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Labori F, Persson J, Svensson M, Bonander C. The impact of stroke on spousal and family income: a difference-in-difference study from Swedish national registries. Top Stroke Rehabil 2024; 31:381-389. [PMID: 37842918 DOI: 10.1080/10749357.2023.2269674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
AIM To investigates the financial consequences in the overall population spouses of persons with stroke in Sweden as well as for subgroups based on spouses age, sex and modified Rankin Scale (mRS) of the person with stroke. METHODS The study population consists of spouses aged ≤ 60 during the year of their partner's stroke event. Each spouse was matched to four reference individuals. This longitudinal registry data covers spouses and a reference population between 2005 and 2016. We use difference-in-differences to estimate the impact on individual income from paid work, disposable individual income, and disposable family income. RESULTS The primary analysis shows a small and statistically insignificant decrease on spouses' individual income from paid work and disposable individual income. In the subgroup analysis based on mRS, the largest effect is seen in mRS 4-5, where spouses' individual income from paid work and disposable individual income increases after their partner's stroke. Further, younger female spouses' individual income from paid work decreases by 1 614 EUR (p = 0.008) on average. CONCLUSION The financial consequences are small in the overall population of spouses. However, for some subgroups, younger women, and spouses of persons with stroke and mRS 4-5, the financial consequences are more prominent.
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Affiliation(s)
- Frida Labori
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Josefine Persson
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Svensson
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, USA
| | - Carl Bonander
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden
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Nadash P. The State of Family Caregiving Policy. J Aging Soc Policy 2024:1-11. [PMID: 38626336 DOI: 10.1080/08959420.2024.2339177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/05/2024] [Indexed: 04/18/2024]
Abstract
As the population ages and supportive services are increasingly delivered in home- and community-based settings, greater demands are placed on family caregivers. This essay introducing the special issue of the Journal of Aging and Social Policy discusses signs of progress on policies to ease the burden on family caregivers. It introduces a series of articles that reflect the growing body of research on caregiver-related policy actions. These actions range from expanding access to paid family leave and payment for providing care, to ensuring access to better data about family caregivers and improving the post- hospital discharge experiences of rural and underserved caregivers. It also explores a major conundrum around caregiving policy - why progress on family caregiving policy has been so slow, despite its clear importance to the health and welfare of those who receive supports, as well as to those providing supports. In addition, the essay discusses developments, such as Biden administration actions and the RAISE Family Caregiver Advisory Council, indicating that the political dynamic around caregiving has changed, concluding that this is a uniquely hopeful time for family caregiver-related policy.
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Affiliation(s)
- Pamela Nadash
- Department of Gerontology, Donna M and Robert J Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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Su Q, Wang Y, Fan L. The Impact of Informal Care on Healthcare Utilization of Older Adults with Functional Limitations in China. J Gerontol Soc Work 2024:1-16. [PMID: 38600766 DOI: 10.1080/01634372.2024.2338061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/15/2024] [Indexed: 04/12/2024]
Abstract
Our study examines the impact of informal care on healthcare utilization, focusing on caregiver types, urban-rural, and gender differences. Analyzing data from the China Health and Retirement Longitudinal Study and using fixed effects models, we discovered complementary effects between informal care and healthcare. Specifically, spousal care increased inpatient care use, adult child care boosted both inpatient and outpatient use, and dual care from children and spouses showed the most significant impact on healthcare use. The association between informal care and healthcare use varied across gender or urban-rural residence. Our findings highlight the importance of caregivers in accessing healthcare services.
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Affiliation(s)
- Qing Su
- School of Public Health, Southeast University, Nanjing, China
| | - Yanshang Wang
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Lijun Fan
- School of Public Health, Southeast University, Nanjing, China
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Li Y, Cai X, Kim YY, Kim J. Informal care provided in US nursing homes: Reduced from 2010 to 2021 and lower for Medicaid residents. J Am Geriatr Soc 2024. [PMID: 38572953 DOI: 10.1111/jgs.18904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/23/2024] [Accepted: 03/14/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Little is known about the trend of informal care (unpaid care provided by family or other caregivers) provided to nursing home residents before or during the COVID-19 pandemic. This study assessed this trend during 2010-2021, for all and Medicaid versus non-Medicaid residents. METHODS Using data from the RAND Health and Retirement Study longitudinal file, our study sample included a total of 2025 resident-years (860 for Medicaid and 1165 for non-Medicaid residents). We fit two-part regression models to determine adjusted trends in average amount of informal care over time, and difference by resident Medicaid status. RESULTS Informal care received by residents reduced substantially over time, from an average of 39.2 h in the past month of interview in 2010-11 to 23.2 h in 2018-19, and then to 11.2 h in the COVID-19 pandemic (2020-21). The reduced hours were due to both reduced percentages of nursing home residents who received any informal care and reduced hours of care among those who did receive it over time. Multivariable analyses confirmed this trend and similar downward trends for Medicaid versus non-Medicaid residents. Medicaid residents on average received 10.02 fewer hours of informal care per month (95% confidence interval -17.16, -2.87; p = 0.006) than non-Medicaid residents after adjustment for resident characteristics and time trends. CONCLUSION Informal care provided to nursing home residents during 2010-2021 reduced over time, especially during the COVID-19 pandemic (2020-21). Medicaid residents tended to receive less informal care than non-Medicaid residents.
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Affiliation(s)
- Yue Li
- Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, New York, USA
| | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA
| | - Yeunkyung Yoon Kim
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, Nevada, USA
| | - Jihye Kim
- Department of Epidemiology & Biostatistics, School of Public Health, University of Nevada, Las Vegas, Nevada, USA
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Van Houtven CH, Smith VA, Miller KEM, Berkowitz TSZ, Shepherd-Banigan M, Hein T, Penney LS, Allen KD, Kabat M, Jobin T, Hastings SN. Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain. Med Care Res Rev 2024; 81:107-121. [PMID: 38062735 DOI: 10.1177/10775587231210026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Disabled Veterans commonly experience pain. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides training, a stipend, and services to family caregivers of eligible Veterans to support their caregiving role. We compared ascertainment of veteran pain and pain treatment through health care encounters and medications (pain indicators) of participants (treated group) and non-participants (comparison group) using inverse probability treatment weights. Modeled results show that the proportion of Veterans with a pain indicator in the first year post-application was higher than that pre-application for both groups. However, the proportion of Veterans with a pain indicator was substantially higher in the treatment group: 76.1% versus 63.9% in the comparison group (p < .001). Over time, the proportion of Veterans with any pain indicator fell and group differences lessened. However, differences persisted through 8 years post-application (p < .001). PCAFC caregivers appear to help Veterans engage in pain treatment at higher rates than caregivers not in PCAFC.
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Affiliation(s)
- Courtney H Van Houtven
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System
- Department of Population Health Sciences, Duke University School of Medicine
- Duke Margolis Center for Health Policy, Duke University
| | - Valerie A Smith
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System
- Department of Population Health Sciences, Duke University School of Medicine
- Department of General Internal Medicine, Duke University
| | - Katherine E M Miller
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System
- Department of Medical Ethics and Health Policy, University of Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania
| | - Theodore S Z Berkowitz
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System
| | - Megan Shepherd-Banigan
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System
- Department of Population Health Sciences, Duke University School of Medicine
| | - Tyler Hein
- Office of Mental Health and Suicide Prevention, Department of Veterans Affairs
| | - Lauren S Penney
- The Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, South Texas Veterans Health Care System
- Department of Medicine, Division of Hospital Medicine, University of Texas Health San Antonio
| | - Kelli D Allen
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System
- Department of Medicine, University of North Carolina at Chapel Hill
| | - Margaret Kabat
- Office of the Secretary US Department of Veterans Affairs
| | - Timothy Jobin
- Caregiver Support Program, Veterans Health Administration, US Department of Veterans Affairs
| | - S Nicole Hastings
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System
- Department of Population Health Sciences, Duke University School of Medicine
- Department of Medicine, Division of Geriatrics, Duke University School of Medicine
- Center for the Study of Aging and Human Development, Duke University School of Medicine
- Geriatrics Research, Education and Clinical Center, Durham VA Health Care System
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Lastuka A, Breshock MR, McHugh TA, Sogge WT, Swart V, Dieleman JL. U.S. dementia care spending by state: 2010-2019. Alzheimers Dement 2024; 20:2742-2751. [PMID: 38411287 PMCID: PMC11032574 DOI: 10.1002/alz.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/05/2024] [Accepted: 01/24/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Dementia is the fourth largest cause of death for individuals 70 years of age and older in the United States, and it is tremendously costly. Existing estimates of the indirect costs of dementia are dated and do not report on differences across the United States. METHODS We used data from multiple surveys to create cost estimates and projections for informal dementia caregiving at the U.S. state level from 2010 through 2050. RESULTS In 2019, the annual replacement cost of informal caregiving was $42,422 per prevalent case, and the forgone wage cost was $10,677 per prevalent case. In 2019, it would have cost $230 billion to hire home health aides to provide all this care. If past trends persist, this cost is expected to grow to $404 billion per year in 2050. DISCUSSION The cost of informal care varied substantially by state and is expected to grow through at least 2050. HIGHLIGHTS In the United States in 2019, foregone wages due to informal dementia care was $58 billion. Replacing informal dementia care with health aides would have cost $230 billion. These costs vary dramatically by state, even when assessed per prevalent case. These costs are expected to nearly double by 2050.
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Affiliation(s)
- Amy Lastuka
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWashingtonUSA
| | - Michael R. Breshock
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWashingtonUSA
| | - Theresa A. McHugh
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWashingtonUSA
| | - William T. Sogge
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWashingtonUSA
| | - Vivianne Swart
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWashingtonUSA
| | - Joseph L. Dieleman
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWashingtonUSA
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Koomson I, Lenzen S, Afoakwah C. Informal care and financial stress: Longitudinal evidence from Australia. Stress Health 2024:e3393. [PMID: 38451735 DOI: 10.1002/smi.3393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
The number of people providing informal care has increased considerably in the last years while, at the same time, about one in four Australians have financial stress problems. This study uses rich longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey to estimate the effect of informal care on financial stress. To establish causality, we exploit a fixed effect-instrumental variable approach to address omitted variable bias and reverse causality problems. Our findings show that informal caregiving increases financial stress between 9.9 and 14.5 percentage points. This finding is robust across a battery of quasi-experimental methods. The effect of informal caregiving on financial stress is more pronounced among males, rural residents and those living in low socioeconomic areas. Our analyses further show that financial fragility and social isolation are important channels through which informal caregiving affects financial stress.
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Affiliation(s)
- Isaac Koomson
- Centre for the Business and Economics of Health, The University of Queensland, St Lucia, Queensland, Australia
- Network for Socioeconomic Research and Advancement (NESRA), Accra, Ghana
| | - Sabrina Lenzen
- Centre for the Business and Economics of Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Clifford Afoakwah
- Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Jiang H, Smit K, Anderson-Luxford D, Willoughby B, Ferrier JA, Tanyos A, Room R, Laslett AM. The burden of alcohol-related caring for others in Australia in the 2021 pandemic period. J Stud Alcohol Drugs 2024. [PMID: 38445854 DOI: 10.15288/jsad.23-00261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVE The magnitude of caring for others due to excessive alcohol use is unclear in Australia and internationally. This study explores the prevalence, sociodemographic predictors, and consequences of informal care for others due to alcohol use. METHOD A survey on harm from others' drinking was conducted among 2,574 Australian adults in November 2021 from national random digit dial and "Life in Australia" panel samples to elicit representative data. Respondents who indicated they had "heavy drinker/s" in their lives (n= 1,585), were asked about their experience of caring for these drinkers and their dependents in the last 12 months. Weighted logistic and linear regressions examined a) sociodemographic factors associated with informal care due to others' drinking, and b) the impact of the caregiving burden on caregiver's financial status, overall health, and quality of life. RESULTS Overall, 20% of participants reported caregiving responsibilities arising from others' drinking. Older age, unemployment, residing in capital cities and reporting birth in a non-English speaking background country were associated with a reduced likelihood of caregiving, whereas higher education and more frequent risky drinking were associated with an increased likelihood. Caregivers reported significantly higher financial disadvantage, a lower quality of life and poorer overall health. CONCLUSIONS One in five adults reported caring for drinkers in the previous 12 months, with this associated with negative consequences for those providing care. Service providers, health promotion practitioners and policy makers should focus upon younger age groups, those who live in regional areas, and those born in Australia who are at greater risk of being burdened by caregiving due to others' alcohol use.
