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van Muijden T, Gräler L, van Exel J, van de Bovenkamp H, Petit‐Steeghs V. Different views on collaboration between older persons, informal caregivers and care professionals. Health Expect 2024; 27:e14091. [PMID: 38924218 PMCID: PMC11196834 DOI: 10.1111/hex.14091] [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: 01/23/2024] [Revised: 04/12/2024] [Accepted: 05/11/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Informal care features high on the policy agenda of many countries to deal with workforce shortages. As a consequence, care provision increasingly takes place in the care triad of care recipients, informal caregivers and care professionals. How collaboration between care partners takes shape depends on how the different partners perceive this collaboration. This paper aims to investigate the relative importance of the different aspects of collaboration from the perspectives of care recipients, informal caregivers and care professionals in the context of the care for older persons in The Netherlands. METHODS Using Q-methodology, 32 participants ranked 28 statements that reflect different aspects of collaboration in the care triad and explained their ranking during a follow-up interview. Participants comprised 9 older persons, 10 informal caregivers and 13 care professionals. Data were analysed using by-person factor analysis to identify common patterns in the rankings of the statements. Emerging patterns were interpreted and described as views on collaboration using aggregated rankings and qualitative data from the interviews. RESULTS Five distinct views on collaboration were found: (1) Emphasizing warm collaboration, (2) trusting care professional's expertise, (3) open and compassionate care professionals, (4) responsive decision-making by autonomous care professionals and (5) prioritizing care recipient's and informal caregiver's interests. Care recipients and/or informal caregivers were associated with views 1, 3 and, 5, whereas care professionals were associated with all five views. CONCLUSIONS Our study highlights the importance of recognizing the potential diversity of views between and within different partner groups in care triads. Governmental and organizational policy makers, as well as healthcare professionals who aim to increase or support the involvement of informal caregivers, should take this heterogeneity into consideration. PATIENT OR PUBLIC CONTRIBUTION An advisory board of older persons (care recipients and informal caregivers) was involved in the recruitment of the participants, the formulation of the statements and the reflection on the findings of the study and potential implications.
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Affiliation(s)
- Teyler van Muijden
- Healthcare GovernanceErasmus School of Health Policy & ManagementRotterdamNetherlands
| | - Leonoor Gräler
- Healthcare GovernanceErasmus School of Health Policy & ManagementRotterdamNetherlands
| | - Job van Exel
- Department of Health EconomicsErasmus School of Health Policy & ManagementRotterdamNetherlands
| | | | - Violet Petit‐Steeghs
- Healthcare GovernanceErasmus School of Health Policy & ManagementRotterdamNetherlands
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2
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Septi Mauludina Y, Yeni Kustanti C, Fields BE, Chang FH. A Descriptive Qualitative Study of Foreign Caregivers of Older Adult Stroke Survivors. THE GERONTOLOGIST 2023; 63:82-95. [PMID: 35660857 DOI: 10.1093/geront/gnac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES With a growing aging stroke population and the changing structure of the society, the demand for foreign caregivers has rapidly increased in Taiwan and many other developed countries. However, little is known regarding the perception, values, and abilities of foreign caregivers and how those may influence their quality of care. This study aimed to explore and describe the experiences of Indonesian foreign caregivers, the largest migrant working population in Taiwan, who reside with and provide support to older adults with stroke and their families. RESEARCH DESIGN AND METHODS By adopting a descriptive qualitative approach, we conducted semistructured interviews with 22 Indonesian caregivers (mean age: 36 years) who were providing care to community-dwelling older stroke survivors (age ≥ 65 years) in Taiwan. Data were analyzed through thematic analysis. RESULTS Six themes were constructed from the interviews: (a) foreign caregiver's background, (b) foreign caregiver's perception of the health and functional status of stroke survivors, (c) foreign caregiver's values and preferences, (d) consequences of caring for stroke survivors, (e) skills/abilities/knowledge of foreign caregivers to provide stroke survivors with required care, and (f) potential resources that foreign caregivers can use. DISCUSSION AND IMPLICATIONS Foreign caregivers described the positive and negative aspects of caring for stroke survivors. Differences in language, religion, culture, values, and expectations between foreign caregivers and stroke survivors influence the caregiving experience. These findings can help Taiwan and other developed countries to better support foreign caregivers providing critical care to older adults with stroke and their families.
