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Huang HL, Liao YT, Kung PC, Shyu YIL, Hsu WC, Hsu JL. Caregiving management needs and predictors for family caregivers of persons with dementia: a cross-sectional study. BMC Geriatr 2024; 24:724. [PMID: 39215257 PMCID: PMC11363448 DOI: 10.1186/s12877-024-05316-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Family caregivers of persons with dementia are faced with complex caregiving management needs. This study had two aims: (1) to identify caregiving management needs of family caregivers of persons with dementia and (2) identify any variables that might influence these needs. METHODS This cross-sectional study recruited family caregivers of persons with dementia (N = 250) through referrals from clinicians at a dementia outpatient clinic in Northern Taiwan. Data were collected with a 32-item researcher-developed instrument, the Caregiving Management Needs Scale (CMNS), to identify management needs specific to family caregivers of persons with dementia. The CMNS was comprised of questions about the types of assistance or support family caregivers would like to receive to facilitate caregiving. RESULTS CMNS scores indicated caregivers had moderate management needs. Caregivers of relatives with a moderate severity of dementia had significantly higher scores on the CMNS compared with caregivers of persons with very mild dementia (p < 0.01). Linear regression analysis indicated significant predictors of high caregiving management needs were caregivers who were female (p < 0.01), and persons with dementia with behavioral problems (p < 0.01), low scores for Activities of Daily Living (p < 0.01), regular medication adherence (p < 0.01), and use of long-term care services (p < 0.001) were significant (F[13, 236] = 7.12; p < 0.001; R2 = 28.2%). CONCLUSIONS Understanding variables and predictors of caregiving management needs for family caregivers could reduce the complexity of caregiving. TRIAL REGISTRATION ClinicalTrials.gov NCT05151185.
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Affiliation(s)
- Huei-Ling Huang
- Department of Gerontology and Health Care Management & Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, No.261, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 333324, Taiwan.
- Department of Nursing, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City, Taiwan.
| | - Yen-Ting Liao
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Pen-Chen Kung
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jung-Lung Hsu
- Department of Neurology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City, Taiwan
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Ross SE, Severance JJ, Murphy SC, Yockey RA, Morkos J, Johnson S, Knebl JA. Primary care and community partnerships to promote age-friendly care for Hispanic older adults. J Am Geriatr Soc 2024. [PMID: 38828999 DOI: 10.1111/jgs.19034] [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: 11/02/2023] [Revised: 04/03/2024] [Accepted: 04/29/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Healthcare and community collaborations have the potential to address health-related social needs. We examined the implementation of an educational initiative and collaborative intervention between a geriatric clinic and Area Agency on Aging (AAA) to enhance age-friendly care for a Hispanic patient population. METHODS As part of a Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Program, a geriatric clinic partnered with AAA to embed an English- and Spanish-speaking Social Service Coordinator (SSC). The SSC met with patients during new and annual visits or by referral to address What Matters and Mentation in the patient's primary language, provide education, and make social service referrals. Patients aged 60 and older, who received SSC services during a 12-month period, were defined as the intervention group (n = 112). Using a retrospective chart review, we compared them to a non-intervention group (n = 228) that received primary care. We examined available demographic and clinical data within the age-friendly areas of What Matters and Mentation. Measures included cognitive health screenings, advance care planning, patient education, and community referrals. RESULTS Most of the intervention groups were eligible for AAA services and had the opportunity for service referrals to address identified needs. A higher proportion of patients within the intervention group completed screenings for cognitive health and advance care planning discussions. CONCLUSION Interagency partnerships between ambulatory care settings and community-based organizations have the potential to expand access to linguistically and culturally competent age-friendly primary care for older adults.
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Affiliation(s)
- Sarah E Ross
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Jennifer J Severance
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Sara C Murphy
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Robert A Yockey
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Johny Morkos
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Shakita Johnson
- United Way of Tarrant County's Area Agency on Aging, Fort Worth, Texas, USA
| | - Janice A Knebl
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Choi H, Reblin M, Litzelman K. Conceptualizing Family Caregivers' Use of Community Support Services: A Scoping Review. THE GERONTOLOGIST 2024; 64:gnad039. [PMID: 37022354 DOI: 10.1093/geront/gnad039] [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: 10/06/2022] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Only a fraction of the 53 million caregivers in the United States use available formal community services. This scoping review synthesized the literature on the barriers and facilitators of community support service utilization by adult caregivers of a family member or friend with an illness, disability, or other limitation. RESEARCH DESIGN AND METHODS We searched PubMed, CINAHL, PsycInfo, and Web of Science for quantitative and qualitative articles assessing barriers and facilitators of caregivers' access to and utilization of resources, following Preferred Reporting Items for Systematic Review and Meta-Analysis scoping review guidelines. Thematic analysis, drawing on an initial conceptualization, informed key insights around caregivers' resource navigation process. RESULTS The review provides support for individual factors affecting service use. Notably, some factors-such as time restrictions and increased caregiving demands-appear to function as barriers to accessing services even as they increase caregivers' need for support. Additionally, contextual barriers including cultural factors and support of friends/family can affect caregivers' access to resources. Finally, experience with health systems and structures and the intersection with other factors can affect service utilization. DISCUSSION AND IMPLICATIONS Suboptimal access to and utilization of community support services can be addressed at both the person and system level to mitigate potential inequities. Ensuring that caregivers are aware of, eligible for, and have the capacity and support to access the appropriate resources at the right time is essential for improving caregiver outcomes, reducing burnout, and supporting continued care.
