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Park NS, Matta-Singh TD, Park J, Rhee MK, Chung S, Jang Y. Dementia Caregiving Experiences Among Korean Americans: Qualitative Inquiry Using the Stress Process Perspective. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-22. [PMID: 38861569 DOI: 10.1080/01634372.2024.2366259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
Dementia caregiving involves a challenging and complex process, especially for immigrant families. Using a qualitative method, this study provides an in-depth exploration of caregiving experiences among Korean American caregivers of people living with dementia. Based on various sampling strategies, 16 Korean American caregivers of family members/relatives with dementia were recruited in the greater Los Angeles area. Guided by the stress process model and the constant comparative method, themes and subthemes were derived and categorized into four domains: (1) background/context; (2) perception/appraisal; (3) resources/coping, and (4) caregiver burden/reward. Findings suggest that intervention efforts should focus on educating and training dementia caregivers.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | | | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Min-Kyoung Rhee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Nguyen LT, Prophater LE, Fazio S, Hülür G, Tate R, Sherwin K, Shatzer J, Peterson LJ, Haley WE. Project VITAL at Home: Impact of Technology on Loneliness and Well-Being of Family Caregivers of People with Dementia. Clin Gerontol 2024; 47:149-160. [PMID: 36111824 DOI: 10.1080/07317115.2022.2123726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Project VITAL At Home aimed to combat social isolation and loneliness in family caregivers of people with dementia through purposeful engagement and connection. This project examined the effects of technology on caregiver loneliness and well-being, as well as their technology experiences, during the COVID-19 pandemic. METHODS Family caregivers were provided iN2L tablets and access to Alzheimer's Association supportive programs. Caregivers (n = 124) completed online surveys at pre and post evaluation points (average 7 months apart) to assess loneliness, subjective well-being (affect), supportive program usage, and tablet experiences. RESULTS Family caregivers had positive perceptions of the tablets for both themselves and their family members. Tablets had positive effects on caregiver well-being, including giving them an additional caregiver tool, alleviating stress, increasing satisfaction with quiet time, and improving access to supportive programs. Caregiver positive affect decreased, but no changes were observed for negative affect or loneliness. CONCLUSIONS Family caregivers found value in the tablets and showed improvements in some aspects of well-being. Randomized trials are needed to more fully assess the benefits of the intervention. CLINICAL IMPLICATIONS Pairing tablets with caregiving supports is a promising intervention to improve caregivers' access to vital resources and services and to improve their well-being.
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Affiliation(s)
- Lydia T Nguyen
- Product Management, iN2L, Greenwood Village, Colorado, USA
| | | | - Sam Fazio
- Care & Support, Alzheimer's Association, Chicago, Illinois, USA
| | - Gizem Hülür
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Rio Tate
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Kasia Sherwin
- Care & Support, Alzheimer's Association, Chicago, Illinois, USA
| | - Julie Shatzer
- Care & Support, Alzheimer's Association, Chicago, Illinois, USA
| | - Lindsay J Peterson
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
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Runacres J, Herron D. Designing Inclusive Qualitative Research with Carers of People Living with Dementia: Methodological Insights. Healthcare (Basel) 2023; 11:2125. [PMID: 37570366 PMCID: PMC10419147 DOI: 10.3390/healthcare11152125] [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: 06/29/2023] [Revised: 07/17/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
The support provided by carers of people living with dementia results in savings for the UK economy; however, providing this care has a significant impact on carers. Supports are needed to ensure that carers can continue to provide care, and carers should be involved in the generation of the evidence necessary to develop such support. However, this relies on their ability to meaningfully engage with research, yet current data collection methods create obstacles to engagement. In this paper, we aim to provide a critical examination of approaches to qualitative data collection with carers and produce recommendations for the design of inclusive research. First, different approaches to qualitative data collection are discussed and appraised. Following this, a case study of inclusive research is presented, illustrating how carers can be facilitated to engage in research. Finally, recommendations for inclusive research are offered, including the collection of data without the cared-for person present, building additional care into a study design, providing 'incidental funds,' offering sustenance and remuneration, and undertaking research in a neutral space. These recommendations are designed to facilitate the involvement of carers in research and promote the use of more varied or multifaceted methods to develop the current evidence base.
