“I Can't Do This Alone”: a study on foreign domestic workers providing long-term care for frail seniors at home

2017 ◽  
Vol 30 (9) ◽  
pp. 1269-1277 ◽  
Author(s):  
Wai Jia Tam ◽  
Gerald Choon-Huat Koh ◽  
Helena Legido-Quigley ◽  
Ngoc Huong Lien Ha ◽  
Philip Lin Kiat Yap
Keyword(s):  
Coping Strategies ◽  
Family Dynamics ◽  
Family Members ◽  
Well Being ◽  
Domestic Workers ◽  
Tertiary Hospital ◽  
Term Care ◽  
Foreign Domestic Workers ◽  
At Home

ABSTRACTBackground:Foreign domestic workers (FDWs) play an important role in long-term caregiving of seniors at home. However, how FDWs cope with the caregiving demands, the dynamic interaction between familial and FDW caregivers and its impact on care recipients remain largely un-explored. Existing caregiver interventions mainly target familial caregivers; little assistance is available for FDW caregivers. This study explores FDWs’ challenges, coping strategies, and the support they need in caring for seniors.Methods:FDWs were recruited from a geriatric ward and outpatient clinic of a tertiary hospital in Singapore. Qualitative in-depth interviews were conducted with 25 FDWs caring for frail seniors and five healthcare staff. Interviews were transcribed and analyzed using thematic analysis.Results:FDWs were from Indonesia, Philippines, and Myanmar. Nineteen cared for seniors with dementia (SWDs). We derived six subthemes, clustered into three salient themes: two described social support to FDWs by the senior's family members, two described their coping strategies, and two described their job satisfaction. Those who cared for SWDs faced more difficulties. We derived two family models of care: FDW-centered family dynamics, where family members rely on FDWs to perform most duties, causing poor impact on seniors’ well-being and team-based family dynamics, where family members and FDWs share the caregiving burden, resulting in better impact on seniors’ well-being.Conclusion:FDWs face significant challenges in eldercare. Improving FDWs’ access to training courses in eldercare, providing them with more emotional support, engaging employers to create healthy caregiving spaces at home, and improving access to senior care services can be helpful.

scholarly journals Foreign domestic workers providing long-term care for frail seniors at home

2018 ◽  
Vol 30 (10) ◽  
pp. 1567-1567
Author(s):  
Sora Yasri ◽  
Viroj Wiwanitkit
Keyword(s):  
Long Term Care ◽  
Domestic Workers ◽  
Term Care ◽  
Local Schools ◽  
Care Services ◽  
Short Course ◽  
Training Courses ◽  
Foreign Domestic Workers ◽  
At Home

We read the article on “‘I can't do this alone’: a study on foreign domestic workers providing long-term care for frail seniors at home” with a great interest (Tam et al., 2017). Tam et al. (2017) noted that “[i]mproving FDWs' access to training courses in eldercare, providing them with more emotional support, engaging employers to create healthy caregiving spaces at home, and improving access to senior care services can be helpful.” This finding is very interesting. In fact, FDW service is common in several countries and approved for usefulness (Østbye et al., 2013). Of interest, the FDWs are usually from the poor developing countries. It is no doubt that the FDWs usually have low education level. Therefore, the education for them has to be carefully considered. We would like to share ideas from Thailand, where several FDW from nearby countries are currently employed. At present, there are many local schools offering inexpensive short course training on home care for elderly people and this becomes a popular course for FDW to attend. Nowadays, before employment, the employers usually ask for certification for verification of the proficiency of the FDW.

scholarly journals Intimacy for older adults in long-term care: a need, a right, a privilege—or a kind of care?

2021 ◽  
pp. medethics-2020-107171
Author(s):  
Vanessa Schouten ◽  
Mark Henrickson ◽  
Catherine M Cook ◽  
Sandra McDonald ◽  
Nilo Atefi
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Family Members ◽  
Well Being ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Survey Tool ◽  
Whole Person

BackgroundTo investigate attitudes of staff, residents and family members in long-term care towards sex and intimacy among older adults, specifically the extent to which they conceptualise sex and intimacy as a need, a right, a privilege or as a component of overall well-being.MethodsThe present study was a part of a two-arm mixed-methods cross-sectional study using a concurrent triangulation design. A validated survey tool was developed; 433 staff surveys were collected from 35 facilities across the country. Interviews were conducted with 75 staff, residents and family members.ResultsIt was common for staff, residents and family members to talk about intimacy and sexuality in terms of rights and needs. As well as using the language of needs and rights, it was common for participants to use terms related to well-being, such as fun, happiness or being miserable. One participant in particular (a staff member) described receiving intimate touch as a ‘kind of care’—a particularly useful way of framing the conversation.ConclusionWhile staff, residents and family frequently used the familiar language of needs and rights to discuss access to intimate touch, they also used the language of well-being and care. Reframing the conversation in this way serves a useful purpose: it shifts the focus from simply meeting minimum obligations to a salutogenic approach—one that focuses on caring for the whole person in order to improve overall well-being and quality of life.

