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Gao X, Tang Y. Association Between Community Elderly Care Services and the Physical and Emotional Burden of Family Caregivers of Older Adults: Evidence from Beijing, China. Int J Aging Hum Dev 2024; 99:247-262. [PMID: 38460958 DOI: 10.1177/00914150241238140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
The rate of usage of community elderly care services in China is low, and past studies about the effects of these services on caregiver burden domestically are few. This study used a large sample of Beijing census data (n = 55,634) to examine the impact of these services on caregiver burden. Logistic regression and propensity score matching were used to estimate the effects. The results showed that meal assistance, respite care, and spiritual comfort are all significantly associated with a lower likelihood of perceived emotional burden among caregivers, while only respite care is very significantly associated with a lower likelihood of feeling physically burdened. However, the effects of these services on caregiver burden also depend on the activities of daily living performance and location of residence of the care recipients. The practical implications for policy makers are discussed.
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Affiliation(s)
- Xiuwen Gao
- Postdoctoral Research Station of Theoretical Economics, Shenzhen University, China
| | - Yong Tang
- School of Government, Shenzhen University, China
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Gao X, Wang K, Sun F, De Fries CM, Xu F, Huang P, Feng Y. Associates of Perceived Quality of Life in Chinese Older Adults Living with Cognitive Impairment. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:368-380. [PMID: 35855574 DOI: 10.1080/01634372.2022.2103865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/17/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study is to examine perceived quality of life in Chinese older adults living with cognitive impairment and explore its associations with caregivers' characteristics. Questionnaires were administered in person to 271 caregiver-care recipient dyads from urban communities in mainland China in 2019. We used the 40-item Alzheimer's Disease-related Quality of Life tool and asked caregiver respondents to indicate care recipients' life conditions. The questionnaire asked caregivers about their sociodemographic characteristics, levels of informal social support, caregiver burden, and depressive symptoms. Caregivers' higher levels of caregiver burden (β = > -0.19, p < .01) and depressive symptoms (β = > -0.19, p < .01) amongst caregivers were significantly associated with lower quality of life among care recipients. Informal support from relatives and friends to caregivers did not significantly affect quality of life of care recipients. The results suggested that reducing caregivers' burden and depressive symptoms are essential to promote quality of life of care recipients. Formal support from health professionals, service organizations, and communities are urgently called to promote the wellbeing of Chinese families affected by cognitive impairment.
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Affiliation(s)
- Xiang Gao
- School of Sociology, Huazhong University of Science and Technology, Wuhan, China
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Carson M De Fries
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Fang Xu
- Department of internal medicine, Huazhong University of Science and Technology Hospital, Wuhan, Hubei, China
| | - Peijun Huang
- School of Sociology, Huazhong University of Science and Technology, Wuhan, China
| | - Yali Feng
- University Library, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Ris I, Volken T, Schnepp W, Mahrer-Imhof R. Exploring Factors Associated With Family Caregivers' Preparedness to Care for an Older Family Member Together With Home Care Nurses: An Analysis in a Swiss Urban Area. J Prim Care Community Health 2022; 13:21501319221103961. [PMID: 35670066 PMCID: PMC9178975 DOI: 10.1177/21501319221103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Home-dwelling older people with chronic diseases often need the support of informal and formal caregivers in order to continue living at home. Family members, however, need to be willing and prepared for caregiving together with home care nurses. Objectives: The purpose of this study was to explore factors associated with family caregivers’ preparedness to care for older home-dwelling adults who also receive home care nursing services. Methods: For this cross-sectional correlational study, a structured questionnaire was sent to family caregivers of adults aged 65 years or older receiving services from a community care agency. A total of 243 participants returned the questionnaire, of which 199 could be analyzed. Results: The stepwise backward regression model explained 29.1% of the variance of family caregivers’ preparedness. Mutuality was the most strongly associated factor with family caregivers’ preparedness whereas professional involvement of family caregiver in care process was important as well. Care intensity showed no significant impact. Conclusion: Nurses should support the whole family emotionally, and appreciate, admire, reinforce, and respect the caregivers’ situation. Home care nurses need to invest in helping families to find solutions, to strengthen their relationships between family members and the older person dwelling at home.
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Affiliation(s)
- Irène Ris
- ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Winterthur Schweiz, Switzerland.,Universität Witten/Herdecke, Fakultät für Gesundheit, Witten, Deutschland
| | - Thomas Volken
- ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Winterthur Schweiz, Switzerland
| | - Wilfried Schnepp
- Universität Witten/Herdecke, Fakultät für Gesundheit, Witten, Deutschland
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Jite IE, Adetunji AA, Folasire AM, Akinyemi JO, Bello S. Caregiver burden and associated factors amongst carers of women with advanced breast cancer attending a radiation oncology clinic in Nigeria. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 34212738 PMCID: PMC8252173 DOI: 10.4102/phcfm.v13i1.2812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND The responsibility of caring for patients with advanced cancer in sub-Saharan Africa is mostly shouldered by family members because of paucity of institutional facilities. There is a growing concern that the number of women needing treatment for advanced breast cancer is rising at an unprecedented rate in Nigeria. AIM To assess the caregiver burden and its associated factors amongst family caregivers of women with advanced breast cancer. SETTING The study was conducted at the radiation oncology clinic of the University College Hospital, Ibadan, Nigeria. METHODS A cross-sectional descriptive study was conducted amongst 157 eligible family caregivers of women with advanced breast cancer. The family caregivers completed an interviewer-administered questionnaire, which included the socio-demographic data, the caregiving process and the Zarit Burden Interview (ZBI). Logistic regression was used to identify factors, and ethical approval was obtained. RESULTS Over half (53%) of the respondents were males with spousal caregivers dominantly constituting 27.4% of all respondents, closely followed by daughters (25.5%) of the care recipients. The mean ZBI score was 29.84 ± 13.9. Most (72%) of the caregivers experienced burden. Factors associated with caregiver burden were previous hospitalisation of the care recipient (odds ratio [OR] = 3.74, confidence interval [CI]: 1.67 to 8.38) and perceived dysfunction in patients activities of daily living (OR = 2.57, CI: 1.14 to 5.78). CONCLUSION Family caregivers of women with advanced breast cancer experience burden of care. Recognition of this vulnerable population and the care recipient as a dyad is a sine qua non in mitigating the burden associated with their caregiving role.
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Fleming V, Litzelman K. Caregiver resource utilization: Intellectual and development disability and dementia. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1468-1476. [PMID: 34124823 DOI: 10.1111/jar.12889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/03/2021] [Accepted: 04/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities and their families have high need for support services. This study assessed resource utilization among caregivers of intellectual and developmental disabilities and other conditions. METHODS We assessed 366 caregivers of adults with intellectual and developmental disabilities, dementia or other conditions Regressions assessed group differences in number of agency contacts and frequency of service use. A secondary analysis assessed reasons for underutilization of services. RESULTS Caregivers of individuals with dementia contacted twice as many agencies as other caregivers and were more likely to report using suggested services. Agency contact and service utilization were similar among caregivers of adults with intellectual and developmental disabilities compared to other caregivers. Caregivers of adults with intellectual and developmental indicated that suggested services were unavailable to them. CONCLUSION The findings of this study shed light on challenges with access to and utilization of support services.
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Affiliation(s)
- Victoria Fleming
- Department of Human Development & Family Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - Kristin Litzelman
- Department of Human Development & Family Studies, University of Wisconsin-Madison, Madison, WI, USA
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Clarkson P, Challis D, Hughes J, Roe B, Davies L, Russell I, Orrell M, Poland F, Jolley D, Kapur N, Robinson C, Chester H, Davies S, Sutcliffe C, Peconi J, Pitts R, Fegan G, Islam S, Gillan V, Entwistle C, Beresford R, Abendstern M, Giebel C, Ahmed S, Jasper R, Usman A, Malik B, Hayhurst K. Components, impacts and costs of dementia home support: a research programme including the DESCANT RCT. PROGRAMME GRANTS FOR APPLIED RESEARCH 2021. [DOI: 10.3310/pgfar09060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background
Over half of people with dementia live at home. We know little about what home support could be clinically effective or cost-effective in enabling them to live well.
