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Riekkola J, Isaksson G, Lilja M, Rutberg S. 'Possibilities and challenges for older couples to continue ageing in place'. J Aging Stud 2024; 69:101229. [PMID: 38834252 DOI: 10.1016/j.jaging.2024.101229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 04/09/2024] [Accepted: 04/20/2024] [Indexed: 06/06/2024]
Abstract
Ageing in place is an imminent concern for both older couples and communities. Identifying ways to support ageing in place is required to meet the needs and challenges of older couples and social services systems. Through focus groups with a total of 46 participants and a constant comparative methodology, this study aimed to explore and describe the experiences and reasoning of spousal carers, healthcare professionals, and stakeholders regarding possibilities for older couples to age in place. The findings consisted of one main category, 'Facilitating ageing in place is a win-win situation with challenges' and four interrelated categories, 'Focus on older couples - building relationships and providing adequate services', 'Engaged civil society as a source of care and social inclusion,' 'Motivated professionals with competence and time,' and 'Services working together for a sustainable society,' that present possibilities and challenges for ageing in place. This study suggests that facilitating ageing in place is possible but involves a complex series of challenges that can be linked to different contexts ranging from individuals and couples to civil society, services provided, organisational systems, and existing resources. All these aspects need to be considered and balanced to achieve a situation that contributes to older couples' possibilities to age in place as well as to a sustainable society.
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Affiliation(s)
| | - Gunilla Isaksson
- Luleå University of Technology, Department of Health, Education and Technology, Sweden
| | - Margareta Lilja
- Luleå University of Technology, Department of Health, Education and Technology, Sweden
| | - Stina Rutberg
- Luleå University of Technology, Department of Health, Education and Technology, Sweden.
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Iacob E, Caserta M, Donaldson G, Sparks C, Terrill A, Thompson A, Wong B, Utz RL. Evaluating the Efficacy of Time for Living and Caring: An Online Intervention to Support Dementia Caregivers' Use of Respite. Innov Aging 2024; 8:igae043. [PMID: 38803611 PMCID: PMC11129597 DOI: 10.1093/geroni/igae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Indexed: 05/29/2024] Open
Abstract
Background and Objectives Respite, defined as time away from caregiving, is the most requested type of caregiver support. Time for Living and Caring (TLC) is a virtual coaching "app" that helps caregivers schedule and plan their respite time-use. The objectives of this analysis are: (1) to assess the efficacy of the TLC intervention on respite time-use and on caregiver well-being and (2) to identify the key features of the intervention that serve as the likely mechanism of action. Research Design and Methods A sample of dementia caregivers (n = 163, 79% female, 84% White, 6% Hispanic, average age 62) were randomized into one of two intervention delivery methods. Intervention efficacy was evaluated using pre/post-comparisons of respite time-use and an additive "dosing" model that estimated unique parameters associated with the exposure to each specific intervention component. Results Both immediate and delayed-attention groups reported increased respite time. They also improved in their ability to plan and perceive benefit from their respite time-use over the 16-week intervention period. At 8 weeks, the immediate group did not change in anxiety, whereas the delayed group worsened (p < .001). At 16 weeks, the groups were similar in their anxiety levels. By the 20-week follow-up period, when neither group had access to TLC, both experienced an increase in anxiety. Discussion and Implications TLC is a promising intervention that may support caregivers' well-being, by helping them schedule and plan their respite to maximize its benefit. The provision of weekly coaching seems to be the intervention component (mechanism) associated with caregiver outcomes. Clinical Trial Registration NCT03689179.