scholarly journals Family Members' Perceptions of Their Psychological Responses One Year Following Pediatric Intensive Care Unit (PICU) Hospitalization: Qualitative Findings From the Caring Intensively Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Janet E. Rennick ◽  
Alyssa M. Knox ◽  
Stephanie C. Treherne ◽  
Karen Dryden-Palmer ◽  
Robyn Stremler ◽  
...  
Keyword(s):  
Family Dynamics ◽  
Sense Of Self ◽  
Family Members ◽  
Behavioral Responses ◽  
Well Being ◽  
New Normal ◽  
The Family ◽  
Health And Illness ◽  
One Year

Introduction: PICU hospitalization can have a profound impact on child survivors and their families. There is limited research on children's long-term recovery within the context of the family following critical illness. This study aimed to explore children's and parents' perceptions of long-term psychological and behavioral responses within the context of the family one year following PICU hospitalization.Materials and Methods: Caring Intensively is a mixed methods multi-site prospective cohort study that aims to examine children's psychological and behavioral responses over a 3-year period following PICU hospitalization. In this study, part of the qualitative arm of Caring Intensively, an interpretive descriptive design was used to explore children's recovery one year post-discharge. Purposive sampling was used to select 17 families, including 16 mothers, 6 fathers, and 9 children. Semi-structured, audio-recorded interviews were conducted. Data were analyzed iteratively using the constant comparison method.Results: Families described efforts to readapt to routine life and find a new normal following PICU hospitalization. Finding a New Normal consisted of four major themes: (1) Processing PICU Reminders and Memories, (2) Changing Perceptions of Health and Illness, (3) We Are Not the Same, and (4) Altered Relationships. Participants described significant emotional and behavioral changes during the year following discharge. The psychological impact of individual family members' experiences led to changes in their sense of self, which affected family dynamics. PICU memories and reminders impacted participants' perceptions of childhood health and illness and resulted in increased vigilance. Parents and siblings demonstrated increased concern for the child survivor's health, and the experience of long absences and new or altered caregiving roles resulted in changes in relationships and family dynamics.Conclusion: PICU hospitalization impacted the psychological well-being of all family members as they sought to re-establish a sense of normalcy one year following discharge. Parent and child experiences and responses were closely interconnected. Findings highlight the importance of increased follow-up care aimed at supporting the family's psychological recovery.

Social Connectivity in the Context of COVID-19 and Long-Term Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 410-410
Author(s):  
Anna Garnett ◽  
Hannah Pollock ◽  
Natalie Floriancic ◽  
Lorie Donelle ◽  
Yolanda Babenko-Mould ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Connectedness ◽  
Long Term Care ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Well Being ◽  
Care Homes ◽  
Health Providers ◽  
Term Care

Abstract The COVID-19 pandemic has disproportionately impacted older adults, particularly those residing in long-term care homes (LTCHs), causing immense loss of life and resulting in overall health declines in LTCH residents. These vulnerable older adults have also experienced extreme loneliness, anxiety and depression. Social connectedness is an important contributor to well-being and quality of life of older adults in LTCHs and family members are an essential component to this. However, restrictions driven by policies to protect resident safety, have constrained family members’ access to long-term care homes and limited in-person contact between residents and their families. In their absence, health providers have been integral to supporting connections between residents and their families within LTCHs. This study aimed to understand the experiences of social connectedness between residents and family members who have been physically separated due to the current pandemic and, to examine LTCH health providers’ experiences and responses to support social connectedness. Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with 21 family members and 11 healthcare providers. Emergent themes from qualitative content analysis are: (a) all-encompassing impacts of separation; (b) advocacy became my life; (c) the emotional toll of the unknown; 4) the burden of information translation; 5) precarious balance between safety and mistrust for the healthcare system; and (d) a formulaic approach impedes connectivity. A more comprehensive understanding of the experiences and support needs of LTCH residents and their family members within the context of a pandemic can inform practice approaches to support social connections going forwards.

scholarly journals Mental well‐being of staff in long‐term care facilities at risk