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Affiliation(s)
- Hyojin Choi
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Maija Reblin
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Kristin Litzelman
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Gaviola MA, Omura M, Inder KJ, Johnson A. Caring for people with dementia from culturally and linguistically diverse backgrounds in nursing homes: A scoping review. Int J Nurs Stud 2024; 151:104674. [PMID: 38215689 DOI: 10.1016/j.ijnurstu.2023.104674] [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: 07/12/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND With continued increase in global migration, older people population in most countries is culturally diverse. Despite lesser preference for nursing home placement, people with dementia from culturally diverse backgrounds with higher needs and acuity do access nursing homes, however, little is known about care provision. OBJECTIVE The aims of this review were to map and synthesise available literature on care provision amongst people with dementia from culturally and linguistically diverse backgrounds in nursing homes and identify literature gaps that could inform future research. DESIGN A scoping review was conducted guided by the six-step scoping review methodology of Levac and colleagues. METHODS A literature search was conducted from August to September 2022 and updated in June 2023 using six databases: Medline, CINAHL, Embase, Cochrane Library, PsycINFO, and Scopus. Screening of articles, data extraction, and quality appraisal was performed independently by two authors. Articles included were primary empirical studies that explored care provision to people with dementia from culturally and linguistically diverse backgrounds living in nursing homes. Critical appraisal was conducted using the Joanna Briggs Institute Critical Appraisal Tool. Data were analysed using thematic analysis. Results were presented in a table and narrative format. RESULTS Of the 1149 articles identified, 25 were included. A majority of the articles were qualitative (n = 17) and conducted in Western countries such as those in Europe (n = 11), as well as Australia (n = 5) and the United States (n = 4). Data analysis led to the development of three themes: (1) maintaining a sense of home; (2) fostering communication and interaction; (3) barriers and facilitators to providing care. Most articles did not specify the model underpinning the approaches to care provision. CONCLUSIONS Care provision for people with dementia from culturally and linguistically diverse backgrounds living in nursing homes entails an environment which enables them to live up to the standards of what "home" means to them, communicate their needs, and engage in meaningful interactions. Predominant barriers to care provision relate to language and the facility's resources and capacity to deliver culture-specific care. Methodological quality of the studies that explored care provision for people with dementia from culturally and linguistically diverse backgrounds in the nursing home context is mostly limited. To strengthen the evidence base, there is a need for more rigorous research that informs care provision approaches and development of an inclusive model of culturally appropriate care to people with dementia from culturally diverse backgrounds in the nursing home context. TWEETABLE ABSTRACT A scoping review synthesised evidence on care provision amongst people with dementia from CALD backgrounds in nursing homes.
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Affiliation(s)
- Minah Amor Gaviola
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
| | - Mieko Omura
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
| | - Kerry Jill Inder
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
| | - Amanda Johnson
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
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5
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Xiao C, Patrician PA, Montgomery AP, Wang Y, Jablonski R, Markaki A. Filial piety and older adult caregiving among Chinese and Chinese-American families in the United States: a concept analysis. BMC Nurs 2024; 23:115. [PMID: 38347512 PMCID: PMC10863110 DOI: 10.1186/s12912-024-01789-0] [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: 07/20/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs. PURPOSE To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework. METHODS A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant's methods. Twenty-six studies were selected in the final full-text analysis. FINDINGS Synthesis of evidence identified four antecedents: (a) filial obligation as a 'cultural gene', (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of 'birth right'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity. CONCLUSION Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework "Caregiving for aging CCAs in the United States" merits further study.
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Affiliation(s)
- Chunhong Xiao
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA.
| | - Patricia A Patrician
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Aoyjai P Montgomery
- University of Alabama at Birmingham School of Public Health, 1665, 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Youhua Wang
- College of State Governance, Southwest University, No. 2 Tianshen Road, Chongqing, 400715, Beibei District, China
| | - Rita Jablonski
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Adelais Markaki
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
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Lee K, Cassidy J, Lee J, Seo CH, Kunz Lomelin A, Shin HW, Grill JD. Examining Utilization of Formal Supports and Related Impacts on Overall Well-Being Among East Asian American Family Caregivers of Persons With Dementia: A Mixed-Methods Study. THE GERONTOLOGIST 2024; 64:gnad086. [PMID: 37394998 DOI: 10.1093/geront/gnad086] [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: 02/17/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although East Asian American family caregivers are known to underutilize formal support services, there is a lack of evidence regarding the associations of formal service utilization with caregivers' well-being. This study examined the prevalence of different types of home-and community-based formal service utilization among Korean and Chinese American family caregivers of persons with dementia and how utilization of such services was associated with their well-being. We also explored their overall experience in accessing and utilizing formal dementia support services and programs. RESEARCH DESIGN AND METHODS We employed a convergent mixed-methods study design. In a convenience sampling method, we recruited 62 family caregivers. Logistic regression and thematic analysis were utilized to analyze data. RESULTS The results showed in-home services were mostly utilized among family caregivers of these ethnic groups. Out of 9 different support services, those who utilized nutrition programs and case management were more likely to report higher overall well-being. Four themes were developed: (1) awareness of formal support services but uncertainty on how to access them, (2) language barriers imposing additional challenges in accessing formal support services, (3) traveling to access culturally appropriate services, and (4) desire for culturally tailored medical and long-term care services. DISCUSSION AND IMPLICATIONS Findings from this study suggest the importance of case management services to overcome barriers to accessing and utilizing a wide range of formal support services and provision of culturally appropriate food in formal support services to increase East Asian American family caregivers' utilization of long-term care services.
