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Agyemang-Duah W, Rosenberg MW. Geographical location as a determinant of caregiver burden: a rural-urban analysis of the informal caregiving, health, and healthcare survey in Ghana. BMC PRIMARY CARE 2024; 25:317. [PMID: 39198724 PMCID: PMC11351011 DOI: 10.1186/s12875-024-02562-7] [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: 10/04/2023] [Accepted: 08/05/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND The caregiving scholarship widely acknowledges informal caregivers' contributions to maintaining older adults' health and well-being. However, informal caregivers encounter economic, physical, social, financial and psychological challenges when caring for older adults. The caregiving literature has shown variations in caregiving intensity and motivation between rural and urban informal caregivers of older adults. This situation is likely to result in rural-urban disparities in caregiver burden. However, the literature on predictors of caregiver burden is more focused on demographic, socio-economic, caregiving and health-related factors with very little attention to geographical dynamics. For this reason, the effects of demographic, socio-economic, caregiving, and health-related factors on the variations in caregiver burden between rural and urban informal caregivers of older adults are yet to be known in the sub-Saharan African context, including Ghana. Notably, the impact of geographical location on caregiver burden is mainly missing in the informal caregiving literature in Ghana. Situated within the stress process model, we determine the association between geographical location and caregiver burden among informal caregivers of older adults in Ghana. METHODS This study employed data from a large cross-sectional survey on informal caregiving, health, and healthcare among caregivers of older adults aged 50 years or above (N = 1,853) in Ghana. We selected the World Health Organization Impact of Caregiving Scale to measure caregiver burden. Generalized multivariable linear regression models were employed to determine the association between geographical location and caregiver burden among informal caregivers of older adults. We reported beta values and standard errors with significance levels of 0.05 or less. RESULTS The results showed that rural informal caregivers of older adults significantly have a decreased caregiver burden compared to urban informal caregivers (β = -1.64; SE = 0.41). Also, participants across all the self-rated health categories (poor/very poor: β = 12.63; SE = 1.65; fair: β = 9.56; SE = 1.07; good: β = 11.00; SE = 0.61, very good: β = 7.03; SE = 0.49) have a significantly increased caregiver burden for the full sample and for both rural (poor/very poor: β = 13.88; SE = 2.4; fair: β = 6.11; SE = 1.62; good: β = 9.97; SE = 0.96, very good: β = 6.06; SE = 0.71) and urban (poor/very poor: β = 11.86; SE = 2.25; fair: β = 12.33; SE = 1.42; good: β = 11.80; SE = 0.79, very good: β = 7.90; SE = 0.67) participants. This study further revealed that participants with no financial support needs reported a decreased caregiver burden compared to those with financial support needs for the full sample (β = -2.92, p-value < 0.01) and for both rural (β = -3.20; p-value < 0.01) and urban (β =-2.70; p-value < 0.01) participants. CONCLUSION The findings from this study underscore geographical location differences in caregiver burden among informal caregivers of older adults in Ghana. Given these findings, the need to consider geographical location variations in providing welfare and health support programs to lessen caregiver burden among informal caregivers of older adults is welcomed. In line with the stress process model, such welfare and health programs should consider background, context, and stressor factors that contribute to variations in caregiver burden between rural and urban informal caregivers of older adults in Ghana and other sub-Saharan African countries.
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Affiliation(s)
- Williams Agyemang-Duah
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada.
| | - Mark W Rosenberg
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada
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Thiemann P, Street AN, Heath SE, Quince T, Kuhn I, Barclay S. Prolonged grief disorder prevalence in adults 65 years and over: a systematic review. BMJ Support Palliat Care 2023; 13:e30-e42. [PMID: 33707297 DOI: 10.1136/bmjspcare-2020-002845] [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] [Received: 12/05/2020] [Accepted: 02/03/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Prolonged grief disorder (PGD) is a recently recognised mental health disorder with an estimated prevalence of 10% in the bereaved adult population. This review aims to appraise and summarise evidence relating to PGD in older adults (≥65 years), a growing population group, most likely to experience bereavement and often assumed to cope well. METHOD Literature from Medline, PsycINFO, CINAHL, Cochrane Library and Web of Science was searched. Epidemiological and non-epidemiological studies including data on frequency of PGD in older adults bereaved by mainly natural causes were included and a descriptive analysis undertaken. RESULTS From 2059 records, three epidemiological and six non-epidemiological studies were included. Most studies had good internal but not external validity. Conditional prevalence for PGD ranged between 3.2% and 48.8%. Heterogeneity in sample characteristics and study methodology contributed to this variability resulting in a descriptive analysis. The prevalence rate of 9.1% by Kersting et al was the best available estimate for PGD in older adults for western countries. The small number of epidemiological studies and the use of varying PGD-constructs which did not match International Classification of Diseases 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria were the main limiting factors. CONCLUSION This first review on PGD prevalence in older adults suggests that, despite studies' methodological short comings, a similar proportion of older adults experience PGD as the general bereaved adult population (1:10). With older adults forming the largest subgroup among the bereaved, health and social care systems need to adapt their provision of care to address the specific needs of older adults.
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Affiliation(s)
- Pia Thiemann
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Anna Naomi Street
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Sarah Eleanor Heath
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thelma Quince
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Isla Kuhn
- Medical Library, University of Cambridge, Cambridge, UK
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Chang M, Michelet M, Skirbekk V, Langballe EM, Hopstock LA, Sund ER, Krokstad S, Strand BH. Trends in the use of home care services among Norwegians 70+ and projections towards 2050: The HUNT study 1995-2017. Scand J Caring Sci 2023; 37:752-765. [PMID: 36967552 DOI: 10.1111/scs.13158] [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: 08/12/2022] [Revised: 01/20/2023] [Accepted: 02/13/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Life expectancy (LE) is increasing worldwide, while there is lack of information on how this affects older individuals' use of formal home care services. AIM We aimed to decompose LE into years with and without home care services and estimate projected number of users towards 2050 in Norway for people 70 years or older. METHODS This study is based on a sample of 25,536 participants aged 70 years and older in the Trøndelag Health Study (HUNT) survey 2 (1995-1997), 3 (2006-2008), or 4 (2017-2019) linked with national data on mortality. Prevalence of home care services was standardised to the Norwegian population by age and sex. The Sullivan method was used to estimate expected years with and without home help services and nursing services for the years 1995, 2006 and 2016. Data from HUNT4 and Statistics Norway were used to estimate projected use of these services between 2020 and 2050. RESULTS During 1995-2017, the use of home help services decreased from 22.6% to 6.2% (p < 0.001), and from 6.4% to 5.5% (p = 0.004) for home nursing services. Adjusted for age and sex, the use of home help services decreased significantly over time (p < 0.001), while home nursing services were stable (p = 0.69). LE at age 70 increased from 11.9 to 15.3 years in men (p < 0.05) during 1995-2017, and from 14.7 to 17.1 in women (p < 0.05). In the same period, the expected years receiving home help decreased from 2.6 to 1.1 in men (p < 0.05), and from 4.4 to 2.1 in women (p < 0.05). The expected years receiving home nursing increased from 0.6 to 0.9 in men (p < 0.05), and from 1.3 to 1.7 in women (p < 0.05). Projected numbers of people 70+ in Norway in need of either of these services were estimated to rise from 64,000 in 2020 to 160,000 in 2050. CONCLUSION While overall life expectancy increased, the expected years receiving home help have decreased and home nursing slightly increased among the Norwegian population aged 70 years and older during 1995-2017. However, the substantial increase in the projected number of older adults using home care services in the future is an alert for the current health care planners.
