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Stokes JE, Kindratt TB, Antonucci TC, Cox CG, Choi H. Employment Dynamics Among Adult Children at the Onset of Parental Dementia: Variation by Sociodemographic Characteristics. J Aging Health 2024; 36:546-558. [PMID: 37707366 PMCID: PMC11010591 DOI: 10.1177/08982643231201547] [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] [Indexed: 09/15/2023]
Abstract
OBJECTIVES To examine the influence of sociodemographic factors on employment changes among adult children following onset of parental Alzheimer's disease and related dementia (ADRD). METHODS We used Health and Retirement Study (2010-2018; N = 20,110) data to examine adult child (ages 50-70) changes in employment and work hours at onset of parental ADRD and potential variation by gender, age, race, ethnicity, and education. RESULTS Parental ADRD onset was not associated with changes in adult child employment overall, although associations differed substantially across subpopulations defined by education level. Sons with the lowest education were least likely to cease employment, while daughters with the lowest education were most likely to reduce work hours. Sons at older ages were increasingly likely to reduce work hours or end employment following parental ADRD onset. DISCUSSION The potential impact of parental ADRD on adult child employment is complex and should be considered in the context of sociodemographic factors.
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Jang S, Chen J. National Estimates of Incremental Work Absenteeism Costs Associated With Adult Children of Parents With Alzheimer's Disease and Related Dementias. Am J Geriatr Psychiatry 2024; 32:972-982. [PMID: 38604922 PMCID: PMC11227392 DOI: 10.1016/j.jagp.2024.03.011] [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: 01/16/2024] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE More than half of primary caregivers for ADRD patients are adult children, yet there is little empirical evidence on how caring for parents with ADRD affects their employment. Using a nationally representative dataset, this study aimed to estimate incremental work absenteeism costs for adult children of parents with ADRD. DESIGN, SETTING, AND PARTICIPANTS The study used the data from the 2015-2021 Medical Expenditure Panel Survey (MEPS). Multivariate regressions and two-part models were employed to estimate the incremental work absenteeism costs among adult children aged 40 to 64 who had at least one parent diagnosed with ADRD, compared with those who did not have ADRD parents. MEASUREMENTS The incremental work absenteeism costs due to caregiving for adult children with ADRD parents was a cumulated estimation of labor productivity cost at three stages: (1) the likelihood of not working due to unemployment, (2) the likelihood of missing any workdays for caregiving, and (3) the number of workdays missed due to caregiving. RESULTS Adult children with ADRD parents were more likely to be unemployed (OR = 1.80, p = 0.024) and 2.95 times more likely to miss work for caregiving (p = 0.002) than those with non-ADRD parents. The difference in the number of workdays missed for caregiving between children with and without ADRD parents was not significant. The incremental effects of having ADRD parents were estimated to be $4,510.29 ($1,702.09-$6,723.69) per person per year. CONCLUSIONS Having ADRD parents significantly increases the chances of unemployment and missing any workdays for caregiving, leading to higher lost labor productivity costs for adult children with ADRD parents.
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Affiliation(s)
- Seyeon Jang
- Department of Health Policy and Management (SJ, JC), School of Public Health, University of Maryland, College Park, MD; The Hospital and Public Health InterdisciPlinarY Research (HAPPY) Lab (SJ, JC), School of Public Health, University of Maryland, College Park, MD.