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Affiliation(s)
- Kathy Lee
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Jessica Cassidy
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Jihui Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburg, Pennsylvania, USA
| | - Chang Hyun Seo
- School of Social Work, University of Nevada, Reno, Reno, Nevada, USA
| | - Alan Kunz Lomelin
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Hye-Won Shin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, California, USA
- Somang Society, Cypress, California, USA
| | - Joshua D Grill
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, California, USA
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7
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Tsai LP, Barr JA. The experiences and perceptions of immigrant informal caregivers about engaging with professional services in the host country: A scoping review. Int J Nurs Pract 2023:e13227. [PMID: 38128928 DOI: 10.1111/ijn.13227] [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: 11/03/2022] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
AIM The inquiry explored immigrant informal caregivers' experiences and perceptions about engaging with professional services in the host country. BACKGROUND The number of informal caregivers is rising, with more people providing home caring. Nurses and other health services are crucial in supporting informal caregivers. Research needs to focus more on immigrants, not just other caregivers. DESIGN This was a scoping review. DATA SOURCES Five databases (January 2017-December 2022) were searched, and 16 articles were included in this inquiry. REVIEW METHODS This scoping review used the Joanna Briggs Institute Scoping Review methodology. This inquiry asked one question: What is the current knowledge about immigrant informal caregivers' experiences and perceptions when engaging mainstream professional services? Themes were identified using a thematic analysis approach. RESULTS Three themes emerged from the review: 'finding cultural bridges: culturally connecting with services'; 'building cultural bridges: addressing "them and us" and "acculturation-sensitive services"'. CONCLUSION Professional service providers are currently not meeting immigrant caregivers' needs. New knowledge is presented, that nurses and health professional services must provide acculturation-sensitive care, commencing with an assessment of the individual's acculturation status. By understanding acculturation status, nurses are more likely to customize person-centred care. Acculturation status refers to the degree that the individual has adapted to the new culture while retaining some traditional cultural beliefs and practices. Acculturation-sensitive care is more likely to provide authentic holistic care that optimizes well-being.
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Affiliation(s)
- Lily P Tsai
- Faculty of Health, Charles Darwin University, Casuarina, Australia
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Turner NR, Freitag C, Johnson I, Parsey CM, Ramirez M, Berridge C. The Role of Trust in Older Adult Service Provision at the Onset of the COVID-19 Pandemic. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:739-762. [PMID: 36617864 PMCID: PMC10329095 DOI: 10.1080/01634372.2022.2164821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic caused near immediate service delivery adaptation among social service and healthcare sectors. Findings from in-depth interviews with 45 senior leaders of social services and healthcare organizations serving older adults in Washington State elucidate the role of trust in service provision at the onset of the pandemic. First, a history of trust facilitated service adaptation. Intentional outreach, programs, and culturally responsive services sustained trust with service recipients. Providing services and information in an older adult's preferred language built trust. Community networks facilitated and reflected trust between organizations and older adults. Finally, mistrust was prevalent for clients who perceived a high risk of experiencing negative consequences from accessing services. Our findings support the need for culturally and linguistically diverse services. To improve trust, the aging network should strengthen and expand partnerships with community-based organizations who have established trust through history, intentionality, and relevance to their service populations..
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Affiliation(s)
- Natalie R. Turner
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Callie Freitag
- Evans School of Public Policy & Governance, University of Washington, Seattle, Washington, USA
| | - Ian Johnson
- College of Social Work, University of Tennessee Knoxville, Tennessee, USA
| | - Carolyn M. Parsey
- School of Medicine, Department of Neurology, University of Washington, Seattle, Washington, USA
| | - Magaly Ramirez
- School of Public Health, Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Clara Berridge
- School of Social Work, University of Washington, Seattle, Washington, USA
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Fields NL, Xu L, Williams IC, Gaugler JE, Cipher DJ. The Senior Companion Program Plus for African American Caregivers of Persons With Alzheimer Disease and Related Dementias: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49679. [PMID: 37486759 PMCID: PMC10407770 DOI: 10.2196/49679] [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: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Alzheimer disease and related dementias (ADRD) pose significant challenges as chronic health conditions in the United States. Additionally, there are notable disparities in the diagnosis and prevalence of ADRD among diverse populations. Specifically, African American populations have a higher risk of developing late-onset ADRD than White people, and missed diagnoses of ADRD are more common among older African American populations than older White populations. These disparities also impact African American ADRD family caregivers. OBJECTIVE The overall goal of this project is to develop a culturally informed, lay provider psychoeducational intervention named Senior Companion Program Plus (SCP Plus), which is specifically designed for African American ADRD caregivers and is potentially accessible, affordable, and sustainable. METHODS In the proposed explanatory sequential mixed methods study, a randomized controlled trial will be used that includes 114 African American family caregivers of a relative with ADRD who will participate in the 3-month SCP Plus program. RESULTS The study was funded on September 15, 2018, by the National Institutes of Health (1R15AG058182-01A1). Data collection began on May 16, 2019, but due to COVID-19 restrictions, ended 12 months into the planned 27-month recruitment period on March 31, 2023. The study was completed in June 30, 2023, and currently the results are being analyzed. CONCLUSIONS The SCP Plus offers promise as an intervention that utilizes an existing platform for the delivery of a lay provider intervention and offers a novel approach for addressing gaps in accessible, community-based support for caregivers of people with ADRD. TRIAL REGISTRATION ClinicalTrials.gov NCT03602391; https://classic.clinicaltrials.gov/ct2/show/NCT03602391. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/49679.