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Affiliation(s)
- Milan Chang
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Icelandic Gerontological Research Institute, Reykjavik, Iceland
| | - Mona Michelet
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Vegard Skirbekk
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ellen M Langballe
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bjørn H Strand
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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Siira E, Olaya-Contreras P, Yndigegn S, Wijk H, Rolandsson B, Wolf A. Older adults' provision of informal care and support to their peers - A cornerstone of swedish society: Demographic characteristics and experiences of social isolation. Scand J Caring Sci 2021; 36:468-481. [PMID: 34970756 DOI: 10.1111/scs.13063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/26/2021] [Accepted: 12/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Family members provide the majority of informal care for older adults in Sweden. Nevertheless, by providing a range of assistance, peers often emerge as a central to counter social isolation among older adults. Therefore, there is a need to know more about what informal care provision by older adults to their peers means for different groups of older adults. AIM This study investigated the types of informal care and support that older adults provide to their peers in Sweden, and how these types of care and support are associated with demographic characteristics and social isolation. We also compared older adults who provide informal care and support with those who do not. METHOD For this purpose, we used a national online survey named "Involuntary loneliness among senior citizens" answered by 10,044 older adults enrolled in the Swedish Citizen Panel. We adopted a mixed-method design to analyse the survey data, including free-text options (n = 2155) and numerical data. Social isolation was assessed using a score built from the social loneliness items of the UCLA Loneliness Scale. RESULTS In our population, 21.5% of the older adults were providing informal care and support to their peers. Practical/instrumental help was frequently offered by younger participants (<75 years), men and respondents who were less socially isolated. On a general level, the factors that were positively associated with giving informal care and support to peers were older age, being male, retired, married/living in a relationship, living in an urban area/big city and exhibiting greater isolation. Focusing specifically on social support shows that older participants (>80) and those experiencing less social isolation (score < 24) were more engaged in social activities. CONCLUSION: This paper is unique in exploring the informal peer-caregiver's perceptions of isolation. Data were collected during the COVID-19 pandemic; this highlights the need to recognise informal care and support between older adults and to acknowledge their contributions as an essential component of Swedish civil society, especially during a societal crisis.
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Affiliation(s)
- Elin Siira
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), The Sahlgrenska Academy, Gothenburg, Sweden
| | - Patricia Olaya-Contreras
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), The Sahlgrenska Academy, Gothenburg, Sweden
| | - Signe Yndigegn
- Department of Digital Design, The IT University of Copenhagen, Copenhagen, Denmark
| | - Helle Wijk
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Bertil Rolandsson
- The Department of Sociology and Work Science, Gothenburg University, Gothenburg, Sweden
| | - Axel Wolf
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), The Sahlgrenska Academy, Gothenburg, Sweden.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Sanches Slusarski Martins R, Pipek LZ, Mesquita GHAD, Nii F, Medeiros KADA, Carvalho BJ, Martines DR, D'Albuquerque LAC, Meyer A, Andraus W. The impact of stressors and overload on informal caregivers of patients with cirrhosis: The first use of the Burden Scale for Family Caregivers in Brazil. J Health Psychol 2020; 27:408-421. [PMID: 32927996 DOI: 10.1177/1359105320953464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cirrhosis affects liver functions and compromises much of the body's organs. The significant increase in chronic diseases, including cirrhosis, has led to changes in medical practice and health systems, leading the informal caregiver to play a major role because of family ties or some level of proximity to the patient, assuming daily care function. However, the burden generated by informal caregivers for uninterrupted care is present at different levels (physical, mental, social, professional, and financial) and even in the prognosis of the patient. OBJECTIVE The present study aims to evaluate the impact of stressors and overload on informal caregivers of cirrhosis patients. METHOD Cross-sectional study, conducted with 54 informal caregivers of cirrhosis patients, followed up at the Liver Transplant Service Outpatient Clinic of the University of São Paulo School of Medicine Hospital das Clínicas, where they had access to a sociodemographic questionnaire, history of the patient's disease and the scale Burden Scale for Family Caregivers. RESULTS It was observed that higher levels of education and income of the caregiver correlates with a lower degree of stress. In addition, there is a significant difference found in the caregiver's age variable, which indicates that the youngest are those who have the highest degree of stress. The variable Na mEg/l of the patient also presents a statistically significant difference. CONCLUSION Our study was a precursor using the BSFC scale of worldwide coverage and that had not yet been applied in any study in Brazil, thus allowing a look at the various aspects that affect the quality of life of caregivers of patients with cirrhosis. Our results and the literature corroborate the importance not only of the patient, but also the informal caregiver's health.
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Affiliation(s)
- Raquel Sanches Slusarski Martins
- Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | | | | | - Fernanda Nii
- Faculdade de Medicina FMUSP, Universidade de São Paulo, SP, Brazil
| | | | | | | | | | - Alberto Meyer
- Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Wellington Andraus
- Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
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Morelli N, Barello S, Mayan M, Graffigna G. Supporting family caregiver engagement in the care of old persons living in hard to reach communities: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1363-1374. [PMID: 31441179 DOI: 10.1111/hsc.12826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
Today, 8.5% of the world's population is 65 and over, and this statistic will reach 17% by 2050 (He et al., U.S. Census Bureau, international population reports, P95/16-1, An ageing world: 2015, U.S., 2016). They are the people who, with increasing age, will find themselves more closely interfacing with the national health system, which in many countries shows strong imbalances between rural and urban areas. In this context, a fundamental role is played by the relatives who find themselves becoming informal caregivers to compensate for lack of services. To date, however, little has been done to help these people. In this article, we want to identify the nature and extent of research evidence that had its objective to help informal caregivers in rural, hard to reach areas (Grant & Booth, Health Information & Libraries Journal, 2009, 26, 91). Following the approach set out by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19), we conducted a scoping review in May 2018 and closed the review with an update in September 2018. We identified 14 studies published from 2012, the European Year of Active Ageing, promoted by the European Commission, which had three domains of implementation: emotional support to decrease the emotional burden of caregivers, educational support to increase their skills, and organisational support to improve the mobility of caregivers and carereceivers. Although informal caregivers play a fundamental role in many countries, the studies that have been involved in alleviating their caring burden are few; nevertheless, they provide interesting indications. This lack of attention confirms how this portion of the population is still neglected by scientific research and risks having unequal access to health and social care. Future research is needed, not only to create and improve services to caregivers in rural, hard to reach areas, but also to evaluate and focus on the participation and the engagement of caregivers in the co-design of these services.