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Affiliation(s)
- Yosika Septi Mauludina
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia
| | - Beth E Fields
- Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison, Madison, Michigan, USA
| | - Feng-Hang Chang
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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3
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Falcão DVDS, Paulson D. Quality of relationship between adult children caregivers and parents with dementia. INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2022. [DOI: 10.5964/ijpr.5481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The main effects for associations between psychosocial stressors and caregiver outcomes are well established, but little is known about the mechanisms of these relationships. Aims of this study were to examine the hypotheses that satisfaction with family relationships (SF) is a mechanism by which quality of relationship (QR) between adult children caregiver and parents with Alzheimer’s disease (AD) influences depression, life satisfaction (LF), and self-rated health (SRH) among these caregivers. The participants were 716 Brazilian adult children who cared for their parents with AD and related disorders. Regression-based path analysis was performed; a PROCESS, bias-corrected and accelerated bootstrapping method was used to test confidence intervals. The relationships between QR and both depression (B = .3263, p < .001) and SRH (B = .3263, p < .001), were fully mediated by SF. The relationship between QR and LF was partially mediated by SF. The primary finding is that SF is one mechanism by which QR relates to depressive symptomatology, self-rated health, and life satisfaction.
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Ho KHM, Wilson IM, Wong JY, McKenna L, Reisenhofer S, Efendi F, Smith GD. Overlooked by nurses: A scoping review on health stressors, problems and coping of migrant domestic workers. Nurs Open 2022; 10:1166-1179. [PMID: 36181249 PMCID: PMC9912437 DOI: 10.1002/nop2.1391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/16/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022] Open
Abstract
AIM The first scoping review is to map and synthesize the stressors, problems and coping strategies surrounding the health issues of migrant domestic workers. DESIGN Scoping review using Arksey and O'Malley's five-stage framework. METHODS Ten electronic databases were systematically searched by keywords for literature published between January 1995 and December 2019. Data were extracted into tables and collated and summarized into themes for presentation. RESULTS Twenty-seven reports were included in the final review. Analysis revealed that stressors to health included abuse, poor health service accessibility, ongoing financial hardship despite demanding working conditions and social isolation. Physical and mental health problems were identified for which migrant domestic workers largely depended on social networks and religion to cope with stressors and health problems. Training para-professional peer leaders of migrant domestic workers by community nurses and including them in interprofessional teams is a possible way for nurses to promote their health and well-being.
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Affiliation(s)
- Ken Hok Man Ho
- Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongHong Kong SAR
| | - Ingrid M. Wilson
- Health and Social Services ClusterSingapore Institute of TechnologySingaporeSingapore
| | - Janet Yuen‐Ha Wong
- School of Nursing & Health StudiesHong Kong Metropolitan UniversityHong KongHong Kong SAR
| | - Lisa McKenna
- School of Nursing and MidwiferyLa Trobe UniversityMelbourneVictoriaAustralia
| | - Sonia Reisenhofer
- Community Wellbeing & PartnershipsBairnsdale Regional Health ServiceBairnsdaleVictoriaAustralia
| | - Ferry Efendi
- Faculty of NursingUniversitas AirlanggaSurabayaIndonesia
| | - Graeme D. Smith
- School of Health SciencesCaritas Institute of Higher EducationHong KongHong Kong SAR
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5
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Ho KHM, Cheung DSK, Lee PH, Lam SC, Kwan RYC. Co-living with migrant domestic workers is associated with a lower level of loneliness among community-dwelling older adults: A cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1123-e1133. [PMID: 34288198 DOI: 10.1111/hsc.13520] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/02/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
Loneliness (inclusive social loneliness and emotional loneliness) of older adults is a prominent public health issue internationally. Factors consistently associated with loneliness are age, gender, education, living arrangements, social network, and functional status. Intergenerational co-living with spouse and adult children is important for the exchange of social, emotional, practical, and financial support provided to older adults. Co-living with migrant domestic workers (MDWs) to care for older adults became an emergent phenomenon internationally, particularly in Asian countries. According to the convoy model of social relations, the effect of co-living with MDWs on older adults' loneliness is unknown. This study examined (1) the prevalence of loneliness among community-dwelling older adults; and (2) the association between co-living with MDWs and older adult loneliness. Using the Chinese version of the 6-item De Jong Gierveld Loneliness Scale on loneliness, 380 older adults were interviewed at busy points in Hong Kong, including subway stations. 35.3% of older adults experienced moderate-to-severe loneliness. Linear regression was performed to examine the association between co-living with MDWs and loneliness. The results showed that co-living with MDWs was significantly associated with lower levels of overall loneliness (β = -0.636; p = .022) and emotional loneliness (β = -0.298, p = .039), but not for social loneliness (β = -0.337, p = .084). While MDWs could be an attachment figure for older adults, they might not be effective in promoting the social integration of older adults. There is a need to investigate the barriers of social integration faced by older adults co-living with MDWs.