Objectives
We aimed to (1) review evidence for components of home support, identify their presence in the literature and in services in England, and develop an appropriate economic model; (2) develop and test a practical memory support package in early-stage dementia, test the clinical effectiveness and cost-effectiveness of routine home support in later-stage dementia and design a toolkit based on this evidence; and (3) elicit the preferences of staff, carers and people with dementia for home support inputs and packages, and evaluate the cost-effectiveness of these approaches in early- and later-stage dementia.
Design
We undertook (1) an evidence synthesis, national surveys on the NHS and social care and an economic review; (2) a multicentre pragmatic randomised trial [Dementia Early Stage Cognitive Aids New Trial (DESCANT)] to estimate the clinical effectiveness and cost-effectiveness of providing memory aids and guidance to people with early-stage dementia (the DESCANT intervention), alongside process evaluation and qualitative analysis, an observational study of existing care packages in later-stage dementia along with qualitative analysis, and toolkit development to summarise this evidence; and (3) consultation with experts, staff and carers to explore the balance between informal and paid home support using case vignettes, discrete choice experiments to explore the preferences of people with dementia and carers between home support packages in early- and later-stage dementia, and cost–utility analysis building on trial and observational study.
Setting
The national surveys described Community Mental Health Teams, memory clinics and social care services across England. Recruitment to the trial was through memory services in nine NHS trusts in England and one health board in Wales. Recruitment to the observational study was through social services in 17 local authorities in England. Recruitment for the vignette and preference studies was through memory services, community centres and carers’ organisations.
Participants
People aged > 50 years with dementia within 1 year of first attendance at a memory clinic were eligible for the trial. People aged > 60 years with later-stage dementia within 3 months of a review of care needs were eligible for the observational study. We recruited staff, carers and people with dementia for the vignette and preference studies. All participants had to give written informed consent.
Main outcome measures
The trial and observational study used the Bristol Activities of Daily Living Scale as the primary outcome and also measured quality of life, capability, cognition, general psychological health and carers’ sense of competence.
Methods
Owing to the heterogeneity of interventions, methods and outcome measures, our evidence and economic reviews both used narrative synthesis. The main source of economic studies was the NHS Economic Evaluation Database. We analysed the trial and observational study by linear mixed models. We analysed the trial by ‘treatment allocated’ and used propensity scores to minimise confounding in the observational study.
Results
Our reviews and surveys identified several home support approaches of potential benefit. In early-stage dementia, the DESCANT trial had 468 randomised participants (234 intervention participants and 234 control participants), with 347 participants analysed. We found no significant effect at the primary end point of 6 months of the DESCANT intervention on any of several participant outcome measures. The primary outcome was the Bristol Activities of Daily Living Scale, for which scores range from 0 to 60, with higher scores showing greater dependence. After adjustment for differences at baseline, the mean difference was 0.38, slightly but not significantly favouring the comparator group receiving treatment as usual. The 95% confidence interval ran from –0.89 to 1.65 (p = 0.56). There was no evidence that more intensive care packages in later-stage dementia were more effective than basic care. However, formal home care appeared to help keep people at home. Staff recommended informal care that cost 88% of formal care, but for informal carers this ratio was only 62%. People with dementia preferred social and recreational activities, and carers preferred respite care and regular home care. The DESCANT intervention is probably not cost-effective in early-stage dementia, and intensive care packages are probably not cost-effective in later-stage dementia. From the perspective of the third sector, intermediate intensity packages were cheaper but less effective. Certain elements may be driving these results, notably reduced use of carers’ groups.
Limitations
Our chosen outcome measures may not reflect subtle outcomes valued by people with dementia.
Conclusions
Several approaches preferred by people with dementia and their carers have potential. However, memory aids aiming to affect daily living activities in early-stage dementia or intensive packages compared with basic care in later-stage dementia were not clinically effective or cost-effective.
Future work
Further work needs to identify what people with dementia and their carers prefer and develop more sensitive outcome measures.
Study registration
Current Controlled Trials ISRCTN12591717. The evidence synthesis is registered as PROSPERO CRD42014008890.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 9, No. 6. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Paul Clarkson
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - David Challis
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Jane Hughes
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Brenda Roe
- Evidence-based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Linda Davies
- Health Economics Research Team, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Ian Russell
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Fiona Poland
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - David Jolley
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Narinder Kapur
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Catherine Robinson
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Helen Chester
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Sue Davies
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Caroline Sutcliffe
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Julie Peconi
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Rosa Pitts
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Greg Fegan
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Saiful Islam
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Vincent Gillan
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Charlotte Entwistle
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Rebecca Beresford
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Michele Abendstern
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Clarissa Giebel
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Saima Ahmed
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Rowan Jasper
- Social Policy Research Unit, University of York, York, UK
| | - Adeela Usman
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Baber Malik
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Karen Hayhurst
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
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Meng D, Xu G, Davidson PM. Perceived unmet needs for community-based long-term care services among urban older adults: A cross sectional study. Geriatr Nurs 2021; 42:740-747. [PMID: 33872858 DOI: 10.1016/j.gerinurse.2021.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to explore the perceived unmet needs for community-based long-term care services among older urban adults in China. We analyzed the cross-sectional data of 5,201 urban community respondents ≥65 years of age from the seventh wave of the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The chi-squared automatic interaction detection technique was used to examine the variables associated with older adults' unmet needs for four common types of community-based services: personal care, grocery shopping, home visits, and psychological consulting. We found that the majority of the older adults perceived that they needed the four services, but only 9%-27.4% of the respondents reported that their perceived needs were met. There was a high prevalence of unmet community-based service needs (51.3%-55.5%) among urban older adults in China. Factors associated with unmet needs included depression status, ADL (activities of daily living) limitations, self-rated health, number of surviving children, educational attainment, and marital status. The results suggest that policy makers should develop services targeting specific segments of the older population, increasing the adequacy of services provided.
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Affiliation(s)
- Dijuan Meng
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, Jiangsu, China
| | - Guihua Xu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, Jiangsu, China
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Shim YS, Park KH, Chen C, Dominguez JC, Kang K, Kim HJ, Hong Z, Lin YT, Chu LW, Jung S, Kim S. Caregiving, care burden and awareness of caregivers and patients with dementia in Asian locations: a secondary analysis. BMC Geriatr 2021; 21:230. [PMID: 33827446 PMCID: PMC8028783 DOI: 10.1186/s12877-021-02178-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 03/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background This study investigated the differences in caregiver activity, caregiver burden, and awareness of both caregivers and patients with Alzheimer’s disease (AD) across different Asian locations. Methods This was a secondary analysis of a multi-national cohort study that aimed to assess caregiver activity and caregiver burden using the Caregiver Activity Scale (CAS) and Zarit Burden Interview (ZBI), respectively. Patients’ awareness of their dementia diagnosis was assessed by asking the following yes/no question: “Do you have dementia?” Caregivers’ awareness of the patient’s dementia diagnosis was assessed by asking the following yes/no question: “Does your patient have dementia?” Results In total, 524 caregivers of patients with AD from China, Hong Kong, South Korea, the Philippines, Singapore, Thailand, and Taiwan participated. The CAS and ZBI score were significantly different across most locations (p < 0.001 and p = 0.033, respectively). Overall, 56.6% of caregivers and 37.5% of patients had awareness of the dementia diagnosis, and the proportion of patients and caregivers with awareness were also different between each location (all, p < 0.001). Conclusions Caregiving, caregiver burden, and the awareness of caregivers and patients were different across many Asian locations. With understanding of cultural differences, further public education on dementia could help increase the awareness of patients and caregivers and reduce caregiver burden. Trial registration ClinicalTrials.gov, NCT02262975. Registered 13 October 2014,
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Affiliation(s)
- Yong S Shim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Christopher Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Kyunghun Kang
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hee-Jin Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Zhen Hong
- Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Yu-Te Lin
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Leung-Wing Chu
- Queen Mary Hospital, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - San Jung
- Department of Neurology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, 582, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Seoul, Republic of Korea.