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Affiliation(s)
- Noelle L Fields
- School of Social Work, University of Texas at Arlington, Arlington, TX, United States
| | - Ling Xu
- School of Social Work, University of Texas at Arlington, Arlington, TX, United States
| | - Ishan C Williams
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Daisha J Cipher
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
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Vipperman A, Savla J, Roberto KA, Burns D. Barriers to Service Use Among Dementia Family Caregivers in Rural Appalachia: Implications for Reducing Caregiver Overload. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:950-960. [PMID: 36543967 PMCID: PMC9771774 DOI: 10.1007/s11121-022-01479-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Although the benefits of home- and community-based services (HCBS) to support the needs of older adults are well-established, researchers have persistently reported service underutilization by dementia caregivers to assist them with their caregiving responsibilities. Using the Health Behavior Model and Conservation of Resources Theory, the aim of the current study was to understand what barriers prevent caregivers from using HCBS and the toll it takes on them. Utilizing a sample of 122 rural family caregivers (74% female, 87% white, Mage = 64.86 years) of persons living with dementia (PLwD), simultaneous ordinary least square regressions were employed to understand the association between barriers to service use and the current use of support services and personal services, and concurrently on caregiver role overload. Financial barriers, caregiver's reluctance to use services, and their capability of seeking services were associated with lower use of support services. After controlling for need and enabling factors, caregivers who used more support services, and those who reported system complexities to using support services experienced higher role overload. Financial barriers, system complexities, and caregivers' reluctance also affected the use of personal care services. Despite the use of personal services, caregivers of PLwD with greater needs and fewer enabling factors experienced higher role overload. Study findings suggest that reducing system complexities of HCBS and improving prevention and intervention efforts to facilitate caregivers' awareness of HCBS are needed to address lack of service use and reduce caregiver overload.
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Affiliation(s)
- Andrew Vipperman
- School of Medicine, University of Virginia, Charlottesville, 22908, VA, USA
| | - Jyoti Savla
- Center for Gerontology, Virginia Tech, 230 Grove Lane, Virginia Tech, Blacksburg, 24061, VA, USA
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, 24016, VA, USA
| | - Karen A Roberto
- Center for Gerontology, Virginia Tech, 230 Grove Lane, Virginia Tech, Blacksburg, 24061, VA, USA.
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, 24016, VA, USA.
- Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, 24016, VA, USA.
| | - Derek Burns
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
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Xu L, Fields NL, Williams IC, Gaugler JE, Kunz-Lomelin A, Cipher DJ, Feinhals G. The Senior Companion Program Plus (SCP Plus): Examining the Preliminary Effectiveness of a Lay Provider Program to Support African American Alzheimer's Disease and Related Dementias (ADRD) Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5380. [PMID: 37047994 PMCID: PMC10094539 DOI: 10.3390/ijerph20075380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES A culturally informed, peer-led, lay provider model, the Senior Companion Program (SCP) Plus, was implemented to decrease caregiving burden/stress and improve coping skills and social support for African American ADRD caregivers. This study reported the preliminary effectiveness of this intervention. METHODS An explanatory sequential mixed methods design was used in this study, and a randomized control trial was conducted for the SCP Plus intervention among participants in three sites (n = 20). A subsample of participants (n = 7) consented to a qualitative interview about their experiences with the intervention. Wilcoxon signed-rank tests, Friedman tests, and one-way repeated measures ANOVA were computed for quantitative analyses. Thematic analysis was used for the qualitative interviews. RESULTS Results demonstrated that knowledge of AD/dementia (KAD) and preparedness for caregiving were significantly improved for all senior companions in the intervention group. Results also showed that caregivers in the intervention group reported significantly decreased caregiving burden, as well as increased KAD, satisfaction with social support, and positive aspects of caregiving. Themes from the qualitative interviews included: learning new skills about caregiving, gaining knowledge about ADRD, and benefits for the dyad. DISCUSSIONS Findings from this study implied that SCP Plus was a promising model for African American family caregivers as it benefits both the SC volunteers and the African American ADRD family caregivers.
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Affiliation(s)
- Ling Xu
- School of Social Work, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Noelle L. Fields
- School of Social Work, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Ishan C. Williams
- School of Nursing, University of Virginia, Charlottesville, VA 22903, USA
| | - Joseph E. Gaugler
- School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alan Kunz-Lomelin
- School of Social Work, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Daisha J. Cipher
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX 76019, USA
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Knipping D, Garnett A, Jiang BB. Access and Use of Services by Caregivers of Older Adults: A Scoping Review of Cultural and Linguistic Diversity. J Appl Gerontol 2023. [PMID: 36866817 DOI: 10.1177/07334648231158490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Westernized countries are home to an increasingly culturally and linguistically diverse (CLD) older adult population. Informal caregivers of CLD older adults face unique challenges accessing and using home- and community-based services (HCBS). This scoping review sought to identify facilitators and barriers to access and use of HCBS for informal caregivers of CLD older adults. Arksey and O'Malley's framework guided a systematic search of five electronic databases. The search strategy retrieved 5979 unique articles. Forty-two studies met the inclusion criteria and informed this review. Facilitators and barriers were identified at three stages of using services: knowledge, access, and use of services. Findings concerning access to HCBS were subdivided into willingness and ability to access HCBS. Results emphasize the need for changes in healthcare systems, organizations, and providers to provide culturally appropriate care and improve the accessibility and acceptability of HCBS for informal caregivers of CLD older adults.