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Affiliation(s)
- Ken Hok Man Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Paul Hong Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Rick Yiu Cho Kwan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Reckrey JM, Li L, Zhan S, Wolff J, Yee C, Ornstein KA. Caring Together: Trajectories of Paid and Family Caregiving Support to Those Living in the Community With Dementia. J Gerontol B Psychol Sci Soc Sci 2022; 77:S11-S20. [PMID: 35034123 PMCID: PMC9122661 DOI: 10.1093/geronb/gbac006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Paid caregivers (e.g., home health aides) often work with family caregivers to support persons living with dementia at home. We identify (a) unique trajectories of paid and family caregiving support among persons living with dementia with high care needs and (b) factors associated with these trajectories. METHODS We used group-based multiple trajectory modeling to identify distinct trajectories of paid and family caregiving hours among National Health and Aging Trends Study respondents with dementia who died or moved to a nursing home (n = 334, mean follow-up 5.5 years). We examined differences between trajectory groups and identified factors associated with group membership using generalized estimating equation modeling. RESULTS A 3-group model best fit our data: (a) "low/stable care" (61.3% of respondents) with stable, low/no paid care and moderate family care, (b) "increasing paid care" with increasing, moderate paid and family care, and (c) "high family care" with increasing, high family care and stable, low paid care. While both the "increasing paid care" and "high family care" groups were more functionally impaired than the "low/stable care" group, the "high family care" group was also more likely to be non-White and experience multiple medical comorbidities, depression, and social isolation. DISCUSSION Study findings highlight the importance of considering unique arrangements in dementia care. Receipt of paid care was not only determined by patient care needs. Creating equitable access to paid care may be a particularly important way to support both persons living with dementia and their family caregivers as care needs grow.
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Affiliation(s)
- Jennifer M Reckrey
- Address correspondence to: Jennifer M. Reckrey, MD, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1216, New York, NY 10029, USA. E-mail:
| | - Lihua Li
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA,Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Serena Zhan
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Jennifer Wolff
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Cynthia Yee
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA,Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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7
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The disruption of the care chain: why do Lithuanian migrant home care workers return to their home country? AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
This study examined reasons for return migration among Lithuanian migrant home care workers who provided care to older adults abroad. In total, 13 interviews were conducted with a diverse sample of returnees. Using constant comparison, three major themes were identified. The first theme described the undocumented nature of the job as a reason to return. The emotional consequences of the job as well as its physically demanding aspects also were portrayed. The third theme addressed the increased awareness to possible losses and care needs brought by the job. Our findings stress the importance of the job characteristics of the worker as a push factor that results in the return of migrant workers to their home. The importance of the documentation status of the job and its precarious nature are discussed.