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Affiliation(s)
- Jessica Runacres
- Department of Midwifery and Allied Health, Staffordshire University, Staffordshire ST4 2DE, UK
| | - Daniel Herron
- Department of Psychology, Staffordshire University, Staffordshire ST4 2DE, UK;
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Herron DL, Runacres J, Danton I, Beardmore J. Carers' experiences of caring for a friend or family member with dementia during the Covid-19 pandemic. DEMENTIA 2023; 22:576-593. [PMID: 36630524 PMCID: PMC9843153 DOI: 10.1177/14713012221150298] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES This study aimed to explore carers' experiences of supporting a family member or friend with dementia through COVID-19 and experiences of hope and resilience during this time. METHODS Qualitative longitudinal research was undertaken in the UK, with 13 unpaid carers of people living with dementia who took part in two semi-structured interviews 8 weeks apart between June and October 2020. All transcripts were analysed using reflexive thematic analysis. FINDINGS Four themes were developed and included: COVID-19 impacted negatively upon everyday living; carer resilience: adapting to COVID-19; analysis of risk: safeguarding the person living with dementia; and thinking about the future with COVID-19. CONCLUSIONS The results illustrated how the sudden changes which occurred during the pandemic negatively impacted on carers and people living with dementia in several ways, including additional responsibilities and taking away hope. The importance of continued formal and informal support for carers and people living with dementia during COVID-19 were highlighted. Formal services, care homes, and organisations need to be supported to implement procedures to ensure a safe environment during future lockdowns or periods of social restrictions. This will enable carers to remain visiting their family members and increase their confidence in accessing services and allowing paid carers to support their family member with dementia. These results have also illustrated the resilience of carers, who adapted to sudden changes which impacted negatively on their wellbeing and the wellbeing of the person living with dementia.
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Affiliation(s)
- Daniel L Herron
- Department of Psychology, School of Health, Science and Wellbeing, 7703Staffordshire University, Stoke-on-Trent, UK
| | - Jessica Runacres
- Midwifery and Allied Health, School of Health, Science and Wellbeing, Centre of Excellence in Healthcare Education, 7703Staffordshire University, Stoke-on-Trent, UK
| | - Ian Danton
- School of Psychology, 2939University of Derby, Derby, UK
| | - Jack Beardmore
- Department of Psychology, School of Health, Science and Wellbeing, 7703Staffordshire University, Stoke-on-Trent, UK
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Leung T, Van Houtven C, Hastings S. Development of a Home-Based Stress Management Toolkit for Dementia Caring Dyads: Protocol for a Pilot Intervention Development and Feasibility Study. JMIR Res Protoc 2022; 11:e43098. [PMID: 36399169 PMCID: PMC9798268 DOI: 10.2196/43098] [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: 09/29/2022] [Accepted: 11/12/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND People living with dementia (PLWD) and their care partners (dementia caring dyads) are at a heightened risk of experiencing stress-related symptoms and conditions. Yet, many dyadic stress management interventions have had limited uptake by health care systems and in the community. An intervention that combines simple, safe, easy-to-use, nonpharmacologic tools (eg, animatronic social pets, weighted blankets and garments, aromatherapy and bright light therapy devices, acupressure, and massage tools) that can be used in the home may be a promising approach to promote stress management among dementia caring dyads. OBJECTIVE The proposed study aims to develop and user test a dyadic toolkit intervention composed of simple, tangible stress management tools for community-dwelling PLWD and their care partners. This study will also explore the feasibility of collecting several stress-related outcome measures to inform measurement selection for future studies. METHODS A human-centered design (HCD) approach will be used to increase the likelihood of developing an intervention that will be translatable to real-world settings. This study consists of 2 phases. The first phase will address the discover, define, and design stages of HCD using qualitative focus groups with dementia caring dyads (N=12-16 dyads). Dyadic focus groups (3-4 groups anticipated) will be convened to understand participants' stress experiences and to co-design a stress management toolkit prototype. Rapid qualitative analysis will be used to analyze focus group data. In phase 2, the toolkit prototype will be user tested for 2 weeks in a new sample to address the validation step of HCD. A within-subjects (n=10 dyads), pre-post design will be used with measures of usability (frequency of toolkit use), feasibility (enrollment and