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Affiliation(s)
- Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, NR1 Building, Melbourne VIC 3086, Australia
- Department of Public Health, School of Psychology and Public Health, La Trobe University
- Care Economy Research Institute, La Trobe University, Melbourne VIC 3086, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne VIC 3053, Australia
| | - Koen Smit
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, NR1 Building, Melbourne VIC 3086, Australia
| | - Dan Anderson-Luxford
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, NR1 Building, Melbourne VIC 3086, Australia
| | - Bree Willoughby
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, NR1 Building, Melbourne VIC 3086, Australia
| | - J Adamm Ferrier
- Department of Public Health, School of Psychology and Public Health, La Trobe University
| | - Amany Tanyos
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, NR1 Building, Melbourne VIC 3086, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, NR1 Building, Melbourne VIC 3086, Australia
- Care Economy Research Institute, La Trobe University, Melbourne VIC 3086, Australia
| | - Anne-Marie Laslett
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, NR1 Building, Melbourne VIC 3086, Australia
- Care Economy Research Institute, La Trobe University, Melbourne VIC 3086, Australia
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Taylor B, Thompson J, Ryan T. 'Moving on' for Adults With a Learning Disability and Their Families: A Constructivist Grounded Theory Study. Qual Health Res 2024:10497323241232360. [PMID: 38437864 DOI: 10.1177/10497323241232360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Ending familial co-residence, termed 'moving on' by participants, is an increasingly relevant life transition for people with a learning disability due to increasing life expectancy and policy developments. Nevertheless, there is an absence of research exploring this transition experience in a United Kingdom (UK) context. This constructivist grounded theory study therefore aimed to explore, conceptualise, and theorise the 'moving on' experiences of adults with a learning disability and their families. This article reports the experiences of five adults with a learning disability and nine family members in England, UK. Narrative interviews and creative storybook methods were used to collect data between April 2015 and May 2016. Constant comparative methods, theoretical sampling, and memo writing were used throughout data collection and analysis. Participants with a learning disability presented personal growth and greater life fulfilment over the course of the transition; they flourished. In parallel, family members relinquished their care responsibilities. Importantly, the iterative and reciprocal relationship between flourishing and relinquishing shows that ongoing family member involvement is crucial during and following relocation. Family members identified factors that potentially inhibit relinquishing: pressure to 'let go', different perceptions of independence between family members and service providers, inadequate future investment, and rapport with professional carers. These novel insights led to the generation of the first known mid-range theory concerning this transition, entitled 'Moving on: flourishing and relinquishing'. Findings will guide future research in this field and facilitate the design of appropriate support for people with a learning disability and their families.
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Affiliation(s)
- Bethany Taylor
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Jill Thompson
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Tony Ryan
- Health Sciences School, University of Sheffield, Sheffield, UK
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Thorn J, Garfield K. How should we measure the use of social care and informal care? Expert Rev Pharmacoecon Outcomes Res 2024; 24:327-329. [PMID: 38277261 DOI: 10.1080/14737167.2024.2309926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/21/2024] [Indexed: 01/28/2024]
Affiliation(s)
- Joanna Thorn
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Kirsty Garfield
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
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Marion C, Manji S, Podlosky L, MacGillivray H, L’Heureux T, Anderson S, Parmar J. Family Involvement Training for Staff and Family Caregivers: Case Report on Program Design and Mixed Methods Evaluation. Healthcare (Basel) 2024; 12:523. [PMID: 38470633 PMCID: PMC10930910 DOI: 10.3390/healthcare12050523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
The COVID-19 pandemic underscored the imperative for meaningful family involvement in long-term care, aligning with policy and safety standards while enhancing outcomes for caregivers, residents, and staff. The objectives of this article are as follows: (1) a case study report on implementing a family involvement intervention designed to facilitate the formal and safe engagement of family caregivers in resident care and (2) the pilot evaluation of the intervention. We used Knapp's six-step implementation science model to guide and describe intervention development to provide insight for others planning family involvement projects. We employed sequential mixed methods, including surveys with quantitative and qualitative questions before and after program implementation for providers, and surveys and interviews with family caregivers a year after. We used the Mann-Whitney U test (p < 0.05) to assess differences in health providers' perceptions pre- and post-education. Families and staff perceived that the Family Involvement Program was important for improving the quality of care, residents' quality of life and family/staff relationships. Providers' perceptions of the program's positive impact on residents' quality of life (p = 0.020) and quality of care (p = 0.010), along with their satisfaction with working relationships with families (p = 0.039), improved significantly after the program. Qualitative data confirmed improvements in family-staff relationships. In conclusion, we documented the design of this family involvement initiative to encourage family caregivers and staff to work together in residents' care. Youville's Family Involvement Program gives families and family caregivers an explicit role as partners in long-term care. The mixed methods pilot evaluation documented improvements in staff and family relationships.
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Affiliation(s)
- Cecilia Marion
- Covenant Health Canada, Youville Home, St. Albert, AB T8N 1K1, Canada; (C.M.); (S.M.); (H.M.)
| | - Shazmin Manji
- Covenant Health Canada, Youville Home, St. Albert, AB T8N 1K1, Canada; (C.M.); (S.M.); (H.M.)
| | - Linda Podlosky
- Family Caregiver, University of Alberta, Edmonton, AB T6G 2T4, Canada;
| | - Heather MacGillivray
- Covenant Health Canada, Youville Home, St. Albert, AB T8N 1K1, Canada; (C.M.); (S.M.); (H.M.)
| | - Tanya L’Heureux
- Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada; (T.L.); (J.P.)
| | - Sharon Anderson
- Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada; (T.L.); (J.P.)
| | - Jasneet Parmar
- Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada; (T.L.); (J.P.)
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Subramaniam A, Mehta KK. Exploring the Lived Experiences of Caregiving for Older Family Members by Young Caregivers in Singapore: Transition, Trials, and Tribulations. Int J Environ Res Public Health 2024; 21:182. [PMID: 38397673 PMCID: PMC10888348 DOI: 10.3390/ijerph21020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Amidst population ageing trends and epidemiological transitions, there has been a growing emergence of young family caregivers, about whom most studies have been conducted in Western countries. Their subjective experiences and perceptions toward caregiving remain underexplored in Asia. This qualitative study explored the lived experiences of caregiving for older family members by young caregivers in Singapore. Interpretative phenomenological analysis was employed to collect and analyse data from semi-structured, in-depth interviews with six young adult caregivers aged between 23 and 29. Interviews were supplemented with photo-elicitation techniques to deepen interview discussions and uncover experiential significance. Findings illustrated transitions into caregiving, challenges across role conflicts and expectations amidst developmental tasks and transitions, and navigation of intergenerational conflicts and ambivalence. Although no definitive conclusions can be reached from this small-scale study, the findings offer important insights into the convergence and intensity of young caregivers' experiences. Given that caregiving challenges are likely to continue amidst Singapore's rapidly ageing population, these necessitate further in-depth research efforts. Implications for policy and practice across multiple stakeholders interfacing with youth and older adults are presented. A whole-of-society approach is called for to enable young caregivers to realise their full potential while contributing to their ageing families and nation.
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Affiliation(s)
- Araviinthansai Subramaniam
- S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore 599494, Singapore;
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13
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Schmitz D, Becker B. Chatbot-Mediated Learning For Caregiving Relatives of People With Dementia: Empirical Findings and Didactical Implications For Mulitprofessional Health Care. J Multidiscip Healthc 2024; 17:219-228. [PMID: 38250309 PMCID: PMC10799614 DOI: 10.2147/jmdh.s424790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
Purpose Supporting family caregivers is a major challenge for the healthcare system. The first points of contact are physicians, nurses and social services, which are not easily accessible. For this reason, an information platform has been developed to provide information for family caregivers caring for people with dementia at home. The aim of this article is to provide an insight into the didactic design of this platform. Sample and Methods A didactic concept was developed based on didactic target group analysis and interviews with caring relatives (n=6). Results The didactic concept of the digital platform takes into account the characteristics of family caregivers as learners, such as time constraints and reciprocity. Therefore two different learning paths, a long and a short version, are offered. Reciprocity is supported by information which are related to individual characteristics of the caring relation. This is made possible by an adaptation of the didactic method "anchored instructions": Family caregivers experience a problematic caring situation. They use the platform and central concepts related to this situation are offered as anchors. In chatbot mediated learning, these concepts are identified and, ideally, relevant information is provided in a short version. These concepts are displayed as a learning map and must be proactively selected. Chatbot mediated learning has the advantage that matching concepts are offered as a pre-selection. Especially for inexperienced carers who are not familiar with the concepts, this learning path seems to be suitable. Conclusion The combination of learning through the "Information for Relatives" website and CML seems to meet all needs. In order to promote learner motivation, the chatbot should not only offer the identified concept, but also those related to this concept, in order to link new knowledge in one's own knowledge network.
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Affiliation(s)
- Daniela Schmitz
- Department for Human Medicine, Junior Professorship for Innovative and Digital Methods of Teaching and Learning in Multiprofessional Health Care, Witten/Herdecke University, Witten, NRW, Germany
| | - Britta Becker
- Department for Human Medicine, Junior Professorship for Innovative and Digital Methods of Teaching and Learning in Multiprofessional Health Care, Witten/Herdecke University, Witten, NRW, Germany
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Garcia CN, Duran MC, Ramirez M. Refining Cultural Adaptations of a Behavioral Intervention for Latino Caregivers of People Living With Dementia: Qualitative Interview Study in Washington State. JMIR Aging 2024; 7:e53671. [PMID: 38206663 PMCID: PMC10811572 DOI: 10.2196/53671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND In the United States, Latino caregivers of individuals with dementia face unique challenges and an elevated risk of adverse health outcomes. Despite the increasing prevalence of Alzheimer disease and related dementias among Latino adults, few evidence-based interventions are tailored to their cultural context. To address this gap, we examined the cultural adaptations required for the STAR caregivers (STAR-C) virtual intervention, an evidence-based intervention that educates family caregivers to manage behavioral and psychological symptoms of dementia. While STAR-C has shown effectiveness, neither the original in-person nor the virtual intervention considered the distinct experiences of Latino caregivers, who often bring culturally significant values into caregiving interactions. OBJECTIVE This study's objective was to test and refine the preliminary cultural adaptations of the STAR-C web-based training modules for Latino caregivers of people living with dementia. METHODS Through qualitative interviews with 15 Latino caregivers in Washington State, we identified key adaptations to enhance the cultural relevance of the web-based training modules. RESULTS The interviews highlighted 4 main themes for adaptation: the delivery of the STAR-C web-based training modules, comprehensive dementia education, simplified problem-solving strategies, and prioritizing caregiver well-being. CONCLUSIONS This study's findings informed the development of culturally adapted STAR-C web-based training modules that aim to provide tailored support to Latino caregivers. While further research is needed to assess the efficacy of these adaptations, our work contributes to bridging the gap in dementia caregiving for Latino families, potentially reducing health disparities and enhancing health care services for this population.