| | - Jie Chen
- Department of Health Policy and Management (SJ, JC), School of Public Health, University of Maryland, College Park, MD; The Hospital and Public Health InterdisciPlinarY Research (HAPPY) Lab (SJ, JC), School of Public Health, University of Maryland, College Park, MD
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Morimoto H. Profiles of psychological flexibility and caregiving experience in dementia family caregivers: A latent profile analysis. J Clin Psychol 2024; 80:1821-1837. [PMID: 38639034 DOI: 10.1002/jclp.23696] [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: 12/21/2023] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES To explore the profiles of psychological flexibility among dementia family caregivers and examine their associations with psychological well-being and caregiving factors. METHODS Participants were 521 dementia family caregivers in Japan. Latent profile analysis was conducted to explore the profiles of psychological flexibility. The analyses examined differences in depression, anxiety, life satisfaction, and work-family conflict/enrichment between the profiles, and whether sociodemographic variables and caregiving stressors predict the profile. RESULTS Four distinct profiles were identified: high psychological flexibility (14.2%), moderate psychological flexibility with high commitment (24.7%), moderate psychological flexibility with low commitment (48.0%), and low psychological flexibility (13.1%). The low psychological flexibility profile exhibited the highest scores of depression, anxiety and work-family conflict, followed by the moderate psychological flexibility with low/high commitment profiles, and the high psychological flexibility profile. The high psychological flexibility and moderate psychological flexibility with high commitment profiles exhibited higher life satisfaction than the moderate psychological flexibility with low commitment profile. Caregiving stressors, marital status, and caregiver status predicted the profile. CONCLUSION Enhancing defusion and acceptance, rather than increasing commitment to personal values, may be beneficial in supporting distressed caregivers. Having more caregiving stressors, being single/divorced/bereaved, and being a primary caregiver may be useful indicators of decreased psychological flexibility among dementia family caregivers.
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Malhotra C, Huynh VA, Østbye T, Malhotra R. Caregivers' Absenteeism and Its Association With Health Shocks and Functional Impairment Among Persons With Severe Dementia. J Aging Soc Policy 2024; 36:603-620. [PMID: 37026473 DOI: 10.1080/08959420.2023.2196232] [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: 08/18/2022] [Accepted: 11/20/2022] [Indexed: 04/08/2023]
Abstract
Adult child caregivers of persons with severe dementia (PWSDs) experience absenteeism due to caregiving. We quantified employed adult child caregivers' absenteeism; its association with PWSDs' functional impairment and health shocks; and characteristics of caregivers not experiencing absenteeism in the presence of PWSDs' health shocks and high functional impairment. We used a prospective cohort of 111 employed adult child caregivers of community-dwelling PWSDs in Singapore surveyed every 4 months for 1 year. We calculated absenteeism days due to caregiving and the corresponding absenteeism cost. Findings showed that 43% of the caregivers experienced absenteeism due to caregiving at least once during 1 year. On average, in a month, caregivers experienced 2.3 (SD = 5.9) absenteeism days and S$758 (SD = 2120) absenteeism cost. Those caring for PWSDs with high functional impairment experienced an additional 2.5 absenteeism days and S$788 absenteeism cost versus caregivers of PWSDs with low functional impairment. Caregivers whose PWSDs experienced a health shock experienced an additional 1.8 absenteeism days and S$772 absenteeism cost versus caregivers of PWSDs without a health shock. Co-residence with PWSDs worsened the impact of PSWDs' high functional impairment on caregivers absenteeism. Caregivers not co-residing with PWSDs and not using a maladaptive coping style were less likely to experience absenteeism when caring for PWSDs with a health shock. Results suggest a need to support caregivers of PWSDs to better cope with their caregiving in order to mitigate caregivers' absenteeism.