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Affiliation(s)
| | - Anna Garnett
- Nursing, 6221University of Western Ontario, London, ON, Canada
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Park VMT, Ly Q, von Oppenfeld J, Lee Y, Joo Y, Shin HW, Rhee Y, Park LG. A scoping review of dementia caregiving for Korean Americans and recommendations for future research. Clin Gerontol 2023; 46:223-239. [PMID: 36268979 PMCID: PMC9928901 DOI: 10.1080/07317115.2022.2133907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This scoping review aims to examine the caregiving experiences of Korean American caregivers of persons with dementia. METHODS A comprehensive electronic search was conducted within 5 databases (PubMed, CINAHL, Web of Science, Embase, PsycINFO-ProQuest) for papers published from 01/01/00 -01/24/22. Seventeen articles met the inclusion criteria. Thematic analysis was used to summarize key findings from these papers. RESULTS Most Korean American dementia caregivers were immigrants and wives/daughters/daughters-in-law. Two themes emerged: 1) how Korean American caregivers perceived their caregiving experiences, and 2) how Korean American caregivers perceived their caregiving support services. Korean American caregivers often experience poor mental health and burden. Social support and familism were found to be two of the most important factors that determine their attitudes toward caregiving. Most reported barriers to utilizing public services. Challenges in finding culturally relevant resources were common. CONCLUSIONS Dementia caregiving is a significant public health problem facing Korean Americans. Recommendations for future research are provided.
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Affiliation(s)
- Van M. Ta Park
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
- Asian American Research Center on Health (ARCH), University of California San Francisco, San Francisco, California, USA
- Multi-Ethnic Health Equity Research Center (MERC), University of California San Francisco, San Francisco, California, USA
| | - Quyen Ly
- J6-Acuity Adaptable Unit, Stanford Health Care, Stanford, California, USA
| | - Julia von Oppenfeld
- San Francisco Veteran Administration Health Care System, San Francisco, California, USA
| | - Yelim Lee
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Yoonmee Joo
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Hye-Won Shin
- Somang Society, Cypress, California, USA
- Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, California, USA
| | - YongJoo Rhee
- Department of Health Science, Dongduk Women’s University, Seoul, South Korea
| | - Linda G. Park
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
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Roberto KA, Savla J, McCann BR, Blieszner R, Knight AL. Dementia Family Caregiving in Rural Appalachia: A Sociocultural Model of Care Decisions and Service Use. J Gerontol B Psychol Sci Soc Sci 2022; 77:1094-1104. [PMID: 34951643 PMCID: PMC9159069 DOI: 10.1093/geronb/gbab236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Examinations of cultural variations in caregiving experiences and practices tend to focus on racially and ethnically diverse family caregivers. We extended this research by exploring the role of place-based cultural constructs on care decisions of family caregivers for persons living with dementia in rural Appalachia whose experiences and backgrounds dwell outside the lines of dominant culture. METHODS Guided by our sociocultural conceptual model of service use and a descriptive qualitative study design, we conducted in-depth interviews with 30 caregivers for persons living with dementia to understand how predisposing and enabling factors influence caregiving decisions, including the use of services to care for persons living with dementia. RESULTS Three predisposing factors reflecting the culture of rural Appalachian counties in Virginia (reasons for becoming a caregiver, previous caregiving experience, and deference to the person living with dementia) shaped decisions about caregiving responsibilities and service use. Three place-based enabling factors (a personal sense of belonging, knowledge of services, and family support for service use) played an important role in facilitating access to services. DISCUSSION Findings revealed subtle variation across caregivers in this study and in comparison, to caregivers' experiences more generally. We interpret these variations in light of culturally influenced attitudes, family norms, and sources of information about formal services. Place-based cultural experience influenced dementia family caregivers' behaviors and choices regarding formal service use, suggesting that investigators should pay more attention to cultural influences in future caregiving research.
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Affiliation(s)
- Karen A Roberto
- Center for Gerontology, Virginia Tech, Blacksburg, Virginia, USA
- Institute for Society, Culture, and Environment, Virginia Tech, Blacksburg, Virginia, USA
| | - Jyoti Savla
- Center for Gerontology, Virginia Tech, Blacksburg, Virginia, USA
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | | | | | - Aubrey L Knight
- Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
- Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
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Sharma RK, Teng A, Asirot MG, Taylor JO, Borson S, Turner AM. Challenges and Opportunities in Conducting Research with Older Adults with Dementia during
COVID
‐19 and Beyond. J Am Geriatr Soc 2022; 70:1306-1313. [PMID: 35285942 PMCID: PMC9106837 DOI: 10.1111/jgs.17750] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/14/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022]
Abstract
The coronavirus disease 19 (COVID‐19) pandemic has created significant and new challenges for the conduct of clinical research involving older adults with Alzheimer's disease and related dementias (ADRD). It has also stimulated positive adaptations in methods for engaging older adults with ADRD in research, particularly through the increased availability of virtual platforms. In this paper, we describe how we adapted standard in‐person participant recruitment and qualitative data collection methods for virtual use in a study of decision‐making experiences in older adults with ADRD. We describe key considerations for the use of technology and virtual platforms and discuss our experience with using recommended strategies to recruit a diverse sample of older adults. We highlight the need for research funding that supports the community‐based organizations on which improving equity in ADRD research participation often depends.
