Development of multi-component counseling program for enhancing resilience among Thai caregivers of older persons with dementia

Purpose

The purpose of this study was to develop a multi-component counseling program and examine the short-term effects of an 8-session program.

Design/methodology/approach

This present study was a research and development of a multi-component counseling program for enhancing resilience. The concept of resilience was reviewed based on a synthesis of existing research, together with an exploration of qualitative data derived from an interview with ten caregivers of older persons with dementia. Six domains of resilience were identified: physical, relationships, emotional, moral, cognitive and spiritual; which were then used to develop the eight-week program. The program was examined by a panel of three experts for content validity, which yielded an index of 0.87. The program was then tried out with 60 caregivers recruited and assigned 30 caregivers in the intervention and control group. The Caregiver’s Resilience Scale (CRS) was used by trained nurses to evaluate the program and data were analyzed using repeated measures ANOVA.

Findings

The results indicated that the resilience scores of the participants in the intervention group were statistically significantly higher than those of the control group at one month after program participation and at the follow-up three months later (p < 0.05).

Originality/value

It could be concluded that the program yielded support for the evidence-based practice of non-pharmacological intervention. The program would be suitable as a clinical practice guideline to provide help to caregivers of older persons with dementia at the outpatient setting.

Identifying and Addressing Family Caregiver Anxiety

Family caregivers are an increasingly diverse group of individuals who provide significant amounts of direct and indirect care for loved ones with long-term chronic illnesses. Caregiver needs are vast, particularly as these relate to the caregiver's quality of life. However, caregivers are often unlikely to address their personal and health-related concerns. Unmet needs combined with the caregiving role often lead to high levels of caregiver anxiety. Unaddressed, this anxiety is likely to result in poor health and low quality of life. Nurses, along with the health care team, are well positioned to assess, monitor, intervene, and reassess anxiety levels in caregivers using standardized screening tools across care settings. This article focuses on the family caregiver anxiety symptom in community-based settings, where health care providers have unique opportunities to detect this symptom in a familiar environment and begin immediate intervention leading to promotion of quality of life for the caregiver and subsequently the care recipient. Additional research efforts should be focused on health care provider goals of care, dyadic assessments, and monitoring of caregiver needs while caring for their loved ones aging in place.

Restoring trust: COVID-19 and the future of long-term care in Canada

The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to inform their decisions. This paper reports the findings of the COVID-19 Long-Term Care (LTC) working group addressing a preferred future for LTC in Canada, with a specific focus on COVID-19 and the LTC workforce. First, the report addresses the research context and policy environment in Canada’s LTC sector before COVID-19 and then summarizes the existing knowledge base for integrated solutions to challenges that exist in the LTC sector. Second, the report outlines vulnerabilities exposed because of COVID-19, including deficiencies in the LTC sector that contributed to the magnitude of the COVID-19 crisis. This section focuses especially on the characteristics of older adults living in nursing homes, their caregivers, and the physical environment of nursing homes as important contributors to the COVID-19 crisis. Finally, the report articulates principles for action and nine recommendations for action to help solve the workforce crisis in nursing homes.

Perceptions of a psychoeducation program for caregivers of persons with dementia at end of life: a qualitative study

OBJECTIVES

Caregivers (CG) of persons with dementia have described positive and challenging experiences related to caring for a person with a neurological disease. This study explored perceived benefits and challenges of a unique psychoeducation program provided at end of life (EOL) jointly attended by current and bereaved CGs of persons with dementia, residing in a hospital Specialized Care Unit.

METHOD

Semi-structured interviews were held with sixteen participants and analyzed with content analysis.

RESULTS

Program benefits were perceived by CGs such as: (i) enhanced emotional well-being, (ii) increased feelings of preparedness for EOL, and (iii) personal growth into role models. Within the organization the program was perceived as promoting relationship-centered care and increasing resources. Challenges such as diverse CG preferences, day-time scheduling and limited involvement of unit staff were perceived as barriers.

CONCLUSIONS

This program fills a gap in care for CGs at the critical stage of EOL with continuity into bereavement. Implications for practice include: increasing engagement of unit staff for involvement and tailoring of the program, and translation of the program into alternative settings like long-term care. Policies outlining the support needs and resources for CGs through EOL within and outside the hospital are necessary to ensure access and continuity of care.

A Comparative Descriptive Study of Characteristics of Early- and Late-Onset Dementia Family Caregivers

Characteristics of early- and late-onset dementia family caregivers were described and compared. Based on a theoretical model of role transition, data were collected through structured interviews from 48 caregivers of adults with Alzheimer's disease or a related dementia older than the age of 70 and 48 caregivers of similarly diagnosed adults younger than the age of 60. A significantly higher proportion of caregivers of younger adults were spouses and gainfully employed compared with those of older adults; they had more years of schooling, took care of a person with more severe impairments, received more help, perceived themselves as better prepared to deal with future needs, and better informed about services. They did not differ from caregivers of older adults in terms of psychological distress, role confidence, self-efficacy, and social support. This study highlights differences and similarities to be considered in the development of services tailored to the specific needs of each group.