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Affiliation(s)
- Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Vinh Anh Huynh
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
| | - Rahul Malhotra
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
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Kokorelias KM, Nadesar N, Bak K, Boger J, Nygård L, Mäki-Petäjä-Leinonen A, Nedlund AC, Astell A. The impact on employment and education of caregiving for a family member with young onset dementia: A scoping review. DEMENTIA 2024; 23:850-881. [PMID: 38623057 DOI: 10.1177/14713012241247339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Young-onset dementia (YOD) affects individuals under 65 years of age, often leading to loss of employment and independence. Families provide increasing levels of care to family members with YOD, resulting in changes to their daily lives, including their occupational pursuits. This review examines evidence of the occupational implications for family members who provide care to a family with YOD to identify: (i) the influence and impact caregiving tasks and responsibilities have on employment, volunteering, and education, and (ii) caregiver, and caregiving situation factors associated with changes in employment, volunteering, and education. A scoping review was performed using eight electronic databases. Included articles were narratively synthesized using a thematic analysis. Sixteen studies met the inclusion criteria and were included for review. The over-arching (main) theme of 'decision-making' was identified, with family members required to make choices about their own occupational goals and roles to be able to provide care to family living with YOD. The outcomes of these decisions are dynamic and changeable across the caregiving trajectory. Three caregiving factors influence decision-making: (1) Implications of Combining Caregiving and Occupations, (2) Altered Identity (3) Strategies to Support Caregivers of Individuals Living with YOD. A fourth theme was also identified 'Guidance for Researchers To Support Caregivers'. There is a scarce body of literature examining the influence caregiving has on occupational outcomes for the YOD caregiver population. Much of this work is descriptive and lacks focus on the implications, particularly long-term impacts. This review provides a foundational guide for future research and practices to support YOD family caregivers to obtain and sustain occupations.
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Affiliation(s)
- Kristina M Kokorelias
- Sinai Health System, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Nirusa Nadesar
- University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Katherine Bak
- University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Jennifer Boger
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
- UBC-Okanagan, Kelowna, BC, Canada
| | - Louise Nygård
- Division of occupational therapy, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Arlene Astell
- University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- University of Reading, Reading, UK
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Oliveira D, da Mata FAF, Aubeeluck A. Quality of life of family carers of people living with dementia: review of systematic reviews of observational and intervention studies. Br Med Bull 2024; 149:1-12. [PMID: 38050333 DOI: 10.1093/bmb/ldad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION Family members are the primary source of support for the growing number of people living with dementia (PLWD) worldwide. However, caring for a person living with dementia can have detrimental impacts on the carer quality of life (QoL). This review of systematic reviews explored the factors associated with the QoL of family carers of PLWD and interventions aimed at improving their QoL. SOURCES OF DATA Several health-related databases (PUBMED, Psychinfo, Google Scholar and COCHRANE) were consulted in November 2022. Nineteen systematic reviews were included, and their methodological quality was assessed via AMSTAR-2. AREAS OF AGREEMENT Better carer physical and mental health, provision of formal support, relationship quality between carers and PLWD, as well as positive psychological traits were associated with better carer QoL. There is no one-size-fits-all intervention that can improve the QoL of all carers, but promising results were found in most of the interventions. AREAS OF CONTROVERSY There is inconsistency in evidence on the association between the carer age and QoL. The use of a wide range of QoL measures, particularly generic QoL scales, has contributed to inconsistencies when comparing the efficacy of interventions. GROWING POINTS Evidence suggests the need for a person-centred approach to improving carer QoL, considering individual and contextual needs as well as the continuum and progressive nature of dementia care. TIMELY AREAS FOR DEVELOPING RESEARCH Future research should be focused on understanding how to best implement and measure person-centred care approaches to carer QoL, including cost-effectiveness. More qualitative studies are necessary to explore carer negative and positive experiences of QoL.