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Affiliation(s)
- Celeste N Garcia
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Miriana C Duran
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
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Teles S, Napolskij MS, Ribeiro O, Alves S, Freitas A, Ferreira A, Paúl C. Willingness to institutionalize a relative with dementia: a web-platform assessment with the Portuguese adapted version of the Desire-to-Institutionalize Scale. Front Med (Lausanne) 2024; 10:1277565. [PMID: 38259839 PMCID: PMC10801059 DOI: 10.3389/fmed.2023.1277565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Older persons with dementia (PwD) are more likely to be institutionalized than their counterparts without dementia. The caregiver's desire to institutionalize has been suggested as the most important predictor of actual institutionalization. This cross-sectional study aimed to culturally adapt the Desire to Institutionalize Scale (DIS) to a country with a high prevalence of dementia (Portugal) and examine its psychometric properties. Methods The reliability, structural validity, and criterion validity of the DIS-PT were assessed by applying the scale using a remote measurement web platform. A sample of 105 dementia caregivers completed the DIS-PT and several psychosocial measures, including caregiver burden, anxiety, depression, quality of life, PwD functional independence, and neuropsychiatric symptoms. Results The DIS-PT demonstrated good structural validity, with one factor explaining 75% of the total variance. The internal consistency of the scale was high (α = 0.802). Most caregivers (65.7%) endorsed at least one item on the DIS-PT (Mdn 2). The caregiver's desire to institutionalize was significantly associated with the caregiver, care recipient, and contextual variables previously known to affect institutional placement. These included the caregivers' occupational status, perceived burden, anxiety (but not depression), physical and psychological quality of life, care recipient education, severity of neuropsychiatric symptoms, and cohabitation with the caregiver. Discussion This study offers preliminary support for the psychometric quality of the DIS-PT. The scale has practical applications in the early identification of caregivers considering nursing home placement, providing room for intervention in modifiable risk factors that may otherwise lead to the institutionalization of PwD. Remote measurement tools may hold value in assessing caregiving dyads non-intrusively and inexpensively.
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Affiliation(s)
- Soraia Teles
- Department of Behavioral Sciences, School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
- Center for Health Technology and Services Research of the Associate Laboratory Health Research Network (CINTESIS@RISE), Porto, Portugal
| | - Milaydis Sosa Napolskij
- Center for Health Technology and Services Research of the Associate Laboratory Health Research Network (CINTESIS@RISE), Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research of the Associate Laboratory Health Research Network (CINTESIS@RISE), Porto, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Sara Alves
- Center for Health Technology and Services Research of the Associate Laboratory Health Research Network (CINTESIS@RISE), Porto, Portugal
- Center of Research, Diagnosis, Training and Care of Dementia (CIDIFAD), SCMRA, Riba D’Ave, Portugal
| | - Alberto Freitas
- Center for Health Technology and Services Research of the Associate Laboratory Health Research Network (CINTESIS@RISE), Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Ana Ferreira
- Center for Health Technology and Services Research of the Associate Laboratory Health Research Network (CINTESIS@RISE), Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Constança Paúl
- Department of Behavioral Sciences, School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
- Center for Health Technology and Services Research of the Associate Laboratory Health Research Network (CINTESIS@RISE), Porto, Portugal
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PRICE D, DI GESSA G. Mental health and self-rated health of older carers during the COVID-19 pandemic: evidence from England. Aging Ment Health 2024; 28:103-111. [PMID: 37482075 PMCID: PMC10803633 DOI: 10.1080/13607863.2023.2236569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/11/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES Older carers play a vital role supporting population health and protecting health and social care systems, yet there has been little research on understanding the effect of the pandemic on this group. In this paper, we investigate caring as a factor contributing to mental and self-rated health. METHODS We investigate cross-sectional and longitudinal associations between provision of family care and mental health and wellbeing using longitudinal data from 5,149 members of the English Longitudinal Study of Ageing who responded to Wave 9 (2018/2019) and two COVID-19 sub-studies (June/July 2020; November/December 2020). We use logistic or linear regression models depending on outcome measures, controlling for pre-pandemic socioeconomic, demographic, and health-related variables. RESULTS Before the pandemic, 21% of respondents cared for family or friends. Older people caring for someone inside the household mostly continued to provide care during the pandemic, with more than a quarter reporting an increase in the amount of care provided. Co-resident carers were disproportionately female, older, in the lowest wealth quintile, and more likely to report disability and chronic conditions. Both cross-sectional and longitudinal analyses suggest that, compared to those caring for people living outside the household, co-resident carers were significantly more likely to report poorer mental health and self-rated health. CONCLUSION The health of older carers worsened disproportionately in the first year of the pandemic, a period also characterised by disruptions to support and closure of respite services. Support for carers' mental and physical health requires greater policy attention, especially in pandemic conditions.
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Affiliation(s)
- Debora PRICE
- Department of Sociology, School of Social Sciences, University of Manchester, Manchester, UK
| | - Giorgio DI GESSA
- Institute of Epidemiology & Health Care, Department of Epidemiology & Public Health, University College London, London, UK
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Hooley B, Otchi EH, Mayeden S, Yawson AE, Awoonor-Williams K, Tediosi F. Examining the Utilization of Social Capital by Ghanaians When Seeking Care for Chronic Diseases: A Personal Network Survey. Int J Public Health 2023; 68:1605891. [PMID: 38179319 PMCID: PMC10764420 DOI: 10.3389/ijph.2023.1605891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 11/29/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives: With limited social security and health protection in Ghana, intergenerational support is needed by those living with NCDs, who incur recurrent costs when seeking NCD care. We measured the level of informal support received by NCD patients and identified factors that influence support provision. Methods: We surveyed 339 NCD patients from three hospitals in Ghana, who listed their social ties and answered questions about their relationship and support frequency. We analyzed the relationship between social support, demographic and health information, characteristics of social ties, and network characteristics. Results: Participants described 1,371 social ties. Nearly 60% of respondents reported difficulties in their usual work or household duties due to chronic illness, which was also the strongest predictor of support. Patients with higher wellbeing reported less social support, while older age and having co-habitant supporters were negatively associated with support, indicating caregiver burnout. Conclusion: Ghanaian NCD patients receive support from various caregivers who may not be able to handle the increasing healthcare and social needs of an aging population. Policies should therefore enhance resource pooling and inclusiveness for old age security.
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Affiliation(s)
- Brady Hooley
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Elom Hillary Otchi
- Korle Bu Teaching Hospital, Accra, Ghana
- Accra College of Medicine, Accra, Ghana
| | | | - Alfred Edwin Yawson
- Korle Bu Teaching Hospital, Accra, Ghana
- Medical School, University of Ghana, Accra, Ghana
| | - Koku Awoonor-Williams
- Department of Policy, Planning, Monitoring and Evaluation, Ghana Health Service, Accra, Ghana
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
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18
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Daynes-Kearney R, Gallagher S. Online Support Groups for Family Caregivers: Scoping Review. J Med Internet Res 2023; 25:e46858. [PMID: 38090796 PMCID: PMC10753418 DOI: 10.2196/46858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Caregiving can affect people of all ages and can have significant negative health impacts on family caregivers themselves. Research has shown that social support acts as a buffer against many negative health impacts. A common source of social support is support groups. Although traditionally, these groups were conducted in a face-to-face setting, the advent of the internet, social media applications, and the smartphone have seen online support groups (OSGs) develop as a space where many caregivers seek support. The number of OSGs has increased exponentially, but there is no clear consensus on what factors or characteristics of OSGs contribute to social support development within them or what types of OSGs are available to family caregivers. OBJECTIVE This study aimed to conduct a scoping review to contribute to the understanding of the types and characteristics of OSGs for family caregivers. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, the CINAHL, PsychInfo, Psych Articles, Social Sciences, Communication Source, Medline, and Web of Science databases were searched for studies (caregiver focused, adults aged 18 years or older, online social support groups, caring for a living person, peer-reviewed journal publications on empirical research). In total, 19 studies were included in the review. The research questions were (1) what type of social support groups are online for adult family caregivers, (2) what the communication mediums and characteristics of these OSGs are, and (3) what psychosocial or other factors make OSGs successful or unsuccessful for participants. RESULTS In response to the first research question, we found that the majority of OSGs took place on public text-based forums and were illness specific. Where demographics were reported, participants were predominately women, White, and working with university-level education. There were a variety of caregiving relationships. For the second research question, the most common communication medium found was text-based communication, with the use of emojis, photos, and GIF (Graphics Interchange Format) files as part of these exchanges. Most frequently, the OSGs were asynchronous with a degree of anonymity, not time-limited by the frequency of contact or duration, and moderated by peer or professional moderators or facilitators. Results for the third research question explored the overarching categories of safe communication and engagement and group management. These described successful OSGs as having a focus on similar others with shared lived experiences communicated in a nonjudgmental space overseen by trained peer or professional facilitators. CONCLUSIONS There are several key considerations for OSGs to be successful for family caregivers. A general recommendation for practitioners is to give importance to building active moderation and multifaceted structures of support to meet different levels of caregiver needs and the ability to engage.
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Affiliation(s)
- Rosemary Daynes-Kearney
- Study of Anxiety, Stress and Health Laboratory, Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Study of Anxiety, Stress and Health Laboratory, Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Ferreira PM, Gomes MC, de Araujo LN, Oliveira TSOD, Ferreira G, Aben-Athar C, da Silva SED, Cruz Ramos AMP, Rodrigues DP, Sousa F. Sociodemographic Profile, Health Conditions, and Burden of Informal Caregivers of Older Adults in Brazil During the COVID-19 Pandemic: Cross-Sectional, Exploratory, Noninterventional, Descriptive Study. JMIR Form Res 2023; 7:e47510. [PMID: 37995120 DOI: 10.2196/47510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Demographic changes in the world population have resulted in an increasingly aging society, with a progressive increase in the number of people in situations of dependence, who require assistance from family members to meet their basic needs. Caring for older adults involves performing diverse activities, resulting in reduced free time and tiredness, and fulfilling the demands and expectations related to personal, family, physical, and social life, consequently compromising the quality of life of the caregiver. In this context, the informal caregiver of hospitalized older adults emerges as the focus of attention. OBJECTIVE The aim of this study was to describe the sociodemographic profile, health conditions, and burden of informal caregivers of older adults admitted to a university hospital in Brazil during the COVID-19 pandemic period. METHODS This is a cross-sectional, descriptive, and analytical study that was conducted with 25 informal caregivers of hospitalized older adults in a university hospital in Brazil between August and September 2022. Three instruments were applied: Caregiver Burden Inventory, sociodemographic questionnaire, and health conditions questionnaire. The data were analyzed using SPSS version 28.0. Descriptive (frequency and percentage) and inferential analyses were performed using 2-sided Student t test with 95% CIs. RESULTS Of the 25 interviewees, 18 (72%) were females, 17 (46%) were married or in a stable union, 14 (56%) completed secondary education, and 11 (44%) lived with the older adults who needed care. The average age of the participants was 44 (SD 12.8) years. Regarding their health conditions, most caregivers self-reported it as good (12/25, 48%). They provided care to their father or mother older than 70 years (14/25, 56%). The Caregiver Burden Inventory analysis showed that the caregivers were the most negatively impacted in the domains of personal life overload (mean 10.8, SD 3.46; P=.047) and physical overload (mean 10.6, SD 2.32; P=.02). CONCLUSIONS In recent years, there has been an increase in the burden on informal caregivers of hospitalized older adults in Brazil, thereby impacting their personal and physical lives. The findings of our study show that health care professionals should be trained to promote health guidelines and actions to improve the personal and physical lives of the caregiver population in Brazil.
