups [Non-Hispanic White (NH...

Background and objectives: Positive associations between social connection/engagement and cognitive function are well documented. However, little is known about whether social connection/engagement can buffer the impact of serious brain injury such as stroke on cognitive functioning. Research design and methods: Participants were 898 individuals...

Guided by stress and coping theory, qualitative content analysis was used to examine student written assignment responses (N = 100) about the importance of and student preparedness for completing their own advance directive (AD). Codes represented primary and secondary appraisals, coping, and outcomes. Primary appraisals were 47% benign, 47% stress...

Objectives:We aimed to compare incident family caregivers and matched controls on change in social network variables and satisfaction with social activities. Methods: A total of 479 participants from the Caregiving Transitions Study were included in the analysis, 244 (50.9%) of whom began substantial and sustained caregiving between baseline and fo...

Caregiving is often considered stressful, even more so if the care recipient has been diagnosed with dementia. The current study examines the rate of cognitive decline of spousal caregivers of persons with dementia (CG-D) when compared to spousal caregivers of persons without dementia (CG) before and after the death of the care recipient. Health an...

Stress process models propose individual differences in caregiver outcomes depending on background characteristics and primary caregiving stressors, and resilience factors including stress appraisals, and internal and external resources. This paper will examine individual differences in the effects of the transition to caregiving on indicators of w...

Participants in the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) study were asked about family caregiving responsibilities at enrollment (2003-2007). Among the 88% of participants who were not caregivers at enrollment, 1,229 reported becoming caregivers before a follow-up interview 12 years later. The Caregiving Transi...

The REGARDS study has provided a unique opportunity to study both disease-specific (stroke) and broader samples of family caregivers, and to examine the effect of transitions to caregiving over time. Using REGARDS has afforded many advantages over conventional caregiving research, including the availability of biomarker and mortality data, a large...

Stroke is the second leading cause of death globally among people aged 60+, yet only 9% of hospice decedents have a primary diagnosis of stroke and little research has examined their end-of-life care experiences. Late referral and admission to hospice is an indicator of poor end of-life-care quality. This project identified factors predicting short...

Persons with dementia (PWD) are increasingly cared for in assisted living (AL) settings with an annual mortality rate of close to 20%. Palliative care (PC) for PWD in ALs can improve end-of-life care. From May, 2019 to February, 2020 a 4-week PC education in AL (PCEAL) program for nurses who provide care to PWD, facilitated by hospice nurses in Flo...

Background and Objectives Despite growing diversity among the aging population and extensive previous research on racial/ethnic minority caregivers, little research has been conducted on the potentially unique experiences and outcomes of informal caregivers of foreign-born care recipients. Using nationally representative data and the Stress Process...

Background and aim Providing care to an older adult with a disability has been associated with increased risk to the caregiver’s health, but most previous studies of caregiving and health compare persons who are already caregivers with poorly matched non-caregiving controls and are often based on convenience samples. In this report, we describe the...

Background and objectives: Few population-based studies have directly compared caregivers of persons with dementia to caregivers of persons with other disabilities (non-dementia caregivers). We enrolled dementia and non-dementia caregivers who were providing substantial and sustained care and compared these groups on measures of caregiver stressor...

Objective: We examined whether older adults’ health and well-being during their final year of life predicts end-of-life (EOL) quality of life (QOL) and quality of care (QOC). Methods: Using data from deceased participants (n = 1125) in the 2011–2015 National Health and Aging Trends Study, we performed latent class analysis to identify profiles of h...

Introduction Informal caregiving has been linked to higher perceived stress. Caregiving stress may be associated with poor sleep. Studies report low sleep quality among caregivers, however, little is known about whether informal caregivers have poorer sleep health than non-caregivers across multiple sleep dimensions. Less is known about whether pot...

Objectives: Compare care demands, strain, and health across 912 primary and secondary caregivers of parents, other family, and friends aged 50 and older. Methods: Data came from the nationally representative Caregiving in the U.S. 2015 data set. Two by three factorial ANOVAs and binary logistic regression examined the effects of primary caregiver s...

Background and objectives: Studies comparing racial/ethnic differences on measures of psychological and physical well-being for dementia caregivers have reported differences between minority and white caregivers. Recruitment methods often differ for minority and white participants due to enrollment targets and may lead to biased comparisons, espec...