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Affiliation(s)
- Déborah Oliveira
- Faculty of Nursing, Universidad Andrés Bello, Campus Viña del Mar, Viña del Mar, 980 Quillota, Tower D, 3rd floor, 2531015, Chile
- Millennium Institute for Care Research (MICARE), 227 Avenida República, Región Metropolitana, Santiago, 8370146, Chile
| | - Fabiana Araújo Figueiredo da Mata
- Department of Psychiatry, Faculty of Medicine, Universidade Federal de Sao Paulo (UNIFESP), 241 Major Maragliano, Vila Mariana, Sao Paulo 04021001, Brazil
- Social Sustainability and Responsibility Centre, Hospital Alemão Oswaldo Cruz (HAOC), 1815 Treze de Maio, Bela Vista, 01323020, São Paulo 01508000, São Paulo, Brazil
| | - Aimee Aubeeluck
- School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Queen's Medical Centre, Derby Road, NG7 2RD, Nottingham, UK
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Sharma S, Hale JM, Myrskylä M, Kulu H. Cognitive impairment and partnership status in the United States, 1998-2016, by sex, race/ethnicity, and education. POPULATION STUDIES 2024; 78:167-177. [PMID: 36812934 DOI: 10.1080/00324728.2023.2174267] [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: 08/29/2021] [Accepted: 08/05/2022] [Indexed: 02/24/2023]
Abstract
Cognitively impaired adults without a partner are highly disadvantaged, as partners constitute an important source of caregiving and emotional support. With the application of innovative multistate models to the Health and Retirement Study, this paper is the first to estimate joint expectancies of cognitive and partnership status at age 50 by sex, race/ethnicity, and education in the United States. We find that women live a decade longer unpartnered than men. Women are also disadvantaged as they experience three more years as both cognitively impaired and unpartnered than men. Black women live over twice as long as cognitively impaired and unpartnered compared with White women. Lower-educated men and women live around three and five years longer, respectively, as cognitively impaired and unpartnered than more highly educated men and women. This study addresses a novel facet of partnership and cognitive status dynamics and examines their variations by key socio-demographic factors.
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Affiliation(s)
- Shubhankar Sharma
- Max Planck Institute for Demographic Research
- University of St Andrews
| | - Jo Mhairi Hale
- Max Planck Institute for Demographic Research
- University of St Andrews
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research
- University of Helsinki
- Max Planck - University of Helsinki Center for Social Inequalities in Population Health
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Scheuermann JS, Gräßel E, Pendergrass A. [Reconciling Employment and Informal Caregiving for an Elderly Person at Home: Factors Influencing a Reduction in Employment due to Caregiving and Work-Related Wishes of Informal Caregivers]. DAS GESUNDHEITSWESEN 2024; 86:S45-S53. [PMID: 38395038 PMCID: PMC10949857 DOI: 10.1055/a-2191-2074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Reconciling informal caregiving and gainful employment is a challenge for many informal caregivers. The goals of this paper are to identify factors influencing care-related employment reduction, and to record work-related wishes for improving the compatibility of informal caregiving and being employed. METHODS Analyses were based on the cross-sectional Benefits of Being a Caregiver Study of 426 employed caregivers of an older person in need of care. Data were collected on characteristics of the care receivers and caregivers, and aspects of the caregiving and employment situation. Potential influencing factors of care-related employment reduction (n=426) were analyzed using binary logistic regression. The wishes regarding the compatibility of informal care at home and employment were examined descriptively using structured content analysis according to Mayring. RESULTS One quarter of the employed informal caregivers (n=108) reduced their hours of employment due to the demands of caregiving. The profile of influencing factors of a care-related employment reduction was composed of a higher number of working hours, higher effort for activities of daily living, and co-residence with the care receiver. Employed caregivers primarily expressed a desire for flexibility in working hours, a reduction in working hours, and some concessions with regard to absenteeism. CONCLUSIONS Relieving the burden on caregivers in the activities of daily living in form of formal and informal support services can probably reduce the likelihood of a care-related reduction in gainful employment.