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Affiliation(s)
- Rashmi K. Sharma
- Division of General Internal Medicine University of Washington Seattle Washington
| | - Andrew Teng
- Department of Biomedical Informatics and Medical Education School of Medicine, University of Washington, Seattle Washington
| | - Mary Grace Asirot
- Department of Health Systems and Population Health School of Public Health, University of Washington Seattle Washington
| | - Jean O. Taylor
- Department of Health Systems and Population Health School of Public Health, University of Washington Seattle Washington
| | - Soo Borson
- Department of Psychiatry and Behavioral Sciences University of Washington Seattle Washington
- Department of Family Medicine, Keck School of Medicine University of Southern California Los Angeles California
| | - Anne M. Turner
- Department of Biomedical Informatics and Medical Education School of Medicine, University of Washington, Seattle Washington
- Department of Health Systems and Population Health School of Public Health, University of Washington Seattle Washington
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Halevi Hochwald I, Arieli D, Radomyslsky Z, Danon Y, Nissanholtz-Gannot R. Emotion work and feeling rules: Coping strategies of family caregivers of people with end stage dementia in Israel-A qualitative study. DEMENTIA 2022; 21:1154-1172. [PMID: 35130758 PMCID: PMC9189436 DOI: 10.1177/14713012211069732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background End stage dementia is an inevitable phase following a prolonged deterioration. Family
caregivers for people with end stage dementia who live in their home can experience an
emotional burden. Emotion work and “feeling-rules” refers to socially shared norms and
self-management of feelings, as well as projecting emotions appropriate for the
situation, aiming at achieving a positive environment as a resource for supporting
others’ wellbeing. Objectives Exploring and describing the experience of family caregivers of people with end stage
dementia at home, in Israel, unpacking their emotional coping and the
emotional-strategies they use, and placing family caregivers' emotion work in a cultural
context. Method We conducted fifty qualitative interviews using semi structured interviews analyzed
through a thematic content analysis approach. Findings Four characteristics of emotion work were identified: (1) sliding between detachment
and engagement, (2) separating the person from their condition (3), adoption of
caregiving as a social role and a type of social reinforcement, and (4) using the
caregiving role in coping with loneliness and emptiness. The emotional coping strategies
are culturally contextualized, since they are influenced by the participants’ cultural
background. Discussion This article’s focus is transparent family caregivers' emotion work, a topic which has
rarely been discussed in the literature is the context of caring for a family member
with dementia at home. In our study, emotion work appears as a twofold concept: the
emotion work by itself contributed to the burden, since family caregivers' burden
experience can evolve from the dissonance between their “true” feelings of anger and
frustration and their expected “acceptable” feelings (“feeling-rules”) formed by
cultural norms. However, emotion work was also a major source of coping and finding
strength and self-meaning. Understanding and recognizing the emotion work and the
cultural and religious influence in this coping mechanism can help professionals who
treat people with end stage dementia to better support family-caregivers.
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Affiliation(s)
- Inbal Halevi Hochwald
- Department of health systems management, Ariel University, Ariel, Israel; School of Nursing, Max Stern Yezreel Valley College, Israel
| | - Daniella Arieli
- School of Nursing, Max Stern Yezreel Valley, Israel; Department of Sociology and Anthropology, Max Stern Yezreel Valley College, Israel
| | - Zorian Radomyslsky
- Department of health systems management, Ariel University, Ariel, Israel; Maccabi Healthcare Services, Tel-Aviv, Israel
| | - Yehuda Danon
- Department of health systems management, 42732Ariel University, Ariel, Israel
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Hwang W, Yoon J, Brown MT, Silverstein M. Is the Relationship Between Religiosity and Filial Elder-Care Norms Declining? A Comparison Between Two Middle-Aged Generations. JOURNAL OF RELIGION SPIRITUALITY & AGING 2021; 33:362-381. [PMID: 34720769 DOI: 10.1080/15528030.2021.1900021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We investigated whether religiosity among middle-aged adults in the Baby Boom generation and Generation-X was associated with filial elder-care norms. The sample consisted of 720 Baby Boom and 520 Gen-X respondents participating in the Longitudinal Study of Generations. A cohort-comparative model was devised using data from Baby Boomers in 1994 and Gen-Xers in 2016, when they were 42 and 40 years old, respectively. A three-step latent class modeling technique identified three religious classes in both generations: strongly religious, weakly religious, and doctrinally religious. Weakly religious Baby Boomers and Gen-Xers reported weaker filial elder-care norms than the strongly religious in each generation. No difference in these effects were detected by generation. However, only among Baby Boomers did the doctrinally religious express stronger filial norms, suggesting cross-cohort weakening in how beliefs translate into filial responsibility in the absence of congregational practice. This research opens lines of inquiry that examine long-term effects of adult children's religiosity on the actual provision of assistance to older parents when they face health difficulties.
