Bridging the Gap: A Mixed Methods Study Investigating Caregiver Integration for People with Geriatric Syndrome

"Systems seem to get in the way": a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease

BACKGROUND

The well-being of informal caregivers of people living with chronic kidney disease is influenced by their experiences with support, however, few studies have focused on exploring these experiences. This study aimed to explore informal caregivers' experiences accessing and receiving support while caring for someone living with chronic kidney disease.

METHODS

Informal caregivers of people living with chronic kidney disease (n = 13) in the United Kingdom were primarily recruited via community organisations and social media adverts to participate in semi-structured interviews. Interviews explored support needs, experiences of receiving support from different groups (e.g. healthcare professionals, family/friends), and barriers and facilitators to accessing support. Support was understood as including emotional, practical, and informational support. Data were analysed using reflexive thematic analysis.

RESULTS

Three themes were generated: (1) "Systems seem to get in the way" - challenges within support systems, illustrating the challenges informal caregivers encountered when navigating complex support systems; (2) Relying on yourself, describing how informal caregivers leveraged their existing skills and networks to access support independently, while recognising the limitations of having to rely on yourself to find support; and (3) Support systems can "take the pressure off", showing how support systems were able to help informal caregivers cope with the challenges they experienced if certain conditions were met.

CONCLUSIONS

In response to the challenges informal caregivers experienced when seeking support, improvements are needed to better consider informal caregiver needs within healthcare systems, and to develop interventions tailored to informal caregiver needs and context. Within the healthcare system, informal caregivers may benefit from system navigation support and better integration within healthcare teams to ensure their informational support needs are met. New interventions developed to support informal caregivers should fit within their existing support systems and incorporate the qualities of support, such as empathy, that were valued. Additionally, use of an equity framework and user-centered design approaches during intervention development could help ensure interventions are accessible and acceptable.

Roles and experiences of informal caregivers of older adults in community and healthcare system navigation: a scoping review

OBJECTIVE

Informal caregivers are playing a vital role in improving the degree to which older adults access community and healthcare systems in a more seamless and timely manner, thereby fulfilling their complex needs. It is critical to understand their experiences and perspectives while navigating these systems. This review aimed to identify and organise the research findings on the roles and experiences of informal caregivers of older adults while navigating community and healthcare systems.

DESIGN

This scoping review was undertaken according to the Joanna Briggs Institute's Reviewer manual. Four databases were used: AgeLine, PsycINFO, CINAHL and Medline to capture literature with a focus on informal caregivers whose care recipients are aged 55 years or older. Articles were included if they focused on examining the experience, perspective and/or role of informal caregivers in providing care for their older care recipients, while articles were excluded if they only focused on healthcare professionals or older adults.

RESULTS

A total of 24 studies were identified that met the study inclusion criteria. This review elucidated the roles of caregivers as a primary system navigator and as an advocate for older adults. Numerous challenges/barriers in system navigation were uncovered, such as lack of consistency in fragmented systems, as well as facilitators, including interface/coordination roles. Finally, recommendations for better system navigation such as caregiver engagement and integration of continuity of care services were identified.

CONCLUSION

The need to raise the visibility of the roles and experiences of informal caregivers in system navigation was highlighted. Further research needs to focus on implementing interventions for informal caregivers incorporating a care coordinator to fill the care gap within community and healthcare systems. This review has the potential to foster greater integration of community and healthcare systems.

Just visiting: A qualitative study of Australian allied health professionals' experiences working in residential aged care facilities during the COVID-19 pandemic

OBJECTIVES

Internationally, the COVID-19 pandemic has negatively impacted health professionals' experiences of delivering effective care. The experiences of health professionals are important: poor experience has been associated with poorer patient outcomes and high staff turnover. This study aimed to narratively explore the impact of the COVID-19 pandemic on the experience of delivering allied health (AH) care in Australian residential aged care (RAC).

METHODS

Semistructured interviews were conducted in February-May 2022 with AH professionals who had experience working in RAC during the pandemic. Interviews were audio-recorded, transcribed verbatim and thematically analysed in NVivo 20. Twenty-five per cent of interview transcripts were independently analysed by three researchers to create a coding structure.

RESULTS

Three themes were identified from interviews with 15 AH professionals to describe experiences delivering care pre-COVID-19, during COVID-19, and perceptions of care delivery in future. Prepandemic AH in RAC was believed to be under-resourced, delivering low-quality and reactive care. During the pandemic, pauses in, and the slow resumption of, AH services exacerbated professionals' feelings of being undervalued in resident care and in the workforce. Participants were optimistic about the impact AH could have in RAC in future if practice was embedded, multidisciplinary and funded appropriately.

CONCLUSIONS

AH professionals' experiences of delivering care in RAC are often poor, regardless of the pandemic. Further research on multidisciplinary practice and health professional experience in RAC is needed.