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Affiliation(s)
- Julia-Sophia Scheuermann
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU),
Erlangen, Germany
| | - Elmar Gräßel
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU),
Erlangen, Germany
| | - Anna Pendergrass
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU),
Erlangen, Germany
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Scheuermann JS, Gräßel E, Pendergrass A. [Care-related Termination of Employment among Informal Caregivers of Elderly Persons: Identification of a Risk Profile]. DAS GESUNDHEITSWESEN 2024; 86:S37-S44. [PMID: 38395037 PMCID: PMC11323155 DOI: 10.1055/a-2183-6741] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Employed informal caregivers often experience role conflicts between caring for an elderly person in need of care at home and their employment. The goal of this paper was to identify a risk profile of care-related termination of employment. METHODS Analyses are based on the cross-sectional Benefits of Being a Caregiver Study (October 2019 - March 2020) with data from 481 informal caregivers of elderly persons in need of care. The data collected relate to characteristics of the care recipient, the informal caregiver, and the caregiving situation, as well as aspects of the employment situation. The risk profile of care-related cessation of employment is based on a binary logistic regression. RESULTS Approximately one in nine in the present sample (n=55) terminated employment because of having to offer informal care to an elderly person at home. Factors characterizing the risk profile of a care-related termination of employment were female gender of the caregivers, younger age of the care receiver, co-residence with the care receiver, and a higher care level of the care receiver. CONCLUSIONS In order to reduce care-related cessation of employment, support and relief services need to be adapted to the factors of the identified risk profile. In particular, the form and content of informal caregiver counselling should be modified in order to reach informal caregivers at an early stage. Adapted support programs should focus on and reach in particular female employed caregivers.
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Affiliation(s)
- Julia-Sophia Scheuermann
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische und
Psychotherapeutische Klinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität
Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Elmar Gräßel
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische und
Psychotherapeutische Klinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität
Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anna Pendergrass
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische und
Psychotherapeutische Klinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität
Erlangen-Nürnberg (FAU), Erlangen, Germany
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Podgorski CA, Anderson SD, Parmar J. A Biopsychosocial-Ecological Framework for Family-Framed Dementia Care. Front Psychiatry 2021; 12:744806. [PMID: 34975562 PMCID: PMC8718405 DOI: 10.3389/fpsyt.2021.744806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/23/2021] [Indexed: 12/05/2022] Open
Abstract
The biopsychosocial model has been applied through collaborative care dementia models to the diagnosis, symptom management, and treatment of dementia with a focus specifically on the person with dementia. Because individuals with dementia are increasingly dependent upon others particularly as the illness advances, dementia care requires the involvement and commitment of others, usually family, along with support from community-based resources. Hence, the quality and effectiveness of a person's dementia care are shaped in large part by the foundation of family relationships and the social and community networks in which they are embedded. While most current dementia care models incorporate biopsychosocial principles and recognize the essential role that family members play as caregivers, they fail to consider a patient's family system and relationships as potential risk factors or social determinants for care outcomes. This paper introduces a biopsychosocial-ecological framework to dementia care that is person-centered and "family-framed" in that it targets factors that influence care considerations at both the individual and relational levels of the social ecological networks that the patient and their family members occupy. We use this model to illustrate how current dementia care practices tend to focus exclusively on the individual patient and caregiver levels but fail to identify and address important relational considerations that cut across levels. We call for the need to add assessment of family relational histories of persons with dementia and family members who care for them in order to better meet the needs of the patient and the caregiver and to prevent harm. This model accentuates the need for interprofessional education on family assessments and caregiver-centered care, as well as interdisciplinary, collaborative models of dementia care that assume more accountability for meeting the needs of family caregivers in addition to those of persons with dementia.
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Affiliation(s)
- Carol Ann Podgorski
- Department of Psychiatry, University of Rochester, Rochester, NY, United States
| | - Sharon D. Anderson
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jasneet Parmar
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
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Teahan Á, Carney P, Cahill S, O'Shea E. Establishing priorities for psychosocial supports and services among family carers of people with dementia in Ireland. DEMENTIA 2021; 20:2109-2132. [PMID: 33423536 DOI: 10.1177/1471301220984907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Many family carers, particularly those caring for people with dementia, report significant personal and social challenges associated with caring. The aim of this article is to identify the range of challenges experienced by family carers of people with dementia and to ascertain their preferences for various supports and services that address those challenges. METHOD Three modified nominal group technique (NGT) focus groups were conducted with family carers of people with dementia. The NGT groups were conducted with 17 participants in two stages, focusing separately on personal and social domains. Family carers identified challenges and individually ranked preferences for both existing and new services and supports. Data analysis consisted of qualitative content analysis and summative scoring of individual rankings. FINDINGS Family carers identified the following personal-level challenges: needing a break, social isolation and relationship changes. Family carers' combined preferences for personal-level supports and services to overcome these challenges were day care, family care support groups, short-term respite, long-break respite and social activities. Social challenges referenced by family carers included finances, rights and entitlements and stigma and awareness. Preferences for supports and services to address these social challenges were non-means-tested carer's allowance, legal recognition, carer's support grant, monthly wage and community awareness programmes. CONCLUSION Participants ranked day care and non-means-tested carer's allowance as their top priorities under personal and social headings. Increased government investment in these two areas would not only help to maintain family carers' contributions to community-based care in dementia but would also facilitate social inclusion, social connectedness and economic sustainability.
