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Shen WC, Chang LH, Huang YC, Wang JJ. Psychological Distress, Multicare Needs and Social Resource Utilisation of Family Caregivers of People With Dementia: A Descriptive-Correlational Study. Int J Older People Nurs 2024; 19:e12624. [PMID: 38895917 DOI: 10.1111/opn.12624] [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: 10/22/2023] [Revised: 04/08/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The population of people with dementia increases yearly, imposing a growing burden on family caregivers. Psychological distress impacts the mental health of family caregivers of people with dementia. Caregiver psychological distress can result in increased social resource utilisation and unmet multicare needs. PURPOSE The study explored the psychological distress of family caregivers of people with dementia and examined the impact on social resource utilisation and multicare needs. METHODS A descriptive-correlational study collected data in Taiwan from a cross-sectional sample of family caregivers of people with dementia using a self-report questionnaire. Data were analysed using linear and logistic regression. RESULTS A total of 301 caregivers provided data for analysis. Nearly two-thirds of caregivers were female with a mean age of 57 years old (SD = 12). Over half of the family caregivers of people with dementia experienced mild-to-moderate psychological distress. The greater the psychological distress, the greater the probability of using social resources (1.09 times per 1-point increase, p = 0.002). Psychological distress was positively associated with the number of caregivers' care needs (β = 0.371, p < 0.001). CONCLUSIONS Findings of this study can assist healthcare professionals in better understanding the psychological distress and care needs of caregivers. Services designed to meet the needs of family caregivers will improve psychological distress.
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Affiliation(s)
- Wan-Ching Shen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ling-Hui Chang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ying-Che Huang
- Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Jing-Jy Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Giebel C. Do people with dementia and carers get what they need? Barriers in social care and carers needs assessments. DEMENTIA 2024; 23:550-566. [PMID: 38429248 PMCID: PMC11059843 DOI: 10.1177/14713012241237673] [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: 03/03/2024]
Abstract
BACKGROUND People with dementia and unpaid carers need to go through a social care or carers needs assessment to access and receive subsidised or fully-funded social care. With no previous evidence, this qualitative study aimed to provide insights into the access to, experiences of receiving and conducting social care or carers needs assessments, and access to social care. METHODS Unpaid carers of people with dementia and professionals conducting social care or carers needs assessment living or working in England were interviewed remotely about their experiences between April and August 2023. Topic guides were co-produced with two unpaid carers, and both were supported to code anonymised transcripts. Thematic analysis was used to analyse the data. FINDINGS Twenty-seven unpaid carers (n = 21) and professionals (n = 6) participated. Four themes were generated: (1) Issues with accessing needs assessments, not the process; (2) Knowledge of needs assessments and the health and social care system; (3) Expectations of unpaid carers; and (4) Post-assessment unmet needs. The most prominent barriers unpaid carers and their relatives with dementia encountered were awareness of and access to needs assessment. Unpaid carers were mostly unaware of the existence and entitlement to a needs assessment, and sometimes realised they had participated in one without their knowledge. Professionals described the pressures on their time and the lack of financial resources within services. CONCLUSIONS To facilitate improved access to dementia care and support for carers, the pathway to accessing needs assessments needs to be clearer, with better integration and communication between health and social care.
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Affiliation(s)
- Clarissa Giebel
- Clarissa Giebel, Institute of Psychology, Health and Society, University of Liverpool, Brownlow Street, Waterhouse Building, Liverpool L69 3GL, UK.
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Ozcan M, Akyar I. The effect of structured education and phone follow-up on moderate stage Alzheimer's disease caregiving: Outcomes for patient and caregivers. Jpn J Nurs Sci 2024; 21:e12574. [PMID: 38031663 DOI: 10.1111/jjns.12574] [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: 07/25/2023] [Revised: 10/02/2023] [Accepted: 10/14/2023] [Indexed: 12/01/2023]
Abstract
AIM To determine the effectiveness of a caregiver education (needs tailored) and telephone follow-up intervention for caregivers of people with moderate stage Alzheimer's disease on caregiver burden, caregiving impact on life, and patients' neuropsychiatric symptoms, dependence on activities of daily living. METHODS This quasi-experimental study sampled caregivers of people with moderate stage Alzheimer's. Caregivers in the intervention group received education and telephone follow-up over 12 weeks, while the control group received routine care. Caregivers were assessed for burden, changes in life, and patients for neuropsychiatric symptoms, and dependence on daily living activities. RESULTS The caregiver burden, life changes, distress, and patients' neuropsychiatric symptom scores showed apparent trend toward betterment, but no statistically significant differences were found in study outcomes between the two groups (P > .05). CONCLUSION The caregiver need-based, structured education and telephone follow-up intervention was not empirically effective. With the promising effect from this study, managing behavioral symptoms with need-based, structured, and skill-oriented training has the potential to alleviate the burden on caregivers.