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Sołtys A, Tyburski E. Predictors of mental health problems in formal and informal caregivers of patients with Alzheimer's disease. BMC Psychiatry 2020; 20:435. [PMID: 32887576 PMCID: PMC7487573 DOI: 10.1186/s12888-020-02822-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caring for a person with Alzheimer's disease (AD) is associated with significant mental burden e.g., depression and anxiety, and difficulties with social, familial, and professional functioning. To date, few studies have examined variables which would allow for a comprehensive and detailed study of the relationship between personal resources and caregiver health status, with a majority of studies focusing on factors that contribute to increased caregiver's burden. Moreover, the available evidence fails to address differences in the functioning of formal and informal carers. Paying proper attention to the problems of nursing home staff can help identify important risk factors. Therefore, this study compared mental health problems in informal and formal caregivers and examined the relationship between mental resources and mental health problems in both groups of caregivers. METHODS This cross-sectional study examined 100 formal (n = 50) and informal (n = 50) caregivers of AD patients. Personal resources were measured with the Social Support Questionnaire (SSQ), the Generalized Self-Efficacy Scale (GSES), and the Sense of Coherence Questionnaire (SCQ), while mental health was assessed with the Depression Assessment Questionnaire (DAQ) and the General Health Questionnaire (GHQ). Multivariate stepwise regression was performed separately for both investigated groups. RESULTS There were no significant differences between informal and formal caregivers in terms of psychological variables, i.e., sense of coherence, social support, self-efficacy, or mental health problems. In contrast, there were different significant predictors of mental health problems in both groups. Comprehensibility (SCQ) was a significant predictor of mental health problems measured by DAQ and self-efficacy (GSES) was a significant predictor of mental health problems measured by GHQ in informal caregivers. For formal caregivers, emotional support (SSQ) and comprehensibility (SCQ) were significant predictors of mental health problems measured by DAQ, while tangible support (SSQ) and meaningfulness (SCQ) were significant predictors of mental health problems measured by GHQ. CONCLUSIONS Personal resources are significant predictors of mental health outcomes in caregivers of AD patients. Preventive actions should therefore include assessment of factors affecting caregivers' mental health in order to provide them with necessary care and create appropriate support groups.
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Affiliation(s)
- Anna Sołtys
- Institute of Psychology, University of Szczecin, 69 Krakowska str, 71-017 Szczecin, Poland
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 10 Kutrzeby str, 61-719 Poznan, Poland
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Satisfaction with Health Care Interventions among Community Dwelling People with Cognitive Disorders and Their Informal Caregivers-A Systematic Review. Healthcare (Basel) 2020; 8:healthcare8030240. [PMID: 32751259 PMCID: PMC7551121 DOI: 10.3390/healthcare8030240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Abstract
Informal caregivers have a leading role when implementing health care services for people with cognitive disorders living at home. This study aims to examine the current evidence for interventions with dual satisfaction with health care services for people with cognitive disorders and their caregivers. Original papers with quantitative and mixed method designs were extracted from two databases, covering years 2009-2018. Thirty-five original papers reported on satisfaction with health care services. The International Classification of Health Interventions (ICHI) was used to classify the interventions. Most interventions had a home-based approach (80%). Reduction in caregiver depression was the outcome measure with the highest level of satisfaction. Interventions to reduce depression or increase cognitive performance in persons with cognitive disorders gave the least satisfaction. Satisfaction of both caregivers and persons with cognitive disorders increased their use of services. In the ICHI, nearly 50% of the interventions were classified as activities and participation. A limited number of interventions have a positive effect on satisfaction of both the persons with cognitive disorders and the caregiver. It is important to focus on interventions that will benefit both simultaneously. More research is needed with a clear definition of satisfaction and the use of the ICHI guidelines.
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Brites R, Brandão T, Moniz Pereira F, Hipólito J, Nunes O. Effects of supporting patients with dementia: A study with dyads. Perspect Psychiatr Care 2020; 56:614-620. [PMID: 31970779 DOI: 10.1111/ppc.12476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/11/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to examine the factors associated with the development of higher burden in informal caregivers of patients with dementia, using dyadic data. DESIGN AND METHODS Seventy-two dyads of patients with dementia and their informal caregivers were assessed, the former in terms of behavioral-psychological symptoms and autonomy, the latter in terms of burden and individual needs. FINDINGS Caregivers at risk for developing higher burden are those who are female, whose care recipient present psychiatric symptoms and lower autonomy, and those who recognize the need for more information/support. PRACTICE IMPLICATIONS Interventions should offer caregivers the tools to provide care, maintaining their psychological well-being. Interventions should target not only common aspects of caregiver burden but also the specificities of caring for a person with dementia.
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Affiliation(s)
- Rute Brites
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Tânia Brandão
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal.,Centro de Psicologia, Universidade do Porto, Porto, Portugal
| | - Francisco Moniz Pereira
- Centro Hospitalar Psiquiátrico de Lisboa, Departamento de Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - João Hipólito
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Odete Nunes
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
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Steiner GZ, Ee C, Dubois S, MacMillan F, George ES, McBride KA, Karamacoska D, McDonald K, Harley A, Abramov G, Andrews-Marney ER, Cave AE, Hohenberg MI. "We need a one-stop-shop": co-creating the model of care for a multidisciplinary memory clinic with community members, GPs, aged care workers, service providers, and policy-makers. BMC Geriatr 2020; 20:49. [PMID: 32046657 PMCID: PMC7014614 DOI: 10.1186/s12877-019-1410-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/30/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Timely diagnosis of dementia has a wide range of benefits including reduced hospital emergency department presentations, admissions and inpatient length of stay, and improved quality of life for patients and their carers by facilitating access to treatments that reduce symptoms, and allow time to plan for the future. Memory clinics can provide such services, however there is no 'gold standard' model of care. This study involved the co-creation of a model of care for a new multidisciplinary memory clinic with local community members, General Practitioners (GPs), policy-makers, community aged care workers, and service providers. METHODS Data collection comprised semi-structured interviews (N = 98) with 20 GPs, and three 2-h community forums involving 53 seniors and community/local government representatives, and 25 community healthcare workers. Interviews and community forums were audio-recorded, transcribed verbatim, and coded by thematic analysis using Quirkos. RESULTS GPs' attitudes towards their role in assessing people with dementia varied. Many GPs reported that they found it useful for patients to have a diagnosis of dementia, but required support from secondary care to make the diagnosis and assist with subsequent management. Community forum participants felt they had a good knowledge of available dementia resources and services, but noted that these were highly fragmented and needed to be easier to navigate for the patient/carer via a 'one-stop-shop' and the provision of a dementia key worker. Expectations for the services and features of a new memory clinic included diagnostic services, rapid referrals, case management, education, legal services, culturally sensitive and appropriate services, allied health, research participation opportunities, and clear communication with GPs. Participants described several barriers to memory clinic utilisation including transportation access, funding, awareness, and costs. CONCLUSION This study demonstrates the importance of working with stakeholders to co-design models of care for people with dementia that take into account the local communities' needs. Findings pave the way for the development of a potential new "gold standard" memory clinic model of care and operationalise new national clinical guidelines.