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Keim-Malpass J, Lunsford C, Letzkus LC, Scheer E, Valdez RS. Establishing the Need for Anticipatory Symptom Guidance and Networked Models of Disease in Adaptive Family Management Among Children With Medical Complexity: Qualitative Study. JMIR Form Res 2023; 7:e52454. [PMID: 37801346 DOI: 10.2196/52454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Caregivers of children with medical complexity navigate complex family management tasks for their child both in the hospital and home-based setting. The roles and relationships of members of their social network and the dynamic evolution of these family management tasks have been underexamined. OBJECTIVE The purpose of this study was to explore the structures and processes of family management among caregivers of children with medical complexity, with a focus on the underlying dynamic nature of family management practices and the role of members of their social network. METHODS This study used a qualitative approach to interview caregivers of children with medical complexity and members of their social network. Caregivers of children with medical complexity were recruited through an academic Children's Hospital Complex Care Clinic in the mid-Atlantic region and interviewed over a period of 1 to 3 days. Responses were analyzed using constructivist grounded theory and situational analysis to construct a new conceptual model. Only caregiver responses are reported here. RESULTS In total, 20 caregivers were included in this analysis. Caregiver perspectives revealed the contextual processes that allowed for practices of family management within the setting of rapidly evolving symptoms and health concerns. The dynamic and adaptive nature of this process is a key underlying action supporting this novel conceptual model. The central themes underpinning the adaptive family management model include symptom cues, ongoing surveillance, information gathering, and acute on chronic health concerns. The model also highlights facilitators and threats to successful family management among children with medical complexity and the networked relationship among the structures and processes. CONCLUSIONS The adaptive family management model provides a basis for further quantitative operationalization and study. Previously described self- or family management frameworks do not account for the underlying dynamic nature of the disease trajectory and the developmental stage progression of the child or adolescent, and our work extends existing work. For future work, there is a defined role for technology-enhanced personalized approaches to home-based monitoring. Due to the disparities caregivers and the children in this population already experience, technology-enhanced approaches must be built alongside key stakeholders with an equity orientation to technology co-development. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/14810.
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Affiliation(s)
- Jessica Keim-Malpass
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Christopher Lunsford
- Department of Physical Medicine and Rehabilitation, Duke University School of Medicine, Durham, NC, United States
| | - Lisa C Letzkus
- Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Eleanore Scheer
- Department of Systems and Information Engineering, University of Virginia School of Engineering and Applied Sciences, Charlottesville, VA, United States
| | - Rupa S Valdez
- Department of Systems and Information Engineering, University of Virginia School of Engineering and Applied Sciences, Charlottesville, VA, United States
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
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21
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McLoughlin C, Goranitis I, Al-Janabi H. The Feasibility and Validity of Preference-Based Quality of Life Measures With Informal Carers: A Think-Aloud Study. Value Health 2023; 26:1655-1664. [PMID: 37516197 DOI: 10.1016/j.jval.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/29/2023] [Accepted: 07/13/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES A range of preference-based quality of life (QoL) measures have been proposed for use with informal carers. Qualitative evaluation of validity and feasibility of the measures is an important step in understanding whether measures will work as intended. At present, little is known about the performance of different types of preference-based QoL measures with informal carers. The objective of this study was to qualitatively assess the feasibility, content validity (including face validity), and acceptability of 5 QoL measures (the Carer Experience Scale, CarerQoL-7D, ASCOT-C, ICECAP-A, and EQ-5D-5L) with informal carers. METHODS A total of 24 "think-aloud" interviews were conducted with a cross-section of carers of adults in the United Kingdom. This think-aloud process was followed by semistructured discussion to probe issues of validity and feasibility in more detail. The interview data were transcribed, coded to identify the frequency of errors in completing the QoL measures and thematically analyzed to study the validity, feasibility, and acceptability of the measures. RESULTS Few errors (3%-7% per item) were identified in completing each of the measures with little distinct pattern. Most participants found the measures to be concise, clear, and relevant. Challenges included relevance, context, time period, missing items, multiple questions, and response options. Informal carers generally expressed a preference for using a care-related QoL measure. CONCLUSIONS Existing preference-based QoL measures have encouraging validity and feasibility within a mixed sample of informal carers, with minor challenges raised. These challenges ought to be considered, alongside the decision context, when administering QoL measures in this context.
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Affiliation(s)
| | - Ilias Goranitis
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Hareth Al-Janabi
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, England, UK.
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Mouchaers I, Metzelthin S, van Haastregt J, Vlaeyen E, Goderis G, Verbeek H. Exploring the Support and Involvement of Family Caregivers for Reablement Programs: A Qualitative Study. J Multidiscip Healthc 2023; 16:2993-3005. [PMID: 37849961 PMCID: PMC10577240 DOI: 10.2147/jmdh.s424147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023] Open
Abstract
Background Reablement is a person-centered, holistic approach promoting older adults' participation through social, leisure, and physical activities. Family caregivers are seldom involved in reablement services despite their wish to be an active member of the care team and expressing a need for more support and recognition. The voice of family caregivers is often forgotten when evaluating services such as reablement. Little is known how family caregivers can be involved and supported more effectively in reablement services, therefore the aim of our research is to investigate the perceived support and involvement of family caregivers. Methods As part of the TRANS-SENIOR project, we studied perceived support and involvement of family caregivers during and after geriatric rehabilitation, a setting in which principles of reablement, like goal setting and training of daily activities, are applied. In total, fourteen semi-structured interviews were conducted with family caregivers of people admitted to a geriatric rehabilitation facility. Thematic analysis was used. Results Results reflected four themes: (1) support for family caregivers, (2) involvement in care, (3) trusting care professionals, and (4) asking for and accepting support. Family caregivers' experiences with support from care professionals were mainly ambivalent. While caregivers expressing a lack of support and information whilst also indicating that they do not expect to be supported by care professionals. Regarding involvement, caregivers wanted to be involved; ie express their opinion and be involved in decision-making. However, more involvement could also lead to a higher burden. Conclusion There is a discrepancy between the perceived support and involvement of family caregivers, their expressed needs, and their expectations of care professionals. A personalized approach is needed to create room for the family caregiver to be an active participant in the care process while also providing the right amount of support, when preferred by the caregiver.
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Affiliation(s)
- Ines Mouchaers
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Silke Metzelthin
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
| | - Jolanda van Haastregt
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
| | - Ellen Vlaeyen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Geert Goderis
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Hilde Verbeek
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
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Gonçalves J, Filipe L, Van Houtven CH. Trajectories of Disability and Long-Term Care Utilization After Acute Health Events. J Aging Soc Policy 2023:1-24. [PMID: 37811807 DOI: 10.1080/08959420.2023.2267399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/11/2023] [Indexed: 10/10/2023]
Abstract
Hip fractures, strokes, and heart attacks are common acute health events that can lead to long-term disability, care utilization, and unmet needs. However, such impacts, especially in the long term, are not fully understood. Using data from the Health and Retirement Study, 1992-2018, this study examines the long-term trajectories of individuals suffering such health shocks, comparing with individuals not experiencing health shocks. Hip fracture, stroke, and heart attack are confirmed to have severe implications for disability. In most cases of stroke and heart attack, informal caregivers provide the daily support needed by survivors, whereas following hip fracture, nursing home care is more relevant. These health shocks put individuals on worse trajectories of disability, care utilization, and unmet needs. There is no long-term recovery or convergence with individuals who do not suffer shocks. Unmet need is prevalent, even pre-shock and among individuals who do not experience health shocks, emphasizing the importance of preventative care measures. These findings support policy action to ensure hospitalized individuals, especially those aged 50 and above, receive rehabilitative services and other post-acute care. Furthermore, hospitalization is an event that requires the detection and addressing of unmet care needs beyond the short run.
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Affiliation(s)
- Judite Gonçalves
- School of Public Health, Imperial College London, London, UK
- NOVA School of Business and Economics, NOVA University Lisbon, Carcavelos, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Luís Filipe
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Courtney H Van Houtven
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
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24
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Wrede C, Braakman-Jansen A, van Gemert-Pijnen L. Understanding acceptance of contactless monitoring technology in home-based dementia care: a cross-sectional survey study among informal caregivers. Front Digit Health 2023; 5:1257009. [PMID: 37860038 PMCID: PMC10582629 DOI: 10.3389/fdgth.2023.1257009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
Background There is a growing interest to support home-based dementia care via contactless monitoring (CM) technologies which do not require any body contact, and allow informal caregivers to remotely monitor the health and safety of people with dementia (PwD). However, sustainable implementation of CM technologies requires a better understanding of informal caregivers' acceptance. This study aimed to examine the (1) general acceptance of CM technology for home-based dementia care, (2) acceptance of different sensor types and use scenarios, and (3) differences between accepters and refusers of CM technology. Method A cross-sectional online survey was conducted among n = 304 informal caregivers of community-dwelling PwD [Mean(SD) age = 58.5 (10.7)] in the Netherlands and Germany. The survey contained a textual and graphical introduction to CM technologies, as well as questions targeting (1) general acceptance of CM technology, (2) acceptance of seven different contactless sensor types, (3) acceptance of five different use scenarios, and (4) caregivers' own and their care recipients' personal characteristics. Data were examined using descriptive and bivariate analyses. Results Participants' general acceptance of CM technology was slightly positive. We found significant differences in acceptability between contactless sensor types (p < .001). RF-based sensors (e.g., radar) and light sensors were considered most acceptable, whereas camera-based sensors and audio sensors (e.g., microphones, smart speakers) were seen as least acceptable for home-based dementia care. Furthermore, participants' acceptance of different use scenarios for CM technology varied significantly (p < .001). The intention to use CM technology was highest for detecting emergencies (e.g., falls, wandering), and lowest for predicting acute situations (e.g., fall prediction). Lastly, accepters and refusers of CM technology significantly differed regarding gender (p = .010), their relation with the PwD (p = .003), eHealth literacy (p = .025), personal innovativeness (p < .001), usage of safety technology (p = .002), and the PwD's type of cognitive impairment (p = .035) and housing situation (p = .023). Conclusion Our findings can inform the development and implementation of acceptable CM technology to support home-based dementia care. Specifically, we show which sensor types and use scenarios should be prioritized from the informal caregiver's view. Additionally, our study highlights several personal characteristics associated with informal caregivers' acceptance of CM technology that should be taken into account during implementation.
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Affiliation(s)
- Christian Wrede
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
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Nadash P, Qu S, Tell EJ. Supporting Diverse Family Caregivers: Key Stakeholder Perspectives. Health Promot Pract 2023:15248399231196854. [PMID: 37694397 DOI: 10.1177/15248399231196854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
This study aimed to understand the perspectives of key stakeholders regarding strategies for better supporting culturally and ethnically diverse family caregivers, aiming to incorporate them into the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Advisory Council's proposed National Strategy. The Strategy, published in 2022, identified priority actions to support the growing population of people providing unpaid care to people of all ages with disabilities, with a goal of improving the health and well-being of both the family caregiver and the person receiving support. Researchers conducted extensive outreach to purposively diverse stakeholder organizations, using six stakeholder strategy sessions with representatives from 42 groups in December 2020 to identify preliminary themes. During July-October 2021, 17 key informant interviews and 16 stakeholder listening sessions were held, involving 103 different organizations. Qualitative data analysis using an inductive approach was used to identify key themes. A significant issue for diverse caregivers is widespread lack of self-identification as caregivers, which is tied to a lack of awareness of potentially helpful services and supports; culturally appropriate outreach is critical to ensure access to services, as well as access to centralized resources and funding for community- and faith-based organizations. A community health worker model was recommended. Tailored activities, involving trusted community- and faith-based groups, as well as investments in caregiver- and culturally-specific supports, are critical for reaching the diverse family caregivers who most need supports. Raising awareness of caregiving among and taking advantage of the expertise of professionals working with diverse communities is also crucial.
