'You've Got No Support': The Experiences of Older Male Caregivers When Their Partner Enters Residential Care

Spouses' Experiences of Emotional and Existential Support When Caring for a Frail Partner Late in Life

INTRODUCTION

The ability to care for a frail older partner late in life often entails the need for support and help from others, a need that sometimes can go unmet. Exploring spouses' views of emotional and existential support can guide further development of supportive structures, which in turn can promote family caregivers' existential health and well-being. Therefore, the aim of this study was to explore what spouses experience as supportive of their emotional and existential concerns when caring, or after having cared for, a frail partner late in life.

METHODS

The study was explorative and based on multistage focus group interviews with older spouses (n = 10) divided in two groups who met three times each. The data were analysed using conventional content analysis. The checklist 'Consolidated criteria for reporting qualitative research' (COREQ) was followed when presenting the study.

RESULTS

The spouses described the importance of an atmosphere in which being sad was allowed for as much time as needed; it was safe to share experiences together with others, they could receive compassion and comfort from others, and they were free to feel hope, let their previous life go and dare to think of their future.

CONCLUSION

Providing emotional and existential support creates an atmosphere that allows older spouses to reflect together with others, listening to their own and others' thoughts, and thus be able to put feelings and experiences into words. A suggestion for organising such support considers the physical, social, personal and spiritual dimensions of people's lifeworlds.

IMPLICATIONS FOR PRACTICE

Nursing interventions aimed at improving emotional and existential support for older spouses should primarily target transitional phases in life and focus on relational aspects.

Care partner experience with telepresence robots in long-term care during COVID-19 pandemic

Objective

As people living with dementia move into long-term care (LTC), their care partners face a difficult role change from primary caregiver to visitor, losing a significant degree of control and direct care involvement. The COVID-19 pandemic exacerbated these challenges with health risks, changing care home protocols, and government policies. To help address these challenges, this study aimed to investigate the experiences of care partners who used telepresence robots to maintain contact with and care for their loved ones during the pandemic.

Methods

This study was guided by the Collaborative Action Research (CAR) approach. Along with interdisciplinary researchers and trainees, our team included patient and family partners as co-researchers throughout the project. We conducted semi-structured interviews with 20 care partners who used the robots in five urban Canadian LTC homes between May 2021 and August 2023.

Results

Thematic analysis identified four key themes characterizing their experiences using the robot: (a) decreases care partner burden, (b) facilitates care partner-staff relationship, (c) creates relational autonomy, and (d) expands the scope of what is possible.

Conclusion

The results of the study suggest that telepresence robots can play a useful role in enhancing the caregiving experience for informal care partners in multifaceted ways. Care partners reported positive benefits of having the robot assist their virtual visits. However, further research is needed to determine the sustainability of robot implementation among diverse geographic regions and care home compositions.

Accelerated Resolution Therapy for Early Maladaptive Grief Study Protocol

The objective of this manuscript is to present the protocol of a study aiming to test the effects of Accelerated Resolution Therapy® (ART) on pre-loss grief and prolonged grief among older adult family caregivers. This study also aims to better understand predictors of response to ART®, and cognitive processes that occur among grieving individuals following ART®.

DESIGN

The study is a double-blinded, randomized clinical trial.

SETTING

This study takes place at both inpatient and outpatient palliative care and hospice programs at two Mayo Clinic sites.

PARTICIPANTS

Participants include older adult (≥ 60 years) immediate family members who are primary caregivers of someone with an advanced illness and life expectancy of less than 12 months.

INTERVENTION

Participants are randomized to either the ART® intervention group or the attention control group. In the ART® intervention, caregivers engage in imaginal exposure, lateral eye movements, and imagery rescripting via 4 sessions lasting 1-1.5 hours each. The attention control group receives a standard social work intervention, including education, resources, and active listening, which is matched for time and attention. Both interventions will longitudinally follow caregivers from active caregiving into bereavement.

OUTCOMES MEASURED

The primary outcomes of pre-loss grief and prolonged grief will be measured with the Pre-Loss Grief 12 item (PG-12-R) before the care recipient's death, and with the Prolonged Grief-13 (PG-13-R) afterwards.

The role of the social environment on dementia caregivers' pre-death grief: A mixed- methods systematic review

This systematic review examined the role of social environment in pre-death grief experiences of dementia caregivers. Ninety-three Chinese and English articles were included from a comprehensive search of empirical studies using nine databases. Six social environment domains were generated: the person with dementia, dyadic relationship, family members and the wider community, health and social care services, place of care, and social-cultural contexts. A complex interplay between caregivers and their social environments that aggravate and attenuate pre-death grief experiences is evident. Research has focused mainly on the effects of people with dementia and dyadic relationships and has paid modest attention to the effects of family, relatives, and health and social care services. Caregivers' experiences with their friends, fellow caregivers, the wider community, and social-cultural norms are influential but understudied. Future research could adopt a systems thinking approach with sociological perspectives to generate a comprehensive and nuanced understanding of pre-death grief experiences.

The experience of entering residential aged care: The views of residents, family members and staff-an Appreciative Inquiry

OBJECTIVES

To understand resident, family and staff perspectives of older people's transition to residential aged care and initiatives that support this transition.

METHODS

A qualitative Appreciative Inquiry was undertaken with residents, family members and staff in residential aged care. It included semistructured interviews (n = 40), three focus groups (n = 17) and an organisational summit (n = 72). Each stage sought to build on the previous one, deepening understanding of the issues experienced and identifying positive strategies for change. Data were analysed thematically using framework analysis.

RESULTS

The transition experience was characterised by grief and guilt felt by family members and the challenges they faced in participating in a decision to admit a relative to residential aged care. Residents found the transition challenging but stressed the need to adjust to the situation. Family members struggled with trusting others to provide appropriate care and both residents and relatives reported challenges in communicating with staff. Initiatives were recommended by the organisational summit to assist in the transition to residential aged care. These included developing a service navigator role, co-designing new systems and resources with residents and relatives, and ensuring more consistent staffing.

CONCLUSIONS

Improved communication strategies and resources are needed to support the resident's identity, build trust in the organisation and support transition to residential aged care. Staff should continue to value the contribution family members play in the life of the resident and the culture of the aged care community.

Self-Help Groups within Nursing Homes: The Experiences of Family Caregivers in Northeastern Italy

Older adults and their family caregivers experience nursing home placement as a particularly critical time of life. The present study explored the experiences of family caregivers of nursing home residents taking part in a self-help group for caregivers. The sample was composed of six caregivers of older adults residing in a nursing home in the northeast of Italy. The respondents, aged 57 to 71, were part of a self-help group set up by the facility between 2017 and 2019. In this qualitative methodological design, we applied the principles of interpretative phenomenological analysis. Two main themes emerged from the interviews: (a) challenges in constructing experience as caregivers; and (b) shared experiences as stabilizing tools. The findings highlight the importance of self-help groups in fostering the well-being of caregivers of older adults living in nursing homes. The self-help group enabled caregivers to deal with nursing home placement and the sense of guilt deriving from it; understand and accept the disabilities affecting their loved one; comprehend the experience of ambiguous loss; and learn to listen to their own needs, thus avoiding physical and emotional exhaustion.