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Peterson LJ, Hackett SE, Dobbs D, Haley WE. Dementia Caregivers' Perspectives on Disaster Preparedness: Barriers, Resources, and Recommendations. THE GERONTOLOGIST 2024; 64:gnad076. [PMID: 37351950 DOI: 10.1093/geront/gnad076] [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: 01/10/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Disaster preparedness is an urgent concern, particularly for caregivers of persons with dementia. Developing and executing plans for oneself and another person who needs care can be difficult when the care recipient is cognitively impaired. We sought to better understand caregivers' disaster preparedness for the purpose of generating guidance for future interventions to increase caregiver resilience. RESEARCH DESIGN AND METHODS We conducted a qualitative descriptive study of caregiver disaster experiences and perceptions of their preparedness. Fifty-two participants from diverse backgrounds participated in a focus group or interview. Deductive thematic data analysis was utilized to identify themes. Stress process models guided the interpretation of our findings. RESULTS Analyses of caregivers' experiences and observations revealed that disaster preparedness was challenging for caregivers, though also perceived to be an important responsibility. We identified 3 main themes: (a) barriers to preparing for a disaster as a caregiver for a person living with dementia, (b) why it is important for a caregiver to develop a disaster plan, and (c) how to facilitate preparedness for caregivers of persons living with dementia. DISCUSSION AND IMPLICATIONS This study highlighted the difficulties of preparing for a disaster while caring for a person with dementia. Applying stress process models to our results provided strong evidence that interventions could be developed to bolster caregivers' resources to cope with stressors associated with disaster preparedness. A key issue for public officials is the question of whether disaster shelters are appropriate for persons with dementia.
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Affiliation(s)
- Lindsay J Peterson
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - Sara E Hackett
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - Debra Dobbs
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - William E Haley
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
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Turner RL, Reese-Melancon C, Harrington EE, Andreo M. Caregiving During the COVID-19 Pandemic: Factors Associated With Feelings of Caregiver Preparedness. J Appl Gerontol 2023; 42:2089-2099. [PMID: 37395127 PMCID: PMC10333559 DOI: 10.1177/07334648231182242] [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: 07/04/2023] Open
Abstract
Examination of caregiver preparedness for the COVID-19 pandemic can inform efforts to support caregivers in future times of global crisis. Informal caregivers of adults with dementia or severe disabilities (n = 72, Mage = 62.82 years, 90.28% female) were recruited through Adult Day Centers across the United States. Caregivers responding to an online survey regarding their experiences and preparedness reported an increase in burden, stress, and time spent caregiving since the onset of the pandemic. Caregivers reported feeling prepared for typical caregiving responsibilities but felt less prepared for someone else to assume the role of primary caregiver. Multiple regression modeling indicated that resilience accounted for significant variance in primary caregiver preparedness, over and above burden, but only caregiver age accounted for significant variability in a component representing feeling prepared to delegate caregiving to another person. These findings have implications for research and applied efforts to promote caregiver well-being and preparedness.
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Affiliation(s)
- Rachael L. Turner
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | | | - Erin E. Harrington
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Micaela Andreo
- Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
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de Rosa CB, Zhou Y, Lyons A, Chang YP. COVID-19 Experiences of Relatives of Nursing Home Residents. Clin Nurs Res 2022; 31:1399-1404. [PMID: 36062527 PMCID: PMC9444825 DOI: 10.1177/10547738221121028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Nursing home residents comprise a disproportionate share of coronavirus-related deaths in the United States. Additionally, lockdown restrictions disrupted residents' relationships with their family members to an unknown extent. This study explored family members' perceived family role and interactions with nursing home residents and staff during the COVID-19 pandemic. Using a qualitative descriptive approach, 10 family members were interviewed using a semi-structured guide. Interviews were audio-recorded and transcribed verbatim, and data were analyzed using Braun and Clarke's Reflexive Thematic analysis. Themes and subthemes indicated that family members accounted for residents' care in new ways, found existing relationships becoming amplified under stress, maintained connections through creative alternatives, and also felt powerless to provide care, despite their knowledge and experience. Family members increasingly relied on staff to meet residents' care needs and provide updates, and often desired to provide assistance and companionship beyond what policy permitted, representing a major opportunity for improving experiences.
