Intention to use respite services among informal care-givers of frail older adults in China: the role of care needs change

2020 ◽  
Vol 41 (1) ◽  
pp. 101-120 ◽  
Author(s):  
Qian Sun ◽  
Nan Lu ◽  
Nan Jiang ◽  
Vivian W. Q. Lou
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Informal Care ◽  
Respite Care ◽  
Intention To Use ◽  
Care Giver ◽  
Care Needs ◽  
Frail Older Adults ◽  
Care Givers ◽  
Time Invariant

AbstractPopulation ageing in China calls for evidence-based solutions, especially in terms of fulfilling long-term care needs among frail older adults. Respite services are identified as effective resources for alleviating care-giver burden and promoting the wellbeing of both older adults and their family care-givers. However, respite care is often under-used in China. This research aimed to examine factors associated with intention to use respite services among informal care-givers in Shanghai, mainland China. This study was part of the Longitudinal Study on Family Caregivers for Frail Older Adults in Shanghai. Pairs of older adults and their care-givers (N = 583) who successfully completed the 2013 and 2016 waves were included in the data analysis. Two logistic regression models were conducted, one with time-invariant and one with time-variant factors. The model with time-variant factors had greater explanatory power than the original Andersen model with time-invariant factors influencing intention to use respite services among care-givers. Care-givers had higher odds of intending to use respite services if they had higher care-giving burden, were caring elderly people who experienced care-giver transitions, or were caring for elderly people with increased function of ambulation or decreased function of feeding. The findings imply that change in functional health was a significant determinant of intention to use respite care. Relevant policy and service implications will be discussed.

scholarly journals Qualitative exploration of the experiences of informal care-givers for dependent older adults in Mexico City

2018 ◽  
Vol 39 (11) ◽  
pp. 2377-2396 ◽  
Author(s):  
Liliana Giraldo-Rodríguez ◽  
Nathalia Guevara-Jaramillo ◽  
Marcela Agudelo-Botero ◽  
Dolores Mino-León ◽  
Mariana López-Ortega
Keyword(s):  
Older Adults ◽  
Mexico City ◽  
Informal Care ◽  
Family Care ◽  
Structured Interviews ◽  
Care Needs ◽  
Cross Sectional ◽  
Term Care ◽  
Care Givers ◽  
Care Giving

AbstractPopulation ageing and increasing prevalence of chronic diseases and their consequences, changes in family structure and a decrease in the potential pool of family care, increase the need for formal long-term care for older adults in Mexico, and the need to understand the experiences of informal care-givers and how this impacts their social, family and personal conditions. This study investigates the experience of informal care-givers of dependent older adults using a cross-sectional qualitative study with an ethnographic focus. Thematic analysis was performed. The study comprised 48 semi-structured interviews with care-givers of dependent older adults who are beneficiaries of an in-home medical programme in Mexico City. The average age of care-givers was 54.7 years (standard deviation = 13.1, range = 24–86) and 75 per cent (36) were women. Results show care-giving experiences are diverse and complex, and profoundly affect the care-giver's life in terms of emotional burden, health deterioration and adverse life conditions due to economic deprivation. They also revealed key aspects such as the need to improve communication between care-givers and health-care personnel, the need for training about specific care needs and opportunity costs incurred. This information can serve as a basis for generating support strategies that may be integrated into the in-home programme. It is essential to promote actions that consider the ‘dependent older adult–informal care-giver’ dyad, and that aim to reduce the care-giving burden.

scholarly journals Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives

2015 ◽  
Vol 36 (9) ◽  
pp. 1891-1914 ◽  
Author(s):  
GAYATHRI NAGANATHAN ◽  
KERRY KULUSKI ◽  
ASHLINDER GILL ◽  
LIISA JAAKKIMAINEN ◽  
ROSS UPSHUR ◽  
...  
Keyword(s):  
Older Adults ◽  
Informal Care ◽  
Health And Safety ◽  
Perceived Value ◽  
Family Health ◽  
Family Physicians ◽  
Care Giver ◽  
Structured Interviews ◽  
Supportive Services ◽  
Care Givers

ABSTRACTThis study investigated the perceived value of informal and formal supports for older adults with multi-morbidity from the perspectives of patients, care-givers and family physicians. Semi-structured interviews were conducted with 27 patients, their informal care-givers and their family physicians in an urban academic family health team in Ontario. Analysis was conducted using a General Inductive Approach to facilitate identification of main themes and build a framework of perceived value of supports. Participant views converged on supports that facilitate patient independence and ease care-giver burden. However, important differences in participant perceptions arose regarding these priorities. Physicians and care-givers valued supports that facilitate health and safety while patients prioritised supports that enable self-efficacy and independence. While formal supports which eased care-giver burden were viewed positively by all members of the triad, many patients also rejected formal supports, citing that informal support from their care-giver was available. Such conflicts between patient, care-giver and physician-perceived value of supports may have important implications for consumer and care-giver willingness to accept formal supports when supports are available. These findings contribute to the broader literature on community-based care by incorporating the perspectives of patients, informal care-givers and family physicians to understand better the barriers and facilitators of uptake of supportive services that contribute to successful ageing at home.

