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Xie Y, Hamilton M, Peisah C, Anstey KJ, Sinclair C. Navigating Community-Based Aged Care Services From the Consumer Perspective: A Scoping Review. THE GERONTOLOGIST 2024; 64:gnad017. [PMID: 37120292 DOI: 10.1093/geront/gnad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The shift to consumer-directed aged care means that older adults need to play a more active role in navigating the complex aged care system for adequate health and social services. Challenges in the navigation process result in unmet needs and difficulty accessing available resources. This scoping review investigates how aged care navigation is conceptualized in literature and interrogates research on the experiences of older adults navigating community-based aged care services with or without support from their informal carers. RESEARCH DESIGN AND METHODS This review follows the Joanna Briggs Institute methodological guidelines. PubMed, Scopus, and ProQuest were searched for relevant literature published from 2008 to 2021, supplemented by grey literature and manual reference list searching. Data were extracted using a predefined data-extraction table and synthesized with an inductive thematic analysis. RESULTS The current conceptualization of aged care navigation focuses on the support provided to older adults, rather than actions taken by older adults themselves. Thematic analysis from the included studies (n = 26) revealed shared themes (lack of knowledge, social networks as information providers, complex care systems) among older adults and informal carers; unique challenges faced by older adults (difficulties with technology, waiting game), and informal carers (structural burden) in aged care navigation. DISCUSSION AND IMPLICATIONS Findings suggest the need to comprehensively assess individual circumstances including social networks and access to informal carers as predictors of successful navigation. Changes that reduce the complexity of the aged care system and improve coordination will relieve the structural burden experienced by consumers.
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Affiliation(s)
- Yuchen Xie
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Myra Hamilton
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
| | - Carmelle Peisah
- Discipline of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Specialty of Psychiatry, University of Sydney, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
| | - Craig Sinclair
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
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Layton N, Lalor A, Slatyer S, Lee DA, Bryant C, Watson M, Khushu A, Burton E, Oliveira D, Brusco NL, Jacinto A, Tiller E, Hill KD. Who cares for the carer? Codesigning a carer health and wellbeing clinic for older care partners of older people in Australia. Health Expect 2023; 26:2644-2654. [PMID: 37680165 PMCID: PMC10632619 DOI: 10.1111/hex.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well-being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well-being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. METHODS Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus-based summaries, arriving at a preferred service model. FINDINGS This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well-being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. PUBLIC CONTRIBUTION This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions.
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Affiliation(s)
- Natasha Layton
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Aislinn Lalor
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
- Department of Occupational Therapy, School of Primary and Allied Health CareMonash UniversityMelbourneVictoriaAustralia
| | - Susan Slatyer
- Centre for Healthy AgeingMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Den‐Ching A Lee
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Christina Bryant
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Moira Watson
- Centre for Healthy AgeingMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Anjali Khushu
- Department of Geriatric MedicinePeninsula HealthFrankstonVictoriaAustralia
| | - Elissa Burton
- Curtin School of Allied HealthCurtin UniversityBentleyWestern AustraliaAustralia
- enAble Institute, Faculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Déborah Oliveira
- Faculty of Nursing, Universidad Andrés BelloCampus Viña del MarViña del MarChile
- Millennium Institute for Care Research (MICARE)SantiagoChile
| | - Natasha L. Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Alessandro Jacinto
- Programa de Pós‐Graduação em Medicina Translacional, Faculty of Geriatric MedicineFederal University of São Paulo (UNIFESP)São PauloBrazil
| | - Elizabeth Tiller
- Department of Geriatrics (Falls Prevention Service)Peninsula HealthFrankstonVictoriaAustralia
| | - Keith D. Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
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Hevink M, Wolfs C, Ponds R, Doucet S, McAiney C, Vedel I, Maćkowiak M, Rymaszewska J, Rait G, Robinson L, Poole M, Gresham M, Jeon YH, Phillipson L, Low LF, Brodaty H, de Vugt M, Verhey F. Experiences of people with dementia and informal caregivers with post-diagnostic support: Data from the international COGNISANCE study. Int J Geriatr Psychiatry 2023; 38:e5916. [PMID: 37132330 DOI: 10.1002/gps.5916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/18/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES The study aims to describe people with dementia and informal caregivers' respective experiences of support after diagnosis and compares these experiences. Additionally, we determine how people with dementia and informal caregivers who are satisfied with support differ from those dissatisfied. METHODS A cross-sectional survey study in Australia, Canada, the Netherlands, Poland, and United Kingdom was carried out to examine people with dementia and informal caregivers experience with support (satisfaction with information, access to care, health literacy, and confidence in ability to live well with dementia). The separate surveys contained closed questions. Analysis consisted of descriptive statistics and Chi-square tests. RESULTS Ninety people with dementia and 300 informal caregivers participated, and 69% of people with dementia and 67% of informal caregivers said support after diagnosis helped them deal more efficiently with their concerns. Up to one-third of people with dementia and informal caregivers were dissatisfied with information about management, prognosis, and strategies for living positively. Few people with dementia (22%) and informal caregivers (35%) received a care plan. People with dementia were more often satisfied with information, had more often confidence in their ability to live well with dementia, and were less often satisfied with access to care compared to informal caregivers. Informal caregivers who were satisfied with support were more satisfied with information and access to care compared to informal caregivers not satisfied with support. CONCLUSIONS Experience of dementia support can be improved and people with dementia and informal caregiver differ in their experiences of support.