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Affiliation(s)
- Genevieve Z. Steiner
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751 Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751 Australia
| | - Shamieka Dubois
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - Freya MacMillan
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751 Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751 Australia
| | - Emma S. George
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751 Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751 Australia
| | - Kate A. McBride
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2751 Australia
- School of Medicine, Western Sydney University, Penrith, NSW 2751 Australia
| | - Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
- School of Psychology, University of Wollongong, Wollongong, NSW 2522 Australia
| | - Keith McDonald
- South Western Sydney Primary Health Network (SWSPHN, Campbelltown, NSW 2560 Australia
| | - Anne Harley
- South Western Sydney Primary Health Network (SWSPHN, Campbelltown, NSW 2560 Australia
| | - Gamze Abramov
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
- School of Psychology, University of Wollongong, Wollongong, NSW 2522 Australia
| | | | - Adele E. Cave
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - Mark I. Hohenberg
- School of Medicine, Western Sydney University, Penrith, NSW 2751 Australia
- Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW 2560 Australia
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Symonds-Brown H, Ceci C, Duggleby W, Purkis ME. Re-thinking the nature of day programs for people with dementia: Implications for research. DEMENTIA 2019; 20:326-347. [PMID: 31696730 DOI: 10.1177/1471301219884429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Day programs are commonly identified in dementia strategies as a solution for keeping people with dementia home for as long as possible. Limited research evidence is available to support these policy approaches, and much of what exists demonstrates equivocal results. While key day program researchers have called for improvements in methodological and theoretical efforts, we argue that basic assumptions concerning what a day program is, and how the effects of day programs should be studied, also require reconsideration. Problematization is a systematic review strategy used to identify and critique assumptions guiding research practices and knowledge development in a field of study. The approach entails a broad overview of a field of research alongside a close reading of key texts to identify prevailing assumptions about the object of study and how it can be known. The intent is to discern how these assumptions are influencing research practices and thus knowledge development. A review of historical texts and research literature reviews was used (1) to identify trends in day program research between 1990 and 2018 and (2) to support identification of influential and typical studies for closer analysis (n = 36). The outcome of our analysis of the research literature suggests three sets of assumptions that guide much of the day program research literature: dementia is mainly treated as a problem of the individual; day programs are treated as stand-alone units of substitute care; and the space of day programs is seen as a simple background to care. We argue that the assumptions regarding care and space have narrowed the field of research and contributed to the production of equivocal findings. We suggest alternative framings of notions of care and space, informed by a Science and Technology Studies' approach to care practices, to generate knowledge about day programs that can usefully inform policy and practice.
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Smith-Carrier TA, Béres L, Johnson K, Blake C, Howard J. Digging into the experiences of therapeutic gardening for people with dementia: An interpretative phenomenological analysis. DEMENTIA 2019; 20:130-147. [PMID: 31426675 DOI: 10.1177/1471301219869121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gardening programmes aim to promote improved engagement and quality of life in persons with dementia. Although a substantial literature has amassed documenting the overall positive outcomes associated with therapeutic gardening and horticulture for persons with dementia, little is known about the specific aspects of the gardening process that engender these benefits, and how and why they are important. The purpose of this research was to explore, using interpretative phenomenological analysis, the experiences of therapeutic gardening for persons with dementia, and their perspectives on the senses and emotions elicited in the gardening process that promote well-being. The themes that emerged in our analysis are to varying degrees substantiated in the literature: the usefulness of activating the senses, particularly those of touch and smell; the significance of being occupied in meaningful, productive work; the importance of cultivating a sense of curiosity, wonder, and learning; the positive gains derived from socialization in a group context; the peace and hope derived from being 'in the moment'; and the positive mental and physical well-being derived from participating in the outdoor garden. Our findings support the integration of therapeutic gardening as a valuable practice for people with dementia.
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Affiliation(s)
| | - Laura Béres
- School of Social Work, King's University College at Western University, London, Ontario, Canada
| | | | | | - Jennifer Howard
- Arthur Labatt Family School of Nursing, London, Ontario, Canada
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Clinical and Demographic Predictors of Adverse Outcomes in Caregivers of Patients with Dementia. Dement Neurocogn Disord 2019; 18:10-18. [PMID: 31097968 PMCID: PMC6494781 DOI: 10.12779/dnd.2019.18.1.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/23/2019] [Accepted: 04/10/2019] [Indexed: 01/07/2023] Open
Abstract
Background and Purpose We aimed to elucidate independent predictors of adverse outcomes in caregivers of patients with dementia using readily available clinical and demographic data of patients with dementia and their caregivers. Methods We reviewed patient-caregiver data from the Clinical Research Center for Dementia of South Korea and Caregivers of Alzheimer Disease Research study. The clinical factors of the patients and the demographics of both patients and caregivers were used to predict adverse outcomes for caregivers. Correlation and linear regression analyses were performed. Results We enrolled 454 patients and their caregivers for the present study. The general burden for the caregiver was higher amongst female caregivers, patients with further decreased the level of activities of daily living (ADL), patients with more abnormal behavior, or younger patients. The time spent by the caregivers was more in cases of patients with higher Caregiver Administered Neuropsychiatric Inventory scores, younger patients and for patients with decreased level of ADL. Depression amongst caregivers was more prominent in patients with higher Clinical Dementia Rating Sum of Boxes scores. Physical health-related quality of life (HRQoL) was lower in female caregivers, more physically affected patients, and older caregivers. Lastly, mental HRQoL was lower in younger, more physically affected, and in patients with abnormal behaviors. Conclusions Clinical and demographic characteristics of patients and caregivers predict adverse outcomes for caregivers. Therefore, these factors should be considered to provide support to both patients and their caregivers.
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Clarkson P, Hughes J, Roe B, Giebel CM, Jolley D, Poland F, Abendstern M, Chester H, Challis D. Systematic review: Effective home support in dementia care, components and impacts - Stage 2, effectiveness of home support interventions. J Adv Nurs 2017; 74:507-527. [DOI: 10.1111/jan.13460] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 01/20/2023]
Affiliation(s)
- Paul Clarkson
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Jane Hughes
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Brenda Roe
- Faculty of Health & Social Care; Evidence-based Practice Research Centre; Edge Hill University; Ormskirk UK
| | - Clarissa M. Giebel
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - David Jolley
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Fiona Poland
- School of Health Sciences; University of East Anglia; Norwich UK
| | - Michele Abendstern
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Helen Chester
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - David Challis
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
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Cations M, Withall A, Horsfall R, Denham N, White F, Trollor J, Loy C, Brodaty H, Sachdev P, Gonski P, Demirkol A, Cumming RG, Draper B. Why aren't people with young onset dementia and their supporters using formal services? Results from the INSPIRED study. PLoS One 2017; 12:e0180935. [PMID: 28723931 PMCID: PMC5517136 DOI: 10.1371/journal.pone.0180935] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 06/24/2017] [Indexed: 11/18/2022] Open
Abstract
Background/Aims Despite reporting high levels of burden, supporters of people with young onset dementia (YOD) underuse formal community services. Previous quantitative studies in YOD are of limited utility in guiding service design because they did not consider important contextual barriers to service use. The aim of this study was to identify all relevant barriers and describe the service features considered most important to improving uptake by people with YOD and their supporters. Methods Eighty-six people with consensus-confirmed YOD (mean onset age 55.3 years) and/or their primary supporter participated in quantitative interviews, and 50 also participated in one of seven qualitative focus groups. Interview participants reported levels of community service use and reasons for non-use, functional impairment, behavioural and psychological symptoms, supporter burden, social network, and informal care provision. Focus group participants expanded on reasons for non-use and aspects of an ideal service. Results Although at least one community service was recommended to most participants (96.8%), 66.7% chose not to use one or more of these. Few of the clinical or demographic factors included here were related to service use. Qualitative analyses identified that lack of perceived need, availability, and YOD-specific barriers (including ineligibility, unaffordability, lack of security, lack of childcare) were commonly reported. Five aspects of an ideal service were noted: unique, flexibile, affordable, tailored, and promoting meaningful engagement. Conclusion People with YOD and their families report that formal community services do not meet their personal and psychological needs. Researchers can provide ongoing assessment of program feasibility, suitability, and generalisability.
