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Cho H, Sefcik JS, Washington K, Parker Oliver D, Demiris G. Exploring Social Support Experiences of Caregivers of Persons Living With Dementia in Hospice Care. J Appl Gerontol 2024:7334648241275968. [PMID: 39214070 DOI: 10.1177/07334648241275968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
As the number of persons living with dementia (PLWD) enrolling in hospice care rises, caregiver support becomes increasingly crucial. While social support can help buffer caregiver stress, many caregivers report feeling isolated and having unmet needs, highlighting the limited research on this population. This qualitative descriptive study aimed to better understand caregivers' social support during the period when the PLWD is enrolled in hospice care. Analyzing qualitative data from 22 caregivers of PLWD using conventional content analysis, we identified the theme "Variations in Social Connections." This theme encompasses two subthemes: "never completely alone," indicating social support from family, friends, and neighbors, and "disappointed sometimes," reflecting instances when some individuals in the caregivers' lives couldn't provide regular support. These findings underscore the need for individualized interventions, as each caregiver experiences social support uniquely. Future research should consider the variations in social support among caregivers of PLWD to inform caregiving practices effectively.
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Affiliation(s)
- Hannah Cho
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Justine S Sefcik
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Karla Washington
- School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | | | - George Demiris
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, Philadelphia, PA, USA
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White J, Falcioni D, Barker R, Bajic-Smith J, Krishnan C, Mansfield E, Hullick C. Persisting gaps in dementia carer wellbeing and education: A qualitative exploration of dementia carer experiences. J Clin Nurs 2024. [PMID: 39152552 DOI: 10.1111/jocn.17404] [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: 05/06/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 08/19/2024]
Abstract
AIMS To explore the emotional wellbeing of dementia carers in the lead up to and during transition of a person living with dementia to a residential aged care facility. DESIGN An interpretative qualitative study. METHODS Semi-structured interviews were conducted with informal carers of person living with dementia between February and June 2023. Data were analysed using an inductive thematic approach and resulted in three themes. RESULTS The majority of carers were adult children (n = 19) and six were wives. Carers lived across metropolitan (n = 20) and regional settings (n = 5) in the most populous state of Australia. Three themes were identified which were attributed to different aspects of the carer role: (1) Carer emotional journey as dementia progresses - impacted by knowledge and lack of support; (2) Questioning decision making-underpinned by knowledge and confidence; and (3) Challenges in re-establishing identity - impacted by ongoing concerns. CONCLUSION As dementia progresses carers of person living with dementia consistently reported gaps in knowledge including how to access support. Specifically, this study identified the need for more to be done to help carers to develop the skills needed for their role, including participation in care planning and identifying care preferences for the future. Nurses can play a key role in promoting referral to services that support carers. Findings offer practical solutions to ameliorate carer stress and promote shared decision making. REPORTING METHOD This research was guided by the Consolidated Criteria for Reporting Qualitative Research.
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Affiliation(s)
- Jennifer White
- College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, Newcastle NSW, Australia
| | - Dane Falcioni
- College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, Newcastle NSW, Australia
| | - Roslyn Barker
- Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia
| | | | - Chitra Krishnan
- Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia
| | - Elise Mansfield
- College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, Newcastle NSW, Australia
| | - Carolyn Hullick
- Hunter Medical Research Institute, New Lambton Heights, Newcastle NSW, Australia
- Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia
- Australian Commission of Safety and Quality in Health Care, Sydney, New South Wales, Australia
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Jagoda T, Dharmaratne SD, Rathnayake S. Designing an mHealth application for informal carers concerning the management of behavioural and psychological symptoms of dementia: a need analysis survey. BMC Health Serv Res 2024; 24:930. [PMID: 39143591 PMCID: PMC11325574 DOI: 10.1186/s12913-024-11273-9] [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: 04/27/2024] [Accepted: 07/02/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Informal carers face difficulties and challenges when dealing with the behavioural and psychological symptoms of dementia (BPSD) of their family members or friends residing at home. Mobile health (mHealth) applications are promising for educating and supporting carers. However, needs analysis studies have not been conducted in Sri Lanka to develop mHealth applications for informal carers of people with dementia. AIMS To explore the needs to design an mHealth application for informal carers of people with dementia concerning the management of BPSD. METHOD An exploratory cross-sectional survey was conducted among a convenience sample (N = 203) of informal carers as a part of developing an mHealth application. Family members, relatives, or friends who lived with people with dementia and provided care on an unpaid basis for more than three months were included. The questionnaire included sociodemographic data, carer-rated prevalence and severity of BPSD, and informal carers' knowledge of dementia, carer burden, information-seeking sources, availability of smartphones, mHealth information seeking and perception of mHealth information seeking related to managing BPSD. Descriptive analysis and inferential tests were performed. RESULTS Informal carers of people with dementia were predominantly female (70.4%), and 64% showed low knowledge of dementia. Of the participants, 35% reported a high carer burden, 53.7% reported a low burden, and only 11.3% reported no carer burden. Most of their care recipients (97%) had at least one BPSD. The prevalence and severity of BPSD were significantly and positively correlated with the carer burden. The participants' main source of information was health professionals. Most of them owned smartphones (63.5%), but none used mHealth applications for dementia-related information seeking. Approximately half of the respondents were ready to spend time (52.7%) and money (46.8%) on mHealth information seeking. Perceived mHealth usefulness was significantly associated with dementia knowledge, smartphone ownership, and readiness to spend time and money on mHealth information seeking. CONCLUSION Informal carers of people with dementia were affected by BPSD in their care recipients. This study explored carers' educational needs concerning dementia, BPSD, and carer burden. Informal carers could adapt mHealth for dementia-related information seeking. Their unmet needs in managing BPSD should be explored.
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Affiliation(s)
- Thilanka Jagoda
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
- Department of Nursing & Midwifery, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
| | - Samath D Dharmaratne
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Postgraduate Institute of Medical Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Sarath Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Iwasaki Y, Fukahori H, Okumura-Hiroshige A, Sakai I, Inoue S, Sugiyama T, Nasu K, Ogawara H. Family Caregivers' Needs in Long-Term Care Facilities: A Descriptive Qualitative Study. Res Gerontol Nurs 2024; 17:177-187. [PMID: 38916473 DOI: 10.3928/19404921-20240614-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
PURPOSE To explore the needs of family caregivers (FCs) and how these are addressed in long-term care facilities (LTCFs). METHOD A descriptive qualitative study was performed, using semi-structured interviews with 23 FCs from seven LTCFs in Japan. RESULTS Inductive content analysis revealed three main themes: Coexistent Needs Related to Residents' and FCs' Own Well-Being, Means by Which FCs Promote Residents' and Their Own Well-Being, and Managing Conflicting Needs by Prioritizing and Compromising. FCs recognized that their needs relate to the well-being of residents and themselves, and both needs coexist. To address these multifaceted needs, FCs engaged in various activities while seeking support. However, limited availability of means often made it challenging to meet multiple needs simultaneously, leading FCs to manage these conflicting needs by prioritizing or compromising. CONCLUSION The current study underscores the significance of comprehensive support that simultaneously addresses FCs' conflicting needs, rather than approaching each need separately. [Research in Gerontological Nursing, 17(4), 177-187.].
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Burridge G, Amato C, Bye R, Basic D, Ní Chróinín D, Hill S, Howe K, Liu KPY. Strategies adopted by informal carers to enhance participation in daily activities for persons with dementia. Australas J Ageing 2024. [PMID: 38804160 DOI: 10.1111/ajag.13341] [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: 09/11/2023] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Carers for people with dementia commonly experience difficulty assisting the care-recipients with their daily activities and may adopt specific strategies to decrease the difficulties experienced. The objective of this qualitative study was to explore and understand the strategies used by carers to assist with daily activities for persons living with dementia. METHODS Individual semi-structured interviews via face-to-face or telephone mode were conducted with 62 carers of persons living with dementia in Australia. Carers were asked about the strategies they have used previously, or are currently using, to assist with daily activity completion. Data were analysed via constant comparison and thematic analysis. RESULTS All carers reported the need for strategies to accommodate the varying behaviour and functioning of the care-recipients. Participants reported a total of 207 strategies that fell into four main categories: (i) engage; (ii) adapt; (iii) orientate; and (iv) sense. The most used strategies were reported as those aimed at adapting the activity by using equipment to facilitate completion. CONCLUSIONS Carers help persons living with dementia complete their daily activities by developing their own strategies based on the care-recipients' needs and personal preferences through a trial-and-error process. Carers can benefit if more advice is provided to them by health/social care professionals regarding what strategies may be helpful. Further studies are needed to develop these strategies into an educational package so that carers can be guided to use these strategies appropriately.
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Affiliation(s)
- Gemma Burridge
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Carmen Amato
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - David Basic
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Danielle Ní Chróinín
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Susanna Hill
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Kaitlin Howe
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
- Translation Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
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Mahomed A, Pretorius C. Giving voice to the voiceless: Understanding the perceived needs of dementia family carers in Soweto, a South African township. DEMENTIA 2024; 23:622-642. [PMID: 38354041 PMCID: PMC11059838 DOI: 10.1177/14713012241234155] [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: 05/01/2024]
Abstract
This qualitative study aimed to provide family caregivers with an independent platform to reflect on and identify their needs in the role of dementia caregiver. Thirty caregivers were interviewed using a semi-structured approach, and data analysis followed a reflective thematic analysis method. The study revealed that Black African caregivers in townships require sufficient information and orientation to dementia-specific services, psychoeducation on dementia as a disease and its behavioural manifestations, as well as practical skills to manage the disease process. Caregivers expressed the need for in-depth, accessible education to boost their confidence and resilience in handling the challenges of dementia caregiving. They also proposed community initiatives to raise awareness, promote knowledge, and facilitate early detection and diagnosis of dementia. Additional needs included informational and educational workshops, resources like transportation services and helplines, day care facilities, media campaigns, and collaboration with the government for funding and policy change. New caregivers were advised to seek comprehensive education, support, and services while preserving the dignity of their family members with dementia. Remarkably, the identified needs and community initiatives aligned with the priority areas outlined by ADI for a National Dementia Plan, which South Africa currently lacks. The study highlights the importance of developing a National Dementia Plan in South Africa through collaboration among stakeholders, including communities, policy-makers, and multidisciplinary healthcare teams, while ensuring that individuals and families affected by dementia have a voice.
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Affiliation(s)
- Aqeela Mahomed
- Department of Psychology, Stellenbosch University, South Africa
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Fan Q, Hoang MN, DuBose L, Ory MG, Vennatt J, Salha D, Lee S, Falohun T. The Olera.care Digital Caregiving Assistance Platform for Dementia Caregivers: Preliminary Evaluation Study. JMIR Aging 2024; 7:e55132. [PMID: 38630527 PMCID: PMC11063878 DOI: 10.2196/55132] [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: 12/03/2023] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The increasing prevalence of Alzheimer disease and Alzheimer disease-related dementia in the United States has amplified the health care burden and caregiving challenges, especially for caregivers of people living with dementia. A web-based care planning tool, Olera.care, was developed to aid caregivers in managing common challenges associated with dementia care. OBJECTIVE This study aims to preliminarily evaluate the quality and usability of the Olera.care platform and assess the preferences of using the technology and interests in learning about different older adult care services among caregivers. METHODS For interview 1, we aim to understand caregiving needs and let the participants start engaging with the platform. After they engage with the platform, we schedule the second interview and let the participants complete the Mobile Application Rating Scale. The survey also included sociodemographic characteristics, caregiving experiences, communication preferences in technology adoption, and older adult care service use and interests. Descriptive statistics were used to describe the quality and usability of the platform and characteristics of the participants. We conducted 2-sample 2-tailed t tests to examine the differences in the Mobile Application Rating Scale evaluation scores by caregiver characteristics. RESULTS Overall, 30 adult caregivers in Texas completed the evaluation. The majority were aged ≥50 years (25/30, 83%), women (23/30, 77%), White (25/30, 83%), and financially stable (20/30, 67%). The Olera.care platform evaluation showed high satisfaction, with an overall mean rating of 4.57 (SD 0.57) of 5, and scored well in engagement (mean 4.10, SD 0.61), functionality (mean 4.46, SD 0.44), aesthetics (mean 4.58, SD 0.53), and information quality (mean 4.76, SD 0.44) consistently across all participants. A statistically significant difference (P=.02) was observed in functionality evaluation scores by duration of caregiving, with caregivers dedicating more hours to care rating it higher than those providing less care (mean 4.6, SD 0.4 vs mean 4.2, SD 0.5). In addition, caregivers with less caregiving experience reported significantly higher evaluation scores for aesthetics (P=.04) and information quality (P=.03) compared to those with longer years of caregiving. All participants expressed a willingness to recommend the app to others, and 90% (27/30) rated the app overall positively. Most of the participants (21/30, 70%) favored anonymous interactions before receiving personalized feedback and preferred computer browsers over mobile apps. Medical home health services were the most used, with a diverse range of services being used. Caregiver support groups, medical providers, memory care, meal services, and adult day care were among the most desired services for future exploration. CONCLUSIONS The Olera.care web-based platform is a practical, engaging, easy-to-use, visually appealing, and informative tool for dementia caregivers. Future development and research are essential to enhance the platform and comprehensively evaluate it among a broader population.