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Affiliation(s)
- Maud Hevink
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Rudolf Ponds
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Shelley Doucet
- Department of Nursing and Health Sciences, The Centre for Research in Integrated Care, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, and Lady Davis Institute for Medical Research, and Jewish General Hospital, Montreal, Quebec, Canada
| | - Maria Maćkowiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Greta Rait
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Marie Poole
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Meredith Gresham
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyn Phillipson
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
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Leung T, Ayers S, Pluye P, Grad R, Sztramko R, Marr S, Papaioannou A, Clark S, Gerantonis P, Levinson AJ. Impact and Perceived Value of iGeriCare e-Learning Among Dementia Care Partners and Others: Pilot Evaluation Using the IAM4all Questionnaire. JMIR Aging 2022; 5:e40357. [PMID: 36150051 PMCID: PMC9816950 DOI: 10.2196/40357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Care partners of people living with dementia may benefit from web-based education. We developed iGeriCare, an award-winning internet-based platform with 12 multimedia e-learning lessons about dementia. OBJECTIVE Our objective was to evaluate users' perceptions of impact. METHODS From March 17, 2021 to May 16, 2022, data were collected upon lesson completion. We used the content-validated Information Assessment Method for all (IAM4all) for patients and the public adapted for dementia care partners. The IAM4all questionnaire assesses outcomes of web-based consumer health information. Responses were collected using SurveyMonkey, and data were analyzed using IBM SPSS Statistics (version 28). RESULTS A total of 409 responses were collected, with 389 (95.1%) survey respondents completing the survey. Of 409 respondents, 179 (43.8%) identified as a family or friend care partner, 84 (20.5%) identified as an individual concerned they may have mild cognitive impairment or dementia, 380 (92.9%) identified the lesson as relevant or very relevant, and 403 (98.5%) understood the lesson well or very well. Over half of respondents felt they were motivated to learn more, they were taught something new, or they felt validated in what they do, while some felt reassured or felt that the lesson refreshed their memory. Of 409 respondents, 401 (98%) said they would use the information, in particular, to better understand something, discuss the information with someone else, do things differently, or do something. CONCLUSIONS Users identified iGeriCare as relevant and beneficial and said that they would use the information. To our knowledge, this is the first time the IAM4all questionnaire has been used to assess patient and caregiver feedback on internet-based dementia education resources. A randomized controlled trial to study feasibility and impact on caregiver knowledge, self-efficacy, and burden is in progress.