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Affiliation(s)
- Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Michael Caserta
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Gary Donaldson
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Catharine Sparks
- College of Health, University of Utah, Salt Lake City, Utah, USA
| | | | - Amber Thompson
- College of Social and Behavioral Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Rebecca L Utz
- College of Social and Behavioral Sciences, University of Utah, Salt Lake City, Utah, USA
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Castro A, Lalonde-LeBlond G, Freitas Z, Arnaert A, Bitzas V, Kildea J, Moffatt K, Phillips D, Wiseblatt L, Hall AJ, Després V, Tsimicalis A. In-Home Respite Care Services Available to Families With Palliative Care Needs in Quebec: Novel Digital Environmental Scan. JMIR Nurs 2024; 7:e53078. [PMID: 38625735 PMCID: PMC11061788 DOI: 10.2196/53078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/12/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Caregiving dyads in palliative care are confronted with complex care needs. Respite care services can be highly beneficial in alleviating the caregiving burden, supporting survivorship and dying at home. Yet, respite care services are difficult to locate and access in the province of Quebec, Canada, particularly when navigating ubiquitous sources of online health information of varying quality. OBJECTIVE This project aimed to (1) compile a list of at-home palliative respite care services in Quebec, Canada; (2) describe key accessibility features for each respite care service; (3) identify accessibility gaps and opportunities; and (4) describe a novel method for conducting environmental scans using internet search engines, internet-based community health databases, and member checking. METHODS A novel environmental scan methodology using 2 internet-based targeted databases and 1 internet search engine was conducted. Results were screened and data were extracted, descriptively analyzed, and geographically schematized. RESULTS A total of 401 services were screened, and 52 at-home respite care services specific to palliative populations were identified, compiled, and analyzed. These respite care services were characterized by various types of assistance, providers, fees, and serviced geographical regions. Accessibility was explored through the lens of service amenability, availability, eligibility, and compatibility. The data revealed important barriers to accessing respite care services, such as a lack of readily available information on service characteristics, limited availability, and a time-consuming, technical search process for potential respite care users and clinicians to identify appropriate services. CONCLUSIONS Both methodological and contextual knowledge have been gained through this environmental scan. Few methodologies for conducting internet-based environmental scans have been clearly articulated, so we applied several learnings from other scans and devised a methodology for conducting an environmental scan using the mixed methods of internet search engines, internet-based community health databases, and member checking. We have carefully reported our methods, so that others conducting community health environmental scans may replicate our process. Furthermore, through this scan, we identified assorted respite care services and pinpointed needs in the provision of these services. The findings highlighted that more easily accessible and centralized information about respite care services is needed in Quebec. The data will enable the creation of a user-friendly tool to share with community support services across Quebec and ultimately help alleviate the added burden caregivers and clinicians face when looking for respite care services in fragmented and complex digital spaces.
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Affiliation(s)
- Aimee Castro
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | - Zelda Freitas
- Professional Practice Directorate of Rehabilitation and Multidisciplinary Services, CIUSSS West-Central Montreal, Montreal, QC, Canada
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Antonia Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Vasiliki Bitzas
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Geriatrics and Palliative Care, CIUSSS West-Central Montreal, Montreal, QC, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Karyn Moffatt
- School of Information Studies, McGill University, Montreal, QC, Canada
| | - Devon Phillips
- Palliative Care McGill, McGill University, Montreal, QC, Canada
| | | | - Audrey-Jane Hall
- Palliative Home-Care Society of Greater Montreal, Montreal, QC, Canada
| | - Véronique Després
- St-Raphaël Palliative Care Home and Day Centre, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, QC, Canada
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Utz RL, Caserta M, Iacob E, Sparks C, Stark L, Terrill A, Thompson A, Wong B. Maximizing the Benefit of Respite for Dementia Caregivers: A Study Protocol Describing the Development & Evaluation of the Time for Living & Caring (TLC) Intervention. OBM INTEGRATIVE AND COMPLIMENTARY MEDICINE 2023; 8:040. [PMID: 38313766 PMCID: PMC10838170 DOI: 10.21926/obm.icm.2304040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Dementia caregivers are susceptible to adverse physical and mental health outcomes, given the often prolonged and challenging care and support they provide to family members with Alzheimer's Disease and Related Dementias (ADRD). This report describes a community-engaged implementation of a novel behavioral intervention - an "app" (interactive website) called TLC (Time for Living and Caring) that coaches caregivers on how to maximize the benefits associated with respite time. The rationale and features of the TLC intervention and the full research protocol used to develop and then evaluate its feasibility, acceptability, and initial efficacy are described here.
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Affiliation(s)
- Rebecca L. Utz
- University of Utah, College of Social and Behavioral Sciences, 260 South Central Campus Drive, Salt Lake City, UT, USA
| | - Michael Caserta
- University of Utah, College of Nursing, 10 S. 2000 E., Salt Lake City, UT, USA
| | - Eli Iacob
- University of Utah, College of Nursing, 10 S. 2000 E., Salt Lake City, UT, USA
| | - Catharine Sparks
- University of Utah, College of Social and Behavioral Sciences, 260 South Central Campus Drive, Salt Lake City, UT, USA
| | - Louisa Stark
- University of Utah, School of Medicine, 27 S. Mario Capecchi Dr, Salt Lake City, UT, USA
| | - Alexandra Terrill
- University of Utah, College of Health, 15 N 2030 East, Salt Lake City, UT, USA
| | - Amber Thompson
- University of Utah, College of Social and Behavioral Sciences, 260 South Central Campus Drive, Salt Lake City, UT, USA
| | - Bob Wong
- University of Utah, College of Nursing, 10 S. 2000 E., Salt Lake City, UT, USA
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van der Putten GJ, de Baat C. An Overview of Systemic Health Factors Related to Rapid Oral Health Deterioration among Older People. J Clin Med 2023; 12:4306. [PMID: 37445340 DOI: 10.3390/jcm12134306] [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: 04/24/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. This paper aims to present an overview of the published evidence on systemic health factors that contribute to rapid oral health deterioration in older individuals, and to explore the implications of these factors for both general healthcare and oral healthcare provision. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal caregivers. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome.