2021 ◽  
Author(s):  
Chiaki Ura ◽  
Tsuyoshi Okamura ◽  
Akinori Takase ◽  
Masaya Shimmei ◽  
Yukan Ogawa
Keyword(s):  
At Risk ◽  
Long Term Care ◽  
Well Being ◽  
Term Care ◽  
Care Facilities ◽  
Mental Well Being

scholarly journals Digital Technologies To Enhance Social Connectedness in Long-Term Care Facilities During COVID-19: A Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 942-943
Author(s):  
Shannon Freeman ◽  
Aderonke Abgoji ◽  
Alanna Koopmans ◽  
Christopher Ross
Keyword(s):  
Social Isolation ◽  
Rural Areas ◽  
Social Connectedness ◽  
Long Term Care ◽  
Care Facility ◽  
Well Being ◽  
Sufficient Information ◽  
Term Care ◽  
Care Facilities

Abstract A consequence of the strict visitor restrictions implemented by many Long-term Care Facilities (LTCFs), during the COVID-19 pandemic, was the exacerbation of loneliness and social isolation felt by older adult residents. While there had been a shift by some persons to utilize digital solutions to mitigate the effects of the imposed social isolation, many facilities did not have sufficient information regarding available solutions to implement institutional strategies to support social connectedness through digital solutions. To support our partners in evidence-based policy-making we conducted a scoping review to identify existing virtual technology solutions, apps, and platforms feasible to promote social connectedness among persons residing in a long-term care facility context during times of lockdown such as experienced during the COVID-19 pandemic. Initial identification of relevant literature involved a combination of keywords and subject headings searches within 5 databases (PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI). DistillerSR was used to screen, chart and summarize the data. There is growth in the availability of technologies focused on promoting health and well-being in later life for persons in long-term care facilities however a gap remains in widespread uptake. We will describe the breadth of technologies identified in this review and discuss how they vary in utility in smaller scale facilities common in rural areas. Of the technologies that can be used to mitigate the impacts of social isolation felt by long-term care residents, many “solutions” depend on stable highspeed internet, which remains a challenge in rural and northern areas.

scholarly journals Informal carer in Portugal: moving towards political recognition in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Fronteira ◽  
J Simoes ◽  
G Augusto
Keyword(s):  
Informal Care ◽  
Long Term Care ◽  
Well Being ◽  
Oecd Countries ◽  
Low Fertility ◽  
Informal Carer ◽  
Term Care ◽  
System Perspective ◽  
Informal Carers

Abstract Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries. Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers. The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation. Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers. Key messages Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

scholarly journals #MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19

2020 ◽  
Author(s):  
Candace L Kemp
Keyword(s):  
Family Involvement ◽  
Long Term Care ◽  
Research Policy ◽  
Well Being ◽  
Direct Care ◽  
Negative Consequences ◽  
Public Health Response ◽  
Term Care ◽  
Care Partners

Abstract The public health response to the current Coronavirus pandemic in long-term care communities, including assisted living, encompasses prohibiting visitors. This ban, which includes family members, has been criticized for being unfair, unhealthy, and unsafe. Against this backdrop, I examine the roles family play in residents’ daily lives and care routines. I argue that classifying family as “visitors” rather than essential care partners overlooks their critical contributions and stems from taken-for-granted assumption about gender, families, and care work, and I demonstrate why families are more than visitors. Policies that ban family visits also reflect a narrow understanding of health that focuses on mitigating infection risk, but neglects overall health and well-being. This policy further stems from a limited comprehension of care relations. Research shows that banning family visits has negative consequences for residents, but also families themselves, and direct care workers. I argue that identifying ways to better understand and support family involvement is essential and demonstrate the utility of the Convoys of Care model for guiding the reconceptualization of family in long-term care research, policy, and practice during and beyond the pandemic.

scholarly journals Attitudes Toward Sexual Behaviors in Long-Term Care: Development of an Assessment Tool

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 602-603
Author(s):  
Rachael Spalding ◽  
Emma Katz ◽  
Barry Edelstein
Keyword(s):  
Sexual Behaviors ◽  
Long Term Care ◽  
Assessment Tool ◽  
Qualitative Interviews ◽  
Family Members ◽  
Community Dwelling ◽  
Term Care ◽  
Care Development

Abstract Most older adults living in long-term care settings (LTCs) indicate that expressing their sexuality is important to them (Doll, 2013). Little is known about the general public’s attitudes towards sexual behaviors in LTCs. Attitudes of LTC residents’ family members are particularly important, as family members are most likely to visit residents and to care about their quality of life. Family members’ attitudes could in turn inform facility policies and management. We will present preliminary data from a series of qualitative interviews with community-dwelling adults regarding their attitudes. We will discuss how these data are being used to inform current work on a measure of attitudes toward sexual behavior in LTCs.

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