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Affiliation(s)
| | - Yanjun Zhou
- University at Buffalo, The State
University of New York, USA
| | - Amy Lyons
- University at Buffalo, The State
University of New York, USA
| | - Yu-Ping Chang
- University at Buffalo, The State
University of New York, USA
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Boucher NA, McKenna K, Dombeck CB, Clark AG, Wang K, Olsen JM, Shepherd-Banigan M. Caregiving in U.S. Gulf States During Natural Disasters and COVID-19. Gerontol Geriatr Med 2022; 8:23337214221133719. [PMID: 36320427 PMCID: PMC9614589 DOI: 10.1177/23337214221133719] [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: 07/28/2022] [Revised: 09/28/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives: To ascertain common experiences and needs of a diverse group of caregivers
challenged by hurricanes/floods and COVID-19. Methods: In-depth interviews with unpaid caregivers in U.S. Southeast/Gulf Coast
states who had experienced caregiving during a natural disaster and during
COVID-19. Results: Caregivers report challenges including daily living disruption, altered
social supports, complicated health management, additional disaster
planning, and emotional/financial impacts. Caregivers suggested helpful
resources, policy options, and preparatory tools at individual, local, and
health system levels to mediate discontinuity. Conclusions: Our data describe combined caregiver experiences of hurricanes/floods and the
pandemic. Caregivers experience unique burdens related to care recipient
diagnosis, location, and veteran status. Access to community supports varies
as they manage the tasks required for care recipients’ health and safety.
Our findings indicate the need for public health reinforcement of caregiving
though caregiver pre-planning and targeted support. Bolstering understanding
of communities’ caregiving capacity though first responder trainings and
caregiver registries may enhance health and safety.
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Affiliation(s)
- Nathan A. Boucher
- Department of Population Health
Sciences, School of Medicine, Duke University, Durham, NC, USA,Duke Center for the Study of Aging and
Human Development, Durham, NC, USA,Nathan Boucher, Sanford School of Public
Policy, Duke University, 206 Rubenstein Hall, Box 90312, Durham, NC 27708, USA
| | - Kevin McKenna
- Department of Population Health
Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Carrie B. Dombeck
- Department of Population Health
Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Amy G. Clark
- Department of Population Health
Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Ke Wang
- Rosalynn Carter Institute for
Caregivers, Americus, GA, USA
| | | | - Megan Shepherd-Banigan
- Department of Population Health
Sciences, School of Medicine, Duke University, Durham, NC, USA,Center of Innovation to Accelerate
Discovery and Practice Transformation (ADAPT), Durham VA Health System HSR&D,
Durham, NC, USA,Duke-Margolis Center for Health Policy,
Durham, NC, USA
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Allen J, Uekusa S, Alpass FM. Longitudinal Cohort Study of Depression and Anxiety Among Older Informal Caregivers Following the Initial COVID-19 Pandemic Response in Aotearoa New Zealand. J Aging Health 2022; 34:653-665. [PMID: 35412393 PMCID: PMC9008474 DOI: 10.1177/08982643211052713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Objectives To assess the impact of providing care and conditions of care on psychological wellbeing among older informal caregivers following the initial period of COVID-19 pandemic restrictions in Aotearoa New Zealand. Methods Data were from population-based cohorts of older adults participating in the 2020 Health, Work and Retirement longitudinal survey (n = 3839, 17.4% informal caregivers). Changes in symptoms of depression and anxiety over 2018–2020 surveys associated with sociodemographic factors, caregiving, cohabitation with the care recipient, assistance provided with activities of daily living, support in providing care, and opportunity cost of care were assessed. Results Increased depression, but not anxiety, was associated with providing informal care. Among caregivers, lower living standards and cohabitation were associated with increased depression. Lower living standards, unemployment, and lower help from friend/family networks were associated with increased anxiety. Discussion Economic hardship and social capital provide targets for supporting psychological wellbeing of older caregivers during periods of pandemic restrictions.
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Affiliation(s)
- Joanne Allen
- 6420Massey University, Palmerston North, New Zealand
| | - Shinya Uekusa
- 6420Massey University, Palmerston North, New Zealand
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Nicosia FM, Williams SL, Dannenbaum TP, Barnes DE. Resilience in the Face of Disaster: Psychosocial Effects of the 2017 Northern California Wildfires in Caregivers and Persons with Cognitive Impairment Participating in an Integrative Group Movement Program at an Adult Day Center. ACTIVITIES, ADAPTATION & AGING 2021. [DOI: 10.1080/01924788.2021.1916716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Francesca M. Nicosia
- San Francisco VA Health Care System, University of California, San Francisco, California, USA
| | - Sienna L. Williams
- San Francisco VA Healthcare System, VA Puget Sound Health Care System, Seattle, Washington, USA
| | | | - Deborah E. Barnes
- San Francisco VA Health Care System, University of California, San Francisco, California, USA
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Uekusa S. Exploring Disasters through the Eyes of Residential Nursing Home Caregivers. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:529-541. [PMID: 31250715 DOI: 10.1080/19371918.2019.1635942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Using qualitative interviews, this research explores the experiences of residential nursing home caregivers in Fukushima, who provided support to elderly sufferers of Alzheimer's or other related forms of dementia during the 2011 Great East Japan Earthquake and Tsunami. Although the disaster vulnerability of care recipients such as the elderly, infirmed, disabled, and sufferers of dementia have been studied, their caregivers' disaster experiences, vulnerability and resilience have remained comparatively invisible and under-investigated. Their experiences suggest that coping with the disasters as caregivers was complex and unexpected, and it should not be misunderstood to imply that their resilience is predictable and expected.
