Background: Most research has viewed social support as unconditionally positive, but negative interactions such as conflict and dissatisfaction with support are present in caregivers' relationships and have a negative impact on their health.
Purpose: The purpose of this study was to describe women's experience of nonsupport and identify the types of nonsupport present in their relationships with family and friends while caring for a family member with dementia.
Ethics: The study received ethical clearance from the university ethics review committee.
Methods: The theoretical perspective of symbolic interaction guided this longitudinal qualitative research. Included in the study were 25 in-depth interviews with a group of eight women selected from a larger study of family caregiving because they described nonsupport in their relationships with family and friends.
Findings: The women experienced two types of problems in realizing support. Unmet expectations for support was the most pervasive difficulty and included unfulfilled or missing offers of assistance, unmet expectations for social interaction, mismatched aid, or incompetence on the part of the potential helper. Negative interactions, particularly with kin, took several forms: disparaging comments that belittled a caregiver's experience, conflict between the caregiver and others in their appraisal of the care recipient's health status, criticism of the caregiver's decisions in caring for the care recipient, and spillover from longstanding conflict and issues in the family history.
Limitations: This study was limited to women caring for an adult relative with dementia and included a relatively homogeneous sample of English speaking, North American women of European descent.
Conclusions: This study highlighted the utility of identity theory to explain the impact of unmet expectations for support and recognized disparaging comments as a form of nonsupportive interactions.