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Affiliation(s)
- Niccolò Morelli
- Department of Sociology and Business Law, Engage Minds Hub Consumer & Health Research Center, Università di Bologna, Bologna, Italy
| | - Serena Barello
- Department of Psychology, EngageMinds Hub Consumer & Health Research Center, Università Cattolica del Sacro Cuore (Milano), Milano, Italy
| | - Maria Mayan
- Faculty of Extension, University of Alberta, Edmonton, AB, Canada
| | - Guendalina Graffigna
- Department of Psychology, EngageMinds Hub Consumer & Health Research Center, Università Cattolica del Sacro Cuore (Milano), Milano, Italy
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Chang M, Geirsdottir OG, Sigurdarsdottir SH, Kåreholt I, Ramel A. Associations between education and need for care among community dwelling older adults in Iceland. Scand J Caring Sci 2019; 33:885-891. [PMID: 31058338 DOI: 10.1111/scs.12685] [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: 10/24/2018] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Older adults in Iceland have good access to social services that support them in maintaining an independent life, although receiving informal care is common for community living older adults in Iceland. The aim of this study was to examine whether the need for care as well as receiving formal and informal care is associated with education among older adults in Iceland. METHODS Among a national sample of 782 Icelandic community dwelling old adults (mean age 76.9 ± 7.4 years, 55% women), a telephone survey was conducted. The survey included questions on: socioeconomic status, social network, health status, activities of daily living and formal/informal care. RESULTS A full data set was available for 720 subjects and among these, 349 (48.5%) had no need for care, 197 (27.4%) received informal care only, 31 (4.3%) received formal care only, and 143 (19.9%) received both type of care. Participants with higher education were significantly less likely to need care (OR 0.67, 95% CI, 0.47-0.97, p = 0.031) when compared with those who had primary education. Categorisation by age showed that this difference was only significant in participants younger than 80 years. Education was not related to formal care, but adults with higher education were less likely to receive informal care compared with older adults who had primary education (OR: 0.65, 95%CI: 0.46, 0.93, p = 0.018). CONCLUSIONS People with higher education were significantly less likely to need care and this association was mainly present among those aged below 80 years. Further, in participants that needed care, the likelihood of receiving informal care was lower in highly educated participants, but no differences in formal care were observed between educational levels.
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Affiliation(s)
- Milan Chang
- Faculty of Health Promotion, Sports and Leisure Studies, School of Education, University of Iceland, Reykjavik, Iceland.,The Icelandic Gerontological Research Institute, National University Hospital of Iceland & Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Olof G Geirsdottir
- The Icelandic Gerontological Research Institute, National University Hospital of Iceland & Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Unit for Nutrition Research, National University Hospital of Iceland & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | - Ingemar Kåreholt
- Institute of Gerontology and Aging Research Network, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Alfons Ramel
- The Icelandic Gerontological Research Institute, National University Hospital of Iceland & Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Unit for Nutrition Research, National University Hospital of Iceland & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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8
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Behm L, Björkman E, Ahlström G. Mental health and reactions to caregiving among next of kin of older people (65+) with multi-morbidity discharged home after hospitalization. Scand J Caring Sci 2018; 32:1458-1467. [PMID: 30092125 DOI: 10.1111/scs.12592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 05/29/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Older people with multi-morbidity are major users of healthcare and are often discharged from hospital with ongoing care needs. This care is frequently provided by informal caregivers and the time immediately after discharge is challenging for caregivers with new and/or additional tasks, resulting in anxiety and stress. AIM This study aimed to describe mental health, with particular reference to anxiety and depression and reactions to caregiving, and to investigate any associations between the two, in next of kin of older people with multi-morbidity after hospitalisation. It also aimed to explore the association between the demographic characteristics of the study group and mental health and reactions to caregiving. METHODS This was a cross-sectional questionnaire study using the Hospital Anxiety and Depression Scale and the Caregiver Reaction Assessment. The study group consisted of 345 next of kin of older people (65+) with multi-morbidity discharged home from 13 medical wards in Sweden. Data were analysed using descriptive and analytical statistics. To identify whether reactions to caregiving and next of kin characteristics were associated with anxiety and depression, a univariate logistic regression analysis was performed. RESULTS More than one quarter of respondents showed severe anxiety and nearly one in 10 had severe depressive symptoms. The frequencies of anxiety and depression increased significantly with increased negative reactions to caregiving and decreased significantly with positive reactions to caregiving. Regarding caregiving reactions, the scores were highest for the positive domain Caregiver esteem, followed by the negative domain Impact on health. Women scored significantly higher than men on Impact on health and spouses scored highest for Impact on schedule and Caregiver esteem. CONCLUSIONS Nurses and other healthcare professionals may need to provide additional support to informal caregivers before and after discharging older people with significant care needs from hospital. This might include person-centred information, education and training.
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Affiliation(s)
- Lina Behm
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Eva Björkman
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Gerd Ahlström
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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9
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Oliveira DC, Vass C, Aubeeluck A. The development and validation of the Dementia Quality of Life Scale for Older Family Carers (DQoL-OC). Aging Ment Health 2018; 22:709-716. [PMID: 28282723 DOI: 10.1080/13607863.2017.1293004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Little is known about how caregiving affects the quality of life (QoL) of older family carers and no dementia and age-specific QoL scale is available for use with this population. This study aimed to develop and validate a unique dementia caregiving- and age-specific tool - the 'Dementia Quality of Life Scale for Older Family Carers' (DQoL-OC). METHODS The scale items were identified in focus groups with older family carers in the UK. Content and face validity were evaluated by a panel of six experts. A set of 100 items assessed on a 5-point Likert scale was tested with 182 older family carers. Test-re-test reliability was conducted with 18 individuals. Exploratory factor analysis was used to identify the QoL model and reduce the number of scale items. Convergent construct validity and internal consistency were also established. RESULTS A one-factor solution containing 22 items was obtained. Test-re-test reliability (lower bound r = 0.835; p < 0.001), internal consistency (Cronbach's α = 0.936), and convergent construct validity were established. Significantly lower levels of QoL were found in female older carers; those who perceived their relatives with dementia as being at the earlier stages of the disease and with unstable dementia symptoms; those providing care more hours per day and more days per week; and those in younger-old age. CONCLUSIONS The DQoL-OC is a valid and reliable scale that will be useful for research and in clinical practice with older family carers of people with dementia. These study results will inform future health and social care aiming to improve life quality for this overlooked population of carers.