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Affiliation(s)
- Qiping Fan
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Minh-Nguyet Hoang
- School of Medicine, Texas A&M University, College Station, TX, United States
| | - Logan DuBose
- School of Medicine, Texas A&M University, College Station, TX, United States
- Internal Medicine, George Washington University, DC, WA, United States
| | - Marcia G Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Jeswin Vennatt
- School of Medicine, Texas A&M University, College Station, TX, United States
| | - Diana Salha
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Shinduk Lee
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Tokunbo Falohun
- Department of Biomedical Engineering, Texas A&M Univesity, College Station, TX, United States
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McLaren JE, Hoang-Gia D, Dorisca E, Hartz S, Dang S, Moo L. Development and Evaluation of a Clinician-Vetted Dementia Caregiver Resources Website: Mixed Methods Approach. JMIR Form Res 2024; 8:e54168. [PMID: 38573761 PMCID: PMC11027049 DOI: 10.2196/54168] [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: 10/31/2023] [Revised: 01/30/2024] [Accepted: 02/22/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND About 11 million Americans are caregivers for the 6.7 million Americans currently living with dementia. They provide over 18 billion hours of unpaid care per year, yet most have no formal dementia education or support. It is extremely difficult for clinicians to keep up with the demand for caregiver education, especially as dementia is neurodegenerative in nature, requiring different information at different stages of the disease process. In this digital age, caregivers often seek dementia information on the internet, but clinicians lack a single, reliable compendium of expert-approved digital resources to provide to dementia caregivers. OBJECTIVE Our aim was to create a dementia caregiver resources website to serve as a hub for user-friendly, high-quality, and expert-reviewed dementia educational resources that clinicians can easily supply to family caregivers of people with dementia. METHODS An interdisciplinary website development team (representing dementia experts from occupational therapy, nursing, social work, geriatrics, and neurology) went through 6 iterative steps of website development to ensure resource selection quality and eligibility rigor. Steps included (1) resource collection, (2) creation of eligibility criteria, (3) resource organization by topic, (4) additional content identification, (5) finalize resource selection, and (6) website testing and launch. Website visits were tracked, and a 20-item survey about website usability and utility was sent to Veterans Affairs tele-geriatrics interdisciplinary specialty care groups. RESULTS Following website development, the dementia caregiver resource website was launched in February 2022. Over the first 9 months, the site averaged 1100 visits per month. The 3 subcategories with the highest number of visits were "general dementia information," "activities of daily living," and "self-care and support." Most (44/45, 98%) respondents agreed or strongly agreed that the website was easy to navigate, and all respondents agreed or strongly agreed that the resources were useful. CONCLUSIONS The iterative process of creating the dementia caregiver resources website included continuous identification, categorization, and prioritization of resources, followed by clinician feedback on website usability, accessibility, and suggestions for improvement. The website received thousands of visits and positive clinician reviews in its first 9 months. Results demonstrate that an expert-vetted, nationally, and remotely available resource website allows for easy access to dementia education for clinicians to provide for their patients and caregivers. This process of website development can serve as a model for other clinical subspecialty groups seeking to create a comprehensive educational resource for populations who lack easy access to specialty care.
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Affiliation(s)
- Jaye E McLaren
- New England Geriatric Research Education and Clinical Center, Veterans Affairs Bedford Health Care System, Bedford, MA, United States
| | - Dat Hoang-Gia
- Palo Alto Geriatric Research Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Eugenia Dorisca
- Bronx Geriatric Research Education and Clinical Center, Veterans Affairs Bronx Health Care System, Bronx, NY, United States
| | - Stephanie Hartz
- Eastern Colorado Geriatric Research Education and Clinical Center, Eastern Colorado Veterans Affairs Health Care System, Aurora, CO, United States
| | - Stuti Dang
- Miami Geriatric Research Education and Clinical Center, Miami Veterans Affairs Health Care System, Miami, FL, United States
- Division of Geriatrics and Palliative Care, University of Miami Miller School of Medicine, Miami, FL, United States
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, United States
| | - Lauren Moo
- New England Geriatric Research Education and Clinical Center, Veterans Affairs Bedford Health Care System, Bedford, MA, United States
- Cognitive Behavioral Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Castillo LIR, Tran V, Hadjistavropoulos T. Are mobile apps meeting the needs of caregivers of people living with dementia? An evaluation of existing apps for caregivers. Aging Ment Health 2024; 28:577-586. [PMID: 36775643 DOI: 10.1080/13607863.2023.2177832] [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] [Received: 11/11/2022] [Accepted: 02/02/2023] [Indexed: 02/14/2023]
Abstract
OBJECTIVES Informal caregivers of people living with dementia (ICPDs) experience stressors that can lead to adverse outcomes. Although apps for ICPDs are available, evidence to support their effectiveness is limited. This investigation was aimed at providing an evaluation of available apps for ICPDs. METHODS We conducted two studies: 1) search and evaluation of available apps; and 2) controlled trial of two apps identified in the Study 1 (NCT05217004). For Study 2, participants were randomly assigned to one of the two app-using groups or a control group. Outcome measures were administered before, post-intervention, and at a follow-up. Interviews with caregivers were conducted to examine their needs regarding the development of future apps. RESULTS Sixteen apps were examined in Study 1. Results suggest that the number and type of features present in each app may not be sufficient to address the multifaceted needs of ICPDs. In Study 2, contrary to expectation, we did not identify differences between the app-using and control conditions on our outcome measures. Participants noted several content and user-experience needs to consider in developing new apps. CONCLUSION Findings from the investigation can inform future developments of apps to address the needs of ICPDs.
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Affiliation(s)
- Louise I R Castillo
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, Canada
| | - Vivian Tran
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, Canada
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Tonkikh O, Chi NC, Herr KA, Fishman SM, Young HM. Supporting the Health and Well-Being of Caregivers of Persons with Pain Strategies to address stress and improve self-care. Home Healthc Now 2024; 42:103-109. [PMID: 38437044 DOI: 10.1097/nhh.0000000000001259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. This new group of articles provides practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses. Cite this article as: Tonkikh, O., et al. Supporting the Health and Well-Being of Caregivers of Persons with Pain. Am J Nurs 2023; 123 (6): 55-61.
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McDarby M, Russell D, King L, Kozlov E, Luth EA. Knowledge Gaps in End-Of-Life Family Caregiving for Persons Living With Dementia: A Study of Hospice Clinician Perspectives. Am J Hosp Palliat Care 2024; 41:270-280. [PMID: 37173809 PMCID: PMC10640658 DOI: 10.1177/10499091231176298] [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: 05/15/2023] Open
Abstract
INTRODUCTION More than 35% of hospice care recipients 65 and older have a dementia diagnosis. Yet family care partners of persons living with dementia report feeling unprepared to address their hospice recipient's changing needs nearing end of life. Hospice clinicians may have unique insight into the knowledge needs of family care partners and strategies for end-of-life dementia caregiving. METHODS Semi-structured interviews were conducted with 18 hospice physicians, nurse practitioners, nurses, and social workers. Interview transcripts were deductively analyzed using thematic analysis to examine clinicians' perspectives on gaps and strategies related to family care partner knowledge about end-of-life dementia caregiving. RESULTS We identified 3 themes related to gaps in family care partners' knowledge: dementia is a progressive, fatal disease; end-of-life symptoms and symptom management in persons living with advanced dementia; and understanding hospice goals and guidelines. Three themes related to clinicians' strategies to increase knowledge included: providing education; teaching strategies to facilitate coping and preparedness for end-of-life care; and communicating with empathy. DISCUSSION Clinicians perceive gaps in knowledge specific to dementia and end of life among family care partners. These gaps include a lack of understanding of Alzheimer's symptom progression and strategies to manage common symptoms. Recommendations for approaches to reduce knowledge gaps include providing education and strategies delivered with empathy toward the family care partner experience. CONCLUSION Clinicians who work with persons living with dementia receiving hospice care have valuable insights regarding family care partners' gaps in knowledge. Implications on the training and preparation of hospice clinicians working with this care partner population are discussed.
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Affiliation(s)
- Meghan McDarby
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Russell
- Department of Sociology, Appalachian State University, Boone, NC, USA
- VNS Health, Center for Home Care Policy & Research, New York, NY, USA
| | - Lori King
- VNS Health, Center for Home Care Policy & Research, New York, NY, USA
| | - Elissa Kozlov
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Elizabeth A. Luth
- Institute for Health, Health Care Policy, and Aging Research and Department of Family Medicine and Community Health, Rutgers University, New Brunswick, NJ, USA
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Scheerbaum P, Gräßel E, Wasic C, Pendergrass A. [Desire and Reality: Discrepancy Between the Actual Usage and the Need to Use Ambulant Support Services - Cross Sectional Study of Elderly People Living at Home in Chronic Need of Care]. DAS GESUNDHEITSWESEN 2024; 86:S13-S20. [PMID: 38395034 PMCID: PMC10949523 DOI: 10.1055/a-2003-9184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
AIM In Germany, people in need of care are mainly cared for by their relatives who make use of various outpatient relief and support services. The aim of this study was to determine the frequency of actual use as well as the desired use of outpatient relief and support services. Dementia and non-dementia as causes behind need for care are distinguished. METHODS A representative sample of informal caregivers of statutorily insured care recipients assessed by the MD Bayern during application for a care level classification (n=958) was analyzed. The use of the following outpatient relief and support services was investigated: outpatient care service; domestic help; day care centre; meals on wheels; driving service; care service; 24-hour care; and care group. Characteristics of the care receiver, the informal caregiver and the care situation were recorded. Difference analyses were carried out using Chi² tests and t-tests. RESULTS The use of outpatient support services was low despite the high care burden on informal caregivers ranging from 1,7% for the care group to 38,4% for the outpatient care service. More than 40% of respondents did not use any of the eight services. However, from this non-user group, 72% had a desire to use at least one of the eight services in the future. Domestic help and outpatient care services were the most frequently requested services by non-users. Actual and desired use was more common for dementia than for other causes of need for care, especially for day care, care group and care service. CONCLUSION The desire for utilization is significantly higher than the reality of utilization. In general, the use of outpatient relief and support services is low. The causes of this discrepancy need to be explored. Therefore, effective strategies need to be developed to advise informal caregivers which ensure suitable respite services will be used to strengthen the home care situation.
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Affiliation(s)
- Petra Scheerbaum
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
| | - Elmar Gräßel
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
| | - Catharina Wasic
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
| | - Anna Pendergrass
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
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Thyrian JR, Boekholt M, Biernetzky O, Blotenberg I, Teipel S, Killimann I, Hoffmann W. Informal Caregivers of People with Dementia in Germany: Psychosocial Characteristics and Unmet Needs. J Alzheimers Dis 2024; 99:1235-1242. [PMID: 38759002 DOI: 10.3233/jad-231055] [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: 05/19/2024]
Abstract
Background Caregivers of people with dementia living at home (CPwDh) are likely to be affected by a range of health problems. However, CPwDh are often regarded as accompanying persons and receive less attention in research and care. Little is known about this population and their needs in Germany. However, better knowledge of CPwDH is needed to design effective interventions. Objective The objective of this report is to describe the situation of CPwDh and highlight differences based on sex and living situation. Methods This was a cross-sectional analysis of the psychosocial characteristics of participants in the GAIN trial, a cluster-randomized, controlled intervention trial investigating the effectiveness of a care management program. A total of n = 192 CPwDh were recruited in GP offices, memory clinics or through public campaigns in the German federal state of Mecklenburg-Western Pomerania. The inclusion criteria were an age of 18 years or above, being a CPwDh, written informed consent. In a comprehensive digital assessment, psychosocial variables, burden, and care needs were assessed. Results Partners, women, and people living in the same household represented the majority of caregivers, and their mean number of needs was 8.7. Overall, participants indicated a mild to moderate burden. There are differences in burden based on sex and living situation, with caregivers living with people with dementia showing less burden and different psychosocial demographics. Conclusions There is a need for interventions to reduce caregivers' unmet needs in the CPwDh. Such interventions should consider differences in sex and living situation to better address individual caregiver needs.