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Affiliation(s)
| | - Stephanie Ayers
- Division of e-Learning Innovation, McMaster University, Hamilton, ON, Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Richard Sztramko
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Sharon Marr
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Sandra Clark
- Division of e-Learning Innovation, McMaster University, Hamilton, ON, Canada
| | - Patricia Gerantonis
- Division of e-Learning Innovation, McMaster University, Hamilton, ON, Canada
| | - Anthony J Levinson
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Division of e-Learning Innovation, McMaster University, Hamilton, ON, Canada
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Lee DCA, Burton E, Slatyer S, Jacinto A, Oliveira D, Bryant C, Khushu A, Tiller E, Lalor A, Watson M, Layton N, Brusco N, Hill KD. Understanding the Role, Quality of Life and Strategies Used by Older Carers of Older People to Maintain Their Own Health and Well-Being: A National Australian Survey. Clin Interv Aging 2022; 17:1549-1567. [PMID: 36304174 PMCID: PMC9594879 DOI: 10.2147/cia.s384202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Carers play a critical role in supporting older people with health problems to remain living at home. This study aimed to understand the role and quality of life of older carers of older people and identify strategies used to manage their own health and well-being. Methods Older carers (aged ≥50 years) of older people (aged ≥65 years) in Australia participated in a cross-sectional survey focused on carer roles, self-rated health, information and activities used to maintain their carer role and health, barriers to accessing health care, and assessment of quality of life (QoL) using the Dementia Quality of Life Scale for Older Family Carers. Multiple regression analysis examined relationships between variables and the QoL outcome. Results The survey was completed by 189 older carers (mean age: 68 years; SD = 9.3). Most were female (83.5%), 80.2% providing care daily and 47.8% provided ≥six hours care daily. Almost half (45.1%) self-reported their health as average or below. Despite rating ensuring personal health as very important (mean importance 8/10), only 46.3% reported receiving support from their general practitioner for their carer role. The most common barrier to accessing care for themselves was “not having enough time”. Factors independently associated with poorer carer QoL were living with the care-recipient, caring for someone with depression/anxiety and poor care-recipient health. Factors independently associated with higher carer QoL were placing high importance on personal health, receiving assistance from a specialist clinic as a carer, and older age. Conclusion Older carers of older people provide high levels of care and experience reduced quality of life. Innovative approaches that provide integrated care and support for older carers to promote their QoL are urgently needed.
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Affiliation(s)
- Den-Ching A Lee
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, 3199, Australia,Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia,Correspondence: Den-Ching A Lee, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Moorooduc Highway, Frankston, Victoria, 3199, Australia, Tel +613 9904 4662, Email
| | - Elissa Burton
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, 6102, Australia,enAble Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, 6102, Australia
| | - Susan Slatyer
- Centre for Healthy Ageing, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - Alessandro Jacinto
- Faculty of Geriatric Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Déborah Oliveira
- Medical School, Faculty Postgraduate Department of Psychiatry, Federal University of Sao Paulo – UNIFESP, Sao Paulo-SP, Brazil
| | - Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Anjali Khushu
- Department of Geriatrics (Falls Prevention Service), Peninsula Health, Frankston, Victoria, 3199, Australia
| | - Elizabeth Tiller
- Department of Geriatrics (Falls Prevention Service), Peninsula Health, Frankston, Victoria, 3199, Australia
| | - Aislinn Lalor
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia,Department of Occupational Therapy, Monash University, Melbourne, Victoria, 3199, Australia
| | - Moira Watson
- Centre for Healthy Ageing, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - Natasha Layton
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia
| | - Natasha Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia,National Centre for Healthy Ageing, Monash University and Peninsula Health, Frankston, Victoria, 3199, Australia
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Zhong X, Song PP, Wang Z, Chen H. Resilience building among Chinese family caregivers of older people with Parkinson's disease in Shanghai. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2395-e2405. [PMID: 34904318 DOI: 10.1111/hsc.13679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
Despite a rapid increase in people with Parkinson's disease (PD) in China, studies focusing on caregiver burden remain scarce. Challenges faced by caregivers in other Asian societies are also underexplored in the PD-related research field. To addresses this gap, this study drew on the theory of resilience and examined the caregiving experiences of Chinese family caregivers for older people with PD. We conducted participant observation and semi-structured interviews with 15 family caregivers of older people with PD in Shanghai in 2018. We used thematic analysis to identify key patterns of stressors and factors affecting the capacity of caregivers to address burdens. Our analysis shows that stressors faced by Chinese PD caregivers included physical limitations, psychological and emotional problems, reduction in social connections, financial burden and lack of information and knowledge. Three levels of factors-personal, social and structural-played different roles in resilience among Chinese PD caregivers. However, resilience was unevenly developed among PD caregivers across gender, kinship, residential status and generation. Our study provides novel empirical evidence about the burden on Chinese PD caregivers. It can inform policymakers and social workers as they develop a holistic understanding of promoting resilience building in this rapidly growing group. Our study also enriches cross-cultural knowledge about factors contributing to caregivers' resilience building in Asian societies.
