scholarly journals IDENTIFYING PREDICTORS OF GUILT FOLLOWING PLACEMENT OF FAMILY MEMBER WITH DEMENTIA INTO RESIDENTIAL LONG-TERM CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S486-S487
Author(s):  
Tamara L Statz ◽  
Colleen M Peterson ◽  
Robyn Birkeland ◽  
Aneri Shah ◽  
Kobe Perez ◽  
...  
Keyword(s):  
Family Member ◽  
Family Caregivers ◽  
Long Term Care ◽  
Controlled Trial ◽  
Adult Child ◽  
Spousal Caregivers ◽  
Term Care ◽  
The Impact ◽  
Residential Long Term Care

Abstract Family caregivers of persons with dementia experience guilt for various reasons when placing their family member into residential long-term care (RLTC). Research has shown a relationship between guilt and overall caregiver burden; however, literature on predictors of guilt related to caregiving following RLTC placement is limited. The Residential Care Transition Module (RCTM) provides counseling and psychoeducation to family caregivers who have recently moved their family member with Alzheimer’s disease or a related dementias into RLTC. This semi-structured intervention provides counseling on various topics including guilt, grief, and family dynamics. Using treatment group data (N=87) from the parent RCTM randomized controlled trial, we identified the impact of caregiver status (i.e., adult child vs spousal caregivers), sense of caregiver competence, and relationship closeness on baseline measures of guilt status and magnitude. Preliminary analyses showed that adult child status was associated with greater prevalence of guilt (37.5%) compared to spousal caregivers (26.7%). In addition, qualitative case notes were coded to identify common themes of experiences of guilt to inform practice. Examples include: Guilt related to no longer being able to care for the family member at home; not meeting self-dictated expectations (e.g., not visiting or staying long enough); and feeling guilted into being a caregiver in the first place. The current analyses aim to help practitioners better predict risk for placement-related guilt and highlight specific issues practitioners should consider to help mitigate such feelings. Specific opportunities for intervention are discussed.

scholarly journals Places of living and places of dying: the case for preventing suicide in residential long-term care

2020 ◽  
pp. 1-16
Author(s):  
Briony Jain ◽  
Viktoryia Kalesnikava ◽  
Joseph E. Ibrahim ◽  
Briana Mezuk
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Residential Care ◽  
Long Term Care ◽  
Public Health Problem ◽  
Future Research ◽  
Term Care ◽  
The Impact ◽  
Residential Long Term Care

Abstract This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.

scholarly journals Insights into the impact and use of research results in a residential long-term care facility: a case study

2012 ◽  
Vol 7 (1) ◽  
Author(s):  
Lisa A Cranley ◽  
Judy M Birdsell ◽  
Peter G Norton ◽  
Debra G Morgan ◽  
Carole A Estabrooks
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Research Results ◽  
Long Term Care Facility ◽  
The Impact ◽  
Residential Long Term Care

scholarly journals Caring Near and Far by Connecting Community-Based Clients and Family Member/Friend Caregivers Using Passive Remote Monitoring: Protocol for a Pragmatic Randomized Controlled Trial

10.2196/15027 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e15027
Author(s):  
Lorie Donelle ◽  
Sandra Regan ◽  
Michael Kerr ◽  
Merrick Zwarenstein ◽  
Michael Bauer ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Member ◽  
Controlled Trial ◽  
Term Care ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled ◽  
The Family ◽  
The Impact

Background Significant chronic disease challenges exist among older adults. However, most older adults want to remain at home even if their health conditions challenge their ability to live independently. Yet publicly funded home care resources are scarce, private home care is expensive, and family/friend caregivers have limited capacity. Many older adults with chronic illness would require institutional care without the support from family member/friend caregivers. This role raises the risk of physical health problems, stress, burnout, and depression. Passive remote monitoring (RM), the use of sensors that do not require any action by the individual for the system to work, may increase the older adult’s ability to live independently while also providing support and peace of mind to both the client and the family member/friend caregiver. Objective This paper presents the protocol of a study conducted in two provinces in Canada to investigate the impact of RM along with usual home care (the intervention) versus usual home care alone (control) on older adults with complex care. The primary outcome for this study is the occurrence of and time to events such as trips to emergency, short-term admission to the hospital, terminal admission to the hospital awaiting admission to long-term care, and direct admission to long-term care. The secondary outcomes for this study are (1) health care costs, (2) client functional status and quality of life in the home, (3) family/friend caregiver stress, and (4) family/friend caregiver functional health status. Methods The design for this study is an unblinded pragmatic randomized controlled trial (PRCT) with two parallel arms in two geographic strata (Ontario and Nova Scotia). Quantitative and qualitative methodologies will be used to address the study objectives. This PRCT is conceptually informed by the principles of client-centered care and viewing the family as the client and aims at providing supported self-management. Results This study is supported by the Canadian Institutes for Health Research. A primary completion date is anticipated in fall 2022. Conclusions Findings from this real-world rigorous randomized trial will support Canadian decision-makers, providers, and clients and their caregivers in assessing the health, well-being, and economic benefits and the social and technological challenges of integrating RM technologies to support older adults to stay in their home, including evaluating the impact on the burden of care experienced by family/friend caregivers. With an aging population, this technology may reduce institutionalization and promote safe and independent living for the elderly as long as possible. Trial Registration International Standard Randomised Controlled Trial Number (ISRCTN) 79884651; http://www.isrctn.com/ISRCTN79884651 International Registered Report Identifier (IRRID) DERR1-10.2196/15027

scholarly journals Transitioning to Long-Term Care: Family Caregiver Experiences of Dementia, Communities, and Counseling