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Affiliation(s)
- Gert-Jan van der Putten
- Orpea Dagelijks Leven, 7327 AA Apeldoorn, The Netherlands
- Department of Dentistry, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Cees de Baat
- Fresh Unieke Mondzorg, 2411 NT Bodegraven, The Netherlands
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Castro AR, Arnaert A, Moffatt K, Kildea J, Bitzas V, Tsimicalis A. Developing an mHealth Application to Coordinate Nurse-Provided Respite Care Services for Families Coping With Palliative-Stage Cancer: Protocol for a User-Centered Design Study. JMIR Res Protoc 2021; 10:e34652. [PMID: 34898464 PMCID: PMC8713105 DOI: 10.2196/34652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background Patients living with palliative-stage cancer frequently require intensive care from their family caregivers. Without adequate community support services, patients are at risk of receiving inadequate care, and family caregivers are at risk for depression and poor health. For such families, in-home respite care can be invaluable, particularly when the services are flexible and staffed by trusted care providers, such as nurses. Other industries are using mobile apps to make services more flexible. However, few apps have been developed to coordinate nurse-provided respite care services, and to our knowledge, none have been designed in conjunction with families affected by cancer. Objective The aim of this study is to develop a mobile health (mHealth) app prototype for coordinating flexible and trusted in-home respite care services provided by nurses to families coping with palliative-stage cancer in Québec, Canada. Methods This user-centered design research comprises the core component of the iRespite Services iRépit research program. For this study, we are recruiting 20 nurses, 15 adults with palliative-stage cancer, and 20 of their family caregivers, from two palliative oncology hospital departments and one palliative home-care community partner. Overseen by an Expert Council, remote data collection will occur over three research phases guided by the iterative Information Systems Research Framework: Phase 1, brainstorming potential app solutions to challenging respite care scenarios, for better supporting the respite needs of both family caregivers and care recipients; Phase 2, evaluating low-fidelity proofs of concept for potential app designs; and Phase 3, usability testing of a high-fidelity interactive proof of concept that will then be programmed into an app prototype. Qualitative and quantitative data will be descriptively analyzed within each phase and triangulated to refine the app features. Results We anticipate that preliminary results will be available by Spring 2022. Conclusions An app prototype will be developed that has sufficient complimentary evidence to support future pilot testing in the community. Such an app could improve the delivery of community respite care services provided to families with palliative-stage cancer in Québec, supporting death at home, which is where most patients and their families wish to be. International Registered Report Identifier (IRRID) PRR1-10.2196/34652
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Affiliation(s)
- Aimee R Castro
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Antonia Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Karyn Moffatt
- School of Information Studies, McGill University, Montreal, QC, Canada
| | - John Kildea
- Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Vasiliki Bitzas
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
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Lee Y, Bierman A, Penning M. Psychological Well-Being Among Informal Caregivers in the Canadian Longitudinal Study on Aging: Why the Location of Care Matters. J Gerontol B Psychol Sci Soc Sci 2020; 75:2207-2218. [PMID: 32906145 PMCID: PMC7664311 DOI: 10.1093/geronb/gbaa159] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objectives A caregiving stress perspective suggests that caregiving harms psychological well-being in informal caregivers, whereas a caregiving rewards perspective suggests that provision of care benefits psychological well-being. This research examines whether both perspectives apply to caregiving experiences, but differently by the primary location of caregiving (i.e., in-home, other residence, and institution), as well as by gender. Methods We analyzed depression and life satisfaction in the nationally representative Canadian Longitudinal Study on Aging (N = 48,648), first comparing noncaregivers (N = 27,699) to a combined caregiver group (N = 20,949) and then stratifying caregivers by the primary location of care. Results When considered as a single group, caregivers suffered relative to noncaregivers in terms of life satisfaction and depression. When stratified by the location of care, only in-home caregivers reported both greater depression and lower life satisfaction. Nonresidential caregivers did not differ significantly in levels of depression from noncaregivers and reported higher life satisfaction. Institutional caregivers reported greater depression than noncaregivers, but did not differ significantly in life satisfaction. These patterns were stronger among women than men. Discussion Both the caregiving stress and caregiving rewards perspectives are applicable to the caregiving experience, with the stress perspective more applicable to in-home caregivers and the rewards perspective more relevant to nonresidential caregivers. Recommendations include targeted practice focused on the location of care as well as the gender of the caregiver. Given that nonresidential caregivers actually benefit from providing care, interventions need to focus on identifying and bolstering positive aspects of the caregiving experience.