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Affiliation(s)
- Munevver Ozcan
- Faculty of Health Sciences, Yozgat Bozok University, Yozgat, Turkey
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Giebel C, Prato L, Metcalfe S, Barrow H. Barriers to accessing and receiving mental health care for paid and unpaid carers of older adults. Health Expect 2024; 27:e14029. [PMID: 38528675 DOI: 10.1111/hex.14029] [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: 10/23/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
AIM The aim of this qualitative study was to explore the barriers and facilitators to accessing and receiving mental health care for paid and unpaid carers of older adults. METHODS Unpaid and paid carers for older adults in England were interviewed remotely between May and December 2022. Participants were asked about their experiences of mental health needs and support. Reflexive thematic analysis was used to analyse the data. RESULTS Thirty-seven carers participated (npaid = 9; nunpaid = 28), with the majority caring for a parent with dementia. Thematic analysis generated four themes: lack of healthcare support, social care system failing to enable time off, personal barriers and unsupportive work culture. Healthcare professionals failed to provide any link to mental health services, including when a dementia diagnosis was received. Structural and organisational barriers were evidenced by carers being unable to take time off from their unpaid caring duties or paid caring role, due to an absence of social care support for their relative. CONCLUSIONS This is the first study to have explored the barriers to mental health care and support for paid and unpaid carers for older adults and suggests that structural, organisational and personal barriers cause severe difficulties in accessing required support to care for older relatives, services users and residents. PUBLIC INVOLVEMENT Two unpaid carers aided with the development of topic guides, data analysis, interpretation and dissemination. Both were supported and trained to code anonymised transcripts.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Laura Prato
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Sue Metcalfe
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Hazel Barrow
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
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Berghout M, Waller A, Lachapelle N, Noble N, Nair BK, Sanson-Fisher R. Preferred type, timing and format of dementia information: A cross-sectional survey of carers of people living with dementia. Australas J Ageing 2024; 43:131-139. [PMID: 37877350 DOI: 10.1111/ajag.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/15/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES To clarify the unmet information needs of carers of people living with dementia, including the stage of their care journey at which topics become relevant, and the preferred format and mode of delivery of information. METHODS A cross-sectional survey of carers of people living with dementia was conducted between April 2022 and October 2022. Carers were recruited through public and private geriatric hospital and community clinics, aged care providers, an online research register and community dementia services. Consenting carers completed a survey assessing sociodemographic characteristics, preferred type and timing of information about dementia, accessing services, changes in behaviour/personality, changes in physical/emotional health, managing own health/well-being and preferred information format and mode of delivery. RESULTS A total of 163 carers returned a survey (20% response rate). Most carers (75-98%) reported wanting information across a range of topics. Carers preferred general dementia information at diagnosis, information about accessing services at or within the first year of diagnosis, and information on managing symptoms as they emerged. Carers were most interested in receiving information in-person face-to-face (60% very interested), written information (51% very interested) or via face-to-face group information sessions (42% very interested). CONCLUSIONS Carers of people living with dementia expressed a desire for information on a wide range of topics, which changed as the dementia of the person they cared for progressed. Information needs to be made available in a variety of formats to cater for differing ways in which it is consumed.
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Affiliation(s)
- Mani Berghout
- John Hunter Hospital, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Amy Waller
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Nicole Lachapelle
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Natasha Noble
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Balakrishnan Kichu Nair
- John Hunter Hospital, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
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Nguyen AN, Nguyen BT, Nguyen BT, Nguyen BTT, Nguyen NTA, Dang NTK, Nguyen ATP, Nguyen AT, Pham T, Mantyh WG, Tran D, Le OTP, Ta M. Care needs assessment of older adults with dementia in a semi-rural district in Vietnam: A community-based cross-sectional study. Psychogeriatrics 2024; 24:249-258. [PMID: 38155441 PMCID: PMC11058465 DOI: 10.1111/psyg.13068] [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: 10/28/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND The increasing needs of people living with dementia (PLWD) in Vietnam present an enormous public health challenge. Vietnam is an understudied country, and little is known regarding the overall unmet needs of caregivers or the demographic risk factors associated with unmet caregiving needs. This study aimed to determine the burden of unmet care needs of community-dwelling PLWD and identify sociodemographic risks associated with unmet care needs. METHODS A cross-sectional study in a rural area facing urbanisation in Hanoi, Vietnam recruited PWLD-caregiver dyads with multistage sampling. We utilised the Camberwell Assessment of Need for the Elderly (CANE) instrument to evaluate care needs across four domains. Caregivers rated PLWD needs, with higher scores indicating greater unmet needs. The Mann-Whitney test was employed for comparing two groups, while the Kruskal-Wallis test was used for comparisons involving more than two groups in the analysis, and a P-value of less than 0.05 was considered statistically significant. RESULTS Among 90 PLWD participating in the study, the overall mean care needs score was 11.6 ± 4.3, with only 16.2% of PLWD having their care needs met. Environmental and physical needs were more frequently met than psychological or social needs. Only 48.0% and 43.9% of environmental and physical needs were met respectively, and a meagre 20.9% and 23.6% for psychological and social needs. Unmet care needs were more frequent for PWLD who were female, single or divorced, had lower monthly household income, or who were in more advanced stages of dementia, as indicated by Clinical Dementia Rating scores ≥1. CONCLUSIONS Unmet needs for PWLD are common. Increased caregiver education, resources, and services in Vietnam are urgently required to improve the quality of life for this population.