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Affiliation(s)
- Monica Cations
- School of Public Health and Community Medicine, UNSW Australia, Syndey, NSW, Australia
- Dementia Collaborative Research Centre–Assessment and Better Care, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
- * E-mail:
| | - Adrienne Withall
- School of Public Health and Community Medicine, UNSW Australia, Syndey, NSW, Australia
| | - Ruth Horsfall
- School of Public Health and Community Medicine, UNSW Australia, Syndey, NSW, Australia
| | - Nicole Denham
- Dementia Collaborative Research Centre–Assessment and Better Care, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
| | - Fiona White
- Dementia Collaborative Research Centre–Assessment and Better Care, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
| | - Clement Loy
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Henry Brodaty
- Dementia Collaborative Research Centre–Assessment and Better Care, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia
- Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Perminder Sachdev
- Dementia Collaborative Research Centre–Assessment and Better Care, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Peter Gonski
- School of Public Health and Community Medicine, UNSW Australia, Syndey, NSW, Australia
- Division of Aged and Extended Care (Southcare), Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Apo Demirkol
- School of Public Health and Community Medicine, UNSW Australia, Syndey, NSW, Australia
- The Langton Centre, South Eastern Sydney Local Health District, Drug and Alcohol Services, Surry Hills, NSW, Australia
| | - Robert G. Cumming
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Brian Draper
- Dementia Collaborative Research Centre–Assessment and Better Care, School of Psychiatry, UNSW Australia, Sydney, NSW, Australia
- Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia
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Wang CL, Shyu YIL, Wang JY, Lu CH. Progressive compensatory symbiosis: spouse caregiver experiences of caring for persons with dementia in Taiwan. Aging Ment Health 2017; 21:241-252. [PMID: 26362821 DOI: 10.1080/13607863.2015.1081148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Spouse caregivers have been the predominant family members who care for persons with dementia in Taiwan. Although studies in western countries have described the caregiving experiences and changes in the marital relationship for these spouse caregivers, this information is lacking in Taiwan. This study explored the experiences of spouse caregivers caring for persons with dementia in Taiwan. METHODS A grounded theory approach was used for this qualitative descriptive study. Data were collected through recorded in-depth interviews and observations with 15 spouse caregivers of persons with dementia. Constant comparative analysis was used to analyse the transcripts and field notes. RESULTS Analysis of interview transcripts revealed that the experiences of caregiving for spouse caregivers who lived with persons with dementia could be described as 'progressive compensatory symbiosis.' This core category included three components: awareness of unbalanced intimacy, making a commitment and implementing a compensatory scheme. These experiences could be either mutually beneficial or unbalanced and fluctuated as the disease progressed through the phases of 'subtle,' 'revealed' and 'confirmed,' which also influence the pace, transition and evolution of the compensatory symbiosis. CONCLUSION This exploratory study describes the family caregiving experiences for 15 spouse caregivers of persons with dementia in Taiwan. These results can provide guidance for developing interventions to prepare, facilitate and promote a mutually beneficial adjustment for spousal caregivers and their spouses as dementia progresses. The findings are worthy of further investigation with a larger sample and a prospective design.
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Affiliation(s)
- Ching-Lin Wang
- a School of Nursing, College of Medicine, Chang Gung University , Taoyuan City , Taiwan.,b Department of Nursing , Tzu Hui Institute of Technology , Pingtung County , Taiwan
| | - Yea-Ing Lotus Shyu
- a School of Nursing, College of Medicine, Chang Gung University , Taoyuan City , Taiwan.,c Healthy Aging Research Center , Chang Gung University , Taoyuan City , Taiwan
| | - Jing-Yun Wang
- d Department of Nursing , Yuh-Ing Junior College of Health Care & Management , Kaohsiung City , Taiwan
| | - Cheng-Hsien Lu
- e Department of Neurology , Chang Gung Memorial Hospital , Kaohsiung City , Taiwan
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Sansoni J, Duncan C, Grootemaat P, Capell J, Samsa P, Westera A. Younger Onset Dementia. Am J Alzheimers Dis Other Demen 2016; 31:693-705. [PMID: 26888862 PMCID: PMC10852741 DOI: 10.1177/1533317515619481] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This literature review focused on the experience, care, and service requirements of people with younger onset dementia. Systematic searches of 10 relevant bibliographic databases and a rigorous examination of the literature from nonacademic sources were undertaken. Searches identified 304 articles assessed for relevance and level of evidence, of which 74% were academic literature. The review identified the need for (1) more timely and accurate diagnosis and increased support immediately following diagnosis; (2) more individually tailored services addressing life cycle issues; (3) examination of the service needs of those living alone; (4) more systematic evaluation of services and programs; (5) further examination of service utilization, costs of illness, and cost effectiveness; and (6) current Australian clinical surveys to estimate prevalence, incidence, and survival rates. Although previous research has identified important service issues, there is a need for further studies with stronger research designs and consideration of the control of potentially confounding factors.
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Affiliation(s)
- Janet Sansoni
- 1 Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Cathy Duncan
- 1 Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Pamela Grootemaat
- 1 Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jacquelin Capell
- 1 Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Peter Samsa
- 1 Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anita Westera
- 1 Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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Han A, Radel J. Spousal Caregiver Perspectives on a Person-Centered Social Program for Partners With Dementia. Am J Alzheimers Dis Other Demen 2016; 31:465-73. [PMID: 26705379 PMCID: PMC10852899 DOI: 10.1177/1533317515619036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This qualitative study explored spousal caregiver perspectives on the experience and impact of a person-centered social program for partners with dementia. Interviews with 5 caregivers and the spouses with dementia were conducted 7 to 8 months after the program ended to explore the sustained impact of the program. Interpretative phenomenological analysis was used to support in-depth exploration of interviews. Three themes emerged including benefits of the program for caregivers, initial expectations and later perspectives of caregivers about the program, and conflicting values and perspectives between caregivers and the spouses. These findings suggest participation in a person-centered social program by people with dementia benefits their caregivers, by meeting the caregivers' desire for their spouses to increase social participation and engagement in meaningful activities. Participation in the program provided a sustained benefit to one couple in particular, by encouraging the caregiver to resume arranging activities the couple once enjoyed but now had difficulty pursuing.
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Affiliation(s)
- Areum Han
- School of Occupational Therapy, Texas Woman's University, Denton, TX, USA
| | - Jeff Radel
- Department of Occupational Therapy Education, University of Kansas Medical Center, Kansas City, KS, USA
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Milliken A, Mahoney EK, Mahoney KJ. “It just took the pressure off”: The voices of Veterans’ family caregivers in a participant-directed program. Home Health Care Serv Q 2016; 35:123-136. [DOI: 10.1080/01621424.2016.1227010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Aimee Milliken
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Ellen K. Mahoney
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Kevin J. Mahoney
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
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Anand KS, Dhikav V, Sachdeva A, Mishra P. Perceived caregiver stress in Alzheimer's disease and mild cognitive impairment: A case control study. Ann Indian Acad Neurol 2016; 19:58-62. [PMID: 27011630 PMCID: PMC4782554 DOI: 10.4103/0972-2327.167695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objectives: Cross sectional studies have reported a tremendous amount of stress in caregivers of patients with Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). The present study aimed at evaluating the perceived stress in caregivers of patients with AD and MCI compared to controls. Materials and Methods: Caregivers of patients diagnosed with Alzheimer's disease/Mild Cognitive Impairment were recruited at the Memory Clinic of Neurology Department of a Tertiary Care Hospital in Northern India. The controls included caregivers of patients with chronic medical and psychiatric disorders. Caregivers were interviewed using Perceived Stress Scale (PSS) and the patients were assessed using The Blessed Activity of Daily Living (ADL), Mini Mental State Examination (MMSE) and Clinical Dementia Rating scale. The perceived stress of caregivers was compared amongst both groups and correlated with the severity of illness and activities of daily living of the patients. Results: Caregivers of a total of 31 patients of AD/MCI (Males = 24, Females = 7), and 30 controls (Males = 18, Females = 12) were interviewed. PSS Score was 23.29 ± 7.17 in cases and 7.5 ± 3.12 in controls. ADL Score was 7.97±5.53 in cases and 0.00 in controls. There was a significant difference between the PSS and ADL scores between those with AD and controls (P < 0.0001). Caregivers of patients with MCI had lower PSS scores compared to AD caregivers but significantly higher scores compared to caregivers of other chronic disorders. Similarly, correlation between Perceived Stress and ADL was significant (P < 0.001). Conclusions: Present study shows that caregivers of patients with AD/MCI have a high perceived stress compared to caregivers of patients with other chronic illness.