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Affiliation(s)
| | - Shan Qu
- University of Massachusetts Boston, Boston, MA, USA
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Roberts HL, Bollens-Lund E, Ornstein KA, Kelley AS. Caring for aging parents in the last years of life. J Am Geriatr Soc 2023; 71:2871-2877. [PMID: 37224430 PMCID: PMC10524882 DOI: 10.1111/jgs.18415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/24/2023] [Accepted: 04/27/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Adult children provide a large portion of end-of-life caregiving for older adults and make up the majority of caregivers for adults with dementia. Yet research has been limited to the hours of care that primary caregivers provide, neglecting the other ways adult children provide caregiving support. This study aims to describe the caregiving support adult children provide to their parents at the end of life and characterize differences by race and ethnicity and dementia status. METHODS We conducted a retrospective study using survey responses from the Health and Retirement Study between 2002 and 2018. The sample population (n = 8040) included decedents aged 65 with at least one living adult child at their time of death. Caregiving support was defined as providing financial support, providing help with basic or instrumental activities of daily living (ADLs or IADLs), or coresiding with the care recipient. Respondents were stratified by self-identified race and ethnicity as Hispanic, non-Hispanic White, or non-Hispanic Black. Respondents were further stratified by dementia and marital status. RESULTS Black and Hispanic respondents without dementia were more likely to report receiving financial help from (28.0% and 25.9%) or coresiding with their adult children (38.9% and 49.7%) compared to White respondents (15.0% receiving financial help and 23.3% coresiding) (p < 0.05). Among respondents with dementia, 47.1% of both Black and Hispanic respondents reported coresiding with their adult children, compared to only 24.6% of White respondents (p < 0.05). Notably, married Black and Hispanic respondents reported significantly higher rates of all support types compared to married White respondents (p < 0.05). CONCLUSIONS The majority of older adults at the end of life receive some form of care and support from their adult children, with Black and Hispanic older adults receiving particularly high rates of care and support from their adult children regardless of dementia or marital status.
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Affiliation(s)
- Harley L Roberts
- Medical Student Research Office, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Evan Bollens-Lund
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy S Kelley
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- James J. Peters VA, Bronx, New York, USA
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Ekezie PE, Eriksson U, Shaw BA, Agahi N, Nilsen C. Is the mental health of older adults receiving care from their children related to their children's dual burden of caregiving and work stress? A linked lives perspective. Aging Ment Health 2023; 27:1796-1802. [PMID: 36137944 DOI: 10.1080/13607863.2022.2126820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/16/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents' mental health is related to their children's dual burden of informal caregiving and job strain. METHODS Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported 'mild' or 'severe' anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child's occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334. RESULTS After adjusting for covariates, caregiving children's lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children's job demands and their older parents' mental health (OR 1.08, p = 0.799). CONCLUSION In line with the linked lives perspective, results highlight that the work-life balance of informal caregiving adult children may play a role in their older parent's mental health.
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Affiliation(s)
- Promise E Ekezie
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ulrika Eriksson
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Benjamin A Shaw
- Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL, USA
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Charlotta Nilsen
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Rashid MAUH, Muneeb SA, Manzoor MM, Fischer F. Religious coping, care burden and psychological distress among informal caregivers of COVID-19 patients: Results of a cross-sectional survey in Pakistan. Int J Soc Psychiatry 2023; 69:1369-1376. [PMID: 36951388 PMCID: PMC10037130 DOI: 10.1177/00207640231162277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND There is a complex relationship between health and religiosity. People may use religion to cope with difficulties and uncertainties in their life - such as induced by the COVID-19 pandemic. AIMS The purpose of this study is to investigate the relationship between religious coping, care burden and psychological distress among caregivers during COVID-19 in Pakistan. METHOD We conducted a cross-sectional survey in Pakistan. We used the Religious Coping Scale (RCOPE), Care Burden Scale (CB), and Depression, Anxiety and Stress Scale (DASS-21) to measure psychological stress from 303 caregivers. Data were analyzed using a hierarchical linear regression model for each of the three outcome variables, which are depression, anxiety, and stress. This analysis allows to investigate whether adding variables significantly improves a model's ability to predict the criterion variable. RESULTS The findings reveal that emotional care burden, physical care burden, negative religious coping, and social care burden explain a significant amount of the variance of three components of psychological distress among caregivers. CONCLUSIONS Health experts, psychologists, and policymakers can make better strategies to combat pandemics like COVID-19 by incorporating religious coping methods.
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Affiliation(s)
| | | | | | - Florian Fischer
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, Kempten, Germany
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Meyer K, Gonzalez A, Benton D. Qualitative Evaluation of Family Caregivers' Experiences Participating in Knowledge and Interpersonal Skills to Develop Exemplary Relationships (KINDER): Web-Based Intervention to Improve Relationship Quality. JMIR Form Res 2023; 7:e42561. [PMID: 37606980 PMCID: PMC10481209 DOI: 10.2196/42561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/29/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The onset of Alzheimer disease and related dementias (AD/ADRD) can alter relationships between family caregivers and persons living with AD/ADRD, such as through the occurrence of distressful behavioral and psychological symptoms of dementia. Poorly perceived relationship quality by caregivers contributes to negative outcomes for both care partners, such as low-quality caregiving and potential mistreatment of older adults. Knowledge and Interpersonal Skills to Develop Exemplary Relationships (KINDER) is a new, web-based, asynchronous psychoeducational intervention with content informed by focus groups with family caregivers. The program was developed to prevent low-quality caregiving and potential mistreatment of older adults by focusing on building healthy caregiving relationships. OBJECTIVE The purpose of this study is to describe caregivers' experiences participating in KINDER to understand intervention acceptability. Of particular interest was learning how comfortable caregivers were viewing content addressing potential mistreatment, as well as whether asynchronous delivery created any barriers to participating in the intervention. Findings will inform future program refinements before efficacy testing. METHODS Although 23 caregivers enrolled in the KINDER parent study, only 7 of them completed the 8-week intervention. In-depth, semistructured qualitative interviews were conducted with all participants who completed the program to understand their experiences while attending KINDER and to decipher barriers to participation. We also asked participants about which program elements were most valuable and which were least valuable to them, as well as how the program could be improved. Interview transcripts were analyzed by 2 coders using thematic analysis. RESULTS Our findings indicate that caregivers were overall satisfied with KINDER's focus and content. Participants particularly liked how KINDER materials felt authentic and relevant to supporting healthy care relationships (Theme 1). The program's multiple components were found to be valuable, especially story-based video vignettes and readings (Theme 2). Most caregivers were comfortable viewing depictions of mistreatment and understood the importance of this content (Theme 3). Notably, while caregivers appreciated the convenience of participating in an asynchronous web-based intervention, several expressed a desire for more opportunities to speak with other caregivers (Theme 4). Technology challenges, such as a lack of clarity about automated intervention activities, deterred completion. CONCLUSIONS Findings from this study suggest an asynchronous web-based intervention covering sensitive topics such as mistreatment is acceptable for at least some AD/ADRD caregivers. Caregivers' comments that materials felt authentic may suggest that the integration of caregiver voices before intervention development enhanced the relevance of content. To make KINDER easier to deliver and participate in, the investigators plan to reduce the use of automation and integrate more group-based programming, as recommended by participants. Further, given the higher-than-expected dropout rate, in future studies, the investigators will collect data to determine the reasons for participants not completing study activities.
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Affiliation(s)
- Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Alexander Gonzalez
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Donna Benton
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
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Theng B, Tran JT, Serag H, Raji M, Tzeng HM, Shih M, Lee WCM. Understanding Caregiver Challenges: A Comprehensive Exploration of Available Resources to Alleviate Caregiving Burdens. Cureus 2023; 15:e43052. [PMID: 37680399 PMCID: PMC10480575 DOI: 10.7759/cureus.43052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION Aging is associated with significant alterations in physical, cognitive, and emotional functions, predisposing older adults to multimorbidity and functional dependence that necessitate assistance with the activity of daily living (ADL) and medical care from caregivers. With a substantial increase in the aging population comes a growing demand for caregivers, particularly informal caregivers who provide unpaid care to older adults with complex needs. However, they face substantial physical, emotional, and financial burdens as they balance caregiving with their family and job demands. AIM This study aimed to explore key challenges faced by caregivers and the resources they need to address their caregiving burden. Additionally, we wanted to identify whether the number of years of caregiving is associated with their burden. These study findings will inform the design and development of our smartphone app which aims to alleviate the burden of diseases for older adults and the burden of caregiving for caregivers. METHODS From October to December 2022, we invited 80 self-reported caregivers for an anonymous online survey. The caregivers were located in three cities (Galveston, Houston, and Dallas in Texas) and were affiliated with the International Buddhist Progress Society-Dallas (IBPS Dallas) and the University of Texas Medical Branch (UTMB) Osher Lifelong Learning Institute (OLLI). The collected data were subjected to content analysis through systematic examination for meaningful patterns, themes, and insights. Individual characteristics and caregiving experiences were divided by years of care: 0-4 vs. 5+ years to investigate whether the caregiving burden was affected by the duration of caregiving. RESULTS The results showed several important insights, including gender dynamics and traditional norms, the advanced age of caregivers, and the prevalent health conditions they are managing. Caregivers' roles ranged from medical (insurance and medication assistance, etc.) at 63.8% to the provision of non-medical related resources (basic needs, utility, transportation, financial assistance, etc.) at 96.3%. Caregiving is also associated with some positive outcomes, such as changes in knowledge and skills (77.5%) with more confidence in ADL support tasks and a deepening of caregiver/care recipient dyad relationships (56.3%). Some faced challenges in navigating complex healthcare and social service systems and others experienced neglect and received inadequate support from the government-supported social services (33.8%). However, there is no significant variation between those with 0-4 and 5+ years of experience across all identified themes, suggesting that the burdens and resource needs of caregivers can manifest early on and are likely to persist beyond the five-year mark. CONCLUSION Our findings reveal that the number of caregiving years does not significantly influence the types of caregiving burden experienced by caregivers or the resources they require. This indicates the need for providing long-term support to older adults with chronic conditions from the early stage, while also emphasizing the critical role of immediate assistance for caregivers to alleviate caregiving burden. A free-of-charge technology like our smartphone app has the potential to effectively reduce stress for caregivers, offering them support at any time and place. Future studies will focus on evaluating the outcomes of caregivers after utilizing our app.