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Fleming V, Litzelman K. Caregiver resource utilization: Intellectual and development disability and dementia. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1468-1476. [PMID: 34124823 DOI: 10.1111/jar.12889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/03/2021] [Accepted: 04/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities and their families have high need for support services. This study assessed resource utilization among caregivers of intellectual and developmental disabilities and other conditions. METHODS We assessed 366 caregivers of adults with intellectual and developmental disabilities, dementia or other conditions Regressions assessed group differences in number of agency contacts and frequency of service use. A secondary analysis assessed reasons for underutilization of services. RESULTS Caregivers of individuals with dementia contacted twice as many agencies as other caregivers and were more likely to report using suggested services. Agency contact and service utilization were similar among caregivers of adults with intellectual and developmental disabilities compared to other caregivers. Caregivers of adults with intellectual and developmental indicated that suggested services were unavailable to them. CONCLUSION The findings of this study shed light on challenges with access to and utilization of support services.
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Affiliation(s)
- Victoria Fleming
- Department of Human Development & Family Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - Kristin Litzelman
- Department of Human Development & Family Studies, University of Wisconsin-Madison, Madison, WI, USA
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Robinson-Lane SG, Zhang X, Patel A. Coping and adaptation to dementia family caregiving: A pilot study. Geriatr Nurs 2021; 42:256-261. [PMID: 32891443 PMCID: PMC7921211 DOI: 10.1016/j.gerinurse.2020.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 11/29/2022]
Abstract
Family caregivers of Black older adults with dementia are at risk for cognitive decline and premature death. Reducing this risk and filling the void of culturally responsive interventions for caregivers requires the development of participant informed models of care that promote group strengths such as effective coping. In this pilot study, Black family caregivers (n=30) completed a survey comprised of a demographic questionnaire, various measures of function, self-efficacy, social support, and coping. Study findings point to a well-educated population with underlying health concerns such as obesity, hypertension, and diabetes that may be complicated by caregiving stress. Common coping strategies used by participants included spiritual coping (80%), use of past experiences (80%), and information gathering (75%). Clinicians can support dementia family caregivers by promoting spiritual coping and self-care, as well as providing reference resources about respite and managing challenging behaviors. Power analysis suggests a future sample size of 385.
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Affiliation(s)
- Sheria G Robinson-Lane
- University of Michigan School of Nursing, 400 N Ingalls Street, #4305, Ann Arbor, MI 48109, United States.
| | - Xingyu Zhang
- University of Michigan School of Nursing, 400 N Ingalls Street, #4305, Ann Arbor, MI 48109, United States
| | - Armaan Patel
- University of Michigan School of Nursing, 400 N Ingalls Street, #4305, Ann Arbor, MI 48109, United States
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Andruske CL, O'Connor D. Family care across diverse cultures: Re-envisioning using a transnational lens. J Aging Stud 2020; 55:100892. [PMID: 33272452 PMCID: PMC7573693 DOI: 10.1016/j.jaging.2020.100892] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 11/25/2022]
Abstract
In an increasingly globalized world, the importance of developing a more culturally complex understanding of family care has been clearly identified. This study explored family care across three different cultural groups - Chinese, South Asian, and Latin American - living in a metropolitan, Pacific-West, Canadian city. In-depth qualitative interviews were conducted with 29 family members from one of the three family groups exploring how they practiced 'care' for their aging, often frail, relatives. The importance of conceptualizing family care as a transnational, collective undertaking emerged from the outset as critical for understanding care practices in all three cultural communities. Three themes identified contributed to this conceptualization: the need to broaden the understanding of family care; the centrality of geographic mobility, and the need to rethink the location of aging and consider its relationship to mobility; and the use of technology by extended family networks to facilitate continuity and connection. An over-riding notion of 'flow' or fluid movement, rather than a fixed, static arrangement, emerged as critical for understanding family care. This perspective challenges the dominant approach to studying family care in gerontology that generally conceptualizes family care practice as one local primary caregiver, often female, with some support from other family members. Understanding family care from a transnational lens builds support for the importance of a feminist Ethics of Care lens and has important implications for policy and service delivery practices.
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Affiliation(s)
- Cynthia Lee Andruske
- Centro de Investigación en Educación, Salud y Deporte - Arequipa, Perú; Red Iberoamericana de Investigación en Desarrollo Biológico Humano, Talca, Chile; University of British Columbia, Vancouver, BC, Canada.
| | - Deborah O'Connor
- School of Social Work, University of British Columbia, Centre for Research on Personhood in Dementia (CRPD), Vancouver, BC, Canada; Centre for Research on Personhood in Dementia (CRPD), University of British Columbia, Vancouver, BC, Canada.
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Barriers and facilitators in the use of formal dementia care for dementia sufferers: A qualitative study with Chinese family caregivers in Hong Kong. Geriatr Nurs 2020; 41:885-890. [PMID: 32636021 DOI: 10.1016/j.gerinurse.2020.06.018] [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] [Received: 05/31/2020] [Revised: 06/26/2020] [Accepted: 06/26/2020] [Indexed: 11/22/2022]
Abstract
Understanding the barriers and facilitators in the use of formal dementia care for dementia sufferers is crucial. However, such studies have largely been conducted in Western countries, and current evidence is not fully applicable to Asian societies. This qualitative enquiry aims to identify the barriers and facilitators for family caregivers of persons with dementia (PwDs) to use relevant services at communities in Hong Kong. Semi-structured face-to-face interviews with 15 PwDs were conducted in three elderly care centres. The content analysis of transcribed audiotaped interviews revealed various barriers related to financial support, service availability and accessibility, life burden, and referral, and facilitators about family responsibility, perceived benefits, and caring relations. The culture rooted in Confucianism with a British melioration may play an important role in shaping PwDs' experiences in the use of dementia services in Hong Kong. Cultural sensitive services could be attempted to attract more PwDs to utilise them.