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Affiliation(s)
- Yeonjung Lee
- Faculty of Social Work, University of Calgary, Alberta, Canada
| | - Alex Bierman
- Department of Sociology, University of Calgary, Alberta, Canada
| | - Margaret Penning
- Department of Sociology, University of Victoria, British Columbia, Canada
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Riekkola J, Rutberg S, Lilja M, Isaksson G. Healthcare professionals' perspective on how to promote older couples' participation in everyday life when using respite care. Scand J Caring Sci 2018; 33:427-435. [PMID: 30570154 DOI: 10.1111/scs.12640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 11/20/2018] [Indexed: 11/29/2022]
Abstract
AIMS The aim is to describe healthcare professionals' perspectives on how they understand and promote older couples' participation in everyday life when using residential respite care. DESIGN AND METHODS Eighteen healthcare professionals with varying degrees of competence and from one residential respite care facility participated in four focus group interviews. Data were analysed through qualitative latent content analysis. FINDINGS The findings revealed a broad, multifaceted view of participation and ways in which participation in everyday life is promoted by these professionals. Trustworthy relationships between professionals, spousal caregivers and clients were implicated. Promoting participation also necessitated that clients have access to meaningful activities. In addition, participation entailed an environment that supported various needs. CONCLUSION Promoting participation for older couples that are using respite care involves multifaceted perspectives that consider social-relational aspects including both the client and their spouse. Furthermore, attention is needed to the meaning a change of context between home and the respite care facility has on relationships, environments and activities in everyday life. Such an approach could benefit the couples' shared everyday life situation and in a wider perspective, also influence their health and well-being when ageing in place together.
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Abarca E, Campos S, Herskovic V, Fuentes C. Perceptions on technology for volunteer respite care for bedridden elders in Chile. Int J Qual Stud Health Well-being 2018; 13:1422663. [PMID: 29336722 PMCID: PMC5769803 DOI: 10.1080/17482631.2017.1422663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/24/2017] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Informal caregivers of bedridden elders need a respite. One form of obtaining a respite is through volunteers who are contacted by means of information and communication technology (ICT). METHOD A qualitative study was carried out in a low-income district in Santiago, Chile, to learn about how caregivers of bedridden elders perceive the possibility of using ICT to access this respite. In-depth interviews were carried out and transcribed verbatim, then analysed using open coding. Results: The results reveal that caregivers are willing to receive a volunteer in their home and use ICT to communicate with them, although a discrepancy exists between the use of devices connected to the Internet and feature phones. Conclusion: This study concludes that informal caregivers of bedridden elders have a favourable disposition towards accessing a respite system by means of ICT based on a peer-to-peer economy.
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Affiliation(s)
- Esmeralda Abarca
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Solange Campos
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Valeria Herskovic
- Department of Computer Science, Pontificia Universidad Católica de Chile Carolina Fuentes, School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Carolina Fuentes
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
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O’ Shea E, Timmons S, O’ Shea E, Fox S, Irving K. Respite in Dementia: An Evolutionary Concept Analysis. DEMENTIA 2017; 18:1446-1465. [DOI: 10.1177/1471301217715325] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim There is a lack of conceptual clarity around ‘respite’ as it relates to people with dementia and their carers. This study provides clarification on the use and meaning of the term and considers the concept in relation to the dominant care paradigm in dementia, i.e. person-centred care. Methods Rodgers’ (1989) evolutionary framework was employed. A systematic search was conducted on the Pubmed/MedLine, Embase, Cinahl, PsychInfo, Scopus, Web of Science and Cochrane databases (1980–2016, English) with fixed search terms relating to ‘respite’ and ‘dementia’. Papers with primary qualitative data and literature reviews were included. This search was supplemented with snowballing techniques (back/forward searching, generic search engines). Data were analysed thematically, through an iterative process of constant comparison. Results Respite is understood both as a service that provides a physical break for the carer and as a psychological outcome, i.e. a mental break for the carer, which can be facilitated by formal services, under certain conditions. The conceptual model outlines how client factors (dyadic relations, recognising/accepting need, carer psychosocial issues, restorative occupation, and stigma) and service factors (model/characteristics, care quality, staff expertise, meaningful occupation for people with dementia and communication and support), interact to influence a respite outcome. The key antecedent for a positive respite experience is that the carer perceives that mutual benefit is garnered from service use. Conclusion The term respite can be interpreted as both a service and an outcome. However, it is clear that ‘respite’, as currently understood, acknowledges the relational experience of the carer only; it is, therefore, potentially damaging to the planning and delivery of person-centred dementia care. We suggest ‘restorative care’ as a potential alternative nomenclature to respite care, thereby highlighting the importance of providing mutual, personalised health and social care services that serve to enhance care relationships rather than diminish them.