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Hoens S, Smetcoren AS. Hiring Live-in Migrant Care Workers: Motivations and Experiences of Older People and their Families. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09351-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Reckrey JM, Boerner K, Franzosa E, Bollens-Lund E, Ornstein KA. Paid Caregivers in the Community-Based Dementia Care Team: Do Family Caregivers Benefit? Clin Ther 2021; 43:930-941. [PMID: 33972126 DOI: 10.1016/j.clinthera.2021.03.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Older adults with dementia often rely on both paid caregivers (ie, home health aides, personal care attendants, other direct care workers) and family caregivers (ie, spouses, children, other unpaid individuals) to remain in the community. This study conceptualizes paid caregivers as part of the collaborative dementia care team and examines the association between receipt of paid care and primary family caregiver experience. METHODS Using data from 3 waves (2011, 2015, and 2017) of the National Health and Aging Trends Study linked to the National Study of Caregiving, community-dwelling Medicare beneficiaries aged ≥67 years with advanced dementia (n = 338 observations) were identified. Primary family caregiver experiences were compared among those with zero, part-time (<40 hours/week), and full-time (≥40 hours/week) paid care, and multivariable models were used to evaluate the associations between full-time paid care and family caregiver strain (eg, being overwhelmed due to caregiving) and activity restriction (eg, being unable to work for pay due to caregiving). FINDINGS About one half of the community-dwelling older adults with advanced dementia received paid care: 30% had part-time paid care and 18% had full-time paid care. The experiences of family caregivers of those receiving part-time and no paid care were not significantly different. After adjusting for family caregiver and care recipient characteristics, receipt of full-time paid care was associated with a nearly 70% reduced odds of having activity restrictions due to caregiving (odds ratio, 0.31; P = 0.01) and a reduction in mean caregiver strain score (-0.73; P = 0.04). There was no statistically significantly association between the odds of high caregiver strain (score ≥5) and receipt of paid care (odds ratio, 0.65; P = 0.33). IMPLICATIONS The provision of paid care for individuals with dementia in the community may benefit family caregivers. Future work should acknowledge the important ways that paid caregivers contribute to outcomes for all members of the collaborative dementia care team.
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Affiliation(s)
- Jennifer M Reckrey
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Kathrin Boerner
- Department of Gerontology, McCormack Graduate School of Policy and Global Studies, University of Massachusetts, Boston, MA
| | - Emily Franzosa
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai and Geriatrics Research, Education, and Clinical Center, James J. Peters VA Medical Center, New York, NY
| | - Evan Bollens-Lund
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY
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10
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The global care network and its impact on sending and receiving countries: current knowledge and future directions. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Research concerning the effects of migrants on elder care in affluent receiving countries has been substantial, but we know little about the effects of migrant care on elder care in sending countries. There also is limited research on elder care in the context of the return migration of migrant care workers. This theoretical article explores the potential relevance of a social network perspective, which views individuals and countries as being interconnected even when they are miles apart. A multi-level framework that considers macro-, meso- and micro-level perspectives is introduced to better account for current migrant care arrangements. The macro-level perspective takes into account country-level characteristics including policies, geography and cultural preferences; the meso-level perspective takes into account the characteristics of the entire network, which may spread over different countries; and the micro-level perspective concerns the unique characteristics of the individuals who make up the network. This approach proposes that the effects of migrant home care go way beyond the care recipient–care-giver dyads or triads to incorporate many individuals and countries that are transnationally interconnected via the work of care. This article also aims to increase public and scientific awareness to the potential impact of migrant care and return migration on elder care in the sending countries by stressing a transnational social network perspective.