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Affiliation(s)
- Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Melanie Boekholt
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
| | - Olga Biernetzky
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
| | - Iris Blotenberg
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Department for Psychosomatic and Psychotherapeutical Medicine, Rostock University Medical Center, Rostock, Germany
| | - Ingo Killimann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Department for Psychosomatic and Psychotherapeutical Medicine, Rostock University Medical Center, Rostock, Germany
| | - Wolfgang Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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14
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Huggins M, Puurveen G, Pesut B, Rush K. Competency development for a volunteer navigation program to support caregivers of people living with dementia: A modified e-Delphi method. DEMENTIA 2024; 23:69-90. [PMID: 37976553 PMCID: PMC10797849 DOI: 10.1177/14713012231216768] [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: 11/19/2023]
Abstract
Caregivers of people living with dementia are pillars of the care community. Providing them with adequate support throughout their caregiving journey is essential to their quality of life and may also contribute to improving the care of people living with dementia. Nav-CARE (Navigation - Connecting, Advocating, Resourcing, Engaging) is a volunteer-led navigation program that provides support to older adults with life-limiting illnesses who are living in the community. However, Nav-CARE does not provide support directly to caregivers of people living with dementia. To adapt Nav-CARE to support caregivers, we needed to establish caregivers' needs and the competencies volunteer navigators should be trained in to support caregivers to meet these needs. To do so, a modified e-Delphi method was utilized, which consisted of administering three sequential questionnaires to a panel of 35 individuals with expertise in a variety of dementia related domains. Through this, two final lists of 46 caregivers' needs and 41 volunteer competencies were established to inform the development of volunteer navigator training curriculum. Findings suggest that trained volunteer navigators may be able to support caregivers of people living with dementia throughout the disease trajectory and can be used to inform the development of future dementia navigation programs.
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Affiliation(s)
- Madison Huggins
- Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna BC, Canada
| | - Gloria Puurveen
- Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna BC, Canada
| | - Barb Pesut
- Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna BC, Canada
| | - Kathy Rush
- Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna BC, Canada
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15
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Liu Y, Hughes MC, Baumbach A, Derain L. An online intervention to improve the health and well-being of informal caregivers of individuals with Alzheimer's disease: A pilot study. PEC INNOVATION 2023; 3:100229. [PMID: 37929051 PMCID: PMC10623357 DOI: 10.1016/j.pecinn.2023.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
Objective Describe an intervention to improve the health and well-being of informal caregivers of individuals with Alzheimer's disease (AD) and present pilot program findings. Methods Participants (N = 31, mean age = 45.7) were randomly assigned to one of two conditions: an online synchronous didactic lesson and peer support session series or an asynchronous didactic only session series. Outcome variables included physical health, nutrition intake, and stress. One-way ANOVA was conducted to examine the effects of the intervention. The least significant difference (LSD) post hoc test was used to analyze the difference pattern between means. Results Participants in both conditions reported healthier dietary behavior and lower level of stress from pre-intervention to the post-intervention. These effects were not maintained at one-month follow up. Conclusion An online educational intervention may improve the health and well-being of informal caregivers of people with AD. Further research is necessary to determine which specific intervention components to include and what strategies may help participants maintain improved health behaviors. Innovation This program focused on the health and well-being of informal caregivers of individuals with AD rather than on emphasizing how caregivers can perform their caregiving duties better. The intervention was provided in an underserved lower-income, rural area.
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Affiliation(s)
- Yujun Liu
- School of Family and Consumer Sciences, Northern Illinois University, 1425 W. Lincoln Hwy, DeKalb, IL 815-753-1301, United States of America
| | - M. Courtney Hughes
- School of Health Studies, Northern Illinois University, DeKalb, IL, United States of America
| | - Abby Baumbach
- School of Family and Consumer Sciences, Northern Illinois University, DeKalb, IL, United States of America
| | - Lily Derain
- School of Nursing, Northern Illinois University, DeKalb, IL, United States of America
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16
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Tasseron-Dries PEM, Smaling HJA, Nakanishi M, Achterberg WP, van der Steen JT. What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review. BMJ Open 2023; 13:e071804. [PMID: 38149428 PMCID: PMC10711828 DOI: 10.1136/bmjopen-2023-071804] [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: 01/16/2023] [Accepted: 11/03/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES This study aimed to determine best practices for involving family caregivers in interventions aimed at preventing and reducing responsive behaviour stemming from unmet needs, including pain. DESIGN Scoping review, reported according to the Preferred Reporting Items for Systematic Reviews, Meta-Analyses extension for Scoping Reviews reporting guideline. DATA SOURCES PubMed, Embase, Emcare, Web of Science, COCHRANE Library, PsycINFO, Academic Search Premier and Cinahl searched up to 23 July 2023. ELIGIBILITY CRITERIA Studies reporting on family involvement in interventions for nursing home residents with dementia were included. DATA EXTRACTION AND SYNTHESIS Two researchers independently extracted the data, followed by a content analysis. RESULTS Of the 1486 records screened, 20 studies were included. Family caregivers were involved in interventions aimed at planning care, life review (eg, documentation of life experiences of their relative), and selecting activities for their relative. Family caregivers preferred an active role in developing optimal care for their relative. Drivers of success and barriers to family involvement centred around three themes: (1) communication between all involved; (2) prerequisites (organisational and other conditions) and (3) personal circumstances (family's coping and skills). CONCLUSION Best practices for involving family caregivers in interventions aimed at addressing responsive behaviour in residents with dementia concerned those interventions in which family caregivers were given an important role in managing responsive behaviour. This means that, in order to achieve an active role of family caregivers in the whole care process, their needs must be taken into account. TRIAL REGISTRATION NUMBER The protocol of the review was regisered at OSF; https://osf.io/twcfq.
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Affiliation(s)
- Petra E M Tasseron-Dries
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Stichting Warande (Nursing Home Organization), Zeist, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Hanneke J A Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Miharu Nakanishi
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Primary and Community Care, and Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
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González-Ortega E, Aza A, Vicario-Molina I, Orgaz MB, Gómez-Vela M, Badia M. What Factors Explain Family Quality of Life in Neurodegenerative Diseases? JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:960-980. [PMID: 37070848 DOI: 10.1080/01634372.2023.2202203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 06/19/2023]
Abstract
Neurodegenerative diseases (NDs) are a major cause of dependency among elderly and affect the entire family unit. However, the literature has paid little attention to Family Quality of Life (FQOL) and focused on the patient and the main caregiver. The aim was to analyze the FQOL of people with NDs from a systemic perspective and to identify associated factors. A sample of 300 family caregivers from the cross-border region of Spain-Portugal completed the FQOLS - ND, which collected FQOL global and domain-level scores in terms of attainment and satisfaction. The highest rates of FQOL were obtained for the domain Family relations and the lowest for Support from services. The level of perceived barriers to social-health services emerged as the strongest predictor of global FQOL in all models. It is essential to reduce the obstacles to access social-health services and provide the family with resources according to their needs, especially in rural areas.
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Affiliation(s)
| | - Alba Aza
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | | | - M Begoña Orgaz
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - María Gómez-Vela
- Institute on Community Integration (INICO), Faculty of Education, University of Salamanca, Salamanca, Spain
| | - Marta Badia
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain
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18
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Huertas-Domingo C, Losada-Baltar A, Romero-Moreno R, Gallego-Alberto L, Márquez-González M. Sociocultural factors, guilt and depression in family caregivers of people with dementia. Kinship differences. Aging Ment Health 2023; 27:1655-1665. [PMID: 37020430 DOI: 10.1080/13607863.2023.2195821] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/18/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES This study aims to analyze the role that family obligations and social desirability have for understanding guilt and depressive symptoms in family caregivers. A theoretical model is proposed to analyze this significance based on the kinship with the person cared for. METHODS Participants are 284 family caregivers of people with dementia divided into four kinship groups (husbands, wives, daughters and sons). Face-to-face interviews were conducted assessing sociodemographic variables, familism (family obligations), dysfunctional thoughts, social desirability, frequency and discomfort associated with problematic behaviors, guilt and depressive symptoms. Path analyses are performed to analyze the fit of the proposed model and multigroup analysis to study potential differences between kinship groups. RESULTS The proposed model fits the data well and explains significant percentages of variance of guilt feelings and depressive symptomatology for each group. The multigroup analysis suggests that, for daughters, higher family obligations were associated with depressive symptomatology through a report of higher dysfunctional thoughts. For daughters and wives, an indirect association between social desirability and guilt was observed through reaction to problematic behaviors. CONCLUSION The results support the need to consider the significance of sociocultural aspects such as family obligations and the desirability bias in the design and implementation of interventions for caregivers, especially for daughters. Considering that the variables that contribute to explaining caregivers' distress vary depending on the relationship with the person cared for, individualized interventions may be warranted depending on the kinship group.
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Affiliation(s)
| | - Andrés Losada-Baltar
- Departamento de Psicología, Universidad Rey Juan Carlos, Madrid, Comunidad de Madrid, Spain
| | - Rosa Romero-Moreno
- Departamento de Psicología, Universidad Rey Juan Carlos, Madrid, Comunidad de Madrid, Spain
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19
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Scheuermann JS, Gräßel E, Pendergrass A. Predictors of expressed, felt, and normative needs for informal caregiver counseling : Domestic care for people aged 65+ years. Z Gerontol Geriatr 2023; 56:395-401. [PMID: 36018386 PMCID: PMC10406654 DOI: 10.1007/s00391-022-02097-5] [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] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Informal caregivers (CGs) often fail to recognize or express a need for informal caregiver counseling (ICC) but ICC is an essential but relatively rarely used support service for CGs. OBJECTIVE Our aim is to identify predictors of CGs' need for ICC. Stirling et al.'s need model, which includes three needs (expressed, felt, and normative), serves as a theoretical basis. MATERIAL AND METHODS Analyses are based on cross-sectional data (n = 958) from the "Benefits of being a caregiver" study. Predictors of the need to use ICC were analyzed with binary logistic regression. A sensitivity analysis using multiple linear regression was performed for the metric value of normative needs. RESULTS We found that 6.8% of CGs currently or have recently used ICC. This expressed need was related to higher education and higher effort in instrumental activities; 24.1% of CGs reported an intention to use ICC in the future. This felt need was related to male gender, lower care level, more problem-focused coping, and a desire for more informal help. Objective need for ICC (normative need), which was related to a higher burden of care, less experienced benefits, and negative relationship quality, was reported by 21.4% of CGs. According to a sensitivity analysis, higher education, a desire for informal help, and living in separate households also predicted a normative need for counseling. DISCUSSION Current utilization is significantly lower than the subjectively perceived and objectively existing need for ICC. The identified predictors provide initial strategies for motivating more CGs to use ICC.
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Affiliation(s)
- Julia-Sophia Scheuermann
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Elmar Gräßel
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Anna Pendergrass
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
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20
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Ramirez M, De Anda S, Jin H, Herrera JR, Wu S. Health Information-Seeking Behavior of Latino Caregivers of People Living with Dementia: A Mixed-Methods Study. J Appl Gerontol 2023; 42:1738-1748. [PMID: 36932723 PMCID: PMC10440225 DOI: 10.1177/07334648231163430] [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: 03/19/2023] Open
Abstract
This mixed-methods study examined the health information-seeking behavior of Latino caregivers of people living with dementia. A structured survey and semi-structured interviews were conducted with 21 Latino caregivers in Los Angeles, California. For triangulation, semi-structured interviews were also conducted with six healthcare and social service providers. The interview transcripts were coded and analyzed via thematic analysis, while the survey data were summarized using descriptive statistics. The results show that caregivers sought information on what changes to expect as dementia progresses. Some desired detailed (limited) information to be better prepared (to worry less). The most common action to address their information needs was searching the Internet. However, those who did this tended to be concerned about the quality of information. Overall, this study sheds light on how much detail Latino caregivers desire in the information they need and the actions they take to obtain this information.