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22
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Anderson JG, Hundt E, Rose KM. Nonpharmacological Strategies Used By Family Caregivers of Persons With Alzheimer's Disease and Related Dementias as Presented in Blogs. J Gerontol Nurs 2020; 45:25-35. [PMID: 31237659 DOI: 10.3928/00989314-20190612-04] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/06/2019] [Indexed: 01/17/2023]
Abstract
Individuals with Alzheimer's disease and related dementias (ADRD) may exhibit behavioral and psychological symptoms of dementia that can increase the strain experienced by their family caregivers. This strain correlates with increased stress and reduced quality of life for the family caregiver and individual with ADRD. More information is needed regarding the ways in which caregivers manage the caregiving experience in their efforts to reduce strain and maintain or improve quality of life. Many individuals, including dementia caregivers, use web blogs as online journals to share their lived experiences. The current study used blogs written by family caregivers of persons with ADRD to explore strategies used to support their care recipients. Using a qualitative thematic analysis, six themes related to the strategies used by caregivers were identified: Modifying the Physical and Personal Environment; Engaging the Person With ADRD; Seeking Outside Assistance; Using Complementary Therapies; Planning and Organization; and Reminiscing and Traditions. The current findings extend our understanding of strategies for caregiving that are used by and acceptable to family caregivers of persons with ADRD. This information can be used to develop or modify nursing-related interventions and services aimed at improving caregiver strain and quality of life. [Journal of Gerontological Nursing, 45(7), 25-35.].
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Nguyen H, Zaragoza M, Wussler N, Lee JA. "I was Confused About How to Take Care of Mom Because this Disease is Different Everyday": Vietnamese American Caregivers' Understanding of Alzheimer's Disease. J Cross Cult Gerontol 2020; 35:217-234. [PMID: 32112183 PMCID: PMC8051361 DOI: 10.1007/s10823-020-09396-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Family members provide the majority of caregiving to individuals living with Alzheimer's disease (AD) and related dementias. Asian American families are disproportionately impacted by the burden of caregiving due to limited knowledge about the disease in this community. This study explored how Vietnamese American caregivers understand AD and provide care to family members with AD. Twenty caregivers who have provided care to a family member with AD participated in a semi-structured qualitative interview. Data were analyzed using thematic analysis. Several themes were identified in the caregivers' understanding of AD: (a) "Now I know:" the disruptions, shocks and surprises leading up to the initial diagnosis; (b) The frustrations of managing family members' cognitive impairments; (c)"Going with the flow:" challenges in managing personality and behavioral changes; (d) The exhaustion of around-the-clock caregiving; (e)"Taking it day by day" in the face of progressively worsening symptoms. Underlining the participants' descriptions of AD was a shared understanding of the progressively worsening, complex and unpredictable nature of the disease that makes it challenging for family caregivers on a daily basis. Findings provide important implications for healthcare workers' outreach to Vietnamese American families to ease the caregiving experience through culturally-responsive education, thereby enhancing the families' ability to recognize the early symptoms and seek appropriate help.
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Affiliation(s)
- Hannah Nguyen
- Department of Human Services, California State University, Dominguez Hills, Carson, CA, USA
| | - Michelle Zaragoza
- Department of Human Services, California State University, Dominguez Hills, Carson, CA, USA
| | - Natalie Wussler
- Department of Social Work, St. Olaf College, Northfield, MN, USA
| | - Jung-Ah Lee
- Sue and Bill Gross School of Nursing, University of California, 100A Berk Hall, Irvine, CA, 92697-3959, USA.
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Quiñones AR, Kaye J, Allore HG, Botoseneanu A, Thielke SM. An Agenda for Addressing Multimorbidity and Racial and Ethnic Disparities in Alzheimer's Disease and Related Dementia. Am J Alzheimers Dis Other Demen 2020; 35:1533317520960874. [PMID: 32969234 PMCID: PMC7984095 DOI: 10.1177/1533317520960874] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Advancements in Alzheimer's disease and related dementias (ADRD) research on the U.S. population acknowledge the importance of the high burden of ADRD on segments of the population and yet-to-be characterized risks attributable to the burden of multiple chronic diseases (multimorbidity). These realizations suggest successful strategies in caring for people with ADRD and their caregivers will rely not only on clinical treatments but also on more refined and comprehensive models of ADRD that take its broad effects on the whole-person and the whole of society into consideration. To this end, it is critical to characterize and address the relationship between ADRD and multimorbidity combinations that complicate care and lead to poor outcomes, particularly with regard to racial and ethnic disparities in the occurrence, course, and effects of ADRD. Several research and policy recommendations are presented to address the intersection of ADRD, multimorbidity, and underrepresented populations most at risk for adverse outcomes.
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Affiliation(s)
- Ana R. Quiñones
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
- OHSU-PSU School of Public Health, Portland, OR, USA
| | - Jeffrey Kaye
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Heather G. Allore
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Biostatistics, Yale University, New Haven, CT, USA
| | - Anda Botoseneanu
- Department of Health & Human Services, University of Michigan, Dearborn, MI, USA
- Institute of Gerontology, University of Michigan, Ann Arbor, MI, USA
| | - Stephen M. Thielke
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
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