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Affiliation(s)
- Shinya Uekusa
- a Department of Sociology, California State University San Marcos , California , USA
- b Department of Sociology, University of Auckland , Auckland , New Zealand
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Gibson A, Walsh J, Brown LM. A perfect storm: Challenges encountered by family caregivers of persons with Alzheimer's disease during natural disasters. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:775-789. [PMID: 29781774 DOI: 10.1080/01634372.2018.1474158] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Since Hurricane Katrina there has been a movement across the U.S. to examine best practice for disaster response within the aging population. However, little is known about the experience of natural disasters from the perspective of family caregivers of persons with Alzheimer's disease and related dementia (ADRD). In this exploratory, qualitative study, family caregivers (n=27) were interviewed about their experience with the historic 2015 South Carolina flood. By using thematic analysis, themes were identified to better understand what unique challenges caregivers of person with ADRD experienced. While many caregivers stated they had experienced a natural disaster previously, none had ever done so in their current caregiving role. The caregiving role affected their ability to prepare for the storm and influenced their decision-making regarding evacuation and utilization of recovery resources. Thus, caregivers were confronted by a "perfect storm" of circumstances and uncertainty. Family caregivers need to have actionable emergency plans for disasters that are specific to their role as caregivers of persons with ADRD. Study implications also suggest the role social work professionals can have in educating, advocating, evaluating, and coordinating support to assist caregivers of persons with ADRD as a potentially vulnerable and at-risk population during all phases of disaster.
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Affiliation(s)
- Allison Gibson
- a College of Social Work , University of Kentucky , Lexington , KY , USA
| | - Jessica Walsh
- b Clinical Psychology , Palo Alto University , Palo Alto , CA , USA
| | - Lisa M Brown
- b Clinical Psychology , Palo Alto University , Palo Alto , CA , USA
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Slyer JT, Archibald E, Moyo F, Truglio-Londrigan M. Advance care planning and anticipatory decision making in patients with Alzheimer disease. Nurse Pract 2018; 43:23-31. [PMID: 29757832 DOI: 10.1097/01.npr.0000532763.68509.e4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Early advance care planning and anticipatory decision making in the Alzheimer disease (AD) trajectory is a strategy NPs can incorporate to improve managing uncertainty around common decisions. This article explores decisions patients and caregivers face along the AD trajectory and provides resources for patients, caregivers, and NPs.
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Affiliation(s)
- Jason T Slyer
- Jason T. Slyer is a clinical assistant professor at Pace University, College of Health Professions, New York, N.Y., and an NP at Matrix Medical Network, New York, N.Y. Ella Archibald is a family NP at Hospital for Special Surgery, New York, N.Y. Fernea Moyo is an NP at New York Presbyterian Hospital, New York, N.Y. Marie Truglio-Londrigan is a professor at Pace University College of Health Professions, Lienhard School of Nursing, New York, N.Y
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Abstract
In concert with lengthening life spans, emerging forms of care in later life reflect complex and diverse social changes. Embracing a polysemic understanding of care as simultaneously resource and relational practice, this review works across scales of social life and theoretical approaches to care to highlight connections and fissures between global political-economic transformations and the most intimate aspects of daily life. Arguing for analyses of care that account for the kinds of projects, stakes, and obstacles that emerge as people engage in social reproduction in later life, this review traces the circulation of care across aging bodies, everyday practices, families, and nations. Care in later life never exclusively impacts the lives of the old; it is thus a critical site for understanding the diverse ways that increased longevity is shaping the meanings, experiences, and consequences of life itself.
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Affiliation(s)
- Elana D. Buch
- Department of Anthropology, University of Iowa, Iowa City, Iowa 52242-1332
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Putnam M. Updating the journal's submission categories and format. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:769-772. [PMID: 25272165 DOI: 10.1080/01634372.2014.966641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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