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Affiliation(s)
- Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Sofia De Anda
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Haomiao Jin
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Joseph R Herrera
- Rancho/USC Geriatric Neurobehavior and Alzheimer's Center, Downey, CA, USA
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
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Shih M, Lee WCM, Tzeng HM, Serag H, Raji M. Comparing Use Patterns and Acceptability of Mobile Digital Devices Between Care Recipients and Caregivers. Cureus 2023; 15:e41832. [PMID: 37575767 PMCID: PMC10423037 DOI: 10.7759/cureus.41832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND The use of smartphones and other digital devices (such as tablets and smartwatches) is important for the aging population to enhance and optimize communications with caregivers, families, friends, and providers. It also provides a platform for app-based activities to promote mental, physical, spiritual, and social well-being and virtual social connectedness. We, therefore, examined types of digital devices and categories of smartphone functions used by caregivers and care recipients in comparison to those without any caregiving roles. METHOD The project team has developed a smartphone app based on Buddhist meditative practice principles for the enhancement of the physical, mental, cognitive, and emotional well-being of older adults and their caregivers and tested it in Galveston, Houston, and Dallas, TX. The study comprised a convenient sample of older adults, including members or volunteers of the International Buddhist Progress Society-Dallas (IBPS Dallas) and the University of Texas Medical Branch Osher Lifelong Learning Institute (UTMB OLLI). The survey focused on people who were 55 years and older (n = 219), with 177 valid responses (~80.8%) meeting the study's inclusion criteria. The survey collected data on (1) caregiving role, (2) demographic characteristics and caregiving concerns, and (3) types of devices, functions, and utilization. Descriptive analysis and logistic regression were used to describe and compare patterns of smartphone function/use by the different groups, i.e., caregivers, care recipients, and neither. RESULTS All of our survey respondents were 55 years and older, and among them, 17.5% were caregivers, 9.1% were care recipients, and 73.4% did not have any role. The majority of the caregivers were females (80.6%), and the average age of their care recipients was 66 years. The care recipients in our sample reported that the average age of their caregiver is only 55 years. Around three-fourths of caregivers reported that they have an app related to health or they are willing to use a health-related app, 32% of them use smart home appliances, whereas only 16% of people who are neither caregivers nor care recipients use such apps. Approximately 42% of caregivers reported taking care of their parents or parents-in-law, and their major concerns are about maintaining their income, scheduling tasks, and updating their knowledge as needed to better care for their loved ones. People use texting or messaging the most. However, the second and third highest utilization are different. The "neither" group significantly spends more time checking email and watching TV; the care recipients spend more time reading and watching TV (sedentary activities); the caregiver group spends more time on phone calls and listening to music. CONCLUSIONS Findings of different patterns of digital device use exist between caregivers, care recipients, and the "neither" group, with 75% of caregivers using a digital device app related to health or reporting willingness to use a health-related app developed from our study. Our findings of their caregiving experiences might also inform the design of different intervention programs aimed at promoting mental, physical, and social well-being, improving quality of life while reducing disease/disability burden for older adults, and preventing burnout among caregivers.
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Affiliation(s)
- Miaolung Shih
- Osher Lifelong Learning Institute, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Wei-Chen Miso Lee
- Department of Family Medicine, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Huey-Ming Tzeng
- School of Nursing, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Hani Serag
- Department of Internal Medicine - Endocrinology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Mukaila Raji
- Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch at Galveston, Galveston, USA
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22
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Arcia A. Functional Dementia Stages App for Hispanic Family Caregivers: Heuristic Evaluation and Usability Testing. J Gerontol Nurs 2023; 49:9-15. [PMID: 37379048 DOI: 10.3928/00989134-20230615-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Hispanic family caregivers of persons with dementia are not getting the anticipatory guidance they need about how functional abilities will change as dementia progresses. Existing informational resources are overwhelming to navigate and written at a high reading level. Furthermore, professional assessment of functional abilities is not universally available. Innovative, tailored approaches are needed. Our aim was to develop and test a mobile application (app), the Interactive Functional Assessment Staging Navigator (I-FASTN), to support Hispanic family caregivers' assessment of care recipients' functional stage of dementia in either English or Spanish. We conducted heuristic evaluation with experts (N = 5) and usability testing with caregivers (N = 20). Chief usability problems were a confusing tutorial and difficulty finding the app's side menu. The app was well-received by caregivers, who indicated that the concise, illustrated content met their informational needs. However, analog alternatives are still needed by caregivers unaccustomed to using apps. [Journal of Gerontological Nursing, 49(7), 9-15.].
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Campbell-Enns HJ, Bornstein S, Hutchings VMM, Janzen M, Kampen M, O'Brien K, Rieger KL, Stewart T, Zendel BR, Doupe MB. The experiences and needs of unpaid family caregivers for persons living with dementia in rural settings: A qualitative systematic review. PLoS One 2023; 18:e0286548. [PMID: 37315078 DOI: 10.1371/journal.pone.0286548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/18/2023] [Indexed: 06/16/2023] Open
Abstract
PURPOSE Unpaid family caregivers provide extensive support for community-dwelling persons living with dementia, impacting family caregivers' health and wellbeing. Further, unpaid family caregiving in rural settings has additional challenges because of lower access to services. This systematic review examines qualitative evidence to summarize the experiences and needs of rural unpaid family caregivers of persons living with dementia. METHODS CINAHL, SCOPUS, EMBASE, Web of Science, PsychINFO, ProQuest, and Medline were searched for articles investigating the experience and needs of rural family caregivers of persons living with dementia. Eligibility criteria were: 1) original qualitative research; 2) written in the English language; 3) focused on the perspectives of caregivers of community-dwelling persons with dementia; 4) focused on rural settings. Study findings were extracted from each article and a meta-aggregate process was used to synthesize the findings. FINDINGS Of the 510 articles screened, 36 studies were included in this review. Studies were of moderate to high quality and produced 245 findings that were analyzed to produce three synthesized findings: 1) the challenge of dementia care; 2) rural limitations; 3) rural opportunities. CONCLUSIONS Rurality is perceived as a limitation for family caregivers in relation to the scope of services provided but can be perceived as a benefit when caregivers experience trustworthy and helpful social networks in rural settings. Implications for practice include establishing and empowering community groups to partner in the provision of care. Further research must be conducted to better understand the strengths and limitations of rurality on caregiving.
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Affiliation(s)
| | - Stephen Bornstein
- Department of Political Science, Memorial University, St. John's, Newfoundland, Canada
- Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Veronica M M Hutchings
- Aging Research Centre-NL, Grenfell Campus, Memorial University, Corner Brook, Newfoundland and Labrador, St. John's, Canada
| | - Maya Janzen
- School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada
| | - Melanie Kampen
- Centre for Transnational Mennonite Studies, University of Winnipeg, Winnipeg, Manitoba, Canada
| | - Kelli O'Brien
- St. Joseph's Care Group, Thunder Bay, Ontario, Canada
- Western Health, Corner Brook, Newfoundland and Labrador, Canada
| | - Kendra L Rieger
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
| | - Tara Stewart
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Benjamin Rich Zendel
- Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
- Aging Research Centre-NL, Grenfell Campus, Memorial University, Corner Brook, Newfoundland and Labrador, St. John's, Canada
| | - Malcolm B Doupe
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Tonkikh O, Chi NC, Herr KA, Fishman SM, Young HM. Supporting the Health and Well-Being of Caregivers of Persons with Pain. Am J Nurs 2023; 123:55-61. [PMID: 37233141 DOI: 10.1097/01.naj.0000938740.48023.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. This new group of articles provides practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
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Affiliation(s)
- Orly Tonkikh
- Orly Tonkikh is a Heather M. Young Postdoctoral Fellow at the Betty Irene Moore School of Nursing at the University of California, Davis, in Sacramento. Nai-Ching Chi is an assistant professor in the College of Nursing at the University of Iowa in Iowa City, where Keela A. Herr is the Kelting Professor in Nursing, associate dean for faculty, and codirector of the Csomay Center for Gerontological Excellence. Scott M. Fishman is a professor, the Anderson Endowed Chair in Wellness, the Fullerton Endowed Chair in Pain Medicine, and executive vice chair in the Department of Anesthesiology and Pain Medicine at the University of California, Davis, School of Medicine in Sacramento, where he is also executive director of the Office of Wellness Education and director of the Center for Advancing Pain Relief. Heather M. Young is a professor and founding dean emerita in the Betty Irene Moore School of Nursing at the University of California, Davis, and national director of the Betty Irene Moore Fellowship for Nurse Leaders and Innovators. This work was funded by the Mayday Fund and the Ralph C. Wilson, Jr. Foundation. Contact author: Orly Tonkikh, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Wiegelmann H, Wolf-Ostermann K, Janssen N, van Hout H, Vroomen JLM, Arzideh F. Sociodemographic structure and health care-related outcomes of community-dwelling dementia caregiving dyads: a latent class replication study. BMC Health Serv Res 2023; 23:482. [PMID: 37173765 PMCID: PMC10182645 DOI: 10.1186/s12913-023-09505-5] [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: 08/03/2022] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The identification of dyadic subgroups of individuals living with dementia and their informal caregivers can help to design effective tailored support. In a previous German study, we identified six dementia dyad subgroups by applying Latent Class Analysis (LCA). Results showed sociodemographic heterogeneity as well as differences in health care outcomes (i.e., quality of life, health status, caregiver burden) between subgroups. The objective of this study is to determine if the dyad subgroups from the previous analysis can be replicated in a similar but distinct Dutch sample. METHODS A LCA 3-step procedure was applied to baseline data from the COMPAS study, a prospective cohort study. LCA is a statistical approach used to identify heterogeneous subgroups within populations based on their pattern of answers on a set of categorical variables. Data comprises 509 community-living individuals with predominantly mild to moderate dementia and their informal caregivers. A narrative analysis was used to compare latent class structures of the original versus the replication study. RESULTS Six distinct dementia dyad subgroups were identified: A subgroup of "adult-child-parent relation with younger informal caregiver" (31.8%), a "couple with female informal caregiver of older age" group (23.1%), an "adult-child-parent relation with middle-aged informal caregiver" group (14.2%), a "couple with middle-aged female informal caregiver" group (12.4%), a "couple with older male informal caregiver" group (11.2%) and a "couple with middle-aged male informal caregiver" group (7.4%). Quality of life of individuals with dementia was rated better in couples than in adult-child-relationships. Worst health for caregivers was reported by subgroups with female informal caregivers living together with male individuals with dementia in couple relationships. A subgroup with older female informal caregivers in couple relationships report the most severe burden on physical and mental health. In both studies, a model with six subgroups fitted the data best. Although substantive similarities between the subgroups of both studies appeared, considerable differences are also evident. CONCLUSION This replication study confirmed the existence of informal dementia dyad subgroups. The observed differences between the subgroups provide useful contributions for a more tailored health care services for informal caregivers and individuals living with dementia. Furthermore, it underlines the relevance of dyadic perspectives. To facilitate replication studies and increase the validity of evidence, a standardization of collected data across studies would be beneficial.
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Affiliation(s)
- Henrik Wiegelmann
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
| | - Karin Wolf-Ostermann
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Niels Janssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Hein van Hout
- General Practice & Medicine of Older People, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Janet L MacNeil Vroomen
- Internal Medicine, Section Geriatrics, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Farhad Arzideh
- University Medical Center Knappschaftskrankenhaus Bochum, Bochum, Germany
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Bauernschmidt D, Hirt J, Langer G, Meyer G, Unverzagt S, Wilde F, Wittmann J, Bieber A. Technology-Based Counselling for People with Dementia and Their Informal Carers: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2023:JAD221194. [PMID: 37125549 DOI: 10.3233/jad-221194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Information technology can enhance timely and individual support for people with Alzheimer's disease and other dementias and their informal carers. OBJECTIVE To review the effectiveness of technology-based counselling interventions for people with dementia and informal carers. METHODS Randomized controlled trials of remote dementia counselling interventions were included. We searched CINAHL, Cochrane Library, MEDLINE, PsycINFO, and the Web of Science Core Collection (April 2021) in combination with citation tracking and free web searching (October to November 2021). We provide meta-analyses for caregiver depression, burden, and self-efficacy/mastery and structured reporting for other outcomes. The Grading of Recommendations Assessment, Development and Evaluation approach and the Risk of Bias 2 tool were applied. RESULTS We included five randomized controlled trials involving 880 participants. Interventions were provided for carers (four studies) or dyads (one study). Carers were predominantly women and were the spouses or children of people with dementia. Counselling was delivered via telephone or videoconference with two to 23 sessions over 1 to 12 months. Control groups received educational and resource materials only, standard (helpline) services, non-directive support, or home visits. Meta-analysis for our primary outcome, depressive symptoms in carers, revealed no statistically significant effect (SMD -0.15; 95% CI -0.40 to 0.10). There were also no significant effects on burden and self-efficacy/mastery. We rated the certainty of evidence as low to very low and all outcomes at an overall high risk of bias. CONCLUSION The effectiveness of technology-based counselling interventions for people with dementia and informal carers remains uncertain. Theory-based approaches are needed for the development and evaluation of these interventions.
