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Chen KX, Hsu PC, Lin JN, Lee FP, Wang JJ. Exploring the Difficulties and Strategies of Family Caregivers in Caring for Patients With Dementia in Acute Care Wards. J Nurs Res 2023; 31:e297. [PMID: 37548951 DOI: 10.1097/jnr.0000000000000575] [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: 08/08/2023] Open
Abstract
BACKGROUND Providing appropriate care to patients with dementia in acute care settings can be a challenge for healthcare professionals. A key factor is working closely with family caregivers. PURPOSE This study aims to explore the difficulties and strategies involved in caring for patients with dementia who have been admitted to an acute care ward from the perspective of family caregivers. METHODS Exploratory research was conducted using a qualitative data collection approach. Data were collected by means of in-depth interviews carried out with participants. Semistructured interviews were conducted with nine participants. Content analysis was performed to analyze the data. RESULTS A number of themes and subthemes were identified based on the primary research purposes. The first theme is "vicious cycle due to multiple factors," with the following subthemes: (a) communication disturbance, (b) endless worries, (c) inadequate care skills of paid caregivers, and (d) physical and psychological exhaustion. The second theme is "do everything," with the following subthemes: (a) management of the behavioral and psychological symptoms of dementia, (b) constant accompaniment of the patient, and (c) seeking sources of support. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The results may be used to help healthcare professionals better anticipate the difficulties faced by family caregivers while providing assistance to patients with dementia and understand the related strategies they use. Acute care wards should consider the specific needs of family caregivers to ensure patients with dementia receive adequate care from the relevant parties in the ecological care chain during the care process.
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Affiliation(s)
- Ko-Xin Chen
- MS, RN, Doctoral Student, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
| | - Pei-Chen Hsu
- MS, RN, Doctoral Student, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Taiwan
| | - Jong-Ni Lin
- PhD, RN, Assistant Professor, Department of Nursing, Da-Yeh University, Taiwan
| | - Feng-Ping Lee
- PhD, RN, Associate Professor, Department of Nursing, California State University, USA
| | - Jing-Jy Wang
- PhD, RN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
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Eriksson E, Jordal M, Hjelm K, Engström M. Job satisfaction and wellbeing among migrant care workers in nursing homes: An integrative review. Nurs Open 2023; 10:3486-3505. [PMID: 36658244 PMCID: PMC10170958 DOI: 10.1002/nop2.1611] [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: 08/10/2022] [Revised: 12/05/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023] Open
Abstract
AIM To systematically analyse and synthesize studies investigating job satisfaction (including turnover and turnover intention) and wellbeing (physical, social and psychological including work stress, acculturation stress and sick leave) among migrant care workers in nursing homes. DESIGN An integrated review was conducted. METHODS Joanna Briggs Institute's manual guided the analysis of qualitative data (n = 31). Quantitative data (n = 17) were summarized and integrated with the qualitative findings. RESULTS Migrants described high job demands, limited control and social support, and stress possibly related to acculturation. Although, compared to natives (born in the country), inconsistent results were reported about wellbeing and job satisfaction, migrant care workers reported enjoying the relational aspects of work and feeling pride when providing care. A satisfying work environment for migrant care workers enables them enjoying working in elderly care with pride. PUBLIC CONTRIBUTION Help managers to promote an inclusive working life in line with the United Nations Sustainable Development Goal number 8.