scholarly journals Linkages between informal and formal care-givers in home-care networks of frail older adults

2015 ◽  
Vol 36 (8) ◽  
pp. 1604-1624 ◽  
Author(s):  
MARIANNE JACOBS ◽  
THEO VAN TILBURG ◽  
PETER GROENEWEGEN ◽  
MARJOLEIN BROESE VAN GROENOU
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Informal Care ◽  
Community Dwelling ◽  
Care Recipient ◽  
Formal Care ◽  
Care Giver ◽  
Care Network ◽  
Care Givers ◽  
Care Recipients

ABSTRACTIn ageing societies, policy makers aim for more contact between informal and formal care-givers as it may enhance the quality of care. So far, the linkage between formal and informal care-givers is generally studied from a one-sided or a single dyadic perspective, without taking into account that care networks of community-dwelling older adults often exist of multiple informal and formal care-givers. The current study examines discussion of care between all potential informal–formal care-giver dyads in a care network, and relates this to characteristics of the older care recipient, the care network and the care-givers. Seventy-four Dutch older care recipients provided information on all care-givers who helped with five different types of tasks; 410 care-givers reported on the contact between all care-givers identified. Multi-level logistic regression was conducted in 2,150 informal–formal care-giver dyads and revealed that in 26 per cent of all these dyads discussion on care occurred. This was more likely when both care-givers performed multiple types of tasks, the informal care-giver was residing with the care recipient, and contact within the formal and the informal sub-network was higher. To enhance discussion of care between informal and formal care-givers in care networks where no discussion occurs at all, home-care organisations may need to allocate formal care-givers who form a bridge with an extra-residential care-giver of care recipients living alone.

scholarly journals The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care

CJEM ◽  
2015 ◽  
Vol 18 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Judah Goldstein ◽  
Jennifer McVey ◽  
Stacy Ackroyd-Stolarz
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Emergency Medical Services ◽  
Acute Care ◽  
Functional Independence ◽  
Adverse Outcomes ◽  
Medical Services ◽  
Care Needs ◽  
Frail Older Adults ◽  
Emergency Medical

AbstractCaring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step.

scholarly journals A NATIONAL PROFILE OF FRAIL OLDER ADULTS WITH INSUFFICIENT CARE AND MISMATCHED SUPPORT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S798-S798
Author(s):  
Jyoti Savla ◽  
Karen A Roberto ◽  
Laura Sands
Keyword(s):  
Older Adults ◽  
Informal Care ◽  
National Health ◽  
Unmet Needs ◽  
Self Care ◽  
Sociodemographic Factors ◽  
Community Living ◽  
Care Needs ◽  
Household Activities ◽  
National Profile

Abstract Older adults differ widely both in the care they require and who they rely upon for care. We use data from the National Health and Aging Trends Study (2011; N=3,265; MAge [SD] = 77 [7.74] years, 62% women) to classify community-living older adults based on their care needs and the various informal and formal providers of care. We also examine the type of care they receive, predictors of this care, and its implications on their health. Older adults with a co-residing caregiver were more likely to report that their needs were not being met (OR = 1.67; 95% CI=1.15–2.42), compared to those who received informal care and paid support. Moreover, older adults who needed help with self-care activities, but received help with household activities were more likely to report unmet needs (OR = 1.55; 95% CI=1.13–2.12). Results are discussed in light of sociodemographic factors differences and mismatched support.

scholarly journals Increasing autonomy through improved care: effects of a professional care-giver training programme on the functional status of older adults

2021 ◽  
pp. 1-18
Author(s):  
Elena Navarro ◽  
Miriam Sanjuán ◽  
M. Dolores Calero
Keyword(s):  
Older Adults ◽  
Treatment Group ◽  
Barthel Index ◽  
Training Programme ◽  
Cognitive Stimulation ◽  
Initial Assessment ◽  
Care Giver ◽  
Care Givers ◽  
Professional Care