2020 ◽  
Vol 33 (1-2) ◽  
pp. 133-146
Author(s):  
Rachel Zmora ◽  
Tamara L. Statz ◽  
Robyn W. Birkeland ◽  
Hayley R. McCarron ◽  
Jessica M. Finlay ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Long Term Care ◽  
Term Care ◽  
Mixed Methods Approach ◽  
Counseling Intervention ◽  
Care Family ◽  
Caregiver Experiences ◽  
Residential Long Term Care ◽  
Analyze Data

Objectives: Previous analyses of interventions targeting relationships between family caregivers of people with Alzheimer’s disease and related dementias and residential long-term care (RLTC) staff showed modest associations with caregiver outcomes. This analysis aimed to better understand interpersonal and contextual factors that influence caregiver–staff relationships and identify targets for future interventions to improve these relationships. Methods: Using a parallel convergent mixed methods approach to analyze data from an ongoing counseling intervention trial, descriptive statistics characterized the sample of 85 caregivers and thematic analyses explored their experiences over 4 months. Results: The findings illustrated that communication, perceptions of care, and relationships with staff are valued by family caregivers following the transition of a relative with dementia to RLTC. Discussion: The findings deepen understanding of potential intervention targets and mechanisms. These results can inform future psychosocial and psychoeducational approaches that assist, validate, and empower family caregivers during the transition to RLTC.

scholarly journals COVID-19 and Long-Term Care: the Essential Role of Family Caregivers

2021 ◽  
Vol 24 (3) ◽  
pp. 195-199
Author(s):  
Whitney Hindmarch ◽  
Gwen McGhan ◽  
Kristin Flemons ◽  
Deirdre McCaughey
Keyword(s):  
Family Caregivers ◽  
Online Survey ◽  
Long Term Care ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Study Data ◽  
Term Care ◽  
Qualitative Thematic Analysis ◽  
The Impact

Background Those most at risk from severe COVID-19 infection are older adults; therefore, long-term care (LTC) facilities closed their doors to visitors and family caregivers (FCGs) during the initial wave of the COVID-19 pandemic. The most common chronic health condition among LTC residents is dementia, and persons living with dementia (PLWD) rely on FCGs to maintain their care provision. This study aims to evaluate the impact of visitor restrictions and resulting loss of FCGs providing in-person care to PLWD in LTC during the first wave of the COVID-19 pandemic. Method An online survey and follow-up focus groups were conducted June to September 2020 (n=70). Mixed quantitative (descrip­tive statistics) and qualitative (thematic analysis) methods were used to evaluate study data. Results FCGs were unable to provide in-person care and while al­ternative communication methods were offered, they were not always effective. FCGs experienced negative outcomes including social isolation (66%), strain (63%), and reduced quality of life (57%). PLWD showed an increase in responsive behaviours (51%) and dementia progression. Consequently, 85% of FCGs indicated they are willing to undergo specialized training to maintain access to their PLWD. Conclusion FCGs need continuous access to PLWD they care for in LTC.

scholarly journals Implications of the COVID-19 Pandemic on Adult Day Services

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 110-111
Author(s):  
Katherine Marx ◽  
Laura Gitlin ◽  
Tina Sadarangani
Keyword(s):  
Family Caregivers ◽  
Long Term Care ◽  
The United States ◽  
Care Provision ◽  
Term Care ◽  
Adult Day Services ◽  
The People ◽  
Day Services ◽  
Residential Long Term Care

Abstract Adult day service (ADS) centers serve an important role in care provision for people living with dementia (PLWD). These programs provide socialization, activities, and access to many therapies for PLWD. Additionally, they offer respite to family caregivers so they can work, run errands, and recharge. In March 2020, like much of the nation, ADS sites across the nation were shut down. This left many PLWD and their caregivers without access to the services they depended on to manage day to day care. It also left many sites without a revenue source to pay employees and maintain buildings. Almost a year later, many states have still not reopened ADS and sites that have reopened have done so with a lower census, increased costs, and the lingering fear of a second closure. Much focus has been on the care of older adults in nursing homes or other residential long-term care settings but the challenges of ADS and the people they serve has been mostly ignored. The purpose of this symposium is to highlight the implications of the COVID-19 pandemic on ADS centers. Holly Dabelko-Schoeny will present data gathered from ADS Centers across Ohio. Lauren Parker, will then present data from ADS sites across the United States that examines the effect of COVID-19 on closures and programming during the closures. Katherine Marx will present the effect of ADS closures on family caregivers of persons living with dementia. Finally, Joseph Gaugler will explore this from a policy perspective and provide recommendations moving forward.

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