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Affiliation(s)
- Elisabet Eriksson
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Malin Jordal
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Katarina Hjelm
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Xiao LD, Gregoric C, Gordon S, Ullah S, Goodwin-Smith I, Muir-Cochrane E, Blunt S. Staff perceived challenges and facilitators in supporting resident self-determination in ethno-specific and mainstream nursing homes. J Clin Nurs 2022. [PMID: 35799405 DOI: 10.1111/jocn.16440] [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: 04/20/2022] [Revised: 06/10/2022] [Accepted: 06/23/2022] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore and compare staff perceived challenges and facilitators in supporting resident self-determination in ethno-specific and mainstream nursing homes. BACKGROUND Staff and residents in ethno-specific and mainstream nursing homes in most developed countries have shown increased cultural and linguistic diversity. This socio-demographic change poses significant challenges for staff to support resident self-determination of their own care. In-depth understanding of those challenges in the two types of nursing homes is much needed to inform practice in nurse-led nursing home care settings. METHOD A qualitative description approach with thematic analysis was used in the study. Data were collected through five focus groups with 29 various direct care workers from two ethno-specific nursing homes and a mainstream nursing home in Australia between March-September 2020. The study report followed the COREQ checklist. RESULTS Four themes were identified from focus group data. First, participants perceived communication challenges in identifying residents' preferences, especially in ethno-specific nursing homes. Second, team efforts that included residents and their family members were highly valued as a way to meet residents' preferences. Third, participants described various levels of staff engagement in residents' care planning. In addition, staff in ethno-specific nursing homes possessed richer resources to maintain meaningful relationships for residents compared with their counterparts in the mainstream nursing home. CONCLUSIONS Staff in ethno-specific nursing homes experience more challenges in supporting resident self-determination but have richer resources to develop culturally safe and culturally competent care compared with their counterparts in the mainstream nursing home. RELEVANCE TO CLINICAL PRACTICE Findings provide new insights into challenges and practical solutions in supporting residents to self-determine their own care in cross-cultural aged care. PATIENT OR PUBLIC CONTRIBUTION This study was co-designed with three aged care organisations who funded the study. Staff employed by these organisations participated in the study.
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Affiliation(s)
- Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Carolyn Gregoric
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sue Gordon
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Ian Goodwin-Smith
- College of Business, Government & Law, Flinders University, Flinders University, Adelaide, South Australia, Australia
| | - Eimear Muir-Cochrane
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sara Blunt
- Kalyra Communities (an aged care organisation), Adelaide, South Australia, Australia
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Booi L, Sixsmith J, Chaudhury H, O'Connor D, Young M, Sixsmith A. 'I wouldn't choose this work again': Perspectives and experiences of care aides in long-term residential care. J Adv Nurs 2021; 77:3842-3852. [PMID: 34235778 DOI: 10.1111/jan.14948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/17/2021] [Accepted: 05/28/2021] [Indexed: 11/28/2022]
Abstract
AIMS To provide insight into the everyday realities facing care aides working in long-term residential care (LTRC), and how they perceive their role in society. DESIGN A qualitative ethnographic case study. METHODS Data were collected over. 10 months of fieldwork at one LTRC setting [September 2015 to June 2016] in Western Canada; semi-structured interviews (70 h) with 31 care aides; and naturalistic observation (170 h). Data were analysed using reflexive thematic analysis. RESULTS The findings in this work highlight the underpinned ageism of society, the gendered work of body care, and the tension between the need for relational connections - which requires time and economic profit. Four themes were identified, each relating to the lack of training, support, and appreciation care aides felt about their role in LTRC. CONCLUSION Care aides remain an unsupported workforce that is essential to the provision of high-quality care in LTRC. To support the care aide role, suggestions include: (i) regulate and improve care aide training; (ii) strengthen care aides autonomy of their care delivery; and (iii) reduce stigma by increasing awareness of the care aide role. IMPACT What problem did the study address? The unsupportive working conditions care aides experience in LTRC and the subsequent poor quality of care often seen delivered in LTRC settings. What were the main findings? Although care aides express strong affection for the residents they care for, they experience insurmountable systemic and institutional barriers preventing them from delivering care. Where and on whom will the research have impact? Care aides, care aide educators, care aide supervisors and managers in LTRC, retirement communities, and home care settings.
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Affiliation(s)
- Laura Booi
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Judith Sixsmith
- School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, Canada
| | | | - Melanie Young
- Origin Longwood Retirement Communities, Vancouver, Canada
| | - Andrew Sixsmith
- Department of Gerontology, Simon Fraser University, Vancouver, Canada
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Lewis JP, Manson SM, Jernigan VB, Noonan C. "Making Sense of a Disease That Makes No Sense": Understanding Alzheimer's Disease and Related Disorders Among Caregivers and Providers Within Alaska Native Communities. THE GERONTOLOGIST 2021; 61:363-373. [PMID: 32789474 PMCID: PMC8023374 DOI: 10.1093/geront/gnaa102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES With the rate of Alzheimer's disease and related dementias (ADRD) increasing among Alaska Indian/Alaska Native (AI/AN) people, the Alaska Native Health system is ill-prepared to meet the challenges associated with the growing population at risk of ADRD. The high cost of care, inadequate training of health care providers, and lack of supportive services for caregivers are especially concerning. RESEARCH DESIGN AND METHODS Interviews were conducted with 22 AN caregivers for ANs with ADRD and 12 ANs and non-Native health care providers in communities across Alaska. Interviews lasted approximately 60 min and were transcribed verbatim. We employed directed content analysis to examine the major agreements and disagreements between the participants' understandings of ADRD in each of the domains of Kleinman's Explanatory Model of Illness. RESULTS Caregivers and health care providers expressed concerns about the lack of understanding, resources, and awareness of ADRD among ANs in rural and urban communities. Both caregivers and providers recognized the need to obtain an early diagnosis, blend Western and traditional medicines, promote lifestyle and dietary changes, and foster training for caregivers. Health care providers acknowledged their limited exposure to AN understanding of ADRD and wish to receive culturally relevant training to better serve AN. DISCUSSION AND IMPLICATIONS As the older AN adult population grows, the need for culturally responsive training and support services will continue to increase. We recommend establishing rural outreach and support groups for caregivers, developing an understanding of how ANs view ADRD to train and educate health care providers, and implement screening early for memory loss during routine medical examinations.