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Affiliation(s)
- Áine Teahan
- Centre for Economic and Social Research on Dementia (CESRD), 8799NUI Galway, Galway, Ireland
| | - Patricia Carney
- Department of Public Health Midlands, 8004Health Service Executive, Tullamore, Ireland
| | - Suzanne Cahill
- Centre for Economic and Social Research on Dementia (CESRD), 8799NUI Galway, Galway, Ireland
| | - Eamon O'Shea
- Centre for Economic and Social Research on Dementia (CESRD), 8799NUI Galway, Galway, Ireland
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12
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Neubert L, Gottschalk S, König HH, Brettschneider C. Vereinbarkeit von Pflege bei Demenz, Familie und Beruf. Z Gerontol Geriatr 2020; 54:643-650. [PMID: 32720196 PMCID: PMC8551114 DOI: 10.1007/s00391-020-01764-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022]
Abstract
Hintergrund Pflegende Angehörige (PA) von Menschen mit Demenz (MMD) sind eine vulnerable Personengruppe, die nicht nur mit den Belastungen aufgrund der Pflege, sondern auch mit Anforderungen aus ihrem Familien- und Berufsleben konfrontiert sein können. Der nationale Forschungsstand zum Erleben des Spannungsfelds zwischen Pflege, Familie und Beruf ist unzureichend. Ziel der Arbeit Die vorliegende Studie ist eine rekonstruktive Analyse der Vereinbarkeit der Pflege eines MMD mit den Lebensbereichen Familie und Beruf, in der Haupt- und Nebenpflegende des MMD berücksichtigt wurden. Methoden Es wurden 14 narrative Interviews mit PA von MMD geführt. Die Auswertung erfolgte anhand der Dokumentarischen Methode nach Nohl und mündete in Typenbildungen. Ergebnisse In pflegenden Familien eines MMD bedingen sich Beziehungsqualität und Aufgabenverteilung gegenseitig. Dies hat Auswirkungen auf das Erleben der Pflege. Stabile Beziehungen und fair verteilte Aufgaben können die Pflege erleichtern, wohingegen konfliktbelastete Beziehungen und ungleich verteilte oder ungeteilte Aufgaben die Pflegebelastung der Familie erhöhen. Erwerbstätige PA nehmen die Lebensbereiche Pflege und Beruf als getrennt voneinander, miteinander in Konflikt geratend oder sich gegenseitig unterstützend wahr. Diskussion Die Belastungen aufgrund der Pflege eines MMD führen zu Beeinträchtigungen im Familien- und Berufsleben, was negative Folgen für die Gesundheit der PA haben kann. Doch ebenso können die Familie sowie der Beruf die Belastung reduzieren, wenn PA beispielsweise durch therapeutische Angebote darin unterstützt werden, positive Pflegeerfahrungen wie gestärkte Familienbeziehungen und -funktionalität zu erleben, und wenn erwerbstätige PA den Beruf als einen stärkenden Lebensbereich erfahren. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00391-020-01764-9) enthalten.
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Affiliation(s)
- Lydia Neubert
- Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Sophie Gottschalk
- Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Hans-Helmut König
- Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Christian Brettschneider
- Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
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