withdrawal rates, adverse events/injuries), and acceptability (satisfaction, benefit) collected via questionnaires (at the end of weeks 1 and 2 of user testing) and focus groups (n=3-4 dyads/group at the end of week 2). The feasibility of collecting participant-reported, stress-related outcomes (neuropsychiatric symptoms of dementia, caregiver stress, dyadic relationship strain) and salivary cortisol as a physiologic measure of stress will be assessed at baseline and after user testing. RESULTS This study will yield a working prototype of a stress management toolkit for dementia caring dyads, as well as preliminary data to support the feasibility and acceptability of the intervention. User testing will elucidate areas to refine the prototype and provide data to inform preliminary testing of the intervention. As of September 2022, this study has received institutional ethics board approval with phase 1 recruitment anticipated to begin January 2023. CONCLUSIONS Few interventions have focused on combining simple, safe, low burden tools to promote stress management among community-dwelling dementia caring dyads. By involving families and exploring feasibility and acceptability at the onset of development, this intervention will have greater potential to be implemented and sustained in the future. TRIAL REGISTRATION ClinicalTrials.gov NCT05465551; https://clinicaltrials.gov/ct2/show/NCT05465551. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43098.
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Affiliation(s)
| | - Courtney Van Houtven
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.,School of Medicine, Duke University, Durham, NC, United States
| | - Susan Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.,School of Medicine, Duke University, Durham, NC, United States
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Daley S, Akarsu N, Armsby E, Farina N, Feeney Y, Fine B, Hughes L, Pooley J, Tabet N, Towson G, Banerjee S. What factors have influenced quality of life in people with dementia and their family carers during the COVID-19 pandemic: a qualitative study. BMJ Open 2022; 12:e053563. [PMID: 35144951 PMCID: PMC8845096 DOI: 10.1136/bmjopen-2021-053563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has led to significant disruption to health and social care services. For people with dementia and their family carers this is problematic, as a group who rely on timely and responsive services to live well with the condition. This study has sought to understand how COVID-19 has affected the quality of life of people diagnosed with dementia and their family carers. DESIGN Our mixed-methods study was nested in a larger cohort study of an education programme, Time for Dementia. SETTING The study took place in the South-East of England. PARTICIPANTS Existing study participants, family carers were approached about the COVID-19 nested study. A purposeful sample of participants were invited to take part in in-depth qualitative interview. The sample included family carers in a range of different caring situations. MEASUREMENT Interviews were undertaken remotely by telephone. Interviews sought to understand quality of life before the pandemic, impact of the restrictions on both the person with dementia and family carer, role of services and other agencies as well as supportive factors. Data were analysed using thematic analysis. RESULTS 16 family carers were interviewed. Seven themes were identified from our analysis: (1) decreased social interaction; (2) reduced support; (3) deteriorating cognitive and physical health for the person with dementia; (4) decreased carer well-being; (5) difficulties understanding COVID-19 restrictions; (6) limited impact for some and (7) trust and relationship with care home. There was little change between themes during the first and second wave of national lockdowns. CONCLUSIONS Our study provides an understanding the short-term impact of COVID-19 on the quality of life of people with dementia and their family carers. Our findings suggest that recovery between the first and second wave of the restrictions did not automatically take place.
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Affiliation(s)
- Stephanie Daley
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Nazire Akarsu
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Elise Armsby
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Yvonne Feeney
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Bethany Fine
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Laura Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Joanna Pooley
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Naji Tabet
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | | | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
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Bakas T, Miller EL. Family Caregiving across the Lifespan and Conditions: Special Issue on Family Caregiving. West J Nurs Res 2021; 44:203-204. [PMID: 34873985 DOI: 10.1177/01939459211064029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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