scholarly journals Family Caregiving Disrupted by COVID-19: Overcoming Challenges Through Resilience and Flexibility

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 450-450
Author(s):  
Mary Wyman ◽  
Laura Wray
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Family Caregiving ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Service Access ◽  
Term Care ◽  
Technology Intervention ◽  
Care Systems

Abstract The impacts of the COVID-19 pandemic have been global and pervasive – yet only partially understood. Older adults and their family caregivers have experienced profound and unprecedented challenges as a result of COVID-19. This symposium features research on these disruptions and the creative adaptations undertaken in response. Four presentations present a variety of geographic regions, caregiving settings, and research focal points. Avidor and Ayalon present findings from interviews with family caregivers of residents in long-term care, highlighting the issues faced as a result of dramatic shifts in policy and procedures in support of pandemic infection control. Gum and colleagues focused on how service access has changed for community-dwelling older adults and their families during the pandemic, and how agencies may best leverage the flexibility of caregivers to adapt service provision. Boucher et al. compare the challenges faced by family caregivers during COVID-19 with those faced during a natural disaster, and highlight unique differences in service access for caregivers of military veterans. Finally, Ko and co-authors share their experience with the implementation of a technology intervention to reduce caregiver stress as part of a research trial, and how the protocol adjustments necessitated by COVID-19 revealed the unique potential of such technologies to support caregivers under isolated conditions. The presenters will focus on themes of resilience and lessons learned for health care systems, service agencies, and society to best support family caregivers in challenging circumstances moving forward.

scholarly journals 2400 How have characteristics of end-of-life family caregiving changed from 1999 to 2015? Preliminary results from two waves of nationally representative data

2018 ◽  
Vol 2 (S1) ◽  
pp. 82-82
Author(s):  
Judith Vick ◽  
Jennifer Wolff
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Family Caregivers ◽  
Family Caregiving ◽  
Physical Strain ◽  
Term Care ◽  
Care Survey ◽  
Nationally Representative ◽  
Over Time

OBJECTIVES/SPECIFIC AIMS: Family members are often critical in the delivery of hands-on care and decisions about care for persons approaching end-of-life (EOL). Prompted by concerns about the poor quality and high costs of care at the EOL, recent delivery reform efforts—such as the growth of hospice and palliative care—have been directed at improving EOL care for both patients and family. Trends of the characteristics of EOL family caregivers and care recipients over time have not been well described. The goal of this study is to evaluate changes in EOL family caregiving from 1999 to 2015. METHODS/STUDY POPULATION: This study uses reconciled data from two nationally representative surveys and their linked caregiver surveys: the 1999 wave of the National Long-Term Care Survey (NLTCS) and the Informal Care Survey (ICS), and the 2015 wave of the National Health and Aging Trends Study (NHATS) and the National Survey of Caregiving (NSOC). RESULTS/ANTICIPATED RESULTS: Crude analysis shows that older adults living in the community and receiving help from family caregivers in the last year of life were significantly better educated (72% with greater than 12 years of education vs. 46%), and more diverse (78% White vs. 89%) in 2015 compared with 1999. Family caregivers in the last year of life were less likely to be female in 2015 compared with 1999 (74% vs. 68%, NS) and significantly less likely to be spouses (45% vs. 38%) in 2015. In 2015, a significantly greater proportion of older adults received help with five or more activities of daily living (47% vs. 34%), but family caregivers reported significantly lower levels of caregiving-associated distress: financial strain (80% reporting none in 2015 vs. 53%), emotional (51% vs. 39%), and physical strain (70% vs. 45%). In addition, a significantly greater proportion of EOL family caregivers used respite care in 2015 compared to 1999 (15% vs. 4%). DISCUSSION/SIGNIFICANCE OF IMPACT: Changes in the experience of EOL family caregiving may be impossible to capture in studies of single interventions, but tracking nationally representative trends can be used as an indicator of broader changes that take place cumulatively over time. Although studies of this nature cannot identify causal mechanisms of change, they are important to monitor long-term impact of program implementation and to guide future research, policy, and resource allocation.

scholarly journals Perceptions and Understandings of Frailty Language: A Scoping Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 177-177
Author(s):  
Mariko Sakamoto ◽  
Pamela Durepos ◽  
Kyla Alsbury ◽  
Patricia Hewston ◽  
Alyson Takaoka ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Community Dwelling ◽  
Critical Examination ◽  
Primary Research ◽  
Care Systems ◽  
Research Studies

Abstract Diagnosing and responding to frailty in older adult populations is of growing interest for health care professionals, researchers and policymakers. Preventing frailty has the potential to improve health outcomes for older adults, which in turn has significant implications for health care systems. However, little is known about how older people understand and perceive the term “frailty”, and what it means for them to be designated as frail. To address this concern, a scoping review was undertaken to map the breadth of primary research studies that focus on community-dwelling older adults’ perceptions and understanding of frailty language, as well as explore the potential implications of being classified as frail. Searches were conducted in MEDLINE, Ageline, PsychInfo, CINAHL and EMBASE databases for articles published between January 1994 and February 2019. 4639 articles were screened and ten articles met the inclusion criteria, detailing eight primary research studies. Using content analysis, three core themes were identified across the included studies. These themes included: 1) understanding frailty as a multi-dimensional concept and inevitable consequence of aging, 2) perceiving frailty as a generalizing and harmful label; and 3) resisting and responding to frailty. Recommendations stemming from this review include the need for health care professionals to use person-centered language with older adults, discuss the term frailty with caution, and be aware of the potential consequences of labeling a person as frail. Importantly, this review demonstrates that for frailty interventions to be successful and meaningful for older adults, ongoing and critical examination of frailty language is necessary.