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Affiliation(s)
- Deborah C Oliveira
- a Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham , Nottingham NG7 2TU , United Kingdom
| | - Catherine Vass
- b Division of Nursing, School of Health Sciences , University of Nottingham , United Kingdom
| | - Aimee Aubeeluck
- b Division of Nursing, School of Health Sciences , University of Nottingham , United Kingdom
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10
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Issues with the measurement of informal care in social surveys: evidence from the English Longitudinal Study of Ageing. AGEING & SOCIETY 2017. [DOI: 10.1017/s0144686x17000757] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTInformal care plays a significant role in the care system for older people in the United Kingdom, and this is projected to increase considerably in the next three decades as the population ages. Understanding these trends requires a good quality measurement of informal care. In this study, we compare care-givers’ responses to different informal care questions from the English Longitudinal Study of Ageing (ELSA) to investigate the influence of question design on the self-reporting of informal care. We also analyse spousal care dyads in order to model discrepancies in the reporting of care provision between spouses to provide an insight into the reliability of informal care measurements. We find that the most common measures used are likely to be under-estimating both the scale and scope of informal care, and we recommend careful consideration of the content of informal care survey questions in order to operationalise the measures of informal care activities.
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11
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Carlsen B, Lundberg K. ‘If it weren't for me…’: perspectives of family carers of older people receiving professional care. Scand J Caring Sci 2017; 32:213-221. [DOI: 10.1111/scs.12450] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/22/2017] [Indexed: 11/26/2022]
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12
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Oliveira D, Vass C, Aubeeluck A. Quality of Life on the Views of Older Family Carers of People with Dementia. DEMENTIA 2017; 18:990-1009. [DOI: 10.1177/1471301217700741] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Deborah Oliveira
- Faculty of Medicine and Health Sciences, University of Nottingham, UK
| | - Catherine Vass
- Faculty of Medicine and Health Sciences, University of Nottingham, UK
| | - Aimee Aubeeluck
- Faculty of Medicine and Health Sciences, University of Nottingham, UK
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The oldest carers: A narrative review and synthesis of the experiences of carers aged over 75 years. Maturitas 2016; 94:161-172. [PMID: 27823738 DOI: 10.1016/j.maturitas.2016.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/04/2016] [Indexed: 11/22/2022]
Abstract
As populations age, numbers of older carers are increasing. These carers play a vital role in supporting others, often partners or spouses with dementia. This narrative review synthesised peer-reviewed evidence published over the last two decades concerning the experiences of carers aged over 75 years, specifically exploring whether their experiences differ from those of younger carers. Four electronic databases were searched and 4102 publications were identified. Eighteen studies involving over one thousand carer participants were included (11 quantitative, 6 qualitative, and 1 mixed-methods study). Most studies came from Europe or North America and almost all were cross-sectional, but few directly compared younger and older carers, making it difficult to determine whether carers' experiences vary with age. Quantitative studies generally emphasised the challenges of caring and frequently highlighted, for example, relationships between carer characteristics and negative outcomes such as burden. Qualitative studies were often more positive, emphasising carers' active responses and the rewards of caring. The normality of caring was highlighted, with some suggesting that caring may be less challenging for older than for younger carers. As with younger carers, being an older carer can be both rewarding and difficult. Our understanding of the experiences of these older carers would be enhanced with more research specifically comparing older and younger carers or comparing older carers and those not in a caring role. Carers are diverse and future research should explore the experiences of carers from different demographic groups. More longitudinal research perhaps focusing on caring dyads and mutual caring is needed.
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Lindvall A, Kristensson J, Willman A, Holst G. Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity. J Gerontol Nurs 2016; 42:24-31. [DOI: 10.3928/00989134-20160615-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/25/2016] [Indexed: 11/20/2022]
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Blusi M, Kristiansen L, Jong M. Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study. Int J Older People Nurs 2014; 10:211-20. [DOI: 10.1111/opn.12074] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 09/29/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Madeleine Blusi
- Department of Research & Development; Association of Local Authorities in Västernorrland County; Härnösand Sweden
- Department of Nursing; Mid-Sweden University; Campus Sundsvall; Sundsvall Sweden
| | - Lisbeth Kristiansen
- Department of Nursing; Mid-Sweden University; Campus Sundsvall; Sundsvall Sweden
| | - Mats Jong
- Department of Nursing; Mid-Sweden University; Campus Sundsvall; Sundsvall Sweden
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Janse B, Huijsman R, de Kuyper RDM, Fabbricotti IN. The effects of an integrated care intervention for the frail elderly on informal caregivers: a quasi-experimental study. BMC Geriatr 2014; 14:58. [PMID: 24885828 PMCID: PMC4021048 DOI: 10.1186/1471-2318-14-58] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/24/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study explored the effects of an integrated care model aimed at the frail elderly on the perceived health, objective burden, subjective burden and quality of life of informal caregivers. METHODS A quasi-experimental design with before/after measurement (with questionnaires) and a control group was used. The analysis encompassed within and between groups analyses and regression analyses with baseline measurements, control variables (gender, age, co-residence with care receiver, income, education, having a life partner, employment and the duration of caregiving) and the intervention as independent variables. RESULTS The intervention significantly contributed to the reduction of subjective burden and significantly contributed to the increased likelihood that informal caregivers assumed household tasks. No effects were observed on perceived, health, time investment and quality of life. CONCLUSIONS This study implies that integrated care models aimed at the frail elderly can benefit informal caregivers and that such interventions can be implemented without demanding additional time investments from informal caregivers. Recommendations for future interventions and research are provided. TRIAL REGISTRATION Current Controlled Trials http://ISRCTN05748494. Registration date: 14/03/2013.