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Affiliation(s)
- Dorothee Bauernschmidt
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Julian Hirt
- Department of Health, Center for Dementia Care, Institute of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Gero Langer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Gabriele Meyer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Fabian Wilde
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Janina Wittmann
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Sonntag J, Schwaizer C, Kreyer C. [Support needs of caregivers of people with dementia: An integrative literature review]. Pflege 2023; 36:77-86. [PMID: 36416381 DOI: 10.1024/1012-5302/a000920] [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: 11/24/2022]
Abstract
Support needs of caregivers of people with dementia: An integrative literature review Abstract: Background: Family caregivers are of great importance in the home care for people with dementia. The care and related stress can have a negative impact on their health. The CSNAT (German: KOMMA) is an approach to support family caregivers in palliative home care that could be used for this group of people. Aim: The aim was to identify support needs for caregivers of people with dementia in the literature and compare these with those that formed the basis for the development of the KOMMA approach. Method: We performed an integrative review. Literature research was conducted in February and March 2021 in the MEDLINE, CINAHL and PsycInfo databases. Relevant studies were identified and assessed using inclusion and exclusion criteria. Using MAXQDA, the data were assigned to categories with a content analytic procedure. Results: 23 studies were included that had been published with peer review procedure. Compared to the KOMMA approach, family caregivers show divergent support needs in the areas of (in)formal assistance, access to knowledge, managing physical and mental health conditions, maintaining the relationship, (temporarily) relinquishing the caregiving role and social integration. Conclusion: The KOMMA tool for identifying support needs cannot be directly adopted for this group of caregivers in its present form. However, given the richness of identified support needs, the development of a person-centered and needs-oriented assessment seems important.
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Affiliation(s)
- Julia Sonntag
- Departement für Pflegewissenschaft und Gerontologie, UMIT TIROL - Privatuniversität für Gesundheitswissenschaften und -technologie, Hall in Tirol, Österreich
| | - Claudia Schwaizer
- Departement für Pflegewissenschaft und Gerontologie, UMIT TIROL - Privatuniversität für Gesundheitswissenschaften und -technologie, Hall in Tirol, Österreich
| | - Christiane Kreyer
- Departement für Pflegewissenschaft und Gerontologie, UMIT TIROL - Privatuniversität für Gesundheitswissenschaften und -technologie, Hall in Tirol, Österreich
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Rand S, Towers AM, Malley J, Silarova B. Exploring the structural characteristics of the Adult Social Care Outcomes Toolkit (ASCOT) and ASCOT-Carer. NIHR OPEN RESEARCH 2023; 2:21. [PMID: 37881301 PMCID: PMC10593358 DOI: 10.3310/nihropenres.13259.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 10/27/2023]
Abstract
Background Measurement models inform the approach to assess a measure's validity and also how a measure is understood, applied and interpreted. With preference-based measures (PBMs), it is generally accepted that they are formative; however, if they are applied without preferences, they may be reflective, formative or mixed. In this study, we sought to empirically test whether the reflective, formative or mixed measurement model best describes PBMs of social care-related quality of life (SCRQoL) - specifically, the ASCOT and ASCOT-Carer. We also explored the network approach, as an alternative. Methods ASCOT and ASCOT-Carer data were analyzed using confirmatory factor analysis and Multiple Indicators Multiple Causes models to test reflective, formative or mixed measurement models, respectively. Network analysis of partial correlations using the Gaussian graphical model was also conducted. Results The results indicated that the reflective measurement model is the worst fit for ASCOT and ASCOT-Carer. The formative or mixed measurement models may apply to ASCOT. The mixed measurement model was the best fit for ASCOT-Carer. The network analysis indicated that the most important or influential items were Occupation and Personal cleanliness and comfort (ASCOT) and Time and space and Self-care (ASCOT-Carer). Conclusions The ASCOT and ASCOT-Carer are best described as formative/mixed or mixed measurement models, respectively. These findings may guide the approach to the validation of cross-culturally adapted and translated versions. Specifically, we recommend that EFA be applied to establish structural characteristics, especially if the measure will be applied as a PBM and as a measure of SCRQoL. Network analysis may also provide further useful insights into structural characteristics.
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Affiliation(s)
- Stacey Rand
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Ann-Marie Towers
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Juliette Malley
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Barbora Silarova
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
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Takechi H, Hara N, Eguchi K, Inomata S, Okura Y, Shibuya M, Yoshino H, Ogawa N, Suzuki M. Dynamics of Interaction among Professionals, Informal Supporters, and Family Caregivers of People with Dementia along the Dementia Care Pathway: A Nationwide Survey in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5044. [PMID: 36981952 PMCID: PMC10049111 DOI: 10.3390/ijerph20065044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
This study aims to clarify the dynamics of information provision and human interaction to satisfy the needs of family caregivers. A questionnaire survey consisting of items on information received at and after diagnosis, persons and resources consulted, needs, and caregiver-oriented outcomes was conducted. Among the respondents, 2295 individuals who were caring for people with dementia were divided into quartiles by the time after diagnosis, and differences were statistically analyzed. The time after diagnosis in the first to fourth quartiles was 0.73 ± 0.4, 2.52 ± 0.49, 4.89 ± 0.73, and 10.82 ± 3.7 years, respectively. The number of persons consulted by family caregivers increased significantly from the first to the fourth quartiles (p < 0.001). During this time, attributes of professionals and informal supporters changed depending on the quartile. As time progressed, acceptance of the diagnosis increased, but so did its impact on the lives of family caregivers. These findings revealed differences over time in what family caregivers wanted and the dynamics of interactions that filled their needs. Informal supporters accounted for a significant proportion of the total resources. However, many family caregivers thought the information and support were insufficient. Thus, continuous reform of the care pathway is needed.
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Affiliation(s)
- Hajime Takechi
- Department of Geriatrics and Cognitive Disorders, School of Medicine, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Naoko Hara
- Department of Gerontological Nursing, Niigata College of Nursing, 240 Shinnan-cho, Joetsu 943-0147, Niigata, Japan
| | - Kyoko Eguchi
- Faculty of Nursing, Shumei University, 1-1 Daigaku-cho, Yachiyo City 270-0003, Chiba, Japan
| | - Shoko Inomata
- Department of Nursing, Akita University Hospital, 44-2 Hasunuma Hiroomote, Akita-shi 010-8543, Akita, Japan
| | - Yuki Okura
- Department of Gerontological Nursing, Niigata College of Nursing, 240 Shinnan-cho, Joetsu 943-0147, Niigata, Japan
| | - Miwa Shibuya
- School of Cultural and Social Studies, The Graduate University for Advanced Studies, Osaka 565-8511, Osaka, Japan
| | - Hiroshi Yoshino
- Department of Geriatrics and Cognitive Disorders, School of Medicine, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Noriyuki Ogawa
- Department of Occupational Therapy, Faculty of Health Sciences, Kyoto Tachibana University, 34 Oyakeyamada-cho, Yamashina-ku, Kyoto City 607-8175, Kyoto, Japan
| | - Morio Suzuki
- Alzheimer’s Association Japan, 811-3 Seimei-cho, Kamigyoku, Kyoto City 602-8222, Kyoto, Japan
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Sanjuán M, Navarro E, Calero MD. Caregiver training: Evidence of its effectiveness for cognitive and functional improvement in older adults. J Clin Nurs 2023; 32:736-748. [PMID: 35332605 PMCID: PMC10078788 DOI: 10.1111/jocn.16301] [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: 11/12/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The objectives of this study were to assess the benefits of a caregiver training programme on the cognitive and functional status of older adults, and to compare the effects of this programme according to type of caregiver (professional vs. family caregiver). BACKGROUND Due to demographic changes that have resulted in an aging population, the role of caregiver of an older adult has become very important in recent years. DESIGN AND METHODS The sample was composed of 160 older adults: (a) 100 received care from caregivers who had taken the three-month training programme (treatment group), of which 60 were professional caregivers and 40 were family caregivers, and (b) 60 received care from caregivers who had not taken the programme (control group). In order to evaluate programme effects on cognitive and functional status, we used both direct measures answered by the older adults (MMSE, CAPE and EuroQol) and caregiver reports (Barthel and RMPBC). We used a quasi-experimental, pre-post design. We followed SQUIRE 2.0 guidelines for reporting. RESULTS The results showed that older adults who were cared for by caregivers that had participated in the training programme showed gains in quality of life and cognitive ability and maintenance of functional ability. Within the treatment group, although everyone significantly improved their scores, the older adults cared for by family caregivers improved in more of the cognitive sub-items than did their peers in the professional caregiver group. CONCLUSIONS The data obtained show that a caregiver training programme based on cognitive stimulation produces cognitive, functional and health-related quality-of-life benefits in older adults. Furthermore, the caregivers reported increased satisfaction with their work. RELEVANCE TO CLINICAL PRACTICE The improvements obtained in the older adults and in caregivers show the relevance of this type of intervention when working in the clinical field of caregiving.
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Affiliation(s)
- Miriam Sanjuán
- The Mind, Brain and Behavior Research Center at University of Granada (CIMCYC-UGR), Granada, Spain
| | - Elena Navarro
- The Mind, Brain and Behavior Research Center at University of Granada (CIMCYC-UGR), Granada, Spain
| | - María Dolores Calero
- The Mind, Brain and Behavior Research Center at University of Granada (CIMCYC-UGR), Granada, Spain
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Tan KP, Ang JK, Koh EBY, Pang NTP, Mat Saher Z. Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4232. [PMID: 36901243 PMCID: PMC10002240 DOI: 10.3390/ijerph20054232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Caregivers of People with dementia (PwD) commonly experience burdens and other mental health issues, e.g., depression and anxiety. At present, there are limited studies that examine the relationships between caregiver psychological factors and caregiver burden, and depressive and anxiety symptoms. Therefore, this study's objectives were to examine the relationships between psychological flexibility and mindfulness in caregivers of PwD, and to determine the predictors of these three outcomes. This was a cross-sectional study conducted in the geriatric psychiatry clinic of Kuala Lumpur Hospital, Malaysia, and the sample (n = 82) was recruited via a universal sampling method over three months. The participants completed a questionnaire that consisted of the sociodemographics of the PwD and caregivers, illness characteristics of the PwD, Acceptance and Action Questionnaire-II (AAQ-II), Mindful Attention Awareness Scale (MAAS), Zarit Burden Interview Scale (ZBI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). The results show that despite significant relationships between psychological flexibility and mindfulness and lower levels of caregiver burden, and depressive and anxiety symptoms (p < 0.01), only psychological inflexibility (p < 0.01) remained as a significant predictor of the three outcomes. Therefore, in conclusion, intervention programs that target the awareness of the caregiver's psychological inflexibility should be implemented to alleviate these adverse outcomes in dementia caregivers.
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Affiliation(s)
- Khai Pin Tan
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan 25100, Pahang, Malaysia
| | - Jin Kiat Ang
- Department of Psychiatry, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Nicholas Tze Ping Pang
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
| | - Zanariah Mat Saher
- Department of Psychiatry and Mental Health, Kuala Lumpur General Hospital, Kuala Lumpur 50586, Federal Territory of Kuala Lumpur, Malaysia
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Liebzeit D, Fields B, Robinson EL, Jaboob S, Ashida S. A qualitative study of unpaid caregivers of persons living with dementia and their interactions with health and community-based services and providers. DEMENTIA 2023; 22:328-345. [PMID: 36534394 DOI: 10.1177/14713012221146253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Unpaid caregivers frequently feel underprepared and without adequate training, support, or access to services and resources to care for persons living with dementia. Health and community-based services and providers are critical to support persons living with dementia and their unpaid caregivers. The objective of this research is to understand how unpaid caregivers of persons living with dementia interact with health and community-based services and providers. RESEARCH DESIGN AND METHODS We used a qualitative descriptive approach to analyze data from one-on-one semi-structured interviews with unpaid caregivers of persons living with dementia (N = 25). We used framework analysis to organize themes and sub-themes within the systems approach to healthcare delivery. FINDINGS Participants described a need for additional guidance, information, and support from health and community-based services and providers. This need was described by participants at 4 levels: individual, care team, organization, and political and economic environment. Participants were active in proposing potential solutions to challenges at all 4 levels, including improving provider awareness and training in dementia, opportunities to provide resources and referrals upon dementia diagnosis, a central clearinghouse for information and resources for persons living with dementia and caregivers, and opportunities to close service gaps. DISCUSSION AND IMPLICATIONS Findings of this study highlight the need for increased involvement of caregivers of persons living with dementia as community stakeholders for improving care and services. Recommendations to promote high quality care and better support unpaid caregivers by developing interventions to address multiple aspects of healthcare delivery are consistent with recent legislation and are important areas of future research.