Consistent with the long history within Psychology and Aging of publishing high impact articles on family caregiving, the current Special Section includes 5 articles that provide important advances, in knowledge and in methodological sophistication, to the study of cognitive difficulty, impairment and family caregiving. One study used daily diary d...

Background and Purpose— Persistent depression after ischemic stroke is common in stroke survivors and may be even higher in family caregivers, but few studies have examined depressive symptom levels and their predictors in patient and caregiver groups simultaneously. Methods— Stroke survivors and their family caregivers (205 dyads) were enrolled f...

Although prior researchers have decried the lack of research on racial/ethnic minority older adults, they have been less vocal about the gaps in research concerning the ways in which immigrant status and race/ethnicity affect their well-being. Thus, we examined the role of immigrant status on the stress coping process by race/ethnicity using the Tr...

Among many possible factors that are associated with increased risk for dementia, one important topic is the role of race and ethnicity. However, previous studies did not examine rates separately by racial/ethnic groups and by nativity status, and little of this research comes from nationally representative data. The current study investigated diff...

Current research must utilize nationally-representative samples of older adults and their family caregivers to accurately reflect the growing diversity of the United States. This study aims to use a stress process model to examine potential racial differences in caregiving in a population-based sample of 844 White and 389 Black family caregivers in...

A common assignment in undergraduate aging courses requires students to consider or complete advance care plans for themselves. Due to the sensitive nature of this topic, it is important to consider student appraisals of such assignments. Using the transactional model of stress and coping, the current study used content analysis to examine student...

Studies comparing racial/ethnic differences on psychological and physical outcomes of dementia caregivers have often reported differences in well-being for minority groups compared to Whites. However, due to issues with enrolling minorities into studies, recruitment methods often differ for minority and White participants and may lead to biased com...

Dementia is one of the most common reasons for needing a caregiver (CG). Few studies have compared dementia and non-dementia caregivers who have transitioned into family caregiving roles. Participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who transitioned into a significant caregiving role were recruited to...

Despite the well-documented clinical and public health impacts of palliative care on older patients’ end of life experiences, racial and ethnic disparities in palliative care use still remain. However, empirical evidence on the sources of disparities is lacking, particularly for Asian Americans. Given the rapid growth and increasing cultural divers...

Family caregiving is often characterized as a chronically stressful situation, and stress process models have been the dominant conceptual foundation underlying caregiving studies for decades. Recently, this perspective has been augmented with more positive views that emphasize potentially healthy and prosocial aspects of caregiving. Replicated fin...

Older adults are often involved in prosocial behaviors including volunteering, informal assistance to family members, or extensive caregiving for family with chronic disease or disability. Many studies find that volunteering and providing informal support can enhance health and well-being, but family caregiving has generally been characterized as b...

Purpose: To examine the roles of both patient symptoms, and subjective appraisals of stress (self-efficacy, symptom barriers, symptom distress), in understanding well-being (anxiety, depression, cancer-specific quality of life, mental health quality of life, and physical health quality of life) in breast cancer patients. Methods: We examined data...

Background and Purpose— Stroke is the leading cause of serious, long-term disability in the United States, and the number of stroke survivors is projected to rise. Physical functioning status may be compromised in survivors living in low socioeconomic status environments in comparison to higher socioeconomic status environments. Higher socioeconomi...

Background: Caregivers (CGs) are critical in helping stroke survivors (SSs) retain function and receive adequate healthcare. Objectives: We aimed to identify the activities that CGs are engaged in over the course of stroke care from open-ended SS interviews and explore the association between CG engagement and SS healthcare utilization post-stroke....

Witnessing end-of-life suffering of loved ones is an underappreciated stressor that may affect caregiver bereavement. We interviewed 61 spousal caregivers of hospice patients who died within the past 6–18 months. Higher rumination about suffering and lower feelings of relief was related to poorer well-being. Rumination by caregivers about end-of-li...

Objective: To examine differences between White and African American caregivers in strain, health, and service use in a population-based sample of informal caregivers for older adults. We also assessed whether relationship type (parent, other family, friend) and dementia care status (yes or no) were moderators of any racial differences. Method: We...

The purpose of this study was to determine if pharmacists believe their role in health care is expanding to provide lifestyle modification counseling to patients with hypertension and/or coronary heart disease (CHD). Preparedness and confidence were measured, as well as pharmacists’ perceived efficacy. Major barriers to this type of patient-pharmac...