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Affiliation(s)
- Xiaohui Zhong
- School of Government, Sun Yat-sen University, Guangzhou, P. R. China
| | - Priscilla P Song
- Centre for the Humanities and Medicine, The University of Hong Kong, SAR, Hong Kong, P.R. China
| | - Zhe Wang
- Department of Social Work, School of Social Development and Public Policy, Fudan University, Shanghai, P. R. China
| | - Honglin Chen
- Department of Social Work, School of Social Development and Public Policy, Fudan University, Shanghai, P. R. China
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
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Dorell Å, Konradsen H, Kallström AP, Kabir ZN. “A friend during troubled times”: Experiences of family caregivers to persons with dementia when receiving professional support via a mobile app. PLoS One 2022; 17:e0271972. [PMID: 35917295 PMCID: PMC9345357 DOI: 10.1371/journal.pone.0271972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Åsa Dorell
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Hanne Konradsen
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gastroenterology, Herley and Gentofte Hospital, Herlev, Denmark
| | - Ana Paula Kallström
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Zarina Nahar Kabir
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
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Egan KJ, Clark P, Deen Z, Paputa Dutu C, Wilson G, McCann L, Lennon M, Maguire R. Understanding Current Needs and Future Expectations of Informal Caregivers for Technology to Support Health and Well-being: National Survey Study. JMIR Aging 2022; 5:e15413. [PMID: 35084339 PMCID: PMC8832269 DOI: 10.2196/15413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 03/23/2020] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background There are approximately 6.5 million informal (unpaid) caregivers in the United Kingdom. Each caregiver plays a critical role in the society, supporting the health and well-being of those who are ill, disabled, or older and who need frequent support. Digital technologies are becoming a ubiquitous part of everyday life for many, but little is known about the real-world impact of technology for those in a caring role, including the abilities of technologies to address the mental and physical impacts of caregiving. Objective This study aims to understand the current and future technology use of caregivers, including digital technologies used to care for themselves and the person they look after. Methods We codeveloped a wide range of questions with caregivers and care professionals and delivered this survey both on the web and in paper format (eg, using social networks such as Twitter alongside in-person events). Questions were focused on providing care and looking after caregiver health and well-being. Analyses focused on both quantitative outcomes (frequency counts and Likert questions) and explored free text entries (thematic analysis). Results From 356 respondents, we identified that caregivers were receptive to, and largely positive about current and future use of technology both for their own care and their caring role (eg, checking in from distance). There were notable concerns, including the risk that technology could replace human contact. We identified several key areas for future work, including communication with health and social care professionals, and the potential for technology to help caregivers with their own health. We also identified several stakeholders (eg, care workers, pharmacy staff, and general practitioners) who could act as suitable points for technology signposting and support. Conclusions Caregivers are a transient, often difficult to reach population, and this work has collated a large body of knowledge across a diverse group of individuals. Many caregivers, like the rest of society, are realizing the benefits of using everyday technology to help deliver care. It is clear that there is already a high level of dependency on technologies, where future expectations will grow. However, many barriers to digital technology use remain, including a lack of ongoing technology support. Preventive measures linked to technology that can help look after a caregiver’s own health appear acceptable, particularly for communicative tools. This collated caregiver knowledge is a call for all stakeholders—academics, policy makers, and practitioners—to take note of these specific challenges, and to ensure that caregiver voices are both heard and fully integrated within the emerging digital health agenda.
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Affiliation(s)
- Kieren J Egan
- Digital Health and Wellness Group, Department of Computing and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | | | - Zahid Deen
- The Health and Social Care Alliance Scotland, Glasgow, United Kingdom
| | | | - Graham Wilson
- Digital Health and Wellness Group, Department of Computing and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Lisa McCann
- Digital Health and Wellness Group, Department of Computing and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Marilyn Lennon
- Digital Health and Wellness Group, Department of Computing and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Roma Maguire
- Digital Health and Wellness Group, Department of Computing and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
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Tokovska M, Nour MM, Sørensen A, Småland Goth U. Informal caregivers and psychosocial support: Analysis of European Dementia Policy documents. J Public Health Res 2021; 11. [PMID: 34579521 PMCID: PMC8874860 DOI: 10.4081/jphr.2021.2416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Various countries in Europe have different strategies for promoting care solutions for dementia challenges. The different approaches of Austria, Belgium, Czechia, Denmark, Finland, Germany, Gibraltar, Ireland, Israel, Malta, Nederland, Norway, Sweden and the United Kingdom (Scotland and Wales) were investigated. Dementia has a significant social, psychological and economic impact on the individual, family and society. As the disease progresses dementia sufferers become increasingly dependent. As many dementia sufferers are at home during the initial stages, the physical, emotional, and social demands of the dementia sufferers are often covered by informal caregivers. This study, therefore, aims to investigate the integration of psychosocial interventions for comprehensive care pertaining to informal caregivers of people with dementia in Europe. Furthermore, the study will highlight how implementation of technologies might enable psychosocial support of informal caregivers. The data is based on 15 national dementia strategies from various European countries. Data was based on preexisting coding systems with the predefined keywords and analyzed by qualitative content analysis by four of the authors. Our results show that psychosocial support is provided in various modalities and that informal caregivers need to be supported by a psychosocial approach. Due to this need the national dementia strategies should include measures to reduce the emotional burden of informal caregivers. Psychosocial support provided to informal caregivers in a comprehensive and systematic way is likely to enable informal caregivers to handle the emotional, cognitive, and behavioral consequences of the disease and its treatment, while helping to maintain their work-life balance. Significance for public health This study has important public health impacts on informal caregivers in a European context. The study reveals that the European countries of Alzheimer Europe - especially policymakers, social and healthcare providers and non-government organizations - should update or prepare the necessary national dementia strategies, promote benchlearning, improve international collaboration and systematically manage those who provide psychosocial support.