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Affiliation(s)
- Daniel Liebzeit
- 16102The University of Iowa College of Nursing, Iowa City, IA, USA
| | - Beth Fields
- Department of Kinesiology, 5228University of Wisconsin-Madison School of Education, Madison, WI, USA
| | - Erin L Robinson
- School of Social Work, 14716University of Missouri, Columbia, MO, USA
| | - Saida Jaboob
- 16102The University of Iowa College of Nursing, Iowa City, IA, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, RinggoldID:%204083The University of Iowa College of Public Health, Iowa City, IA, USA
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Lauritzen J, Nielsen LM, Kvande ME, Brammer Damsgaard J, Gregersen R. Carers' experience of everyday life impacted by people with dementia who attended a cognitive stimulation therapy (CST) group intervention: a qualitative systematic review. Aging Ment Health 2023; 27:343-349. [PMID: 35232308 DOI: 10.1080/13607863.2022.2046699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
ObjectivesTo explore carers' experiences of everyday life impacted by people with dementia who attended a seven-week cognitive stimulation therapy (CST) group intervention.MethodsA systematic review of qualitative studies and qualitative mixed method studies was conducted. Eight databases were searched. The selected studies were screened and assessed for methodological quality using the Rayyan Qatar Computing Research Institute (QCRI) and Critical Appraisal Skills Programme Qualitative Checklist (CASP-QC). Three studies were included following an inductive content analysis.ResultsTwo themes were identified: 'Enrichment by enhanced communication' and 'Growth through positive emotional interaction'.ConclusionQualitative research on the impact of the CST group intervention on carers' everyday life with a person with dementia is scarce. Carers experienced feelings of enrichment due to improvement and equality in communication and a possible source of happiness. There was a sense of togetherness and reconnection through music and singing together as well as a sense of mutual growth, increased positive interaction, increased ability to socialize, and feelings of fondness when experiencing glimpses of the previous personality of the person with dementia. Nevertheless, knowledge about the impact of the CST group intervention on carers' personal everyday life is lacking and requires further research.
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Affiliation(s)
- Jette Lauritzen
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark.,Research Centre for Health and Welfare Technology, the Dementia Program, VIA University College, Aarhus, Denmark
| | - Louise Møldrup Nielsen
- Research Centre for Health and Welfare Technology, the Dementia Program, VIA University College, Aarhus, Denmark
| | | | | | - Rikke Gregersen
- Research Centre for Health and Welfare Technology, the Dementia Program, VIA University College, Aarhus, Denmark
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Shoults CC, Rutherford MW, Kemp AS, Addicott MA, Brown A, Greene CJ, Hayes CJ, Gan JM, Larson-Prior LJ, Bona JP. Analysis of Caregiver Burden Expressed in Social Media Discussions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1933. [PMID: 36767297 PMCID: PMC9915402 DOI: 10.3390/ijerph20031933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Almost 40% of US adults provide informal caregiving, yet research gaps remain around what burdens affect informal caregivers. This study uses a novel social media site, Reddit, to mine and better understand what online communities focus on as their caregiving burdens. These forums were accessed using an application programming interface, a machine learning classifier was developed to remove low information posts, and topic modeling was applied to the corpus. An expert panel summarized the forums' themes into ten categories. The largest theme extracted from Reddit's forums discussed the personal emotional toll of being a caregiver. This was followed by logistic issues while caregiving and caring for parents who have cancer. Smaller themes included approaches to end-of-life care, physical equipment needs when caregiving, and the use of wearables or technology to help monitor care recipients. The platform often discusses caregiving for parents which may reflect the age of Reddit's users. This study confirms that Reddit forums are used for caregivers to discuss the burdens associated with their role and the types of stress that can result from informal caregiving.
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Affiliation(s)
- Catherine C. Shoults
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Michael W. Rutherford
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Aaron S. Kemp
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Merideth A. Addicott
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Aliza Brown
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Carolyn J. Greene
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Corey J. Hayes
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- VA HSR&D COIN Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
| | - Jennifer M. Gan
- Department of Medical Humanities and Bioethics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Linda J. Larson-Prior
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Jonathan P. Bona
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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Mendez KJW, Labrique AB, Budhathoki C, Sadak T, Tanner EK, Cotter VT, Han HR. Use of mobile applications and health technologies among dementia caregivers with chronic conditions: A cross-sectional study. Digit Health 2023; 9:20552076231181213. [PMID: 37361436 PMCID: PMC10286551 DOI: 10.1177/20552076231181213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Objective Almost 80% of people, who are caring for someone with dementia, have one or more chronic conditions and require self-management support. New technologies offer promising solutions; however, little is known about what technologies caregivers use for their health or in general. This study aimed to describe the prevalence of mobile application (app) and health-related technology use among caregivers who have chronic conditions and care for someone with dementia. Methods A cross-sectional study was conducted with 122 caregivers recruited online and from communities in the Baltimore-metropolitan area. Data were collected with online surveys and computer-assisted telephone interviews. Descriptive and inferential statistics were used to analyze survey data. Results Study participants were primarily female (95 of 122, 77.9%), middle-aged (average 53 years, standard deviation (SD) 17), well educated (average 16 years, SD 3.3), an adult child of the person with dementia (53 of 122, 43.4%), and had 4 chronic conditions on average (SD 2.6). Over 90% of caregivers used mobile apps (116 of 122), spending a range of 9 to 82 min on each app. Most caregivers reported using social media apps (96 of 116, 82.8%), weather apps (96 of 116, 82.8%), and/or music or entertainment apps (89 of 116, 76.7%). Among caregivers using each app type, more than half of caregivers used social media (66 of 96, 69%), games (49 of 74, 66%), weather (62 of 96, 65%), and/or music or entertainment apps (51 of 89, 57%) daily. Caregivers also used several technologies to support their own health-the most common being websites, mobile devices, and health-related mobile apps. Conclusion This study supports the feasibility of using technologies to promote health behavior change and support self-management among caregivers.
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Affiliation(s)
| | - Alain Bernard Labrique
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Tatiana Sadak
- University of Washington School of Nursing, Seattle, WA, USA
| | | | | | - Hae-Ra Han
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Du K, Pan YY, Yan WW. Qualitative descriptive study during the COVID-19 pandemic on the needs of informal caregivers of Chinese minors who underwent craniopharyngioma surgery. J Pediatr Nurs 2023; 68:e87-e95. [PMID: 36437132 DOI: 10.1016/j.pedn.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the needs of informal caregivers during the long-term health management of minors who have undergone craniopharyngioma surgery. Design and methodology This is a qualitative and descriptive research study. Purposive sampling was used to select participants, and semi-structured interviews were conducted to explore the needs of 21 informal caregivers for postoperative minors. Due to the COVID-19 pandemic, the respondents were provided with the options of online video call or offline one-on-one interviews. Following this, a content analysis method was conducted. RESULTS Four themes and 14 sub-themes were extracted from the results of the study, including needs for relieving psychological stress (including psychological pressure on both minors and on caregivers); requirement for on-campus assistance (physical activity, eliminating verbal violence in schools, special education needs for child, healthcare services provided by school hospitals); demands for medical help (acquiring medical knowledge, need for medication management, convenience and reliable access to medical services, need for technological development, expectations of multidisciplinary cooperation, the necessity of health review reminders); and the desire for financial aid (charity platform assistance, inclination of government policy). CONCLUSIONS In China, informal caregivers of young patients with onset craniopharyngioma require both the multidisciplinary cooperation of medical institutions and the multi-departmental cooperation of society. Information and medical technology advancements may benefit families with young patients. Improving community hospitals' medical services and encouraging the practical use of online medical treatment and prescriptions are both necessary in the context of COVID-19. PRACTICE IMPLICATIONS By identifying the needs of informal caregivers, medical professionals are able to develop care plans and interventions aimed at reducing the burden of care for minors who have undergone craniopharyngioma surgery.
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Affiliation(s)
- Kun Du
- Emergency Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Yuan Pan
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Wen Wen Yan
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Dyadic relationship, carer role, and resources: a theory-driven thematic analysis of interviews with informal carers focusing on the stability of home-based care arrangements for people living with dementia. BMC Geriatr 2022; 22:908. [PMID: 36437442 PMCID: PMC9703724 DOI: 10.1186/s12877-022-03618-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Most people with dementia live at home and are supported by informal carers. During the care trajectory, the creation of a stable care situation is a guiding principle of informal carers, who often manage complex care arrangements. A recently developed theory - 'Stability of home-based care arrangements for people living with dementia' (SoCA-Dem) - conceptualises how such care arrangements develop over time, and it highlights the relevance of the dyadic relationship, carer role, and resources with regard to the continuation of home-based care throughout the course of dementia. To further explore these three concepts, and to provide feedback for a further refinement of SoCA-Dem theory, this study aims to gain a deeper understanding of (1) how informal carers perceive their dyadic relationship, their carer role, and the resources of the care arrangement, and (2) how these concepts are interrelated. METHODS This study was a secondary data analysis of n = 11 problem-centred interviews. Data were interpreted by a thematic qualitative text analysis. RESULTS The findings distinguished subthemes within the concepts and uncovered their interrelations. The kinship relation, living situation and character of the dyadic relationship shaped informal carers' self-conception of the carer role. This influenced the integration of resources into the care arrangement. Conversely, the quantity and quality of informal and formal support resulted in a feeling of relief or overload in the carer role, that shaped the informal carers' way of living their dyadic relationship. The respective forming of the concepts had a significant impact with regard to the perceived stability or instability of the care situation in the examined care arrangements. CONCLUSIONS This study provided valuable evidence for future research alignment and targeted refinement of the SoCA-Dem theory. Scholars should further explore the specifics of spousal versus parent-child-dyads to better understand the dyads' diverse strategies in the creation of stable home-based care arrangements. Furthermore, future research should focus on the complex dynamics of dyads, family networks, and service providers, and all actors' perspectives should be integrated in SoCA-Dem theory. Based on this growing knowledge base, innovative care interventions and structures should be developed to support people with dementia and their informal carers in better living and caring in the place of their choice.
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Roberto KA, Savla J. Extended Family Caregivers for Persons Living With Dementia. JOURNAL OF FAMILY NURSING 2022; 28:396-407. [PMID: 35960005 PMCID: PMC10112257 DOI: 10.1177/10748407221115455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite changes in the structure of contemporary families, little is known about extended family members-siblings, grandchildren, nieces/nephews, stepkin-who are primary caregivers for a relative living with dementia. Information about these caregivers is needed to help ensure their needs are understood by providers in health care and social service settings. The focus of this research was on the care situations of extended family caregivers and the impact of caregiving on their health and well-being. In Study 1, data from the National Study of Caregiving were used to describe the experiences of 107 extended family caregivers. In Study 2, case study techniques elicited additional information about the experiences of 10 extended family caregivers. Collectively, these caregivers provide care with little or no formal support and occasional help from a small informal network. Caregiving affected their physical and emotional health, depending on the strength of the relationship between the caregiver and the person living with dementia and the type of care provided. Findings contribute new knowledge about extended family caregivers and highlight the important role extended family dementia caregivers play and the challenges they face.
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Wittek M, Kiefer A, Voß H, Wiloth S. Versorgung pflegender Angehöriger von Menschen mit Demenz in der Kommune während der Pandemie. Pflege 2022; 36:129-138. [DOI: 10.1024/1012-5302/a000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Zusammenfassung. Hintergrund: Die Verfügbarkeit von Unterstützungsangeboten für pflegende Angehörige von Menschen mit Demenz in der Kommune weist durch die Corona-Pandemie Defizite auf und birgt somit eine veränderte Versorgung der Pflegenden. Fragestellung: Es stellen sich die Fragen, welche Veränderungen der Versorgung pflegender Angehöriger von Menschen mit Demenz Pflegende wahrnehmen, wie Akteur_innen aus der Kommune diese Versorgungssituation während der Pandemie erleben und inwiefern die Wahrnehmung der Gruppen übereinstimmt bzw. sich unterscheidet. Methode: Die Datengrundlage bilden Rathausgespräche und Fokusgruppen aus 13 Kommunen Deutschlands. Hieran nahmen pflegende Angehörige von Menschen mit Demenz sowie Akteur_innen aus der Kommune teil. Die Datenanalyse erfolgte mittels qualitativer Inhaltsanalyse. Ergebnis: Nachteilige Veränderungen der Versorgung Pflegender zeigen sich z.B. durch den Wegfall von Betreuungsangeboten oder Angehörigengruppen. V.a. Akteur_innen nehmen vorteilhafte Veränderungen wahr, wie eine voranschreitende Digitalisierung oder verstärkte Nachbarschaftshilfe. Die Wahrnehmung der Veränderungen der Versorgungssituation unterscheidet sich in mehreren Subkategorien zwischen Pflegenden und Akteur_innen. Schlussfolgerung: Obwohl durch die Pandemie große Versorgungslücken entstanden sind, ergeben sich durch aufkommende Herausforderungen neue Möglichkeiten der Unterstützung wie digitale Angehörigengruppen. Zukünftig müssen Möglichkeiten geschaffen werden, um bereits entwickelte Interventionen so zu implementieren, dass die Zielgruppe diese in Anspruch nehmen kann.
