PURPOSE: To describe the ways in which caregivers (CGs) and their care receivers (CRs) negotiate the dyadic rules that influence how the care experience "fits into" their lives and to suggest theory based on the data. DESIGN: This qualitative study was part of a larger, NIH-funded study of 60 care dyads and their use of respite care in the Midwestern United States. The sample for this analysis included 60 informal CGs and CRs in their home settings. Data collection for the larger study began in 1994 and continued through 1998. METHODS: CGs and CRs were interviewed in their homes with one researcher interviewing the CG regarding the care experience while another researcher interviewed the CR. Qualitative content analysis was used to analyze the data. FINDINGS: The theory of CG and CR dyadic identity development, formulated in this study, indicates that a mutually agreed-upon care dyadic identity is developed when both parties negotiate a set of rules about their conduct together in the caregiving and care receiving relationship. Failure to agree on these dyadic rules may result in strain in the care process. Three archetypes of dyadic relationships were identified, based on the degree of immersion into a dyadic identity: (a) complete and mutually accepted immersion of an identity into the care process by both parties, (b) retention of personal identities while also accepting the caregiving or care-receiving roles, and (c) rejection of the roles by one or both parties. CONCLUSIONS: Negotiation was important in these dyadic care relationships, and thus attention to assisting CGs and CRs to develop negotiation skills is needed. More research is needed to substantiate and expand this theory of CG and CR dyadic identity development, and to examine linkages between negotiated processes and outcomes.
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