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Affiliation(s)
- Kuljeet Singh Anand
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vikas Dhikav
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ankur Sachdeva
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pinki Mishra
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Moon H. Predictors of perceived benefits and drawbacks of using paid service among daughter and daughter-in-law caregivers of people with dementia. J Women Aging 2016; 28:161-9. [DOI: 10.1080/08952841.2014.954505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sutcliffe CL, Giebel CM, Jolley D, Challis DJ. Experience of burden in carers of people with dementia on the margins of long-term care. Int J Geriatr Psychiatry 2016; 31:101-8. [PMID: 25963021 DOI: 10.1002/gps.4295] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 04/09/2015] [Accepted: 04/10/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study aimed to identify the factors determining carer burden in a group of carers supporting people with dementia (PwD) deemed to be at high risk of moving to long-term residential or nursing home care. DESIGN National data collected as part of the European RightTimePlaceCare project were analysed. This included 81 dyads of community-dwelling people with dementia and their informal carers. METHODS Structured face-to-face interviews were conducted in North West England between June 2011 and April 2012. Interviews collected data relating to the person with dementia (cognitive functioning, activities of daily living, neuropsychiatric symptoms and formal and informal dementia care resource use) and carers' level of burden (22-item Zarit Burden Index), hours spent caring and availability of additional informal support. RESULTS Logistic regression analysis identified five factors associated with high carer burden: neuropsychiatric symptomatology in the PwD, intensive supervision of the PwD by the carer, being a female carer, being an adult-child carer and absence of informal carer support. Use of home care or day care services was unrelated to burden. CONCLUSION Support programmes focusing on challenging behaviours and risk management may be of benefit to carers. More individually tailored interventions for specific carer groups including female or younger carers may be warranted. The implementation of peer support networks could be beneficial to carers who lack additional family support.
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Affiliation(s)
- Caroline L Sutcliffe
- Personal Social Services Research Unit, University of Manchester, Manchester, UK
| | - Clarissa M Giebel
- Personal Social Services Research Unit, University of Manchester, Manchester, UK
| | - David Jolley
- Personal Social Services Research Unit, University of Manchester, Manchester, UK
| | - David J Challis
- Personal Social Services Research Unit, University of Manchester, Manchester, UK
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Abstract
BACKGROUND Caregiver burden is a complex and multidimensional construct. Although previous studies have explored numerous factors associated with caregiver burden, these factors have not been identified with a large population-based sample in a theory-based multidimensional way. This study explores multidimensional determinants associated with family caregiver burden to determine the main contributors of caregiver burden in Alzheimer's disease (AD) using a large community dataset. METHODS A retrospective secondary data analysis was conducted on 1,133 patients with AD and 1,133 primary caregivers who were registered in a metropolitan city dementia center in South Korea. The patient data included socio-demographic and disease profiles. The caregiver data consisted of socio-demographic and caregiving profiles. RESULTS The study results identified that dementia-related factors were the most significant factors, representing 25.6% of caregiver burden and were followed by caregiving-related factors explaining caregiver burden significantly. Behavioral problems and instrumental activities of daily living (IADL) dependency of the patient, spousal relationship, hours of caregiving, and the number of diseases associated with the caregiver were found to be significant individual variables. CONCLUSIONS It is vital to develop a service and support program with a greater emphasis on the behavioral problems and IADL deficiency of patients with AD as well as on improving the competence ability of caregivers to deal with such difficulties.
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Raccichini A, Spazzafumo L, Castellani S, Civerchia P, Pelliccioni G, Scarpino O. Living with mild to moderate Alzheimer patients increases the caregiver's burden at 6 months. Am J Alzheimers Dis Other Demen 2015; 30:463-7. [PMID: 25712057 PMCID: PMC10852853 DOI: 10.1177/1533317514568339] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
The objective of our study was to demonstrate that living with a person affected by mild to moderate Alzheimer's disease can lead to an increased perception of the caregiver's burden using the Caregiver Burden Inventory (CBI). The sample consisted of 153 dyads, caregiver-patient. At baseline, a greater perception of the caregiver's burden was observed in the live-in caregivers. A further increase in the total burden of the live-in caregivers was noticed at the 6-month follow-up. More specifically, with the inclusion of correction factors such as the caregiver's age and the CBI subscales at baseline, the social and emotional burden becomes statistically significant (P < .001). The present paper confirms our hypothesis that live-in caregivers perceive a greater burden than nonlive-in, and this difference increases further after 6 months. The difference in involvement between live-in and nonlive-in caregivers could be the foundation to tailor more specific interventions.
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Affiliation(s)
| | - Liana Spazzafumo
- Biostatistical Center, Italian National Research Center on Aging, Ancona, Italy
| | - Simona Castellani
- Neurology Unit, Italian National Research Center on Aging, Ancona, Italy
| | - Patrizia Civerchia
- Neurology Unit, Italian National Research Center on Aging, Ancona, Italy
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Caregiver profiles and determinants of caregiving burden in Ghana. Public Health 2015; 129:941-7. [PMID: 26115592 DOI: 10.1016/j.puhe.2015.05.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 12/24/2014] [Accepted: 05/15/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Due to the growing elderly population, the high cost of care in Ghana and low coverage of the National Health Insurance Scheme, demands for family caregiving have become more imperative in Ghana than ever before. Many caregivers experience high burdens, yet literature on caregiving in Ghana is lacking. This study examined caregiver profiles and determinants of the burden of caregiving in Ghana. STUDY DESIGN Cross-sectional study. METHODS This study used data from Wave 1 of the World Health Organization (WHO) Study on Global Ageing and Adult Health (2007-2008). In total, 238 caregivers were analysed in the study. The burden of caregiving was measured using the WHO Impact of Caregiving Scale. Independent sample t-tests, correlations and analysis of variance were used to investigate associations between background characteristics and the burden of caregiving. Linear regression was used to examine determinants of the burden of caregiving. RESULTS The mean age of caregivers was 61 years (standard deviation 14.5), and the male:female ratio was approximately equal. On average, approximately two adults per household required care. Less than five percent of caregivers received financial, emotional, health, physical and personal care support. Place of residence, provision of financial, health and physical support to care recipients, and receipt of financial, physical and health support were significant determinants of the burden of caregiving. CONCLUSIONS This study found a mismatch between the number of people needing care and the number of people providing care. In order to improve the health of caregivers and care recipients, there is a need to provide financial support for caregivers. In addition, pro-caregiving government programmes and policies should be established.
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Fianco A, Sartori RDG, Negri L, Lorini S, Valle G, Delle Fave A. The relationship between burden and well-being among caregivers of Italian people diagnosed with severe neuromotor and cognitive disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 39:43-54. [PMID: 25666898 DOI: 10.1016/j.ridd.2015.01.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/22/2014] [Accepted: 01/19/2015] [Indexed: 05/15/2023]
Abstract
In studies on caregiving, high levels of perceived burden are commonly considered as synonymous with poor well-being. This study aimed at better disentangling the relationship between burden and well-being dimensions through their joint investigation. To this purpose, perceived well-being and social resources were evaluated among caregivers reporting different levels of burden. Participants were 91 caregivers (mean age=50.4; SD=9.6), parents of people diagnosed with severe neuromotor and cognitive disorders. Participants completed a semi-structured interview and a set of scaled questionnaires: Caregiver Burden Inventory (CBI), Satisfaction with Life Scale, Positive and Negative Affect Schedule, Depression Anxiety Stress Scale, Eudaimonic and Hedonic Happiness Investigation, Resilience Scale for Adults, and Multidimensional Scale of Perceived Social Support. Participants were divided into two groups according to their perceived burden level, assessed through CBI. In both groups, the subjective components of burden accounted for the major fraction of the total burden level. Participants perceiving high burden reported higher levels of depression related emotions, lower life satisfaction and lower resilience than participants perceiving low burden. No group difference emerged in perceived meaningfulness and social support. A regression analysis showed that the best predictor of perceived burden was life satisfaction, followed to a lesser extent by resilience, while depression related emotions did not provide significant contribution. Findings suggest that the joint assessment of burden and well-being dimensions, that are co-existing in caregivers' experience, allow for the identification of personal and relational resources that can be usefully included in interventions addressed to caregivers.