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Affiliation(s)
- Benjamin Janse
- Erasmus University Rotterdam, Institute of Health Policy and Management, P.O. Box 1738, Rotterdam, DR 3000, The Netherlands
| | - Robbert Huijsman
- Erasmus University Rotterdam, Institute of Health Policy and Management, P.O. Box 1738, Rotterdam, DR 3000, The Netherlands
| | | | - Isabelle Natalina Fabbricotti
- Erasmus University Rotterdam, Institute of Health Policy and Management, P.O. Box 1738, Rotterdam, DR 3000, The Netherlands
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Sigurdardottir SH, Kåreholt I. Informal and formal care of older people in Iceland. Scand J Caring Sci 2014; 28:802-11. [DOI: 10.1111/scs.12114] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 12/28/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Sigurveig H. Sigurdardottir
- Faculty of Social Work; School of Social Sciences; University of Iceland; Reykjavik Iceland
- Institute of Gerontology; School of Health Sciences; Jönköping University; Jönköping Sweden
| | - Ingemar Kåreholt
- Institute of Gerontology; School of Health Sciences; Jönköping University; Jönköping Sweden
- Aging Research Center; Karolinska Institutet and Stockholms University; Stockholm Sweden
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Older family carers in rural areas: experiences from using caregiver support services based on Information and Communication Technology (ICT). Eur J Ageing 2013; 10:191-199. [PMID: 28804294 DOI: 10.1007/s10433-013-0260-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The aim of this intervention study was to illuminate the meaning of ICT-based caregiver support as experienced by older family carers living in vast rural areas, caring for a spouse at home. In order to access, the support service participants were provided with a computer and high speed Internet in their homes. Semi structured webcam-interviews were carried out with 31 family carers. A strategy for webcam interviewing was developed to ensure quality and create a comfortable interview situation for the family carers. Interviews were analysed using content analyses, resulting in the themes: Adopting new technology with help from others and Regaining social inclusion. The results indicate that ICT-based support can be valuable for older family carers in rural areas as it contributes to improve quality in daily life in a number of ways. In order to fully experience the benefits, family carers need to be frequent users of the provided support. Adequate training and encouragement from others were essential in motivating family carers to use the support service. Access to Internet and webcamera contributed to reducing loneliness and isolation, strengthening relationships with relatives living far away and enabled access to services no longer available in the area. Use of the ICT-service had a positive influence on the relationship between the older carer and adult grandchildren. It also contributed to carer competence and promote feelings of regaining independence and a societal role.
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Hautsalo K, Rantanen A, Astedt-Kurki P. Family functioning, health and social support assessed by aged home care clients and their family members. J Clin Nurs 2012; 22:2953-63. [PMID: 23228118 DOI: 10.1111/j.1365-2702.2012.04335.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2012] [Indexed: 10/27/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to describe aged home care clients' and their family members' experiences of their family functioning, family health and social support received. An additional purpose was to determine which factors are connected with social support. BACKGROUND Increasing life expectancy and ageing of the population require consideration of the adequacy of home care services and the role of family members as care providers. The older population is a very heterogeneous group because of their variable needs and several disabilities. To ensure the quality of home care, experimental information is needed from clients and their family members. DESIGN A survey design with convenience sampling. METHODS The home care client and a family member of his/her answered a questionnaire together, including background questions, the Family Functioning, Health and Social Support instrument and an open question about support received from home care. Statistical methods were used to describe quantitative data, and content analysis was used in analysing the replies to the open question. RESULTS Family health was noted as good, and family functioning and overall social support fairly good. An older person's higher basic education, higher age of the family member, better family health and male gender were connected with better social support received. The relationship of the older person and the family member as well as the duration of home care service use had an effect on social support received. The content analysis raised expectations related to time, planning of service, organisational factors and caring practise. CONCLUSIONS Home care clients' and families' needs for support vary, and therefore, the assessment of needs, care planning and updating are important. RELEVANCE TO CLINICAL PRACTICE The variable support needs of older people and their family members require flexible and adaptable home services. Cooperation between all participants involved in care would promote the well-being of the older person and the entire family.
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Affiliation(s)
- Katja Hautsalo
- School of Health Sciences, Nursing Science, University of Tampere, Finland, Finland
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van Campen C, de Boer AH, Iedema J. Are informal caregivers less happy than noncaregivers? Happiness and the intensity of caregiving in combination with paid and voluntary work. Scand J Caring Sci 2012; 27:44-50. [PMID: 22571683 DOI: 10.1111/j.1471-6712.2012.00998.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Informal caregivers are one of the pillars of home health care. In the Netherlands, the free help they provide to sick or disabled family members, acquaintances or friends exceeds the number of hours of home care provided by professionals. While the government welcomes their contribution, there is concern about the potential burden their work imposes on them. On the one hand, there is concern that informal caregiving could be experienced as a burden and diminish subjective well-being; on the other, helping others as a meaningful activity might increase their subjective well-being. Happiness ratings (as an indicator of subjective well-being) of persons whose involvement in informal caregiving, voluntary work and paid work ranged from none to full time were analysed using multivariate regression models, which also took into account levels of physical disability and socio-economic characteristics (age, sex, household composition, education level). The sample consisted of 336 informal caregivers and 1765 noncaregivers in the Dutch population. In line with the subjective well-being assumption, the results suggest that caregivers are happier than noncaregivers when they provide care for <6 hours a week; and in line with the burden assumption, the results show that providing care for more than 11 hours a week is associated with lower levels of happiness. Other results contradicted the burden assumption that combining caregiving with paid or voluntary work is associated with more time burden and less happiness. The result that combining caregiving with paid employment or volunteering is related to higher rates of happiness confirms the subjective well-being assumption. It is concluded that these cross-sectional results open ways to longitudinal research that can inform governments in the development of policies to support informal caregivers.
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Affiliation(s)
- Cretien van Campen
- Netherlands Institute for Social Research / SCP, The Hague, The Netherlands.
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Erlingsson CL, Magnusson L, Hanson E. Family caregivers' health in connection with providing care. QUALITATIVE HEALTH RESEARCH 2012; 22:640-55. [PMID: 22203389 DOI: 10.1177/1049732311431247] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Our aim was to investigate connections between Swedish family caregivers' health and providing care for an ill relative by conducting a systematic search and synthesis of previous research. We analyzed 31 articles using first qualitative content analysis then hermeneutic analysis. Analysis resulted in three derived themes-sliding sideways into caregiving, caregiving in reciprocity, and caregiving in disintegration-and a main interpretation and conceptual model of Swedish family caregivers' health-caregiving in a sphere of beliefs. Results indicated that Swedish family caregivers' beliefs, experiences of reciprocity, or nonsupport, together with quality of interpersonal relationships and feelings of responsibility and guilt, have a profound impact on their health. These results point to the value and importance of nurses gaining an understanding of family caregivers' beliefs and experiences of reciprocity or nonsupport to effectively promote family caregivers' health.
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Hounsgaard L, Pedersen B, Wagner L. The daily living for informal caregivers with a partner with Parkinson’s disease - an interview study of women’s experiences of care decisions and self-management. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2011.01126.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sigurdardottir SH, Sundstrom G, Malmberg B, Bravell ME. Needs and care of older people living at home in Iceland. Scand J Public Health 2011; 40:1-9. [PMID: 21983193 DOI: 10.1177/1403494811421976] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Icelandic old-age care system is universal and the official goal is to support older people live independently for as long as possible. The aim of this study is to analyse living conditions and use of formal and informal care of older people in Iceland. METHODS The results are based on the new study ICEOLD, a telephone survey which included questions on social network, health, activities of daily living, and received support from the community and/or from relatives, neighbours, and friends. RESULTS Almost half of the sample (47%) receives some kind of care, with 27% of them receiving only informal care, which is understood to mean that informal care is of great importance and families are the main providers of help. For hypothetical future long-term care, older people wish to be cared for in their homes, but those already in need of assistance prefer to be cared for in institutions. DISCUSSION Caring relatives are the main providers of support to older people in their homes and it is important to provide them with suitable formal support when the care responsibility increases. CONCLUSIONS As the care system in Iceland is now under reconstruction, the important contribution of informal carers must be recognised and taken into account when planning the care of older people.