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11
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Fisher O. The Impact of Micro and Macro Level Factors on the Working and Living Conditions of Migrant Care Workers in Italy and Israel-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E420. [PMID: 33430340 PMCID: PMC7825798 DOI: 10.3390/ijerph18020420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
Abstract
Background: The provision of home-based care for frail older adults in Italy and Israel is predominately provided by live-in migrant care workers (MCWs). However, despite the important role that they play in filling the demand for home care, MCWs often experience labor rights violations. This not only impacts the well-being of MCWs but also leads to lower-quality care being provided to people in need of support. Method: This scoping review used Arksey and O'Malley's methodological framework to map literature. This article aims to analyze the scope, main topics, themes and gaps in the existing academic literature on how micro and macro level indicators impact the working and living conditions of live-in MCWs in Italy and Israel. Scopus, Pubmed, and Web of Science Core Collection were searched for peer-reviewed articles. Search terms were adapted from the Multilevel Framework of Transnational Care Migration (MFTCM). Themes were developed using Braun and Clarke's method for conducting reflexive thematic analysis. Articles were included if they focused on Italy and/or Israel, included analysis on the working and living conditions of live-in MCWs at the macro and/or micro levels, were written in English, and were published between 2015 and 2020. Results: Out of the 1088 articles retrieved, 33 met the inclusion criteria. A total of 18 articles focused on Italy and 14 on Israel, and one focused on both Italy and Israel. The majority of articles in Italy (84 per cent) and Israel (53 per cent) included analysis on care regimes. Only 37 per cent of articles in Italy and 20 per cent in Israel included analysis on gender regimes. At the micro level, 80 per cent of articles in Israel discussed Power/Class Asymmetry, compared to 37 per cent in Italy. In total, six themes were developed. At the macro level, these themes included funding care work, MCWs as a pragmatic approach, care in the home, and valuing care work. At the micro level, the themes included being part of the family, and perceptions on class asymmetries. The findings presented in this review show that MCWs in both Italy and Israel face many of the same challenges in accessing decent work opportunities, despite contrasting employment and migration policies in each country. This can be partially attributed to the undervaluing of care work because of racialized and gendered notions of care. At the macro level, this has contributed to a lack of political will to develop long-term sustainable solutions to create or monitor decent work standards for MCWs. At the micro level, this has led to power imbalances between MCWs and people in need of care and their family members, resulting in MCWs being expected to work hours beyond those contractually allowed, having little to no time off, and experiencing emotional, physical, and sexual abuse. Conclusion: This study provides a review of the most recent contributions to the fields of labor migration and health concerning the MCW markets in Italy and Israel. While there have been many studies in each country that detail the labor rights violations experienced by MCWs, this is the first review that develops themes around the underlying causes of these violations. By thematically analyzing the findings of recent studies and current gaps in existing knowledge, this scoping review assists in building the groundwork for the development and implementation of policy, strategies, practice and research to improve the rights and migration experiences of MCWs.
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Affiliation(s)
- Oliver Fisher
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, 60124 Ancona, Italy;
- Department of Economics and Social Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy
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12
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Reckrey JM, Tsui EK, Morrison RS, Geduldig ET, Stone RI, Ornstein KA, Federman AD. Beyond Functional Support: The Range Of Health-Related Tasks Performed In The Home By Paid Caregivers In New York. Health Aff (Millwood) 2020; 38:927-933. [PMID: 31158023 DOI: 10.1377/hlthaff.2019.00004] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Paid caregivers (for example, home health aides and personal care attendants) are formally tasked with helping older adults with functional impairment meet their basic needs at home. This study used thirty semistructured interviews with dyads of patients or their proxies and their paid caregivers in New York City to understand the range of health-related tasks that paid caregivers perform in the home and determine whether these tasks are taught in the New York State Department of Health's curriculum. We found that patients, proxies, and paid caregivers all reported that paid caregivers performed a wide range of health-related tasks that were often not part of their formal training. Creating clear competencies for paid caregivers that reflect the full breadth of health-related tasks they may perform in the home could help maximize the positive impact of the paid caregiver workforce on the lives of patients living at home with functional impairment.