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Affiliation(s)
- Maren Wittek
- Institut für Gerontologie, Universität Heidelberg, Deutschland
| | - Anna Kiefer
- Institut für Gerontologie, Universität Heidelberg, Deutschland
| | - Henrike Voß
- Institut für Gerontologie, Universität Heidelberg, Deutschland
| | - Stefanie Wiloth
- Institut für Gerontologie, Universität Heidelberg, Deutschland
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Clark IN, Ip-Winfield V, Murphy M, Shanahan E, Grocke D. The Bonny Method of Guided Imagery and Music for family caregivers of people with dementia: A within subject feasibility study. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2113913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Imogen N. Clark
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, University of Melbourne, Victoria, Australia
| | | | - Melissa Murphy
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, University of Melbourne, Victoria, Australia
| | | | - Denise Grocke
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, University of Melbourne, Victoria, Australia
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Windle G, Flynn G, Hoare Z, Masterson-Algar P, Egan K, Edwards RT, Jones C, Spector A, Algar-Skaife K, Hughes G, Brocklehurst P, Goulden N, Skelhorn D, Stott J. Effects of an e-health intervention 'iSupport' for reducing distress of dementia carers: protocol for a randomised controlled trial and feasibility study. BMJ Open 2022; 12:e064314. [PMID: 36130751 PMCID: PMC9494593 DOI: 10.1136/bmjopen-2022-064314] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION In the UK, National Health Service (NHS) guidelines recommend that informal carers of people living with dementia should be offered training to help them develop care skills and manage their own physical and mental health. The WHO recommends access to affordable, proven, well-designed, online technologies for education, skills training and support for dementia carers. In response to these recommendations, this multisite randomised controlled trial (RCT) is the first study in the UK to evaluate the clinical and cost-effectiveness of an online support programme developed by the WHO called 'iSupport for dementia carers'. METHODS AND ANALYSIS 350 informal carers (age 18+ years) living in Britain who self-identify as experiencing stress and depression will be recruited. They will be randomised to receive 'iSupport', or standardised information about caring for someone with dementia (control-comparison). Data will be collected via videoconferencing (eg, Zoom) or telephone interview at baseline, 3 months and 6 months. Intention-to-treat analysis will ascertain effectiveness in the primary outcomes (distress and depression) and combined cost, and quality-adjusted life-year data will be used to assess cost-effectiveness compared with usual care from a public sector and wider societal perspective. A mixed-methods process evaluation with a subgroup of carers in the intervention (~N=50) will explore the barriers and facilitators to implementing 'iSupport'. A non-randomised feasibility study will adapt 'iSupport' for young carers (n=38 participants, age 11-17 years). ETHICS AND DISSEMINATION The research plan was scrutinised by National Institute for Health Research reviewers ahead of funding being awarded. Ethical approval was granted by Bangor University's School of Health and Medical Sciences Academic Ethics Committee, reference number 2021-16915. Dissemination plans include delivering events for stakeholders, social media, a project website, developing policy briefings, presenting at conferences and producing articles for open access publications. TRIAL REGISTRATION NUMBER ISRCTN17420703.
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Affiliation(s)
- Gill Windle
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Greg Flynn
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Zoe Hoare
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | - Kieren Egan
- Department of Computer and Information Science, University of Strathclyde, Glasgow, UK
| | | | - Carys Jones
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Katherine Algar-Skaife
- Department of Neuro-medicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Gwenllian Hughes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Paul Brocklehurst
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Nia Goulden
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Debbie Skelhorn
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
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Evaluation of the Reitman Centre CARERS program for supporting dementia family caregivers: a pre-post intervention study. Int Psychogeriatr 2022; 34:827-838. [PMID: 33455610 DOI: 10.1017/s1041610220004019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES While family caregivers (CGs) of persons with dementia are cost-effective for the health system, this form of caregiving leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among CGs. The study goal was to determine the effect of the Reitman Centre CARERS program on key outcomes in family CGs of people with dementia. The Reitman Centre CARERS program is an innovative, group psychotherapeutic skills training intervention based on integrated problem-solving techniques (PST), simulation learning, and group psychotherapy designed to address each CGs' unique situation. DESIGN A quasi-experimental, non-randomized, pre-post evaluation, multiple groups, multisite trial. SETTING Multisite group intervention provided in community agencies and hospital-based locations. PARTICIPANTS Spousal or adult child family CGs (n = 264) living in the community and providing care to community-dwelling family members with dementia. MEASUREMENT CGs were assessed for depression (CES-D); stress (PSS); burden (12-item SZBI); role overload, mastery, caregiving competence, and role captivity (Perlin scales), coping (CISS - Coping Inventory for Stressful Situations), CG reactions to CR's memory and behavioral symptoms (RMBPC). Care recipients (CRs) were assessed on basic and complex activities of daily living (Katz and Lawton). Paired t-tests and Wilcoxon signed-rank test were used for statistical analysis of both the whole group and a more compromised subgroup of CGs. RESULTS For the group as a whole, CGs showed significant positive change on post-intervention outcome measures of stress, depression, burden, competence, role captivity, overload, mastery, coping, and reaction to memory issues. The intervention showed especially robust effect sizes (ES) in more compromised CGs. These positive outcomes emerged despite a significant measured deterioration in CRs' function. CONCLUSION The CARERS program may be an effective multicomponent intervention to improve the well-being, functioning, and coping skills of dementia CGs.
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Atoyebi O, Eng JJ, Routhier F, Bird ML, Mortenson WB. A systematic review of systematic reviews of needs of family caregivers of older adults with dementia. Eur J Ageing 2022; 19:381-396. [PMID: 36052180 PMCID: PMC9424446 DOI: 10.1007/s10433-021-00680-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 11/25/2022] Open
Abstract
Family caregivers provide vital assistance to older adults living with dementia. An accurate assessment of the needs of caregivers supports the development and provision of appropriate solutions to address these needs. This review of systematic reviews analyzes and synthesizes the needs identified by family caregivers. We conducted a systematic review of systematic reviews using the AMSTAR guideline. Electronic databases were searched for systematic reviews on the needs of caregivers in the context of dementia using a combination of keywords and medical subject headings. Records resulting from the search were screened by two reviewers. Data on the needs of caregivers were extracted from the articles and analyzed using a narrative synthesis approach. Out of the 17 potentially eligible systematic reviews obtained initially, 6 met the inclusion criteria. In total, 20 main needs were identified in the reviews included in this study. The need for information and social support were prominent in this review. Factors such as gender, resources available to the caregiver and the care recipient's health status may influence caregivers' needs. Interventions can be tailored toward addressing the most prominent needs of caregivers such as adequate information and resources and available programs may further accommodate and offer need-tailored support to them.
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Affiliation(s)
- Oladele Atoyebi
- Rehabilitation Sciences Program, University of British Columbia, Vancouver, BC Canada
- GF Strong Rehabilitation Research Program, University of British Columbia, Vancouver, BC Canada
| | - Janice J. Eng
- GF Strong Rehabilitation Research Program, University of British Columbia, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, QC Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré de Santé Et de Services Sociaux de la Capitale-Nationale, Quebec City, QC Canada
| | - Marie-Louise Bird
- GF Strong Rehabilitation Research Program, University of British Columbia, Vancouver, BC Canada
- School of Health Sciences, University of Tasmania, Newnham, TAS Australia
| | - W. Ben Mortenson
- GF Strong Rehabilitation Research Program, University of British Columbia, Vancouver, BC Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC Canada
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Kinchin I, Edwards L, Adrion E, Chen Y, Ashour A, Leroi I, Brugulat‐Serrat A, Phillips J, Masterson F, Kochovska S. Care partner needs of people with neurodegenerative disorders: What are the needs, and how well do the current assessment tools capture these needs? A systematic meta-review. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5764. [PMID: 35665539 PMCID: PMC9328373 DOI: 10.1002/gps.5764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 05/12/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The burden on care partners, particularly once dementia emerges, is among the greatest of all caregiving groups. This meta-review aimed to (1) synthesis evidence on the self-reported needs of care partners supporting people living with neurodegenerative disorders; (2) compare the needs according to care partner and care recipient characteristics; and (3) determine the face validity of existing care partner needs assessment tools. METHODS We conducted a systematic review of reviews involving a thematic synthesis of care partner needs and differences in needs according to demographic and other characteristics. We then conducted a gap analysis by identifying the themes of needs from existing needs assessment tools specific to dementia and cross-matching them with the needs derived from the thematic synthesis. RESULTS Drawing on 17 published reviews, the identified range of needs fell into four key themes: (1) knowledge and information, (2) physical, social and emotional support, (3) care partner self-care, and (4) care recipient needs. Needs may differ according to disease trajectory, relationship to the care recipient, and the demographic characteristics of the care partner and recipient. The 'captured needs' range between 8% and 66% across all the included needs assessment tools. CONCLUSIONS Current tools do not fully or adequately capture the self-identified needs of care partners of people living with neurodegenerative disorders. Given the high burden on care partners, which has been further exacerbated by the COVID-19 (SARS CoV-2) pandemic, the needs assessment tools should align with the self-reported needs of care partners throughout the caregiving trajectory to better understand unmet needs and target supportive interventions.
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Affiliation(s)
- Irina Kinchin
- Centre for Health Policy and ManagementTrinity College DublinUniversity of DublinDublinIreland
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) CentreUniversity of Technology SydneyUltimoNew South WalesAustralia
| | - Layla Edwards
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) CentreUniversity of Technology SydneyUltimoNew South WalesAustralia
| | - Emily Adrion
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Global Health Policy Unit, Social PolicyUniversity of EdinburghEdinburghUK
| | - Yaohua Chen
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Univ.Lille, Inserm UMR‐S1172, Lille Neurosciences & Cognition, Degenerative and Vascular Cognitive DisordersDepartment of GeriatricsCHU Lille, LiCENDLilleFrance
| | - Aya Ashour
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Department of NeurologyAin Shams UniversityCairoEgypt
| | - Iracema Leroi
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
| | - Anna Brugulat‐Serrat
- Global Brain Health InstituteUniversity of Dublin/University of California San FranciscoDublinIreland
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Medical Research Institute (IMIM)BarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Jane Phillips
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) CentreUniversity of Technology SydneyUltimoNew South WalesAustralia
- School of NursingQueensland University of TechnologyBrsibaneQueenslandAustralia
| | - Fiona Masterson
- Family Carers Ireland Research Advisory NetworkDublinIreland
| | - Slavica Kochovska
- Faculty of Science, Medicine and HealthUniversity of WollongongWollongongNew South WalesAustralia
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SHARING Choices: Design and rationale for a pragmatic trial of an advance care planning intervention for older adults with and without dementia in primary care. Contemp Clin Trials 2022; 119:106818. [PMID: 35690262 DOI: 10.1016/j.cct.2022.106818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/27/2022] [Accepted: 06/06/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Advance care planning (ACP) and involving family are particularly important in dementia, and primary care is a key setting. The purpose of this trial is to examine the impact and implementation of SHARING Choices, an intervention to improve communication for older adults with and without dementia through proactively supporting ACP and family engagement in primary care. METHODS We cluster-randomized 55 diverse primary care practices across two health systems to the intervention or usual care. SHARING Choices is a multicomponent intervention that aims to improve communication through patient and family engagement in ACP, agenda setting, and shared access to the patient portal for all patients over 65 years of age. The primary outcomes include documentation of an advance directive or medical orders for life-sustaining treatment in the electronic health record (EHR) at 12 months for all patients and receipt of potentially burdensome care within 6 months of death for the subgroup of patients with serious illness. We plan a priori sub-analysis for patients with dementia. Data sources include the health system EHRs and the Maryland health information exchange. We use a mixed-methods approach to evaluate uptake, fidelity and adaptation of the intervention and implementation facilitators and barriers. CONCLUSIONS This cluster-randomized pragmatic trial examines ACP with a focus on the key population of those with dementia, implementation in diverse settings and innovative approaches to trial design and outcome abstraction. Mixed-methods approaches enable understanding of intervention delivery and facilitators and barriers to implementation in rapidly changing health care systems. CLINICALTRIALS gov Identifier: NCT04819191.