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Affiliation(s)
- Andrea Fianco
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
| | - Raffaela D G Sartori
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
| | - Luca Negri
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
| | - Saverio Lorini
- IRCCS Fondazione Don Carlo Gnocchi, Centro IRCSS "S. Maria Nascente", Via A. Capecelatro, 66, 20148 Milano, Italy
| | - Giovanni Valle
- IRCCS Fondazione Don Carlo Gnocchi, Centro IRCSS "S. Maria Nascente", Via A. Capecelatro, 66, 20148 Milano, Italy.
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
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Campbell CL, Freytes M, Hoffman N. A Home-Based Intervention's Impact on Caregiver Burden for Veterans With Dependence Performing Activities of Daily Living: An Interdisciplinary Approach. SOCIAL WORK IN HEALTH CARE 2015; 54:461-473. [PMID: 25985288 DOI: 10.1080/00981389.2015.1030056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Veterans Health Administration offers multiple programs to support veteran's caregivers. This study examines one such program, modeled after the national VHA Home Based Primary Care Program (HBPC). A retrospective secondary data analysis was conducted on the VHA GAP program, examining the impact on reducing caregiver burden. Findings from examination of 48 veteran/caregiver dyads indicated the program had a clinically and statistically significant impact on decreasing caregiver role strain. These findings were compared to the national evidence-based HBPC program, finding no significant differences in decrease of caregiver burden between the recipients of the GAP program and the national HBPC programs.
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Affiliation(s)
- Colleen L Campbell
- a Department of Veterans Affairs , Home Based Primary Care, The Villages Outpatient Clinic , The Villages , Florida , USA
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Neville C, Beattie E, Fielding E, MacAndrew M. Literature review: use of respite by carers of people with dementia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:51-53. [PMID: 25602093 DOI: 10.1111/hsc.12095] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Respite care is a cornerstone service for the home management of people with dementia. It is used by carers to mitigate the stress related to the demands of caring by allowing time for them to rest and do things for themselves, thus maintaining the caring relationship at home and perhaps forestalling long-term placement in a residential aged care facility. Despite numerous anecdotal reports in support of respite care, its uptake by carers of people with dementia remains relatively low. The aim of this paper was to examine the factors that constitute the use of respite by carers of people with dementia by reviewing quantitative and qualitative research predominantly from the years 1990 to 2012. Seventy-six international studies of different types of respite care were included for this review and their methods were critically appraised. The key topics identified were in relation to information access, the barriers to carers realising need for and seeking respite, satisfaction with respite services including the outcomes for carers and people with dementia, the characteristics of an effective respite service and the role of health workers in providing appropriate respite care. Finally, limitations with considering the literature as a whole were highlighted and recommendations made for future research.
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Affiliation(s)
- Christine Neville
- School of Nursing and Midwifery, The University of Queensland, Ipswich, Qld, Australia
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Campbell CL, McCoy S, Hoffman N, Oneil P. Decreasing role strain for caregivers of veterans with dependence in performing activities of daily living. HEALTH & SOCIAL WORK 2014; 39:55-62. [PMID: 24693604 DOI: 10.1093/hsw/hlu006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In response to the implementation of new Patient Aligned Care Teams (PACT) within the Veterans Administration health care system, the interdisciplinary nature of social work in health care settings is expanding to address emerging needs of veterans and their caregivers. One such area of expansion is the receipt of extended care services in the veteran's home environment. Social workers within PACT, also known as the patient-centered medical home, are tasked with movement of health care resources and care coordination centered around veterans in their residences. This presents social workers in the health care setting with new challenges for dealing with high burden and role strain for caregivers of veterans in noninstitutional settings who are dependent in performing activities of daily living. The current article establishes an approach, grounded in community science, for interventions within the Veterans Health Administration aimed at alleviating caregivers' role strain when caring for veterans with functional disabilities while optimizing implementation of home care and care coordination.
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Herrera AP, George R, Angel JL, Markides K, Torres-Gil F. Variation in Older Americans Act caregiver service use, unmet hours of care, and independence among Hispanics, African Americans, and Whites. Home Health Care Serv Q 2013; 32:35-56. [PMID: 23438508 DOI: 10.1080/01621424.2012.755143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Home- and community-based services (HCBS) are underused by minority seniors and their caregivers, despite greater rates of disability. We examined racial/ethnic variation among 1,749 Hispanics, African Americans, and Whites receiving Older Americans Act Title III caregiver services in 2009. In addition, we identified the volume of services used by caregivers, their unmet hours of respite care, and the relationship between service use and seniors' ability to live independently. Minority caregivers cared for seniors in urban areas who had higher rates of disability, poverty, and Medicaid coverage. Hispanics had the highest rate of unmet hours of care, while caregiver services were less likely to help African Americans remain at home. Minorities sought services through community agencies and were more educated than demographically similar national cohorts. Greater efforts to reach minority caregivers of less educated, disabled seniors in urban areas and through community agencies may reduce unmet needs and support independent living.
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Affiliation(s)
- Angelica P Herrera
- University of Maryland, Baltimore County, Health Administration and Policy Program, Department of Sociology and Anthropology/Center for Aging Studies, 252 Public Policy Building, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
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Abstract
SummaryMost individuals with dementia live in the community, receiving care from family or lay carers. Carers’ wellbeing, and the quality of the care they provide, depends on their resilience in the face of the challenges associated with caring for someone with dementia. However, factors associated with carers’ resilience are not yet fully understood. The aim of this review is to present a narrative synthesis of factors, materials and resources associated with carers’ resilience. Electronic and hand searches identified relevant published literature, which was narratively synthesized. A framework consisting of three inter-related domains of factors influencing carers’ resilience emerged, encompassing: social and cultural factors; properties of the care relationship; and carers’ psychological factors. Holistic assessment based on this framework can help practitioners to identify vulnerable carers and to target help on factors that help to make them vulnerable but that are amenable to change.
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Robinson KM, Buckwalter K, Reed D. Differences between dementia caregivers who are users and nonusers of community services. Public Health Nurs 2013; 30:501-10. [PMID: 24579710 DOI: 10.1111/phn.12041] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine differences between users and non-users of community services in caregivers of persons with dementia (PWD). A profile of who used services versus did not use services was developed. DESIGN AND SAMPLE Existing cross-sectional data from the NINR funded National Caregiver Training Project (data collected 1995-1997) were used. The sample (N = 241) of caucasian, well-educated caregivers reflected a mix of spouse and adult caregivers with a mean age of 64.8 years. MEASURES Variables measured included caregiver social support, burden, and depression as well as problem behavior of PWD. RESULTS The majority of caregivers did not attend support groups (73%) or use respite services (79%). Among caregivers who did not use services, 78% lived with the recipient and 77% were spouses. The profile of non-users compared to users revealed that non-users were significantly older, more depressed, and received less social support. On the other hand, non-users provided fewer hours of care per week to recipients who had less cognitive and functional deterioration and fewer behavior problems. CONCLUSIONS These findings provide public health nurses with knowledge about service use in caregivers of PWD. Recommendations regarding caregiver needs for assistance and increased use of services before a crisis ensues are presented.
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Affiliation(s)
- Karen M Robinson
- School of Nursing, University of Louisville, Louisville, Kentucky
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35
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Mast ME. To Use or Not to Use: A Literature Review of Factors that Influence Family Caregivers’ Use of Support Services. J Gerontol Nurs 2013; 39:20-8; quiz 29. [DOI: 10.3928/00989134-20121107-02] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Casado BL, Lee SE. Access Barriers to and Unmet Needs for Home- and Community-Based Services Among Older Korean Americans. Home Health Care Serv Q 2012; 31:219-42. [DOI: 10.1080/01621424.2012.703540] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fields NL, Anderson KA, Dabelko-Schoeny H. The effectiveness of adult day services for older adults: a review of the literature from 2000 to 2011. J Appl Gerontol 2012; 33:130-63. [PMID: 24652952 DOI: 10.1177/0733464812443308] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Adult Day Service (ADS) centers offer a variety of services to meet the needs of older adults and their caregivers. During the last decade, ADS has received increased attention due to shifts in policy toward home and community-based services for an aging population. This article reviews the effectiveness of ADS from 2000 to the present, with particular attention given to caregiver and participant outcomes, health care utilization, and future directions in ADS research. Multiple databases were searched to identify relevant research and 61 articles were selected for review based on inclusion criteria. The results of this review emphasize the need to implement and test more specific interventions targeting the needs of the ADS population.