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Affiliation(s)
- Jennifer M Reckrey
- Jennifer M. Reckrey ( ) is an associate professor in the Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City
| | - Emma K Tsui
- Emma K. Tsui is an assistant professor of community health and social sciences at the City University of New York School of Public Health, in New York City
| | - R Sean Morrison
- R. Sean Morrison is a professor in the Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai
| | - Emma T Geduldig
- Emma T. Geduldig is a student in the Department of Medical Education, Icahn School of Medicine at Mount Sinai
| | - Robyn I Stone
- Robyn I. Stone is senior vice president for research at LeadingAge, in Washington, D.C
| | - Katherine A Ornstein
- Katherine A. Ornstein is an assistant professor in the Department of Geriatrics and Palliative Medicine and the Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai
| | - Alex D Federman
- Alex D. Federman is a professor in the Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai
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Lambotte D, Smetcoren AS, Zijlstra GAR, De Lepeleire J, De Donder L, Kardol MJM. Meanings of Care Convoys: The Structure, Function, and Adequacy of Care Networks Among Frail, Community-Dwelling Older Adults. QUALITATIVE HEALTH RESEARCH 2020; 30:583-597. [PMID: 31303115 DOI: 10.1177/1049732319861934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Researchers propose that the convoy of care model should be used to study care networks of frail, older individuals. Care convoys are defined as the evolving collection of individuals who may or may not have close personal connections to the recipient or to one another, but who provide care, including help with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), socio-emotional care, skilled health care, monitoring, and advocacy. This study reports on community-dwelling older adults' experiences of their care convoy, how care convoys change over time, and perceived (positive) outcomes. A qualitative analysis among 65 semi-structured interviews with frail, community-dwelling older adults demonstrates a great variety in the composition of care convoys. Participants were often actively involved in their care convoy and valued the social/relational aspect of care. Care and support covered a wide range of activities, with some activities being provided by specific types of caregivers. Participants expressed the adequacy of their care convoy in terms of satisfaction and sufficiency. Noteworthy, participants who were satisfied with their care convoy did not necessarily receive sufficient help. Policies and practice should recognize the relational aspect of care, the complex interplay between all actors, and the dynamic character of care convoys.
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14
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Ohta R, Sakamoto N, Maeno T. Home Care Workers’ Judgment of Acute Conditions in Home Care Patients: A Retrospective Cohort Study. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2019. [DOI: 10.1177/1084822319861095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Home care workers are likely to detect acute conditions in home care patients. Obtaining data about home care workers’ detection of acute conditions is essential for improving the present quality of home care. This study investigates how home care workers approach the acute conditions of their patients. A retrospective cohort study was conducted with all home care patients who received services from home care workers in Unnan City, Shimane, Japan. The primary outcome was the frequency of acute conditions occurring in home care patients. We used logistic regression to model the acute conditions of the patients based on their age, gender, dependent condition, home-care-worker visit frequency, isolation, and number of chronic diseases. Of 445 participants, 74 had acute conditions (16.6%). The most common among the acute conditions was fever. There were no statistically significant relationships found between admission and the independent variables. The results of the logistic regression model demonstrated that visit frequency and isolation were statistically significant (odds ratio [OR] = 1.24, 95% confidence interval [CI] = [1.08, 1.43], p < .001; OR = 1.95, 95% CI = [1.09, 3.09], p = .001). This research shows that home care workers may be able to identify the early stages of acute diseases in their patients. The improvement of their detection skills may contribute to better health care for home care patients. The application of support systems such as information and communication technologies can promote the identification of acute conditions.
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Affiliation(s)
- Ryuichi Ohta
- Unnan City Hospital, Japan
- Maastricht University, The Netherlands
- University of Tsukuba, Japan
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Casanova G, Tur-Sinai A, Lamura G. Innovating Long-Term Care Provision in Mediterranean Welfare States: A Comparison Between Italy and Israel. J Aging Soc Policy 2019; 32:55-82. [PMID: 30929585 DOI: 10.1080/08959420.2019.1589888] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Social innovations in long-term care (LTC) may be useful in more effective responses to the challenges of population aging for Western societies. One of the most investigated aspects in this regard is the role of family/informal care and strategies to improve its integration into the formal care system, yielding a more holistic care approach that may enhance opportunities for aging in place. This article reports the findings of a comparative research focusing on the Italian and Israeli LTC systems as representative of the Mediterranean "family-based" care model. To analyze the innovative solutions that have been adopted or are needed to improve LTC provision in these two contexts, focus groups and expert interviews have been carried out in both countries to identify the most relevant challenges and responses to them and to highlight promising policies and strategies to be adopted or up-scaled in the future. These include multidisciplinary case and care management, a stronger connection between prevention and LTC provision, and more systematic recognition of the role and limits of informal caregivers' contributions.