scholarly journals Perceptions of Family Caregivers of People With Dementia Regarding Symptom Management and the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 154-155
Author(s):  
Melissa Harris ◽  
Marita Titler
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Community Services ◽  
Community Dwelling ◽  
Care Recipient ◽  
Future Research ◽  
Service Access ◽  
Psychological Responses ◽  
People With Dementia ◽  
The Impact

Abstract Nearly 98% of older adults with Alzheimer’s disease and related dementias (ADRD) experience behavioral and psychological symptoms of dementia (BPSD). Although BPSD are linked to caregiver burden, perceptions of family caregivers on the impact of BPSD and their experiences addressing them in the home are unclear, and little is known about the impact of the pandemic on these experiences. Study aims were to explore: 1) the experiences of family caregivers of community dwelling older adults with ADRD regarding BPSD and how they manage BPSD in the home, and 2) how the pandemic impacted family caregivers’ experiences, BPSD of their relatives, and BPSD management. A qualitative, exploratory approach was used; 21 family caregivers were interviewed virtually. Content analysis and constant comparative methods were used. Ten major themes emerged: 1) Emotional and psychological responses of caregiver, 2) Loss, 3) Anticipation, 4) Reliance, 5) Learning to caregive, 6) Rewarding, 7) Emotional and psychological responses of care recipient 8) Cognition of care recipient, 9) Care strategies, 10) Caregiver perspectives. Caregivers did not use terms “behaviors” or “symptoms”, instead they described their relatives’ and their own experiences interdependently. Caregiving challenges presented before the pandemic (e.g. equivocal effects of medications, increasing care demands), many of which were compounded by the pandemic. Future research should explore the experiences of caregivers from a range of backgrounds. Findings illustrate communication barriers exist between clinicians, community services, people with ADRD and their families which may be addressed through clinician education, family-centered care planning, and policies to expand support service access.

scholarly journals A Theoretical Framework for the Development of Views of One’s Own Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 6-6
Author(s):  
Sarah Marrs ◽  
Jennifer Inker ◽  
Madeline McIntyre ◽  
Leland Waters ◽  
Tracey Gendron
Keyword(s):  
Older Adults ◽  
Medical Students ◽  
Assisted Living ◽  
Health Professions ◽  
Theoretical Framework ◽  
Community Dwelling ◽  
Mentoring Program ◽  
Term Care ◽  
Before And After ◽  
Students Attitudes

Abstract Senior mentoring programs have been established that provide medical students exposure to a community-dwelling older adult mentor. The goal of these programs is to expose students to healthy older adults, increase knowledge of geriatrics, and prepare them to care for an aging population. However, even while participating in a senior mentoring program, health professions students still demonstrate some discriminatory language towards older adults (e.g., Gendron, Inker, & Welleford, 2018). In fact, research suggests ageist practices occur, intentionally or not, among all health professions and within assisted living and long-term care facilities (e.g., Bowling, 1999; Dobbs et al., 2008; Kane & Kane, 2005). There is reason to believe that how we feel about other older adults is a reflection of how we feel about ourselves as aging individuals. As part of an evaluation of a Senior Mentoring program, we found that students’ attitudes towards older adults were not significantly improved (t (92) = .38, p = .70). To further explore this, we collected subsequent qualitative data. Specifically, we asked students to respond to the open-ended prompt before and after completing their senior mentoring program: How do you feel about your own aging? Our findings have revealed just how complex students’ views towards aging and elderhood are, pointing to a need to develop a theoretical framework for how these views are formed. Thus, the results of this qualitative grounded theory study illustrate the stages of development medical students’ progress through as they come to accept themselves as aging humans.

The Socialization of Unpaid Family Caregivers: A Scoping Review

2021 ◽  
pp. 016402752110050
Author(s):  
Kirstie McAllum ◽  
Mary Louisa Simpson ◽  
Christine Unson ◽  
Stephanie Fox ◽  
Kelley Kilpatrick
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Scoping Review ◽  
Family Caregiving ◽  
Family Processes ◽  
Future Research ◽  
Socialization Process ◽  
Role Negotiation ◽  
Role Learning ◽  
Socialization Agents