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Affiliation(s)
- Anh Ngoc Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Binh Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
| | - Binh Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Binh Thi Thanh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Nguyet Thi Anh Nguyen
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | - Nhung Thi Kim Dang
- Department of Neurology and Alzheimer’s Disease, National Geriatric Hospital, Hanoi, Vietnam
| | | | - Anh Trung Nguyen
- Hanoi Medical University, Hanoi, Vietnam
- National Geriatric Hospital, Hanoi, Vietnam
| | - Thang Pham
- National Geriatric Hospital, Hanoi, Vietnam
| | | | - Duyen Tran
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Oanh Thi Phương Le
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - My Ta
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA
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Michalowsky B, Rädke A, Scharf A, Mühlichen F, Buchholz M, Platen M, Kleinke F, Penndorf P, Pfitzner S, van den Berg N, Hoffmann W. Healthcare Needs Patterns and Pattern-Predicting Factors in Dementia: Results of the Comprehensive, Computerized Unmet Needs Assessment from the Randomized, Controlled Interventional Trial InDePendent. J Alzheimers Dis 2024; 100:345-356. [PMID: 38875036 DOI: 10.3233/jad-240025] [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: 06/16/2024]
Abstract
Background Determining unmet need patterns and associated factors in primary care can potentially specify assessment batteries and tailor interventions in dementia more efficiently. Objective To identify latent unmet healthcare need patterns and associated sociodemographic and clinical factors. Methods This Latent Class Analysis (LCA) includes n = 417 community-dwelling people living with dementia. Subjects completed a comprehensive, computer-assisted face-to-face interview to identify unmet needs. One-hundred-fifteen predefined unmet medical, medication, nursing, psychosocial, and social care needs were available. LCA and multivariate logistic regressions were performed to identify unmet needs patterns and patient characteristics belonging to a specific pattern, respectively. Results Four profiles were identified: [1] "few needs without any psychosocial need" (n = 44 (11%); mean: 7.4 needs), [2] "some medical and nursing care needs only" (n = 135 (32%); 9.7 needs), [3] "some needs in all areas" (n = 139 (33%); 14.3 needs), and [4] "many medical and nursing needs" (n = 99 (24%); 19.1 needs). Whereas the first class with the lowest number of needs comprised younger, less cognitively impaired patients without depressive symptoms, the fourth class had the highest number of unmet needs, containing patients with lower health status, less social support and higher comorbidity and depressive symptoms. Better access to social care services and higher social support reduced unmet needs, distinguishing the second from the third class (9.7 versus 14.3 needs). Conclusions Access to the social care system, social support and depressive symptoms should be assessed, and the patient's health status and comorbidities monitored to more comprehensively identify unmet needs patterns and more efficiently guide tailored interventions.
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Affiliation(s)
- Bernhard Michalowsky
- German Center for Neurodegenerative Diseases - DZNE, Rostock/Greifswald, Greifswald, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases - DZNE, Rostock/Greifswald, Greifswald, Germany
| | - Annelie Scharf
- German Center for Neurodegenerative Diseases - DZNE, Rostock/Greifswald, Greifswald, Germany
| | - Franka Mühlichen
- German Center for Neurodegenerative Diseases - DZNE, Rostock/Greifswald, Greifswald, Germany
| | - Maresa Buchholz
- German Center for Neurodegenerative Diseases - DZNE, Rostock/Greifswald, Greifswald, Germany
| | - Moritz Platen
- German Center for Neurodegenerative Diseases - DZNE, Rostock/Greifswald, Greifswald, Germany
| | - Fabian Kleinke
- Section of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Peter Penndorf
- Section of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Stefanie Pfitzner
- Section of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Neeltje van den Berg
- Section of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases - DZNE, Rostock/Greifswald, Greifswald, Germany
- Section of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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