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Affiliation(s)
- Georgia Casanova
- Researcher, Centre for Socio-Economic Research on Ageing, IRCCS INRCA - National Institute of Health & Science on Ageing, Ancona, Italy
| | - Aviad Tur-Sinai
- Assistant Professor, Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Giovanni Lamura
- Researcher, Centre for Socio-Economic Research on Ageing, IRCCS INRCA - National Institute of Health & Science on Ageing, Ancona, Italy
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16
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Abstract
UNLABELLED ABSTRACTObjective:With the aging of the population, the demand for long-term services is increasing accordingly and the recruitment of paid caregivers to older adults has become a critical issue. Hence, there is a great need to train people in the care of older adults. This study examined motivations to participate in a new program, which aims to train young people (ages 19-25) to become paid caregivers for older adults. METHODS The study is based on focus groups with program participants (N = 33) and on phone interviews with former participants (N = 8) and face-to-face interviews with staff members (N = 14). Transcripts were analyzed using qualitative content analysis. RESULTS Three major themes emerged: (1) "Motivations to participate in the program," referred to participants' motivations to work with older adults. (2) "Reduced motivations due to ambiguity of roles," referred to the unclear definition of the care worker's role, which created a decrease in participants' motivations to provide care. (3) "Inadequate financial compensation," concerned participants' reduced motivation to participate in the program as a result of financial promises that were not realized. CONCLUSIONS Findings suggest that it is important to be cautious about the motivations for participation in the program because by emphasizing the difficult situation of older adults, one stresses the low status assigned to older adults, rather than positive attributes. It is also suggested that care workers should be financially rewarded, so that despite the difficulties that may arise during work, they will feel valued and will want to remain in the profession.
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Shinan-Altman S, Ayalon L. Perceived control among migrant live-in and local live-out home care workers in Israel. Aging Ment Health 2019; 23:189-195. [PMID: 29156948 DOI: 10.1080/13607863.2017.1401584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine perceived control among live-in and live-out home care workers and to identify factors that contribute to perceived control among both types of caregiving. METHOD 338 migrant live-in home care workers and 185 local live-out home care workers were asked to report their perceived control. Burnout, satisfaction with the relationship with the care recipient and the care recipient's family, and satisfaction with social relationship were also gathered. RESULTS Both types of caregivers reported high levels of perceived control, although live-in home care workers expressed more perceived control. Higher age, higher levels of satisfaction with the relationship with the care recipient and the care recipient's family and lower levels of burnout, predicted perceived control. Satisfaction with social relationship was a stronger predictor of one's perceived control among live-in home care workers. CONCLUSIONS Promoting social relationships outside the home care context by allowing migrant live-in home care workers to take part in social gatherings is recommended as this can strengthen their sense of perceived control.
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Affiliation(s)
| | - Liat Ayalon
- a School of Social Work , Bar- Ilan University , Ramat Gan , Israel
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18
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Care and the shadow of the fourth age: how does home care get caught up in it and how does it stay away from it? AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18001241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AbstractThis article examines how care encounters at the elders’ homes are forged, and how the way these encounters are forged avoids or evokes the social imaginary of the fourth age. Data were gathered in Portugal from elders receiving home care (16 cases), their care workers (eight cases) and family carers (six cases), through participant observation and informal conversations (conducted at the elders’ homes), as well as focus groups. The collected data were analysed according to the procedures of Framework Analysis. This study found five forms of care encounters – marked by conflict, infantilisation, burden, harmony and indifference – the harmony form being the only one found to maintain the fourth age at a distance. It concludes that home care has a Janus-like nature in relation to the fourth age, and that the way home care encounters are forged depends on the conditions of the care settings and the actions of all participants in care encounters. It also concludes that it is difficult to maintain the social imaginary of the fourth age at a distance when the elders exhibit high levels of infirmity. Finally, it concludes that family carers play a crucial role in the way care encounters unfold. Implications for practice and policy include vocational training regarding the relational component of care, and information and educational programmes for family carers.