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Abstract
BACKGROUND Numerous studies have examined the caregiver burden that family caregivers often experience. However, caregiving situations may also include positive elements that have recently received greater research attention. AIM The aim was to examine the positive value and negative impact of caregiving for the family caregiver. METHOD Caregiving experience was measured with the modified 15-item Carers of Older People in Europe Index. Surveys were completed by family caregivers at the baseline and after 6 months. RESULTS At the baseline, most family caregivers thought that caregiving was worthwhile, had a good relationship with the person they cared for and coped well as a caregiver. Fifty-five per cent of the respondents did not feel trapped in their caregiver role, though a third did, and a majority found caregiving to be too demanding. Most perceived themselves to be supported by their family, while 40% did not feel supported by health and social services. During the 6-month study period, the negative impact score declined, and the scores for positive value and quality of support improved. The care recipient's management at home (p < 0.001) was the single best predictor of the negative impact on the family caregiver; the family caregiver's older age (p < 0.01) best predicted the quality of support; and the family caregiver's good relationship with the care recipient (p < 0.01) best predicted the positive value of caregiving. CONCLUSIONS The study indicated that even if the health status of the care recipient dramatically worsened, the family caregiver's experiences of caregiving became more positive. This is because family caregiving was perceived to be worthwhile, most family caregivers had a close relationship with the person they cared for and they received support from their family. Interventions that focus on family caregivers' positive experiences of caregiving would be important in protecting them from the negative consequences of caregiving.
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Affiliation(s)
- Maisa Toljamo
- National Institute for Health and Welfare (THL), Helsinki, Finland.
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Ferreira CG, Alexandre TDS, Lemos ND. Fatores associados à qualidade de vida de cuidadores de idosos em assistência domiciliária. SAUDE E SOCIEDADE 2011. [DOI: 10.1590/s0104-12902011000200012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
O objetivo do presente estudo foi investigar se o comportamento da qualidade de vida (QV) de cuidadores de idosos em assistência domiciliária pode ser influenciado por características sociodemográficas, pela rede de suporte oferecida ao cuidador e por variáveis relacionadas ao ato de cuidar. Foram entrevistados 40 cuidadores de idosos de um Programa de Assistência Domiciliária da cidade de São Paulo. A QV foi mensurada utilizando-se a versão brasileira do Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36). Características sociodemográficas, as variáveis relacionadas à rede de suporte oferecida ao cuidador e ao ato de cuidar foram obtidas por meio de questionário complementar. A análise de regressão linear mostrou relação independente entre três domínios do SF-36 e o maior número de horas dedicadas ao cuidado: domínios capacidade funcional, aspecto físico e aspecto emocional. Possuir mais de oito anos de escolaridade implicou em melhor pontuação no domínio estado geral de saúde e pior pontuação no domínio aspecto social. Os cuidadores com mais de 60 anos de idade apresentaram pior pontuação no domínio aspecto físico e as mulheres pior pontuação no domínio dor. Os filhos ou cônjuges que prestam cuidado aos seus pais ou parceiros apresentaram pior pontuação no domínio aspecto emocional. Os cuidadores que modificaram sua rotina para prestar os cuidados apresentaram pior pontuação no domínio saúde mental. Tanto fatores sociodemográficos como a rede de suporte oferecida ao cuidador e os fatores relacionados à dinâmica do cuidado são capazes de influenciar negativamente a QV de cuidadores principais de idosos em atendimento domiciliário.
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O’Connor M. The challenge of recruiting control groups. An experiment of different recruitment models in the control group of a clinical psychological postal survey. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s11135-010-9423-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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O'Connor M, Lasgaard M, Shevlin M, Guldin MB. A confirmatory factor analysis of combined models of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: are we measuring complicated grief or posttraumatic stress? J Anxiety Disord 2010; 24:672-9. [PMID: 20510576 DOI: 10.1016/j.janxdis.2010.04.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 02/26/2010] [Accepted: 04/18/2010] [Indexed: 10/19/2022]
Abstract
The aim of this study was to assess the factorial structure of complicated grief (CG) and investigate the relationship between CG and posttraumatic stress disorder (PTSD) through the assessment of models combining both constructs. The questionnaire was completed by elderly, married respondents with a history of at least one significant, interpersonal loss (145 males and 147 females, 60-81 years). Confirmatory factor analysis (CFA) supported a two-factor model of separation and traumatic distress in CG. To investigate the relationship between CG and PTSD three combined models were specified and estimated using CFA. A model where all five factors, the two factors of CG and the three factors of PTSD, as defined by the DSM-IV, were allowed to correlate provided the best fit. The results indicated a considerable overlap between the dimensions of CG and PTSD, and complicated grief is construct that appears to be largely accounted for by especially the intrusive component of PTSD.
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Affiliation(s)
- Maja O'Connor
- Department of Psychology, Aarhus University, Jens Chr. Skousvej 4, 8000 Arhus C, Denmark.
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Abstract
OBJECTIVE The aim of the study was to investigate the experience of being next of kin to an older person in the last phase of life as narrated after the older person's death. METHOD Qualitative interviews were performed with the next of kin (n = 17) to people aged 75 years and older who had recently died and had received help and/or care from the municipality in the last phase of life. Eleven women and six men participated, of whom seven were spouses, nine were children, and one was a grandchild. The interviews were analysed using qualitative content analysis. RESULTS The experience of the next of kin could be understood as being a devoted companion during the transition toward the inevitable end, embracing the categories of living in the shadow of death; focusing on the needs of the dying person, making adjustments to everyday life; feeling the major responsibility; struggling with the health and social care system; and gaining strength from support. SIGNIFICANCE OF RESULTS Being next of kin to an old person at the end of life means being a devoted companion during the transition toward the inevitable end, including the feeling of bearing the major responsibility and the need to be acknowledged by professionals. This study points to the importance of having access to professional care when it is needed, to complement and support the next of kin when his or her own resources and strength falter. This also includes support to enable the next of kin to remain involved in the care of his or her loved ones, thereby fulfilling their own wishes.
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Molzahn AE, Gallagher E, McNulty V. Quality of life associated with adult day centers. J Gerontol Nurs 2009; 35:37-46. [PMID: 19681562 DOI: 10.3928/00989134-20090706-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Accepted: 04/29/2009] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to describe the quality of life (QOL) of current adult day center (ADC) clients and their family caregivers in one region of Canada. Semi-structured interviews were conducted with 10 ADC clients and 10 caregivers. Data analysis used a modified constant comparative method. The major categories relating to QOL that emerged in the analysis included Physical Health and Well-Being, Social Networks/Relationships, Aging in Place, Safety, Respite, Activation, Respect and Inclusion, and Adequate Health Care Services. These themes are consistent with those of other studies of QOL of older adults. It was evident that ADCs played an important role in maintaining and improving the QOL of both the older adults and caregivers participating in this study.