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Affiliation(s)
- Bunnarin Theng
- Radiology, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
| | - Jessica T Tran
- Medicine, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
| | - Hani Serag
- Department of Internal Medicine - Endocrinology, University of Texas Medical Branch, Galveston, USA
| | - Mukaila Raji
- Department of Internal Medicine - Geriatrics & Palliative Medicine, University of Texas Medical Branch, Galveston, USA
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, USA
| | - Huey-Ming Tzeng
- School of Nursing, University of Texas Medical Branch, Galveston, USA
| | - Miaolung Shih
- Artificial Intelligence, Humanistic Buddhism Practice (HBP), Osher Lifelong Learning Center, University of Texas Medical Branch, Galveston, USA
| | - Wei-Chen Miso Lee
- Department of Family Medicine, University of Texas Medical Branch, Galveston, USA
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Nakanishi M, Stanyon D, Richards M, Yamasaki S, Ando S, Endo K, Hosozawa M, Miyashita M, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Informal Caregiving in Adolescents from 10 to 16 Years Old: A Longitudinal Study Using Data from the Tokyo Teen Cohort. Int J Environ Res Public Health 2023; 20:6482. [PMID: 37569023 PMCID: PMC10419092 DOI: 10.3390/ijerph20156482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/26/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023]
Abstract
There is growing evidence of the impact of informal caregiving on adolescent mental health, and its role is often hidden unintentionally or intentionally, which may hamper early identification and support for young informal caregivers. However, the quantitative evidence regarding household factors relating to informal caregiving has mostly been based on cross-sectional findings. This study examines the longitudinal associations between household characteristics and the duration of informal caregiving in adolescents from 10 to 16 years of age. Child-household respondent pairs (n = 2331) from the Tokyo Teen Cohort in Japan were followed every 2 years from 10 to 16 years of age. Informal caregiving was assessed repeatedly based on the household respondent's survey responses. Persistent caregiving was defined as daily caregiving at two or more waves. There were 2.2% of children who gave daily care at two or more waves. Cross-sectional associations with daily informal caregiving at each wave were found with girls, low household income, and cohabiting with grandparents. A significant association with persistent caregiving was found only in cohabiting with grandparents at 10 years of age after adjusting for sex, number of siblings, single parent, and household income. Our longitudinal examination highlighted cohabiting with grandparents as a preceding factor for persistent caregiving. Identification and support for young informal caregivers should be integrated into social care service systems for older adults. The mechanism of persistent caregiving requires clarification.
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Affiliation(s)
- Miharu Nakanishi
- Department of Public Health and Primary Care, Leiden University Medical Center, 2300RC Leiden, The Netherlands
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai-shi 980-8575, Japan
- Mental Health Promotion Unit, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo 156-8506, Japan
| | - Daniel Stanyon
- Mental Health Promotion Unit, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo 156-8506, Japan
| | - Marcus Richards
- MRC Unit for Lifelong Health & Ageing at UCL, University College London, London SW1H 9NA, UK
| | - Syudo Yamasaki
- Mental Health Promotion Unit, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo 156-8506, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kaori Endo
- Mental Health Promotion Unit, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo 156-8506, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Mitsuhiro Miyashita
- Mental Health Promotion Unit, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo 156-8506, Japan
| | - Mariko Hiraiwa-Hasegawa
- Department of Evolutionary Studies of Biosystems, The Graduate University for the Advanced Studies, Hayama 240-0193, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Bunkyo-ku, Tokyo 113-0033, Japan
| | - Atsushi Nishida
- Mental Health Promotion Unit, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo 156-8506, Japan
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Cruz SA, Soeiro J, Canha S, Perrotta V. The concept of informal care: ambiguities and controversies on its scientific and political uses. Front Sociol 2023; 8:1195790. [PMID: 37534330 PMCID: PMC10391834 DOI: 10.3389/fsoc.2023.1195790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023]
Abstract
Starting from an analysis of the scientific and political uses of the concept of informal care, this paper raises questions and launches the debate on the causes and effects of its uses. Recognizing the diversity and the contradictions found across the use of the term, it explains how its predominant use in Europe can be problematic. First, although it is widely recognized that care is provided primarily by women, this gender dimension is not emphasized in a concept that obscures the sexual division. Second, it does not render explicit that informal care is work, despite being unpaid. Third, the allusion to informality is likely to generate confusion with informal employment of care workers. Finally, studies often focus exclusively on care provided by family members, without distinguishing the spaces in which the work takes place and the social relationships it involves, namely the family or community. In Europe, where documents from (non)governmental organizations focus mainly on long-term care related to demographic aging, it is the care crisis of formal care provision systems, faced with financial fragility, reduction in funds and insufficient supply to meet the demand, that brings informal care to the political and scientific agendas. This paper argues that it is necessary to define conceptual boundaries that allow international studies on the dimension and value of this care work to be compared. It also advocates the importance of making visible that this is work, unpaid and female-dominated, since this view supports action guidelines more focused on social transformation and empowerment.
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Affiliation(s)
| | - José Soeiro
- Faculty of Arts, Institute of Sociology, University of Porto, Porto, Portugal
| | - Sara Canha
- Centre for Research in Anthropology (CRIA), University Institute of Lisbon (ISCTE), Lisbon, Portugal
| | - Valentina Perrotta
- Faculty of Social Sciences, University of Republic of Uruguay, Montevideo, Uruguay
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Wimo A, Seeher K, Cataldi R, Cyhlarova E, Dielemann JL, Frisell O, Guerchet M, Jönsson L, Malaha AK, Nichols E, Pedroza P, Prince M, Knapp M, Dua T. The worldwide costs of dementia in 2019. Alzheimers Dement 2023; 19:2865-2873. [PMID: 36617519 PMCID: PMC10842637 DOI: 10.1002/alz.12901] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Dementia is a leading cause of death and disability globally. Estimating total societal costs demonstrates the wide impact of dementia and its main direct and indirect economic components. METHODS We constructed a global cost model for dementia, presenting costs as cumulated global and regional costs. RESULTS In 2019, the annual global societal costs of dementia were estimated at US $1313.4 billion for 55.2 million people with dementia, corresponding to US $23,796 per person with dementia. Of the total, US $213.2 billion (16%) were direct medical costs, US $448.7 billion (34%) direct social sector costs (including long-term care), and US $651.4 billion (50%) costs of informal care. DISCUSSION The huge costs of dementia worldwide place enormous strains on care systems and families alike. Although most people with dementia live in low- and middle-income countries, highest total and per-person costs are seen in high-income countries. HIGHLIGHTS Global economic costs of dementia were estimated to reach US $1313.4 in 2019. Sixty-one percent of people with dementia live in low-and middle-income countries, whereas 74% of the costs occur in high-income countries. The impact of informal care accounts for about 50% of the global costs. The development of a long-term care infrastructure is a great challenge for low-and middle-income countries. There is a great need for more cost studies, particularly in low- and middle-income countries. Discussions of a framework for global cost comparisons are needed.
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Affiliation(s)
- Anders Wimo
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
| | | | | | - Eva Cyhlarova
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Joseph L. Dielemann
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Maëlenn Guerchet
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Linus Jönsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
| | - Angeladine Kenne Malaha
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Emma Nichols
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Paola Pedroza
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Tarun Dua
- World Health Organization, Geneva, Switzerland
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Lyu JY, Hu B, Wittenberg R, King D. The relationships between informal and formal social care for older people in England: A comparison before and after the Care Act 2014. J Aging Soc Policy 2023:1-18. [PMID: 37353920 DOI: 10.1080/08959420.2023.2226308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
Social care is an integral part of the UK welfare system and plays an imperative role in promoting the well-being of older people. This study investigates the impacts of receiving informal social care on formal social care use among community-dwelling older people in England before and after the implementation of the Care Act 2014. Data came from the Health Survey for England for the years 2011 to 2018 (N = 17,292). Bivariate probit models were used to address the endogeneity issue. The analysis shows that receipt of informal care substitutes for formal care. Informal care had a strong substitution effect on formal personal care before 2015, which was significantly weakened after 2015. While the receipt of formal personal care has been increasingly "carer-blind," that of formal domestic care depends on the availability of informal carers and personal affordability, which may result in unmet care needs.
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Affiliation(s)
- Jae Yeon Lyu
- Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Bo Hu
- Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Raphael Wittenberg
- Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Derek King
- Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
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Meese KA, Boitet LM, Sweeney KL, Nassetta L, Mugavero M, Hidalgo B, Reamey R, Rogers DA. Still Exhausted: The Role of Residual Caregiving Fatigue on Women in Medicine and Science Across the Pipeline. J Med Internet Res 2023; 25:e47629. [PMID: 37314842 DOI: 10.2196/47629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/15/2023] Open
Abstract
Understanding the impact of caregiving responsibilities on women in medicine is crucial for ensuring a healthy and intact workforce, as caregiving responsibilities have the potential to affect the careers of women in health care along the entire pipeline, from students and trainees to physicians, physician-scientists, and biomedical researchers.
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Affiliation(s)
- Katherine A Meese
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Laurence M Boitet
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Katherine L Sweeney
- UAB Medicine, Birmingham, AL, United States
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lauren Nassetta
- UAB Medicine, Birmingham, AL, United States
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bertha Hidalgo
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rebecca Reamey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Hynek K, Gotehus A, Methi F, Nes RB, Skirbekk V, Hansen T. Caregiving + Migrant Background = Double Jeopardy? Associations between Caregiving and Physical and Psychological Health According to Migrant Backgrounds in Norway. Int J Environ Res Public Health 2023; 20:ijerph20105800. [PMID: 37239528 DOI: 10.3390/ijerph20105800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
Informal caregiving can have detrimental consequences for physical and psychological health, but the impacts are highly heterogenous. A largely ignored question is whether these impacts differ with migrant backgrounds, and whether caregiving and a migrant background combine to create double jeopardy. We explored these questions using large-scale data that allows stratification by sex, regional background, and types (inside vs. outside of household) of caregivers. We used cross-sectional 2021 data collected from two Norwegian counties as part of the Norwegian Counties Public Health Survey (N = 133,705, RR = 43%, age 18+). The outcomes include subjective health, mental health, and subjective well-being. The findings show that both caregiving, especially in-household caregiving, and a migrant background relate to lower physical-psychological health. In bivariate analysis, non-Western caregivers, women particularly, reported poorer mental health and subjective well-being (but not physical health) than other caregiver groups. After controlling for background characteristics, however, no interaction exists between caregiver status and migrant background status. Although the evidence does not suggest double jeopardy for migrant caregivers, caution is warranted due to the likely underrepresentation of the most vulnerable caregivers of migrant backgrounds. Continued surveillance of caregiver burden and distress among people of migrant backgrounds is critical to develop successful preventive and supportive intervention strategies for this group, yet this aim hinges on a more inclusive representation of minorities in future surveys.