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Affiliation(s)
- Emma O’ Shea
- School of Nursing and Human Sciences, Dublin City University, Ireland
| | - Suzanne Timmons
- Centre for Gerontology & Rehabilitation, University College Cork, Ireland
| | - Eamon O’ Shea
- Irish Centre for Social Gerontology, National University of Ireland, Ireland
| | - Siobhan Fox
- Centre for Gerontology & Rehabilitation, University College Cork, Ireland
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Ireland
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Radford K, Oxlade D, Fitzgerald A, Vecchio N. Making Intergenerational Care a Possibility in Australia: A Review of the Australian Legislation. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2016. [DOI: 10.1080/15350770.2016.1160732] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McCann TV, Bamberg J, McCann F. Family carers' experience of caring for an older parent with severe and persistent mental illness. Int J Ment Health Nurs 2015; 24:203-12. [PMID: 25963281 PMCID: PMC4682461 DOI: 10.1111/inm.12135] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
While the burden of caring for older people with chronic medical illness and dementia has been well documented, considerably less is known about how carers develop the strength and resilience to sustain this important role with older family members with mental illness. The aim of the study was to understand the lived experience of primary caregivers of older people with severe and persistent mental illness, and to explore what, if anything, helps to sustain them in their caring role. An interpretative phenomenological analysis approach was adopted, and qualitative interviews were used with 30 primary caregivers. Two overarching themes, and related subthemes, were abstracted from the data. First, caring is a difficult and demanding responsibility. It affects carers adversely, emotionally, physically, socially, and financially, and their lifestyle in general. This is reflected in three subthemes: (i) physically and emotionally draining; (ii) grieving about the loss; (iii) and adverse effects on lifestyle and social relationships. Second, carers develop resilience in caring, which helps sustain them in their role, as illustrated in three subthemes: (i) caring as purposeful and satisfying; (ii) harnessing social support from others; and (iii) purposefully maintaining their own well-being. Community mental health nurses have a key role in assessing carers' needs and supporting them in their caring role.
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Affiliation(s)
- Terence V McCann
- Centre for Chronic Disease, College of Health and Biomedicine (Discipline of Mental Health Nursing), Victoria University, Melbourne, Victoria, Australia
| | - John Bamberg
- Centre for Chronic Disease, College of Health and Biomedicine (Discipline of Mental Health Nursing), Victoria University, Melbourne, Victoria, Australia
| | - Flora McCann
- Centre for Chronic Disease, College of Health and Biomedicine (Discipline of Mental Health Nursing), Victoria University, Melbourne, Victoria, Australia
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Rose MS, Noelker LS, Kagan J. Improving Policies for Caregiver Respite Services. THE GERONTOLOGIST 2015; 55:302-8. [DOI: 10.1093/geront/gnu120] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 10/24/2014] [Indexed: 11/14/2022] Open
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Lund DA, Utz RL, Caserta MS, Wright SD, Llanque SM, Lindfelt C, Shon H, Whitlatch CJ, Montoro-Rodriguez J. Time for living and caring: an intervention to make respite more effective for caregivers. Int J Aging Hum Dev 2015; 79:157-78. [PMID: 25536704 DOI: 10.2190/ag.79.2.d] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article presents the rationale for and description of a promising intervention, Time for Living and Caring (TLC), designed to enhance the effectiveness of respite services for family caregivers. It is guided by the theoretical principles of the Selective Optimization with Compensation (SOC) model, which individually coaches caregivers on how to assess their personal circumstances, identify their greatest needs and preferences, and engage in goal setting and attainment strategies to make better use of their respite time. Focusing on respite activities that match caregivers' unique needs is likely to result in improved well-being. We report on a pilot study examining TLC's feasibility and potential benefits and how caregivers viewed their participation. While additional research is needed to test and refine the intervention, we need to find more creative ways to enhance respite services.
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Poor oral health, a potential new geriatric syndrome. Gerodontology 2014; 31 Suppl 1:17-24. [DOI: 10.1111/ger.12086] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2013] [Indexed: 12/01/2022]
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