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Affiliation(s)
- Anita E Molzahn
- University of Alberta, 3rd Floor Clinical Sciences Building, Edmonton, Alberta T6G 2G3, Canada.
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Salin S, Kaunonen M, Astedt-Kurki P. Informal carers of older family members: how they manage and what support they receive from respite care. J Clin Nurs 2009; 18:492-501. [PMID: 19191998 DOI: 10.1111/j.1365-2702.2008.02550.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To describe informal carers' coping strategies and their experiences of the support provided by respite care. BACKGROUND The target set in the Finnish national old age policy strategy is that 90% of the population over 75 should be able to live at home. A major source of support for older people and their families is respite care in an institution. DESIGN Survey. METHODS The data were collected among informal carers who regularly use respite care services (n = 143). Two structured questionnaires were used: the Carers' Assessment of Managing Index (Nolan et al. 1995) and an index developed by the researchers. RESULTS Informal carers who provided care for younger individuals or people who needed less help had a better quality of life. Spouse carers and older informal carers were less satisfied with their quality of life than younger carers. Periods of respite care had a major influence on informal carers' quality of life: 93% said they felt invigorated. Care periods remained rather isolated episodes in the lives of the older patients in that there was hardly any discussion at the institution about the family's situation, the objectives of respite care, or about how the informal carer was coping. Altogether, 47% of the nurses remained fairly distant. The most useful coping strategies involved creating alternative perspectives in the caring relationship. CONCLUSIONS The results strengthen the knowledge base of informal caregiving by showing how caregivers cope and what kind of support they need in their demanding caring role. RELEVANCE TO CLINICAL PRACTICE Respite care nurses should invest greater effort in supporting informal carers. The service should be developed as an integral part of home care for older people. Nurses and informal carers should see each other as partners who share a common goal, i.e. the well-being of the entire family.
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Affiliation(s)
- Sirpa Salin
- Department of Nursing Science, University of Tampere, Finland.
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Ziegert K, Fridlund B, Lidell E. “Time for dialysis as time to live”: Experiences of time in everyday life of the Swedish next of kin of hemodialysis patients. Nurs Health Sci 2009; 11:45-50. [DOI: 10.1111/j.1442-2018.2009.00429.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sandberg J, Eriksson H. From alert commander to passive spectator: older male carers' experience of receiving formal support. Int J Older People Nurs 2009; 4:33-40. [PMID: 20925799 DOI: 10.1111/j.1748-3743.2008.00147.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aim. The aim was to describe older male carers' experience of receiving formal support. Background. To older male carers, creating new roles seems to be important. Their need for support in their caregiving is poorly understood. Design. A qualitative approach with a critical perspective on men and masculinities was used. Participants. Focus groups comprising a total of 11 men were used. Methods. Qualitative content analysis was adopted. Results. Three categories of response were found: 'using ad hoc solutions for maintaining a protective environment', 'coping but being left behind' and 'recapturing the caregiving role'. Discussion. Not only the quantity of support services offered to older male carers but also their quality dimension, based on a genuine understanding of the men's support needs, must be addressed. Conclusions. Professional caregivers attempt to relieve the men of their care obligations entirely. A reciprocal arrangement involving the men as partners, instead, may help them to regard their caring experience as valuable, which is important to their self-image. Relevance to clinical practice. These men's socially based networks need to be recognized by professional caregivers as important, to reframe the men's identity and notion of masculinity.
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Affiliation(s)
- Jonas Sandberg
- Senior Lecturer, Department of Caring Sciences, Ersta Sköndal University College, Stockholm, SwedenAssociate Professor, Department of Caring and Public Health Sciences, Malardalen University, Eskilstuna, Sweden
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The impact of gender regarding psychological well-being and general life situation among spouses of stroke patients during the first year after the patients’ stroke event: A longitudinal study. Int J Nurs Stud 2008; 45:257-65. [DOI: 10.1016/j.ijnurstu.2006.08.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Revised: 08/21/2006] [Accepted: 08/30/2006] [Indexed: 11/23/2022]
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Kristensson J, Hallberg IR, Jakobsson U. Healthcare consumption in men and women aged 65 and above in the two years preceding decision about long-term municipal care. HEALTH & SOCIAL CARE IN THE COMMUNITY 2007; 15:474-85. [PMID: 17685993 DOI: 10.1111/j.1365-2524.2007.00706.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The aim was to investigate healthcare consumption in men and women aged 65 and above in the two years preceding decision about long-term municipal care at home or in special accommodation and to investigate determinants for healthcare consumption. The study comprised 362 people (aged 65 or over), all subject to a decision about municipal care and/or services during 2002-2003, drawn from the Swedish National Study on Aging and Care (SNAC). Data were collected from three existing registers, the SNAC data covered age, gender, marital status, functional ability, informal care and living conditions and were merged with the Skåne County Council's patient administration system PASiS and PrivaStat covering healthcare consumption from the year 2000 and forward. About 50% of the acute hospital stays (n = 392) occurred within 5 months prior to municipal care. The men (n = 115, mean age 80.8) had significantly longer stays in hospital (P = 0.025), more diagnoses (P = 0.004) and contacts with other staff groups beside physicians in outpatient care (P < 0.001) compared to the women (n = 247, mean age 83.8). The regression analysis showed heart conditions, cancer, musculoskeletal problems, genitourinary diseases, injuries and unspecified symptoms to be significantly associated with various kinds of healthcare consumption. The findings indicated a breakpoint in terms of hospital admissions about 5 months prior to municipal care and service and a share of 15% having several admissions to hospital. Early detection and preventive interventions to these people in a transitional stage of becoming increasingly dependent on continuous care and services seems urgent to prevent escalating acute healthcare consumption.
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Affiliation(s)
- Jimmie Kristensson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
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Franzén-Dahlin A, Larson J, Murray V, Wredling R, Billing E. Predictors of psychological health in spouses of persons affected by stroke. J Clin Nurs 2007; 16:885-91. [PMID: 17462038 DOI: 10.1111/j.1365-2702.2006.01744.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To identify predictors of psychological health and examine if these predictors change over time in spouses of stroke patients during the first year after stroke. A second aim was to identify gender differences in psychological health among the spouses. BACKGROUND The impact of burden in long-term caregivers may result in psychological consequences for the spouse. The rehabilitation process for the patient can be negatively affected by a stressed caregiver and result in long-term hospitalization. To identify spouses at risk for physical and psychological distress is, therefore, essential to support those in need. DESIGN Longitudinal, comparative study. METHODS One hundred spouses of stroke patients were assessed at baseline, as well as after six and 12 months, regarding psychological health, well-being, own illness, need of assistance from general practitioner and/or district nurse, social network and knowledge about stroke. Stepwise multiple regression analyses were conducted for baseline, six- and 12-month assessments, respectively, with psychological health as the dependent variable. RESULTS General well-being and presence of illness in spouse were the most prominent predictors of psychological health, throughout the first year. CONCLUSIONS Enhancing psychological health and preventing medical problems in the caregiver are essential considerations to enable patients with stroke-related disabilities to continue to live at home. RELEVANCE TO CLINICAL PRACTICE Evaluating the situation for spouses of stroke patients is an important component when planning for the future care of the patient.