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Affiliation(s)
- Jordan P Lewis
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, Aurora
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Valarie B Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa
| | - Carolyn Noonan
- Institute for Research and Education to Advance Community Health, Washington State University, Pullman
- Elson S. Floyd College of Medicine, Washington State University, Pullman
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Wilson T, McDonald P, Temple J, Brijnath B, Utomo A. Past and projected growth of Australia's older migrant populations. GENUS 2020; 76:20. [PMID: 32834077 PMCID: PMC7403568 DOI: 10.1186/s41118-020-00091-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/20/2020] [Indexed: 01/05/2023] Open
Abstract
In recent years, Australia’s older population (aged 65 and over) has been growing rapidly, accompanied by a shift in its country of birth composition. Although a great deal of research has been undertaken on past and current aspects of Australia’s migrant groups, little attention has been paid to future demographic trends in older populations. The aim of this paper is to examine recent and possible future demographic trends of Australia’s migrant populations at the older ages. We present population estimates by country and broad global region of birth from 1996 to 2016, and then new birthplace-specific population projections for the 2016 to 2056 period. Our findings show that substantial growth of the 65+ population will occur in the coming decades, and that the overseas-born will shift from a Europe-born dominance to an Asia-born dominance. Cohort flow (the effect of varying sizes of cohorts moving into the 65+ age group over time) will be the main driver of growth for most older birthplace populations. The shifting demography of Australia’s older population signals many policy, planning, service delivery and funding challenges for government and private sector providers. We discuss those related to aged care, health care, language services, the aged care workforce, regulatory frameworks and future research needs in demography and gerontology.
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Affiliation(s)
- Tom Wilson
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Peter McDonald
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Jeromey Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Parkville, Australia
| | - Ariane Utomo
- School of Geography, University of Melbourne, Melbourne, Australia
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Diederich F, König HH, Brettschneider C. How Politico-Economic Systems Shape Individuals' Value of Elderly Care: Evidence From the German Reunification. THE GERONTOLOGIST 2020; 60:350-358. [PMID: 31602474 DOI: 10.1093/geront/gnz128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Perceptions of how societies should care for the elderly people can differ among countries. This study examines to what extent individuals' value of informal care is shaped by the politico-economic system in which they grew up and if this value adjusts once an individual lives in a different politico-economic system. RESEARCH DESIGN AND METHODS We use data from the German Family Panel and take advantage of the unique setting of the German separation and reunification. Probit models are used to examine the effect of being born in East Germany on individuals' value of informal care relative to employment at different birth cohorts and survey waves (N = 14,093). Average marginal effects are calculated. RESULTS Twenty years after reunification, East Germans who spent their adolescence under communism exhibit a higher value of informal care relative to employment than West Germans who grew up in a western social market economy. Differences in values between East and West Germans do not significantly converge over time. DISCUSSION AND IMPLICATIONS Individuals' value of informal care is deeply shaped by the politico-economic system in which they grew up. If immigration policies are introduced to increase the care for elderly people, differences in individuals' cultural perceptions of elderly care should be considered as these will not suddenly adjust.
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Affiliation(s)
- Freya Diederich
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
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Meeks S. Common Themes for Im/migration and Aging: Social Ties, Cultural Obligations, and Intersectional Challenges. THE GERONTOLOGIST 2020; 60:215-218. [PMID: 32092143 DOI: 10.1093/geront/gnz193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Suzanne Meeks
- Department of Psychological and Brain Sciences, University of Louisville, Kentucky
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