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Affiliation(s)
- Kamila Hynek
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Aslaug Gotehus
- Work Research Institute (AFI), Oslo Metropolitan University, 0130 Oslo, Norway
| | - Fredrik Methi
- Department of Health Services Research, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, 0213 Oslo, Norway
- Promenta Research Center, University of Oslo, 0373 Oslo, Norway
- Department of Philosophy, Classics, History of Arts and Ideas, University of Oslo, 0213 Oslo, Norway
| | - Vegard Skirbekk
- Center for Fertility and Health, Norwegian Institute of Public Health, 0213 Oslo, Norway
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, 0213 Oslo, Norway
- Promenta Research Center, University of Oslo, 0373 Oslo, Norway
- Norwegian Social Research (NOVA), Oslo Metropolitan University, 0130 Oslo, Norway
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Hong YA, Shen K, Han HR, Ta Park V, Bagchi P, Lu HK, Chen H, Wang JHY. A WeChat-based Intervention, Wellness Enhancement for Caregivers (WECARE), for Chinese American Dementia Caregivers: Pilot Assessment of Feasibility, Acceptability, and Preliminary Efficacy. JMIR Aging 2023; 6:e42972. [PMID: 37018042 PMCID: PMC10131589 DOI: 10.2196/42972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Chinese American family caregivers of persons with dementia experience high rates of psychosocial distress and adverse health outcomes. Due to their immigrant and minority status, they face substantial obstacles to care and support, including stigma and misperception of dementia, limited knowledge and use of welfare and services, and poor social support. Few interventions have been developed or tested for this vulnerable population. OBJECTIVE This study aims to pilot-test the Wellness Enhancement for Caregivers (WECARE) intervention, a culturally tailored program delivered via WeChat, a social media app highly popular in the Chinese population. The 7-week WECARE was designed specifically for Chinese American dementia caregivers to improve their caregiving skills, reduce stress, and enhance psychosocial well-being. Feasibility, acceptability, and preliminary efficacy of the WECARE were assessed in this pilot. METHODS A total of 24 Chinese American family caregivers of persons with dementia were recruited for a pre-post 1-arm trial of the WECARE. By subscribing to the WECARE official account, participants received interactive multimedia programs on their WeChat account multiple times a week for 7 weeks. A backend database automatically delivered program components and tracked user activities. Three online group meetings were organized to facilitate social networking. Participants completed a baseline and a follow-up survey. Feasibility was assessed by the follow-up rate and curriculum completion rate; acceptability was assessed by user satisfaction and perceived usefulness of the program; and efficacy was assessed with pre-post differences in 2 primary outcomes of depressive symptoms and caregiving burden. RESULTS The intervention was completed by 23 participants with a retention rate of 96%. Most of them (n=20, 83%) were older than 50 years and the majority (n=17, 71%) were female. The backend database revealed that the mean curriculum completion rate was 67%. Participants also reported high rates of user satisfaction and perceived usefulness of the intervention and high ratings of weekly programs. The intervention led to significant improvement in participants' psychosocial health outcomes; their depressive symptoms reduced from 5.74 to 3.35 with an effect size of -0.89 and caregiving burden decreased from 25.78 to 21.96 with an effect size of -0.48. CONCLUSIONS This pilot study suggests that WeChat-based WECARE intervention was feasible and acceptable; it also demonstrated initial efficacy in improving psychosocial well-being in Chinese American dementia caregivers. Further research with a control group is needed to assess its efficacy and effectiveness. The study highlights the need for more culturally appropriate mobile health interventions for Chinese American family caregivers of persons with dementia.
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Affiliation(s)
- Y Alicia Hong
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, VA, United States
| | - Kang Shen
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, VA, United States
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Van Ta Park
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Pramita Bagchi
- Department of Statistics, George Mason University, Fairfax, VA, United States
| | - Huixing Kate Lu
- Chinese Culture and Community Service Center, Inc, Gaithersburg, MD, United States
| | - Hsiaoyin Chen
- Chinese Culture and Community Service Center, Inc, Gaithersburg, MD, United States
| | - Judy Huei-Yu Wang
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
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Brotman S, Simard J, Hanley J, Raymond É, Delgado P. [Les personnes âgées immigrantes et leurs proches à Montréal : des vies oubliées durant la pandémie]. Can J Aging 2023; 42:177-83. [PMID: 36574964 DOI: 10.1017/S0714980822000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Malgré l'attention renouvelée de plusieurs médias sur la question des risques liés à la COVID-19 au sein de diverses communautés marginalisées au Québec, nous entendons encore très peu parler des personnes âgées immigrantes et de leurs proches. Dans cette note sur les politiques et pratiques, nous aborderons l'expérience du contexte pandémique chez les personnes âgées immigrantes montréalaises et leurs réseaux. Nous présenterons d'abord quelques données sociodémographiques sur les immigrants âgés montréalais. Nous exposerons ensuite nos constats sur les impacts de la COVID-19 sur les personnes âgées immigrantes, en particulier en ce qui concerne l'accès aux soins de la santé et aux services sociaux, la proche-aidance, l'emploi et le logement, à partir de nos travaux et de la littérature en gérontologie sociale. Nous terminerons en proposant quelques recommandations qui permettraient d'améliorer l'inclusion sociale des personnes âgées immigrantes et de leurs proches, autant en matière de politiques publiques que de pratiques sur le terrain.
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Zwar L, König HH, Hajek A. Are informal caregivers more likely to believe in conspiracy theories during the COVID-19 pandemic?: Findings of a representative study from Germany. Aging Ment Health 2023; 27:588-594. [PMID: 35862616 DOI: 10.1080/13607863.2022.2102141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES This study analyzed the conspiracy mentality of informal caregivers for older persons compared to non-caregivers and whether this association was dependent on age. METHODS The sample was collected randomly from a population-based online panel (forsa.omninet) and represents individuals aged ≥40 years from Germany. In total, 3022 participants were questioned about conspiracy mentality (Conspiracy Mentality Questionnaire), informal care provision (N = 489 informal caregivers of older adults), and sociodemographic background. Data assessment took place between 4th and 19th March 2021 and the questions referred to the time between December 2020 and March 2021. RESULTS No significant differences were found between informal caregivers and non-caregivers. A significant interaction effect was found, indicating a decrease of conspiracy mentality among non-caregivers and an increase among informal caregivers with higher age. After stratifying by gender, this effect was found only among female informal caregivers. CONCLUSION Middle-aged informal caregivers had a lower, and older-aged a higher, susceptibility to conspiracy theories during the COVID-19 pandemic compared to non-caregivers. The results indicate that providing care could be protective among middle-aged individuals, whereas older informal caregivers may benefit from interventions to reduce susceptibility to conspiracy theories and the associated risks for health and wellbeing.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Warren JL. Young Carers' Needs and Changing Experiences during an Era of Austerity. Int J Environ Res Public Health 2023; 20:3418. [PMID: 36834113 PMCID: PMC9959629 DOI: 10.3390/ijerph20043418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Many children caring for ill or disabled family members remain 'hidden' and 'invisible' in our communities. This study is the first to explore patterns of change, over time and throughout austerity, for children with caregiving roles to better understand how their lives differ from those of their non-caregiving peers. A survey of 2154 children, aged 9-18 years in the general population, and a further 21 children, aged 8-18 years and known to be young carers from the same English unitary authority, was conducted to gain an in-depth understanding of children's perceptions and experiences of what they do to help at home. This study shows that children with caregiving roles remain a distinctive group who assume more domestic and caring responsibilities than their peers, and who also perform many of these activities more frequently than young caregivers in 2001. Approximately 19% of the respondents in the general population showed signs of being in a caring role, double the percentage identified by the author in 2001, 72% of whom were from Black and Minority Ethnic backgrounds. Indicating over time higher levels of unmet needs among parents and other family members who are ill or disabled, these findings have important implications for professional policy, planning and practice across adult and children's services.
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Affiliation(s)
- Janet L Warren
- Department of Social Work and Social Care, University of Bradford, Bradford BD7 1DP, UK
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Urwin S, Lau Y, Grande G, Sutton M. Informal caregiving, time use and experienced wellbeing. Health Econ 2023; 32:356-374. [PMID: 36303421 PMCID: PMC10092671 DOI: 10.1002/hec.4624] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/20/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Informal carers report lower evaluative wellbeing than non-carers. In contrast to this literature and our own analysis of evaluative wellbeing, we find carers have a small but higher level of experienced wellbeing than non-carers do. To investigate why, we use decomposition analysis which separates explanatory factors into how time is used and how those uses of time are experienced. We analyze activities and associated experienced wellbeing measured in ten-minute intervals over two days by 4817 adults from the 2014/15 UK Time Use Survey. We use entropy balancing to compare carers with a re-weighted counterfactual non-carer group and then apply Oaxaca-Blinder decomposition. The experienced wellbeing gap of 0.066 is the net result of several substantial competing effects of time use. Carers experienced wellbeing would be higher by 0.188 if they had the same patterns and returns to time use as non-carers which is driven by sleep, time stress and alternative characteristics of time use. However, leisure and non-market activities serve to dampen this increase in experienced wellbeing. Initiatives to improve and assess carer wellbeing should pay close attention to how carers spend their time.
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Affiliation(s)
- Sean Urwin
- Health OrganisationPolicy and Economics GroupSchool of Health SciencesUniversity of ManchesterManchesterUK
| | - Yiu‐Shing Lau
- Health OrganisationPolicy and Economics GroupSchool of Health SciencesUniversity of ManchesterManchesterUK
| | - Gunn Grande
- Division of NursingMidwifery and Social WorkManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - Matt Sutton
- Health OrganisationPolicy and Economics GroupSchool of Health SciencesUniversity of ManchesterManchesterUK
- Melbourne Institute; Applied Economic and Social ResearchUniversity of MelbourneMelbourneAustralia
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Abstract
Aim: Informal caregivers share common experiences in providing care to someone with health and/or social needs, but at the same time their experiences differ across diverse backgrounds such as gender, age, culture, as these aspects of diversity co-shape these experiences. This scoping review aims to explore how aspects of diversity, across their intersections, are currently incorporated in informal care research and discusses how an intersectional perspective can further develop our understanding of informal care. Methods: A scoping review was performed to map relevant caregiving literature from an intersectionality perspective. Key terms 'informal care' and 'intersectionality' were used for a search in four databases resulting in the inclusion of 28 articles. All 28 studies were analysed based on a scoping review created intersectionality informed coding scheme. Results: Aspects of diversity are largely understudied in informal care research, in particular across their intersections and from a critical perspective. This intersectional informed analysis revealed that when studying diverse caregiving experiences the use of intersections of dimensions of diversity provides a nuanced understanding of these experiences. Conclusions: Adopting an intersectional perspective ensures that not only different categories or social identities of caregivers are included in future studies, but the mutual relationships between these categories embedded in their specific context are actually studied.
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Affiliation(s)
- Aldiene H. Hengelaar
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands,Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands,Aldiene H Hengelaar, Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557/1000, 1081 Amsterdam, HV, The Netherlands. E-mail:
| | - Yvette Wittenberg
- Faculty of Social and Behavioral Sciences, University of Amsterdam, The Netherlands,Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Rick Kwekkeboom
- Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Margo Van Hartingsveldt
- Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands
| | - Petra Verdonk
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands
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Nadash P, Tell EJ, Jansen T. What do Family Caregivers Want? Payment for Providing Care. J Aging Soc Policy 2023:1-15. [PMID: 36688324 DOI: 10.1080/08959420.2022.2127599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/12/2022] [Indexed: 01/24/2023]
Abstract
Although the primary goal of self-directed programs providing long term services and supports (LTSS) is to maximize choice and control for service recipients, such programs may also benefit family caregivers by compensating them for providing supportive services. This study draws on qualitative data from research supporting the RAISE Family Caregiver Advisory Council, finding that family caregivers themselves see the expansion of self-directed programs as a policy priority due to their need for financial security. The request for compensation was the strongest finding, with respondents highlighting the incompatibility of work with caregiving and their inability to rely on the existing paid workforce due to supply and quality issues; the consequences of this loss of earned income were reported as severe. Ultimately, respondents saw payment for providing care as an issue of fairness. This evidence supports the policy case for expanding access to self-directed programs that permit the employment of family caregivers.