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Ekwall AK, Hallberg IR. The association between caregiving satisfaction, difficulties and coping among older family caregivers. J Clin Nurs 2007; 16:832-44. [PMID: 17462034 DOI: 10.1111/j.1365-2702.2006.01382.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
AIMS AND OBJECTIVES The aim was to study the association between gender, extent and content of care, satisfaction, coping and difficulties in the caregiving situation among older (75+) caregivers and to identify clusters of caregivers. The aim was also to explore psychometrically two instruments assessing satisfaction and difficulties in family caregivers. BACKGROUND Caregiving is a complicated phenomenon. Much of the research has focused on negative aspects, such as the burden, stress and emotional strain. Caregiving is known to affect health negatively for the caregivers. Little is known about satisfaction and motivation in voluntary work, such as informal caregiving, especially among older persons. DESIGN AND METHODS Cross-sectional. The sample for this study consisted of 171 informal caregivers aged 75 and over, identified from an age-stratified sample in a postal survey among older people in the southern part of Sweden. RESULTS Male caregivers proved to be more satisfied than female caregivers; caregiving had seemingly widened their horizon and had helped them to grow as persons. Based on satisfaction scores, those satisfied had a higher proportion of male caregivers and a significantly higher amount of caregiving hours per week. They used other coping strategies than the respondents in the other cluster, i.e. less satisfied in using more problem-solving strategies. CONCLUSIONS The instruments tested were appropriate for work in clinical and research settings, although the internal dropout indicates that a shorter version would be more useful. Those who found satisfaction in care used more problem-focused coping strategies and were more often men than women. From a salutogenic point of view, this may give important knowledge about factors that can promote health. The findings indicate that women deserve extra attention as informal caregivers as they did not find caregiving as rewarding as the men did. This may in turn make them less protected against the negative consequences of caregiving. RELEVANCE TO CLINICAL PRACTICE Reinforcing the health-promoting qualities in caregivers who are not feeling well, with women as a particularly vulnerable group, may restrict unnecessary suffering for both the caregiver and the person cared for.
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Ekwall AK, Sivberg B, Hallberg IR. Older caregivers? coping strategies and sense of coherence in relation to quality of life. J Adv Nurs 2007; 57:584-96. [PMID: 17346317 DOI: 10.1111/j.1365-2648.2006.03994.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM This paper reports a study to investigate coping strategies and sense of coherence in relation to gender, the extent of care, caregiving activities and health-related quality of life in a population-based sample of caregivers aged 75 and over. BACKGROUND Caring for another person can be stressful both emotionally, and caregiver burden may affect quality of life in a negative way for the carer. Caregivers' experience of burden may depend on for example, the behaviour of the person cared for, their own health and their sense of coherence. Older people take a great part of caregiving responsibility and thus understanding of their strain and coping is required. METHODS A postal survey was carried out in 2001 with 171 informal caregivers, aged 75 or older. The response rate was 47%. The questionnaire included the Short-Form 12, Carer's Assessment of Managing Index, and Sense of Coherence instrument. RESULTS Almost 70% of caregivers provided help every day. Higher health-related quality of life was predicted by using self-sustaining coping strategies and by high sense of coherence. Poor economic situation and demanding social and practical support predicted low scores. CONCLUSION These findings could help identify those at risk of low quality of life due to caregiving, dysfunctional coping or lack of information about care. Early intervention, including education about alternative coping strategies and practical information, might allow caregivers better possibilities to continue caring with less negative effects on their lives.
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Sanders S. Experiences of rural male caregivers of older adults with their informal support networks. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2007; 49:97-115. [PMID: 17953064 DOI: 10.1300/j083v49n04_06] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
More male caregivers are assuming primary caregiving roles for older adults with chronic health conditions. One of the main sources of support for many caregivers is the assistance that is provided by members of their informal support network. Little is known about the relationship between male caregivers and their informal support networks. This qualitative study examines the experience of male caregivers with their informal support networks, specifically looking at two phenomena: (1) Perceptions of the male caregivers about the willingness of their informal support networks to provide caregiving assistance and (2) Willingness of the male caregivers to ask their informal support networks for assistance. Twenty male caregivers were recruited across a rural Midwestern state. Each male caregiver engaged in two interviews that lasted between 60 and 120 minutes. Seven themes emerged from the data about the male caregivers experience with their informal support networks. Results from this study have implications for geriatric health professionals who work with male caregivers to obtain the necessary amount of caregiving assistance.
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Affiliation(s)
- Sara Sanders
- School of Social Work, The University of Iowa, 355 North Hall, Iowa City, IA 52242, USA
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Larson J, Franzén-Dahlin A, Billing E, Arbin M, Murray V, Wredling R. Predictors of quality of life among spouses of stroke patients during the first year after the stroke event. Scand J Caring Sci 2005; 19:439-45. [PMID: 16324071 DOI: 10.1111/j.1471-6712.2005.00369.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stroke, a disease with severe consequences for patients and their families, often lead to psychosocial stress, and a decline in the quality of life (QoL) among carers. Predicting the QoL is essential in the development of effective nursing support interventions. AIM The aim of the present study was to identify predicting factors for the general QoL among spouses of stroke patients, and to determine whether these predictors change during the first year after the patient's stroke event. DESIGN One hundred spouses were followed three times during 1 year regarding QoL, own illness, economic situation, well being, life situation, sense of coherence, social network and the patients' ability in activities of daily living (ADL). Stepwise multiple linear regression analyses were conducted for the baseline, 6- and 12-month assessments respectively, with the present QoL as the dependent variable. RESULTS Over time during the first year after the patients' stroke event, there were significant differences in the spouses perceived general QoL. Life situation and economic situation were the only predictors of the spouses' QoL, which emerged during the entire year after the patient's stroke event, while well being, education, own illness, social network and ADL ability (patient) emerged at one or two occasions. CONCLUSION The psychosocial factors -- life situation, well being, social network, education and economy -- are important in predicting QoL among spouses of stroke patients, and these predicting factors change over time. Determining the predictors at an early stage, and continuously over time, will help to focus clinical nursing interventions on the spouses' changing needs.
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Affiliation(s)
- Jenny Larson
- Department of Nursing, Karolinska Institutet, Stockholm, Sweden.
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