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Beaton D, McLaughlin PM, Orange JB, Munoz DP, Mandzia J, Abrahao A, Binns MA, Black SE, Borrie M, Dowlatshahi D, Freedman M, Fischer CE, Finger EC, Frank A, Grimes D, Hassan A, Kumar S, Lang AE, Levine B, Marras C, Masellis M, Pollock BG, Rajji TK, Ramirez J, Sahlas DJ, Saposnik G, Scott CJM, Seitz DP, Strother SC, Sunderland KM, Tan B, Tang-Wai DF, Troyer AK, Turnbull J, Zinman L, Swartz RH, Tartaglia MC, Breen DP, Kwan D, Roberts AC, The Ondri Investigators. Caregiving concerns and clinical characteristics across neurodegenerative and cerebrovascular disorders in the Ontario neurodegenerative disease research initiative. Int J Geriatr Psychiatry 2022; 37. [PMID: 35633037 DOI: 10.1002/gps.5727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/20/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Caregiving burdens are a substantial concern in the clinical care of persons with neurodegenerative disorders. In the Ontario Neurodegenerative Disease Research Initiative, we used the Zarit's Burden Interview (ZBI) to examine: (1) the types of burdens captured by the ZBI in a cross-disorder sample of neurodegenerative conditions (2) whether there are categorical or disorder-specific effects on caregiving burdens, and (3) which demographic, clinical, and cognitive measures are related to burden(s) in neurodegenerative disorders? METHODS/DESIGN N = 504 participants and their study partners (e.g., family, friends) across: Alzheimer's disease/mild cognitive impairment (AD/MCI; n = 120), Parkinson's disease (PD; n = 136), amyotrophic lateral sclerosis (ALS; n = 38), frontotemporal dementia (FTD; n = 53), and cerebrovascular disease (CVD; n = 157). Study partners provided information about themselves, and information about the clinical participants (e.g., activities of daily living (ADL)). We used Correspondence Analysis to identify types of caregiving concerns in the ZBI. We then identified relationships between those concerns and demographic and clinical measures, and a cognitive battery. RESULTS We found three components in the ZBI. The first was "overall burden" and was (1) strongly related to increased neuropsychiatric symptoms (NPI severity r = 0.586, NPI distress r = 0.587) and decreased independence in ADL (instrumental ADLs r = -0.566, basic ADLs r = -0.43), (2) moderately related to cognition (MoCA r = -0.268), and (3) showed little-to-no differences between disorders. The second and third components together showed four types of caregiving concerns: current care of the person with the neurodegenerative disease, future care of the person with the neurodegenerative disease, personal concerns of study partners, and social concerns of study partners. CONCLUSIONS Our results suggest that the experience of caregiving in neurodegenerative and cerebrovascular diseases is individualized and is not defined by diagnostic categories. Our findings highlight the importance of targeting ADL and neuropsychiatric symptoms with caregiver-personalized solutions.
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Affiliation(s)
- Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Paula M McLaughlin
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medicine - Geriatrics, Dalhousie University, Halifax, NS, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
- Canadian Centre for Activity and Aging, Western University, London, ON, Canada
- Faculty of Health Sciences, Western University, London, ON, Canada
| | - Douglas P Munoz
- Department of Biomedical and Molecular Sciences, Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, London Health Sciences Center, Western University, London, ON, Canada
| | - Agessandro Abrahao
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Michael Borrie
- Department of Medicine, Division of Geriatric Medicine, Western University, Toronto, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Elizabeth C Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Andrew Frank
- Bruyere Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - David Grimes
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Northern Ontario School of Medicine, Clinical Science Division, Depart of Internal Medicine, Thunder Bay, ON, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anthony Edward Lang
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Mario Masellis
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Joel Ramirez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- LC Campbell Cognitive Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Demetrios J Sahlas
- Department of Medicine (Division of Neurology), McMaster University, Hamilton, ON, Canada
| | - Gustavo Saposnik
- Outcomes and Decision Neuroscience Research Unit, Toronto, ON, Canada
| | - Christopher J M Scott
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- LC Campbell Cognitive Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Dallas P Seitz
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - David F Tang-Wai
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Department of Medicine (Geriatric Medicine), University of Toronto, Toronto, ON, Canada
- University Hospital Network Memory Clinic, Toronto, ON, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Neuropsychology & Cognitive Health Program, Baycrest Health Sciences, Toronto, ON, Canada
| | - John Turnbull
- Department of Medicine (Division of Neurology), McMaster University, Hamilton, ON, Canada
| | - Lorne Zinman
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Richard H Swartz
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
- Division of Neurology, Krembil Neuroscience Centre Memory Clinic, Toronto, ON, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders and Department of Computer Science, Northwestern University, Evanston, Illinois, USA
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Sadavoy J, Sajedinejad S, Duxbury L, Chiu M. The impact on employees of providing informal caregiving for someone with dementia. Aging Ment Health 2022; 26:1035-1043. [PMID: 33459037 DOI: 10.1080/13607863.2021.1871878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine if employees who are concurrently providing informal caregiving for a person with dementia (DCG) experience greater challenges than employees providing informal caregiving to older adults without dementia (ND CG). METHOD From a sample of employee respondents to a national Canadian survey three groups were studied: ND CG, and two subgroups of DCGs defined by the level of demand posed by the care recipient (CR) - low dementia demand (LDD) and moderate/high dementia demand (HDD). The dependent variables were CGs' job profile, health/well-being, nature of caregiving and work-caregiving balance and CRs' health demands. We used general linear models for analysis. RESULTS 1839 employee respondents were informal caregivers for an older adult, of whom 666 were DCGs. HDD CGs (n = 363) had significantly greater role demands and challenges on measures of perceived stress, depressed mood, burden, self-efficacy, mastery, control, absenteeism, job-caregiving conflict and role overload than LDD (n = 303) and ND CGs (n = 1173). LDD and ND CGs did not differ on these measures. CONCLUSION Employees concurrently caring informally for persons with dementia who pose moderate to high care demands experience significantly more difficulties than employees providing LDD or ND informal care for an older adult. These results may guide employers and clinicians in identifying and responding to CG employees who need enhanced support both in the workplace and the community to maintain their work productivity.
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Affiliation(s)
- Joel Sadavoy
- Reitman Centre and Enhancing Care Program, Sinai Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,The Cyril & Dorothy, Joel & Jill Reitman Centre for Alzheimer's Support and Training, Toronto, ON, Canada.,Department of Psychiatry, Sinai Health, Toronto, ON, Canada.,Canadian Consortium on Neurodegeneration in Aging, Toronto, ON, Canada
| | - Sima Sajedinejad
- The Cyril & Dorothy, Joel & Jill Reitman Centre for Alzheimer's Support and Training, Toronto, ON, Canada.,Department of Psychiatry, Sinai Health, Toronto, ON, Canada
| | - Linda Duxbury
- Sprott School of Business, Carleton University, Ottawa, ON, Canada
| | - Mary Chiu
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
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Mueller A, Thao L, Condon O, Liebzeit D, Fields B. A Systematic Review of the Needs of Dementia Caregivers Across Care Settings. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223211056928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The U.S. population of older adults living with dementia is projected to double by 2060. They rely on over 16 million family and unpaid caregivers to provide for their increasingly complex needs and care transitions. Caregivers frequently feel underprepared and without adequate support or access to resources. This systematic review seeks to identify the needs of family and unpaid caregivers of older adults living with dementia across various care settings in the U.S. A systematic search was conducted to identify articles pertaining to the needs of caregivers of older adults living with dementia. The data extraction tool was developed using aspects from the Care Transitions Framework and the Family Caregiver Alliance. Data were organized based on 3 domains of caregiver needs and the care setting(s) of the older adults living with dementia and their caregivers. A total of 31 articles were eligible for inclusion. The majority met the MMAT screening criteria, but more than half only met 2 or less of the 5 quality criteria. Caregivers’ needs were identified in the care settings of home/community-residing, assisted living, long-term care, skilled nursing, and memory care. Most articles either did not specify a care setting or included more than 1 and did not report the findings separately. Caregivers in each care setting, except memory care, identified needs in all 3 of the following domains: (1) social support—formal and informal, (2) confidence, competence, and strengths in the caregiving role, and (3) values and preferences.
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Alves S, O'Caoimh R, Ribeiro O, Teixeira L, Molloy DW, Paúl C. Screening for Caregiver Burden in the Community: Validation of the European Portuguese Screening Version of the Zarit Burden Interview (ZBI-4). Clin Gerontol 2022; 45:525-537. [PMID: 32065071 DOI: 10.1080/07317115.2020.1728807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Brief screening instruments are useful in busy clinical practice to identify those requiring further assessment. This study aims to translate and validate a Portuguese version of the four-item Zarit Burden Interview (ZBI-4) to identify caregiver burden in a community-based sample in Northern Portugal.Methods: We collected data from 203 informal caregivers of community-dwellers aged ≥80 years. Internal consistency and factors were measured using Cronbach's alpha. Pearson's correlation was used to examine construct validity against negative and positive aspects of caregiving from the Caregiving Appraisal Scale. Discriminative ability was evaluated from the area under the receiver operating characteristic curve (AUC). Optimal cutoffs were calculated using Youden´s Index.Results: The internal consistency of the Portuguese version of the ZBI-4 was good (alpha = 0.71). Concurrent validity was acceptable, showing strong correlation with the negative (rho = 0.66) and medium correlation with positive (rho = -0.33) aspects of the Caregiving Appraisal Scale. Discriminative accuracy for caregiver burden was also good (AUC = 0.86). Youden's index produced an optimal cutoff of ≥7 points for burden.Conclusions: The Portuguese version of the ZBI-4 screen demonstrates good psychometric properties.Clinical implications: These results show the utility of the Portuguese version of ZBI-4 as a short screen for caregiver burden for use in the community to facilitate rapid screening for this important and complex stressor.
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Affiliation(s)
- Sara Alves
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.ICBAS), University of Porto, Porto, Portugal
| | - Rónán O'Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Cork City, Ireland.,Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork City, Ireland
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal.,Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Laetitia Teixeira
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.ICBAS), University of Porto, Porto, Portugal.,EPIUnit, Public Health Institute, University of Porto, Porto, Portugal
| | - David William Molloy
- Department of Geriatric Medicine, Mercy University Hospital, Cork City, Ireland.,Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork City, Ireland
| | - Constança Paúl
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.ICBAS), University of Porto, Porto, Portugal
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50
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Wiloth SS, Kiefer A, Wittek M, Arroyo y Villora T, Obermeier M, Schmitt E, Kruse A. Rethinking a Traditional Method of Participation: “Town-Hall Meetings” to Support Family Carers of People with Dementia. J Alzheimers Dis 2022; 87:981-990. [DOI: 10.3233/jad-215582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A growing number of people with dementia, a simultaneous decline of professional caregivers, and changing family structures clearly illustrate the societal relevance of the question of how dementia care can be arranged and delivered in the future. The demand for innovative solutions especially to support family carers requires a deeper insight into their life situation and a focused perception of their needs. This article presents the main hypothesis that specific forms of social integration and participation based on an equal dialogue between family caregivers, the public, and policymakers is needed to achieve that. Therefore, the main point here is to give family caregivers of people with dementia a voice to learn how to better support them in caring as well as self-care. A learning process triggered by a dialogue might result in a higher level of community readiness to implement new forms of support or social innovations. The hypothesis will be supported by John Dewey’s theory of political and democratic learning and the model of transformative learning according to Jack Mezirow indicating that learning particularly succeeds in interpersonal communication. In this context, the Town-Hall Meeting method and its potential to promote interpersonal communication and reflexive learning is discussed. The article addresses an important debate, namely that of how dementia care and support of family carers can succeed. It also sets the direction for future empirical research as the Town-Hall Meeting method might be applicable for gerontological action and participatory research.
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Affiliation(s)
| | - Anna Kiefer
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Maren Wittek
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | | | - Monika Obermeier
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
- Philosophical Seminar, Heidelberg University, Heidelberg, Germany
| | - Eric Schmitt
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Andreas Kruse
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
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