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Affiliation(s)
- Pamela Nadash
- Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts, Boston, Massachusetts, USA
| | - Eileen J Tell
- Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts, Boston, Massachusetts, USA
- ET Consulting, LLC
| | - Taylor Jansen
- Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts, Boston, Massachusetts, USA
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Fuchs J, Gaertner B, Rommel A, Starker A. Informal caregivers in Germany - who are they and which risks and resources do they have? Front Public Health 2023; 11:1058517. [PMID: 36875417 PMCID: PMC9978811 DOI: 10.3389/fpubh.2023.1058517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023] Open
Abstract
Background The aim of this study is to describe the social characteristics, the health and living situation and the prevalence of behavioral risk factors of adult informal caregivers compared to non-caregivers in Germany. Methods We used data from the German Health Update (GEDA 2019/2020-EHIS survey) which is a cross-sectional population-based health interview survey conducted between 04/2019 and 09/2020. The sample comprised 22,646 adults living in private households. Three mutually exclusive groups of providing informal care or assistance were differentiated: intense caregivers (informal care ≥10 h/week), less-intense caregivers (informal care<10 h/week) and non-caregivers. For the three groups weighted prevalences of social characteristics, health status (self-perceived health, health-related activity limitations, chronic diseases, low back disorder or other chronic back defect, depressive symptoms), behavioral risk factors (at-risk drinking, current smoking, insufficient physical activity, non-daily fruit and vegetable consumption, obesity) and social risk factors (single household, low social support) were calculated and stratified by gender. Separate regression analyses adjusted for age-group were conducted to identify significant differences between intense and less-intense caregivers vs. non-caregivers, respectively. Results Overall, 6.5% were intense caregivers, 15.2% less-intense caregivers and 78.3% non-caregivers. Women provided care more often (23.9%) than men (19.3%). Informal care was most frequently provided in the age group of 45 to 64 years. Intense caregivers reported worse health status, were more often current smokers, physical inactive, obese and lived less often alone than non-caregivers. However, in age-group adjusted regression analyses only few significant differences were seen: Female and male intense caregivers had more often a low back disorder and lived less often alone compared to non-caregivers. In addition, male intense care-givers reported more often worse self-perceived health, health-related activity limitation, and the presence of chronic diseases. In contrast, less-intense caregivers and non-caregivers differed in favor of the less-intense caregivers. Discussion A substantial proportion of the adult German population provides informal care regularly, especially women. Intense caregivers are a vulnerable group for negative health outcomes, especially men. In particular measures to prevent low back disorder should be provided. As the necessity of providing informal care will probably increase in the future, this will be important for the society and public health.
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Affiliation(s)
- Judith Fuchs
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Beate Gaertner
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Alexander Rommel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anne Starker
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Offer J. On welfare pluralism, social policy and the contribution of sociology: Revisiting Robert Pinker. Front Sociol 2023; 8:1076750. [PMID: 37139226 PMCID: PMC10149760 DOI: 10.3389/fsoc.2023.1076750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/20/2023] [Indexed: 05/05/2023]
Abstract
On occasion it makes sound sense to undertake a retrospective review of a late colleague's contribution to his or her subject area. This applies to Robert Pinker, Professor of Social Administration at the London School of Economics, who died at the age of 89 in February 2021. Over a long life he made a major impact on working for press freedom and to social work studies, but this article concerns his work on social policy, and particularly on the idea of welfare pluralism, a many-faceted idea the exploration of which powered two pathbreaking books Social Theory and Social Policy (1971) and The Idea of Welfare (1979). In the twentieth century many states including the United Kingdom had greatly expanded their welfare provisions for their citizens, and, in some, an academic subject area, often called social administration or social policy had grown in response. Pinker started writing in the 1960s, dissatisfied with the conventional approach of Richard Titmuss and others, almost exclusively concerned with the state and welfare. He made the case for a radical rebalance toward including everyday experiences of obligations and how familial informal welfare practices are strengthened, weakened or modified by formal social services. However, ahead of his time, Pinker was arguing for an enhanced sociological imagination in the study of social policy and on the very idea of "welfare". This article has sections reflecting the facets of Pinker's thinking about welfare pluralism, including "social policy's past", "exchange and stigma", "taking informal welfare seriously", "divergent views of altruism", "comparative studies", "on a mixture of means to welfare" and "aspects of Pinker's legacy". The idea of welfare pluralism is now familiar. But Pinker's crucial pioneering role, depth of understanding of the issues and grasp of their intertwining is seldom recalled. This article should help to meet the need for his contribution to be reinserted into the mainstream of sociological thought on welfare, so enriching new research.
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Sušac J, Vukojević J, Debogović S, Bajić Ž, Savić A, Đuran N, Hanževački M, Vitezić D, Mimica N. Share of and Absolute Costs of Informal Care in Five Subpopulations of Outpatients with Dementia in Croatia: A Latent Profile Analysis. J Alzheimers Dis 2023; 94:1417-1430. [PMID: 37424466 DOI: 10.3233/jad-230161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND High heterogeneity exists in estimates of the share of and absolute costs of informal care (IC) for individuals diagnosed with dementia. OBJECTIVE To assess the differences in the share of and absolute costs of IC between subpopulations defined by latent profiles of activities of daily living (ADLs), neuropsychiatric symptoms, and global cognitive functioning. METHODS We performed a nested cross-sectional analysis of data collected from 2019-2021 at the Zagreb-Zapad Health Center, Zagreb, Croatia, from a sample of patients and their caregivers. The outcome was the share of costs of IC in the total costs of care estimated using the Resource Utilization in Dementia questionnaire. We used latent profile analysis of six principal components of the Alzheimer's Disease Cooperative Study ADLs inventory, Neuropsychiatric Inventory and Mini-Mental State Examination, and conducted the analysis using beta and quantile regression. RESULTS We enrolled 240 patients with a median age of 74 years; 78% were women. The annual cost for treatment and care for one patient was 11,462 (95% confidence interval 9,947; 12,976) EUR. After the adjustment for covariates, five latent profiles were significantly associated with the share of costs and absolute cost of IC. The adjusted annual costs of IC ranged from 2,157 EUR, with a share of 53% in the first latent profile, to 18,119 EUR, with a share of 78% in the fifth latent profile. CONCLUSION The population of patients with dementia was heterogeneous, and there were relatively large differences in the share and absolute costs of IC between particular subpopulations.
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Affiliation(s)
- Jelena Sušac
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
| | | | | | - Žarko Bajić
- Psychiatric Clinic Sveti Ivan, Zagreb, Croatia
| | - Aleksandar Savić
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nataša Đuran
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
| | - Miroslav Hanževački
- General and Family Medicine Clinic, Health Center Zagreb-Zapad, Zagreb, Croatia
| | - Dinko Vitezić
- School of Medicine, University of Rijeka, Rijeka, Croatia
- University Hospital Centre Rijeka, Rijeka, Croatia
| | - Ninoslav Mimica
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Zhang Z, Kato C, Otsuka Y. Loneliness Factors in Older People and the Influence on Attitudes Toward Informal Care: A Study of Older Chinese People in Urban Areas. J Prim Care Community Health 2023; 14:21501319231205166. [PMID: 37933566 PMCID: PMC10631332 DOI: 10.1177/21501319231205166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/23/2023] [Accepted: 09/15/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Loneliness is thought to be more likely to occur in older people and influences their lives. This study aimed to verify the influence of loneliness in older Chinese people on their attitudes toward informal care, as well as the demographic, social, and economic factors that may cause loneliness. METHODS Data was collected from older P (age: >60 years) using an online questionnaire. Hierarchical linear regression was used to analyze the associations between demographic, social, and economic factors, loneliness, and attitudes toward informal care. RESULTS Results have shown that cohabitation and family savings could significantly negatively influence loneliness. Educational background and cohabitation could significantly positively influence attitudes toward informal care. However, loneliness could significantly negatively influence attitudes toward informal care. CONCLUSION Older people living alone and with worse economic conditions may need attention from the community and society because they are more likely to suffer from loneliness. Loneliness may also significantly impact older people's attitudes toward long-term care. Older people are more likely to feel lonely may have more negative attitudes toward informal care. Communities need to make more efforts to improve community health services or formal care services for these older people to address situations where informal care is not sufficiently provided.
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Hu B, Rodrigues R, Wittenberg R, Rhee Y. Editorial: Long-term care for older people: A global perspective. Front Public Health 2023; 11:1178397. [PMID: 37124809 PMCID: PMC10132367 DOI: 10.3389/fpubh.2023.1178397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Affiliation(s)
- Bo Hu
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
- *Correspondence: Bo Hu
| | - Ricardo Rodrigues
- ISEG Lisbon School of Economics and Management, SOCIUS—Research Centre in Economic and Organizational Sociology/CSG—Research in Social Sciences and Management, Lisboa, Portugal
| | - Raphael Wittenberg
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - YongJoo Rhee
- Department of Health Sciences, Dongduk Women's University, Seoul, Republic of Korea
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Bastoni S, van Gemert-Pijnen L, Sanderman R, van Dongen A. Implementation of eMental health technologies for informal caregivers: A multiple case study. Front Digit Health 2023; 5:1130866. [PMID: 37035479 PMCID: PMC10081674 DOI: 10.3389/fdgth.2023.1130866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Informal caregivers offer continuous unpaid support to loved ones who are unable to live independently. Providing care can be a very burdensome commitment, that heavily impacts informal caregivers' mental health. eMental health is a possible, yet challenging, solution to improve caregivers' mental health and their overall experience of caregiving. In fact, eMental health technologies often face challenges of implementation. The present work gathers knowledge on how to best deal with these challenges by collecting testimonies of implementation experts of eight eMental health technologies for informal caregivers with the aim of comparing them and extracting lessons learned. Methods For this multiple case study, technologies were selected (through informal suggestions and independent search) according to the following inclusion criteria: they were intended for informal caregivers as main user group, were aimed at improving informal caregivers' mental wellbeing and caregiving experience and were available and running in real life settings in Europe. Ten interviews were conducted (two pilots and eight included cases). The interviewees were asked to provide a description of the technology and its aims and their implementation approach, method and frameworks used. Finally, determinants of implementation, the influence of the Covid-19 pandemic on implementation processes and lessons learned were investigated. Results The results highlight key differences between technologies developed within academia and the industry regarding efficacy testing and use and use and choice of frameworks. Also, similarities in terms of recognized barriers such as financing are illustrated. Discussion Possible ways to overcome main barriers and examples of best practices, such as structuring a business model and discussing tool maintenance and long-term hosting in advance, are discussed.
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Affiliation(s)
- Sofia Bastoni
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
- Correspondence: Sofia Bastoni
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, Netherlands
| | - Anne van Dongen
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
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Tolea MI, Camacho S, Cohen IR, Galvin JE. Mindfulness and Care Experience in Family Caregivers of Persons Living with Dementia. J Alzheimers Dis Rep 2023; 7:151-164. [PMID: 36891256 PMCID: PMC9986707 DOI: 10.3233/adr-220069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
Background Greater mindfulness, the practice of awareness and living in the moment without judgement, has been linked to positive caregiving outcomes in dementia caregivers and its impact attributed to greater decentering and emotion regulation abilities. Whether the impact of these mindfulness-based processes varies across caregiver subgroups is unclear. Objective Analyze cross-sectional associations between mindfulness and caregiver psychosocial outcomes, considering different caregiver and patient characteristics. Methods A total of 128 family caregivers of persons living with Alzheimer's disease and related disorders were assessed on several mindfulness measures (i.e., global; decentering, positive emotion regulation, negative emotion regulation) and provided self-reported appraisals of caregiving experience; care preparedness; confidence, burden, and depression/anxiety. Bivariate relationships between mindfulness and caregiver outcomes were assessed with Pearson's correlations and stratified by caregiver (women versus men; spouse versus adult child) and patient (mild cognitive impairment (MCI) versus Dementia; AD versus dementia with Lewy bodies; low versus high symptom severity) characteristics. Results Greater mindfulness was associated with positive outcomes and inversely associated with negative outcomes. Stratification identified specific patterns of associations across caregiver groups. Significant correlations were found between all mindfulness measures and caregiving outcomes in male and MCI caregivers while the individual mindfulness component of positive emotion regulation was significantly correlated to outcomes in most caregiver groups. Conclusion Our findings support a link between caregiver mindfulness and improved caregiving outcomes and suggest directions of inquiry into whether the effectiveness of dementia caregiver-support interventions may be improved by targeting specific mindfulness processes or offering a more inclusive all-scope approach depending on individual caregiver or patient characteristics.
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Affiliation(s)
- Magdalena I Tolea
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Simone Camacho
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Iris R Cohen
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
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