Caregiver stress: a failed negotiation? A qualitative study in South West France

The purpose of this work is to analyze the various negotiations involved in setting up and developing a caregiving relationship with a disabled elderly person, to understand the processes inducing caregiver stress. Within the conceptual framework defined by the paradigm of negotiation, this study uses the theoretical contributions of the parallelist theory and the theory of the gift. It is based on a qualitative inquiry including fifty-four caregivers conducted in Toulouse (South West France). The analysis focuses on two undersystems of the caregiver's relationships: 1) the caregiver/cared-for's relationship, which is characterized by the establishment and maintenance of a "tacit contract" and 2) the relationships with other eligible caregivers, which are marked by the "designation" of the principal caregiver. This analysis shows that a failure in the negotiation process can induce a designation and/or a weak tacit contract-the result of which is the caregiver's expression of stress. This expression is closely linked to the caregiver's perception of a negative balance in his/her exchanges with the partners. This study should help break away from the one-way arrow model currently dominating the field of caregiver stress research.