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Affiliation(s)
| | - Magde Mohamed Nour
- School of Health Science, Kristiania University College, Oslo; Department of Information Science and Media Studies, University of Bergen, Bergen.
| | - Anette Sørensen
- School of Health Science, Kristiania University College, Oslo.
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Eyaloba C, De Brauwer I, Cès S, Benoit F, Gillain S, Pesch L, Rouvière H, De Breucker S. Profile and needs of primary informal caregivers of older patients in Belgian geriatric day hospitals: a multicentric cross-sectional study. BMC Geriatr 2021; 21:315. [PMID: 34001018 PMCID: PMC8130294 DOI: 10.1186/s12877-021-02255-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background With the improvement of life expectancy, the world faces increasing demands for care of older persons. In this manuscript, we define the characteristics of primary informal caregivers (PIC) of patients aged 75 years and older admitted to geriatric day hospitals (GDH) in Belgium. A PIC is defined as the person who most often provides care and assistance to persons who need to be cared for. We describe PIC socio-demographic characteristics, satisfaction, burden and wishes about caring; the type of assistance provided and received, their self-rated health, socio-demographic and medical characteristics of proxies, in particular the presence of behavioural disorders. Methods We conducted a cross-sectional study in 25 GDH. Participants Four hundred seventy-five PIC of patients ≥75 years and their proxies. PIC completed a questionnaire at the GDH assessing burden by Zarit Burden Index-12 (ZBI-12), self-rated health, social restriction due to caregiving and financial participation. We compared the characteristics of PIC with high and low burden, and the characteristics of spouses and adult children PIC. We also analyzed factors associated with a high burden in a multivariable logistic regression model. Results PIC were mainly women (72%), adult children (53.8%) and spouses (30.6%). The mean age was 64 ± 14 years for PIC and 84 ± 5 years for care recipients. PIC helped for most of Activities in Daily Living (ADL) and Instrumental ADL (iADL). The median ZBI-12 score was 10 [IQR 5–18]. In multivariable regression analysis, a high burden was positively associated in the total group with living with the relative (p = 0.045), the difficulty to take leisure time or vacation (p < 0.001), behavioral and mood disorders (p < 0.001;p = 0.005), and was negatively associated with bathing the relative (p = 0.017) and a better subjective health status estimation (p < 0.001). Conclusion Primary informal caregivers, who were predominantly women, were involved in care for ADL and iADL. A high burden was associated with living with the relative, the difficulty to take leisure time or vacation and the relative’s behavioral and mood disorders. Bathing the relative and a subjective health status estimated as good as or better than people the same age, were protective factors against a high burden. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02255-1.
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Affiliation(s)
- C Eyaloba
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium
| | - I De Brauwer
- IRSS, Institute of Health and Society, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - S Cès
- IRSS, Institute of Health and Society, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - F Benoit
- Department of Geriatric Medicine, Brugmann Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gillain
- Department of Geriatric Medicine, University Hospital of Liège, Université de Liège, Liège, Belgium
| | - L Pesch
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium
| | - H Rouvière
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium
| | - S De Breucker
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium.