As unpaid family caregiving of older adults becomes increasingly prevalent, it is imperative to understand how family caregivers are socialized and how they understand the caregiving role. This PRISMA-ScR-based scoping review examines the published literature between 1995–2019 on the socialization of potential and current unpaid family caregivers of older adults. Of 4,599 publications identified, 47 were included. Three perspectives of socialization were identified: (1) role acculturation; (2) role negotiation and identification; and (3) specialized role learning. The findings show how socialization involves different contexts (e.g., cultures), imperatives for action (e.g., circumstances), socialization agents (e.g., family), processes (e.g., modeling), and internal (e.g., normalization) and external (e.g., identification) consequences for caregivers. Future research could fruitfully explore how caregivers manage key turning points within the socialization process, disengage from the caregiving role, and negotiate the socialization and individualization processes within diverse cultural and funding contexts.

scholarly journals Enhancing Our Understanding of Transitional Care Programs

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 136-137
Author(s):  
Katherine McGilton ◽  
Shirin Vellani ◽  
Alexandra Krassikova ◽  
Alexia Cumal ◽  
Sheryl Robertson ◽  
...  
Keyword(s):  
Older Adults ◽  
Transitional Care ◽  
Discharge Planning ◽  
Grey Literature ◽  
Occupational Therapists ◽  
Community Dwelling ◽  
Bibliographic Databases ◽  
Multidisciplinary Teams ◽  
Term Care ◽  
Hospitalized Older Adults

Abstract Many hospitalized older adults experience delayed discharge. Transitional care programs (TCPs) provide short-term care to these patients to prepare them for transfer to nursing homes or back to the community. There are knowledge gaps related to the processes and outcomes of TCPs. We conducted a scoping review following Arksey & O’Malley’s framework to identify the: 1) characteristics of older patients served by TCPs, 2) services provided within TCPs, and 3) outcomes used to evaluate TCPs. We searched bibliographic databases and grey literature. We included papers and reports involving community-dwelling older adults aged ≥ 65 years and examined the processes and/or outcomes of TCPs. The search retrieved 4828 references; 38 studies and 2 reports met the inclusion criteria. Most studies were conducted in Europe (n=19) and America (n=13). Patients admitted to TCPs were 59-86 years old, had 2-10 chronic conditions, 26-74% lived alone, the majority were functionally dependent and had mild cognitive impairment. Most TCPs were staffed by nurses, physiotherapists, occupational therapists, social workers and physicians, and support staff. The TCPs provided 5 major types of services: assessment, care planning, treatment, evaluation/care monitoring and discharge planning. The outcomes most frequently assessed were discharge destination, mortality, hospital readmission, length of stay, cost and functional status. TCPs that reported significant improvement in older adults’ functions (which was the main goal of the TCPs) included multiple services delivered by multidisciplinary teams. There is a wide variation in the operationalization of TCPs within and between countries.

scholarly journals The ACHIEVE Trial: Lessons Learned From Nesting a Randomized Controlled Trial Within an Observational Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 811-811
Author(s):  
Jennifer Deal ◽  
Nicholas Reed ◽  
David Couper ◽  
Kathleen Hayden ◽  
Thomas Mosley ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Observational Study ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Randomized Controlled ◽  
Study Staff ◽  
Increased Risk

Abstract Hearing impairment in older adults is linked to accelerated cognitive decline and a 94% increased risk of incident dementia in population-based observational studies. Whether hearing treatment can delay cognitive decline is unknown but could have substantial clinical and public health impact. The NIH-funded ACHIEVE randomized controlled trial of 977 older adults aged 70-84 years with untreated mild-to-moderate hearing loss, is testing the efficacy of hearing treatment versus health education on cognitive decline over 3 years in community-dwelling older adults (Clinicaltrials.gov Identifier: NCT03243422.) This presentation will describe lessons learned from ACHIEVE’s unique study design. ACHIEVE is nested within a large, well-characterized multicenter observational study, the Atherosclerosis Risk in Communities Study. Such nesting within an observational study maximizes both operational and scientific efficiency. With trial results expected in 2022, this presentation will focus on the benefits gained in design and recruitment/retention, including dedicated study staff, well-established protocols, and established study staff-participant relationships. Part of a symposium sponsored by Sensory Health Interest Group.

scholarly journals Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults

2021 ◽  
pp. 084456212110443
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Caregivers ◽  
Older Adult ◽  
Long Term Care ◽  
Home Care Services ◽  
Term Care ◽  
Care Services ◽  
Hospital To Home

Background An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Older adults often lack adequate support to transition from hospital to home, without access to appropriate health services when they are needed in the community and resources to live safely at home. Purpose This study collaborated with an existing enhanced home care program called Home Again in Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of multiple stakeholders, from December 2019 to February 2020, through analysis of nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results Findings indicate home care services for older adults are being sought too late, after hospital readmission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services led to barriers preventing family caregivers from continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional care services, highlighting the importance of investing in additional home care services for rehabilitation and prevention of rapidly deteriorating health.

Public-Private Partnership in Health and Long-Term Care

2018 ◽  
pp. 103-124
Author(s):  
Wing Tung Ho ◽  
Ben Yuk Fai Fong
Keyword(s):  
Hong Kong ◽  
Long Term Care ◽  
Health Care Systems ◽  
Public Private Partnership ◽  
Term Care ◽  
Related Services ◽  
Private Partnership ◽  
Aging Populations ◽  
Care Systems

An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.

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