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Francescato D, Pezzuti L, Mebane M, Tomai M, Benedetti M, Moro A. Dispositional characteristics, relational well-being and perceived life satisfaction and empowerment of elders. Aging Ment Health 2017; 21:1052-1057. [PMID: 27248667 DOI: 10.1080/13607863.2016.1191058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The broad purpose of this research is to identify the key modifiable variables most related to elders' life satisfaction and empowerment in order to improve the efficacy of interventions projects. Our study aims to integrate the theoretical perspectives of personality and community psychology focusing both on dispositional characteristics and relational well-being of elders, investigating triads, composed by an elder, a paid caregiver and the most involved relative. This study explores the impact of (1) some socio-demographic characteristics of elders, (2) some modifiable dispositional variables of elders and (3) elders' relational well-being on elders' empowerment and life satisfaction. METHOD The study involved 429 people in 143 triads. Semi-structured interviews with elders, paid caregiver and close relatives were used to construct a new pilot measure of elders' relational well-being. Life Satisfaction, Empowerment, Loneliness, Positivity, Humor and Emotions self-efficacy scales were also administered. Hierarchical multiple regressions were performed. RESULTS Elders' positivity, relational well-being of elders and living alone were significantly related to empowerment. Elders' relational well-being and positivity significantly contributed to life satisfaction. DISCUSSION Interventions to increase empowerment and life satisfaction should focus primarily on augmenting positivity and relational well-being integrating the theoretical premises of both personality and community psychology.
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Affiliation(s)
- Donata Francescato
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Lina Pezzuti
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Minou Mebane
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy.,b Department of Psychology , Sapienza University of Rome , Rome , Italy
| | - Manuela Tomai
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Maura Benedetti
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Annalisa Moro
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
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Tomai M, Pezzuti L, Mebane M, Benedetti M, Moro A. The Impact Of Dispositional Variables Of Elders, Relatives, And Paid Caregivers On Elders' Empowerment And Life Satisfaction. Exp Aging Res 2017; 43:367-378. [PMID: 28718757 DOI: 10.1080/0361073x.2017.1333833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background/Study Context: The impact of dispositional characteristic of elders' closest network members on elders' life satisfaction and empowerment has remained largely unexplored. This innovative study aimed to assess the impact of dispositional variables of elders, relatives, and paid caregivers on life satisfaction and empowerment of elders. METHODS One hundred forty-three triads (one elder, one paid caregiver, and one relative) completed six scales measuring modifiable personality characteristics (loneliness, optimism, regulation of positive and negative emotions), life satisfaction, and sense of empowerment. RESULTS Two dispositional variables of relatives (positivity and ability to set goals) and one dispositional variable of care workers (self-satisfaction) were significantly related to life satisfaction of elders. Positivity of elders and the capacity to set objectives of the family members affected empowerment of elders. CONCLUSION Future interventions aiming to improve life satisfaction and empowerment of elders should focus on these modifiable dispositional variables.
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Affiliation(s)
- Manuela Tomai
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Lina Pezzuti
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Minou Mebane
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Maura Benedetti
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Annalisa Moro
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
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Gleason HP, Boerner K, Barooah A. Supporting home health aides through a client's death: The role of supervisors and coworkers. Geriatr Nurs 2016; 37:278-83. [PMID: 27156784 DOI: 10.1016/j.gerinurse.2016.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/29/2016] [Accepted: 04/04/2016] [Indexed: 11/28/2022]
Abstract
This study evaluated home health aides (HHAs) experiences related to the support they received around a client's death. 80 HHAs who had recently experienced a client death participated in semi-structured interviews. They were asked to what extent they felt support was available to them from their supervisor or coworker, whether they sought support, the type of support they sought, and how helpful it was. They were also asked what type of support they would like to receive. Findings showed that just over one third of the HHAs felt they could turn to their supervisors for support and one fifth could turn to their coworkers. Even fewer sought support. However, those who did receive support, found it to be extremely helpful, in particular when the support came from supervisors. Desired types of support were primarily related to having someone to talk to or check in with them, pointing to an important role of nursing supervisors in providing critical support to direct care staff.
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Affiliation(s)
- Hayley P Gleason
- Department of Gerontology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, USA.
| | - Kathrin Boerner
- Department of Gerontology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, USA
| | - Adrita Barooah
- Department of Gerontology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, USA
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