Abstract The aim of the present research was to evaluate the effectiveness of a care-giver training programme that trains professional care-givers in cognitive stimulation strategies for functional maintenance in care-dependent older adults. The sample contained 69 older adults (37 in the treatment group, 32 control group) assessed with the Barthel Index, the Mini-Mental State Examination and the Clifton Assessment Procedure for the Elderly (Cognitive Scale). Participants in the treatment group were treated by professional care-givers who were trained with the programme CUIDA-2 in communication and cognitive stimulation strategies. The results from the Barthel Index showed significant differences in the post-intervention assessment and in the follow-up assessment, where the treatment group obtained higher scores, and there were significant differences within the treatment group between the initial assessment and the post-treatment assessment, as well as between the initial assessment and the follow-up. The data obtained reflect that a training programme to train professional care-givers produced functional benefits in the older adults, and these improvements persisted over time. Moreover, the care-givers saw themselves as more competent and more satisfied with their work.

scholarly journals Multicultural voices: attitudes of older adults in the United States of America about elder mistreatment

2012 ◽  
Vol 34 (5) ◽  
pp. 877-903 ◽  
Author(s):  
SUSAN M. ENGUIDANOS ◽  
MARGUERITE DELIEMA ◽  
IRIS AGUILAR ◽  
JORGE LAMBRINOS ◽  
KATHLEEN H. WILBER
Keyword(s):  
United States ◽  
Older Adults ◽  
United States Of America ◽  
Partner Violence ◽  
Elder Abuse ◽  
The United States ◽  
Care Needs ◽  
Elder Mistreatment ◽  
Care Givers ◽  
Racial Ethnic

ABSTRACTDespite international growth in policies to increase the identification and response to elder abuse and neglect, there remain considerable barriers to treating the problem. Some of these barriers may be attributed to how older adults from different racial/ethnic backgrounds define, experience and seek to remedy elder mistreatment. Using focus group discussions based on case vignettes, this paper examines how older adults from different racial and ethnic backgrounds in the United States of America perceive elder mistreatment. Five focus groups were conducted with African Americans, English-speaking Latinos, Spanish-speaking Latinos, non-Latino Whites and African American care-givers for older adults. While similar definitions and meanings of elder abuse were expressed across the different racial/ethnic groups, Latino participants introduced additional themes of machismo, respect, love and early intervention to stop abuse, suggesting that perceptions/beliefs about elder mistreatment are determined by culture and degree of acculturation in addition to race/ethnicity. Most differences in attitudes occurred within groups, demonstrating that perceptions vary by individual as well as by culture. In identifying scenarios that constitute elder mistreatment, some participants felt that certain cases of abuse are actually the persistence of intimate partner violence into old age. Participants also indicated that victims may prefer to tolerate mistreatment in exchange for other perceived benefits (e.g. companionship, security); and out of fear that they could be placed in an institution if mistreatment is reported. Findings suggest the need for person-centred intervention and prevention models that integrate the cultural background, care needs and individual preferences of older adults.

scholarly journals Factors affecting missed nursing care in hospitalized frail older adults in the medical wards: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zahra Rezaei-Shahsavarloo ◽  
Foroozan Atashzadeh-Shoorideh ◽  
Abbas Ebadi ◽  
Robbert J. J. Gobbens
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Nursing Care ◽  
Care Needs ◽  
Factors Affecting ◽  
Frail Older Adults ◽  
Communication Problems ◽  
Moderating Factors ◽  
High Care ◽  
Missed Nursing Care

Abstract Background Frail older adults who are hospitalized, are more likely to experience missed nursing care (MNC) due to high care needs, communication problems, and complexity of nursing care. We conducted a qualitative study to examine the factors affecting MNC among hospitalized frail older adults in the medical units. Methods This qualitative study was carried using the conventional content analysis approach in three teaching hospitals. Semi-structured interviews were conducted with 17 nurses through purposive and snowball sampling. The inclusion criteria for the nurses were: at least two years of clinical work experience on a medical ward, caring for frail older people in hospital and willingness to participate. Data were analyzed in accordance with the process described by Graneheim and Lundman. In addition, trustworthiness of the study was assessed using the criteria proposed by Lincoln and Guba. Results In general, 20 interviews were conducted with nurses. A total of 1320 primary codes were extracted, which were classified into two main categories: MNC aggravating and moderating factors. Factors such as “age-unfriendly structure,” “inefficient care,” and “frailty of older adults” could increase the risk of MNC. In addition, factors such as “support capabilities” and “ethical and legal requirements” will moderate MNC. Conclusions Hospitalized frail older adults are more at risk of MNC due to high care needs, communication problems, and nursing care complexity. Nursing managers can take practical steps to improve the quality of care by addressing the aggravating and moderating factors of MNC. In addition, nurses with a humanistic perspective who understand the multidimensional problems of frail older adults and pay attention to their weakness in expressing needs, can create a better experience for them in the hospital and improve patient safety.

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