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38
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O'Connell B, Hawkins M, Ostaszkiewicz J, Millar L. Carers’ perspectives of respite care in Australia: An evaluative study. Contemp Nurse 2012. [DOI: 10.5172/conu.2012.1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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39
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Accessing community-based and long-term care services: challenges facing persons with frontotemporal dementia and their families. J Mol Neurosci 2011; 45:737-41. [PMID: 21826393 DOI: 10.1007/s12031-011-9612-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 07/22/2011] [Indexed: 11/27/2022]
Abstract
There are several barriers to accessing services for persons with frontotemporal dementia (FTD), and few studies have examined service needs and satisfaction with services for family caregivers of persons with FTD. Persons with FTD and their families have reported consistent difficulties in their attempts to access care and support. These are: (1) difficulty obtaining a diagnosis; (2) financial concerns due to loss of employment, job-related income; (3) problems accessing social security disability insurance; and (4) lack of adequate community-based and long-term care services and resources. Successful care practices such as use of an interdisciplinary team and helpful care models such as person-centered care and the antecedent-behavior-consequence method are described. Further investigation and research are needed to understand best care strategies for persons with FTD.
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Kim H, Chang M, Rose K, Kim S. Predictors of caregiver burden in caregivers of individuals with dementia. J Adv Nurs 2011; 68:846-55. [PMID: 21793872 DOI: 10.1111/j.1365-2648.2011.05787.x] [Citation(s) in RCA: 308] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS This article is a report on a study of the multidimensional predictors of caregiver burden in caregivers of individuals with dementia using nationally representative data. BACKGROUND Caregiver burden affects the health of both caregivers and their care-recipients. Although previous studies identified various predictors of caregiver burden, these predictors have not been confirmed in nationally representative population. METHODS Data for this secondary analysis was provided by the National Alliance for Caregiving, American Association of Retired Persons. The data were collected through a telephone survey of randomly selected adults in seven states in 2003 (weight adjusted n = 302). Descriptive statistics, inter-correlation analysis and a hierarchical multiple regression analysis were performed. RESULTS/FINDINGS Disease-related factors were the most significant predictors, explaining 16% of caregiver burden; these were followed by caregiver socio-demographical factors and caregiving-related factors (F = 21·28, P < 0·01). Significant individual predictors were impairment of activities of daily living or instrumental activities of daily living, the number of hours of caregiving, use of coping strategies, co-residence, spousal status and caregiver gender (P < 0·05). CONCLUSION Impaired function in care-recipients predicts caregiver burden, and also interacts with demographical- and caregiving-related factors. Thus, it will be beneficial to both care-recipients and caregivers to target nursing interventions and community services to improve the functional abilities of individuals with dementia.
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Affiliation(s)
- Heejung Kim
- School of Nursing, University of Virginia, Charlottesville, Virginia, USA.
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41
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Raivio MM, Laakkonen ML, Pitkälä KH. Alzheimer's patients' spouses critiques of the support services. ISRN NURSING 2011; 2011:943059. [PMID: 21994898 PMCID: PMC3168926 DOI: 10.5402/2011/943059] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 05/07/2011] [Indexed: 11/23/2022]
Abstract
Introduction. Caregiving families of patients with dementia are often reluctant to use support services. The aim of this study was to describe their subjective critiques of these services.
Material and Methods. A cross-sectional questionnaire was sent to a random sample (N = 1943) of Alzheimer's patients' spouses in Finland with an open-ended question: “What kind of problems have you faced with the services?” Their responses were analyzed with thematic content analysis.
Results. Of the responders identifying themselves as caregivers (N = 1386), 728 (mean age 77.8, 65.1% females) responded. Opinions could be divided into two categories: (1) problems with the service application process (N = 296); (2) critiques of the services offered (N = 270) including either problems with community care support services or institutional care. 74 indicated that they had no need for services, and 15 praised the services they had received.
Conclusions. From the caregiver's perspective, the service system is complicated, bureaucratic and works organization centredly.
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Affiliation(s)
- Minna M Raivio
- Department of Health, The Social Insurance Institution of Finland, Kirkkokatu 8, 15141 Lahti, Finland
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42
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LeBlanc LA. Integrating behavioral psychology services into adult day programming for individuals with dementia. Behav Modif 2011; 34:443-58. [PMID: 20935243 DOI: 10.1177/0145445510383528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many individuals with dementia and problem behavior are served in nursing home settings long before health issues necessitate constant medical care. Alternative community-based adult day health care programs allow individuals with dementia to remain in their home with their families at a substantially reduced cost; however, many adult day programs face the same difficulties in managing problem behavior as family members do, leading to premature termination of services. This article describes a multiyear project that integrated behavior analytic services into an adult day program for individuals with dementia and problematic behavior. A comprehensive practicum system was developed to provide assessment and treatment services that allowed consumers with problem behavior to remain successfully served in adult day programming while postponing out-of-home nursing home care.
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Affiliation(s)
- Linda A LeBlanc
- Department of Psychology, 226 Thach Hall, Auburn University, AL 36849-5214, USA.
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Casado BL, van Vulpen KS, Davis SL. Unmet Needs for Home and Community-Based Services Among Frail Older Americans and Their Caregivers. J Aging Health 2010; 23:529-53. [PMID: 21084723 DOI: 10.1177/0898264310387132] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study examined unmet needs for home- and community-based services (HCBS) among frail older Americans. Method: Using population-based sample from the National Long-Term Care Survey, a hierarchical logistic regression analysis was conducted to examine the predictors of unmet needs for seven types of HCBS. Results: Lack of awareness, reluctance, unavailability, and affordability of services were the main reasons for unmet needs for HCBS. Factors that were associated with unmet needs included Black race/ethnicity, greater care needs (functional limitations and behavioral problems), and less informal support (substitute help and family agreement). Discussion: It is important to identify risk factors that may lead to older adults’ unmet needs for HCBS. The findings of this study charge researchers to look beyond service utilization and give more attention to service needs among those who did or could not access the services.
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Affiliation(s)
| | | | - Stacey L. Davis
- University of Maryland School of Social Work, Baltimore, MD, USA
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Abstract
Lewy body dementia (LBD) is a common cause of dementia but to date, little is known about caregiver burden. The Lewy Body Dementia Association (www.LBDA.org) conducted a web-based survey of 962 caregivers (mean age 56 y; 88% women). The most common initial symptoms were cognitive (48%), motor (39%), or both (13%). Caregivers expressed concerns about fear of future (77%), feeling stressed (54%), loss of social life (52%), and uncertainty about what to do next (50%). Caregivers reported moderate-to-severe burden; 80% felt the people around them did not understand their burden and 54% reported feelings of isolation with spousal caregivers reporting more burden than nonspousal caregivers. Only 29% hired in-home assistance, whereas less than 40% used respite or adult day care, geriatric case managers, or attended a support group meeting. Lack of service utilization occurred despite two-thirds of caregivers reporting medical crises requiring emergency services, psychiatric care, or law enforcement. Caregivers reported preferences for web-based information, directories of LBD expert providers, information on LBD research, and location of local support groups. These findings highlight significant unmet needs for LBD caregivers and provide targets for intervention to reduce caregiver burden. Community resources such as the Lewy Body Dementia Association may serve this end, while also providing practical information and support for caregivers.
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Harris M. A Closer Look at Caregiving. J Psychosoc Nurs Ment Health Serv 2010; 48:11; author reply 11-12. [DOI: 10.3928/02793695-20100215-98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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