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Levinson AJ, Ayers S, Butler L, Papaioannou A, Marr S, Sztramko R. Barriers and Facilitators to Implementing Web-Based Dementia Caregiver Education From the Clinician's Perspective: Qualitative Study. JMIR Aging 2020; 3:e21264. [PMID: 33006563 PMCID: PMC7568210 DOI: 10.2196/21264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/14/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022] Open
Abstract
Background Internet-based dementia caregiver interventions have been shown to be effective for a range of caregiver outcomes; however, little is known about how to best implement them. We developed iGeriCare, an evidence-based, multimedia, web-based educational resource for family caregivers of people living with dementia. Objective This study aims to obtain feedback and opinions from experts and clinicians involved in dementia care and caregiver education about 1 iGeriCare and 2 barriers and facilitators to implementing a web-based caregiver program. Methods We carried out semistructured interviews with individuals who had a role in dementia care and/or caregiver education in several key stakeholder settings in Southern Ontario, Canada. We queried participants’ perceptions of iGeriCare, caregiver education, the implementation process, and their experience with facilitators and barriers. Transcripts were coded and analyzed using a grounded theory approach. The themes that emerged were organized using the Consolidated Framework for Implementation Research. Results A total of 12 participants from a range of disciplines described their perceptions of iGeriCare and identified barriers and facilitators to the implementation of the intervention. The intervention was generally perceived as a high-quality resource for caregiver education and support, with many stakeholders highlighting the relative advantage of a web-based format. The intervention was seen to meet dementia caregiver needs, partially because of its flexibility, accessibility, and compatibility within existing clinical workflows. In addition, the intervention helps to overcome time constraints for both caregivers and clinicians. Conclusions Study findings indicate a generally positive response to the use of internet-based interventions for dementia caregiver education. Results suggest that iGeriCare may be a useful clinical resource to complement traditional face-to-face and print material–based caregiver education. More comprehensive studies are required to identify the effectiveness and longevity of web-based caregiver education interventions and to better understand barriers and facilitators with regard to the implementation of technology-enhanced caregiver educational interventions in various health care settings.
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Affiliation(s)
- Anthony J Levinson
- Division of e-Learning Innovation, McMaster University, Hamilton, ON, Canada
| | - Stephanie Ayers
- Division of e-Learning Innovation, McMaster University, Hamilton, ON, Canada
| | - Lianna Butler
- Division of e-Learning Innovation, McMaster University, Hamilton, ON, Canada
| | | | - Sharon Marr
- Department of Geriatric Medicine, McMaster University, Hamilton, ON, Canada
| | - Richard Sztramko
- Department of Geriatric Medicine, McMaster University, Hamilton, ON, Canada
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Chuakhamfoo NN, Phanthunane P, Chansirikarn S, Pannarunothai S. Health and long-term care of the elderly with dementia in rural Thailand: a cross-sectional survey through their caregivers. BMJ Open 2020; 10:e032637. [PMID: 32209620 PMCID: PMC7202699 DOI: 10.1136/bmjopen-2019-032637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To describe the circumstances of the elderly with dementia and their caregivers' characteristics in order to examine factors related to activities of daily living (ADL) and household income to propose a long-term care policy for rural areas of Thailand. SETTING A cross-sectional study at the household level in three rural regions of Thailand where there were initiatives relating to community care for people with dementia. PARTICIPANTS Caregivers of 140 people with dementia were recruited for the study. PRIMARY AND SECONDARY OUTCOME MEASURES Socioeconomic characteristics including data from assessment of ADL and instrumental ADL and the Thai version of Resource Utilisation in Dementia were collected. Descriptive statistics were used to explain the characteristics of the elderly with dementia and the caregivers while inferential statistics were used to examine the associations between different factors of elderly patients with dementia with their dependency level and household socioeconomic status. RESULTS Eighty-six per cent of the dementia caregivers were household informal caregivers as half of them also had to work outside the home. Half of the primary caregivers had no support and no minor caregivers. The elderly with dementia with high dependency levels were found to have a significant association with age, dementia severity, chance of hospitalisation and number of hospitalisations. Though most of these rural samples had low household incomes, the patients in the lower-income households had significantly lower dementia severity, but, with the health benefit coverage had significantly higher chances of hospitalisation. CONCLUSION As the informal caregivers are the principal human resources for dementia care and services in rural area, policymakers should consider informal care for the Thai elderly with dementia and promote it as the dominant pattern of dementia care in Thailand.
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Affiliation(s)
- Nalinee N Chuakhamfoo
- Department of Community Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Pudtan Phanthunane
- Department of Economics, Faculty of Business, Economics and Communications, Naresuan University, Phitsanulok, Thailand
| | - Sirintorn Chansirikarn
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Supasit Pannarunothai
- Research unit, Centre for Health Equity Monitoring Foundation, Phitsanulok, Thailand
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