Care for the spiritual dimension provided by caregivers in a nursing home

ABSTRACT Objectives: to understand care for the spiritual dimension provided by caregivers in a Nursing Home. Methods: this is a qualitative research, carried out in a geriatric center of a philanthropic hospital in the city of Salvador, Bahia. Eighteen formal caregivers participated, through a semi-structured interview, between January and February 2019. The data were analyzed in the light of Jean Watson’s Theory of Transpersonal Caring. Results: formal caregivers discuss the spiritual dimension based on older adults’ religious beliefs, encourage religious practices and exercise spiritual care according to older adults’ physical, emotional and spiritual demands. Final Considerations: formal caregivers understand that older adults’ religious or spiritual experiences should be included in their work routine. Care for the spiritual dimension occurs by stimulating faith in God, encouraging religious practices and embracing their beliefs in the face of physical, emotional and spiritual demands.

Burnout Among Formal Caregivers and Risk of Violence Against Institutionalized Elderly

Sociodemographic changes occurring in past decades are reflected as increased population aging, resulting in a higher need to institutionalize elderly. Violence against elderly is a relevant public health problem. The aims of the present cross-sectional exploratory and descriptive study with a quantitative approach were to analyze burnout among formal caregivers at institutions for elderly and to assess the risk of violence against institutionalized elderly. As a part of project ESACA—Envelhecer com Segurança no Alentejo (Prevenir as Quedas e a Violência sobre Idosos)—Compreender para Agir (Aging Safely in Alentejo [Preventing Falls and Violence against Elderly]), the present study analyzed 34 formal caregivers from three institutions that provide care to elderly in the Evora district, Portugal. No situations involving violence against institutionalized elderly were detected. Most participants (96.3%) did not exhibit burnout, although they did report feeling physically and emotionally tired.

Caregivers’ experiences and perspectives of factors associated with relapse in Iranian people living with schizophrenia: A qualitative study

Background: Relapse in People Living with Schizophrenia (PLS) has several reasons and recognizing these can increase the effectiveness of treatment interventions. Formal and informal caregivers are an informed source to reduce relapse in PLS. Aim: This study explores the caregivers’ perspective in Iran on the factors affecting relapse in PLS. Method: A total of 28 caregivers (16 formal caregivers and 12 informal caregivers) of PLS were enrolled in our qualitative study. A content analysis was conducted using individual and group, semi-structured in-depth interviews with informal and formal caregivers of PLS. This study was conducted in a hospital, three universities, and a non-governmental organization in Tehran, Iran. Results: The majority (69%) of the participants were females. About half of the informal caregivers were over 60 years old and about 40% of the formal caregivers were in the age range of 30 to 40 years. The average number of years of work for informal caregivers was 17.6 years and the average of work experience among the formal caregivers was 14.1 years. Seven key dual themes were identified from data: ‘awareness-stigma’, ‘social support-social exclusion’, ‘treatment adherence-treatment discontinuation’, ‘holistic approach – one-dimensional approach’, ‘supported employment-social dysfunction’, ‘emotional management in family – family with high emotional expression’, and ‘access to treatment-treatment gap’. Conclusion: The results of this research can help practitioners and policymakers to enable evidence-based practices to reduce relapse in PLS by emphasizing and acting on factors identified in our analyses.

Boundary work in value co-creation practices: the mediating role of cognitive assistants

PurposeHow to improve healthcare for the ageing population is attracting academia attention. Emerging technologies (i.e. robots and intelligent agents) look relevant. This paper aims to analyze the role of cognitive assistants as boundary objects in value co-creation practices. We include the perceptions of the main actors – patients, (in)formal caregivers, healthcare professionals – for a fuller network perspective to understand the potential overlap between boundary work and value co-creation practices.Design/methodology/approachWe adopted a grounded approach to gain a contextual understanding design to effectively interpret context and meanings related to human–robot interactions. The study context concerns 21 health solutions that had embedded the Watson cognitive platform and its adoption by the youngest cohort (50–64-year-olds) of the ageing population.FindingsThe cognitive assistant acts as a boundary object by bridging actors, resources and activities. It enacts the boundary work of actors (both ageing and professional, caregivers, families) consisting of four main actions (automated dialoguing, augmented sharing, connected learning and multilayered trusting) that elicit two ageing value co-creation practices: empowering ageing actors in medical care and engaging ageing actors in a healthy lifestyle.Originality/valueWe frame the role of cognitive assistants as boundary objects enabling the boundary work of ageing actors for value co-creation. A cognitive assistant is an “object of activity” that mediates in actors' boundary work by offering novel resource interfaces and widening resource access and resourceness. The boundary work of ageing actors lies in a smarter resource integration that yields broader applications for augmented agency.

THE ROLE OF INFORMAL CAREGIVERS FROM THE COMMUNITY NURSE’S PERSPECTIVE: QUALITATIVE STUDY

Patients with chronic health care conditions who require long-tern care are nursed at home, therefore, there is a shift in responsibility for their care from paid formal caregivers to unpaid family members. Aim of this study was to assess the role of informal caregiver’s in-home care from the community nurse’s perspective. Thirty-one nurses, providing home care services to patients with special needs requiring constant care, participated in five semi-structured focus-group discussions. The data analysis was based on descriptive phenomenology. Three distinct phases in the development of informal caregiver–nurse relationship was uncovered: (1) the first phase is associated with the organization of home care in the family context, (2) the management of possibilities and challenges faced by informal caregivers in-home care phase; (3) the impact of home care on informal caregivers‘ quality of life and health phase. This study result shows that in organizing home care for the elderly are lack of cross-sectoral cooperation and teamwork between informal caregivers and community nurses. Therefore, informal caregivers must accept a new role in life as a provider of care, advocating, and supporter roles. Furthermore, as a result of daily fatigue, the informal caregivers‘ quality of life is deteriorating and their social exclusion is increasing.

Effect of Dementia Educational Program on Formal Caregivers Burden in Elderly Homes

Background: Dementia disease is usually identified among older patients, but it is not a part of the normal aging process. The number of Dementia's patients in the Arab countries is increasing due to increased longevity and improvement in the health care system. This study aimed to assess the effect of an educational program on Formal Caregivers Burden in Elderly Homes. Methodology: This study employed a quasi-experimental one-group pre-test-post-test design. The study was conducted in three elderly nursing private homes in Amman, Jordan using purposive sampling of 50 formal caregivers. Results: Dementia patient’s caregivers’ burden was decreased after program implementation, with statistically significant between pre- post, and three months after program implementation (p<.001). Findings demonstrated that the formal Dementia caregiver’s education program can effectively decrease burden among caregivers. Recommendation: Conducting continuing education program for Dementia patient’s caregivers in the nursing homes to promote their practices and decrease their burden.

Developing a pragmatic evaluation of ICTs for older adults with cognitive impairment at scale: the IN LIFE experience

Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impact on users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment, this requires evaluation that can accommodate different levels of cognitive impairment, alongside input from family and formal caregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions for the Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six national pilot sites to examine a number of variables including impact on the users, user acceptance of the individual services and the overall platform, plus the economic case for the IN LIFE platform. The results confirmed the interest and need among older adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT). Relative to the baseline, quality of life improved and cognition stabilised; however, there was an overall reluctance to pay for the platform. The findings provide insights into existing barriers and challenges for adoption of ICT for older people living with cognitive impairment.

State Regulatory Response to COVID-19 Limited Assisted Living Resident Caregiver Networks

This paper describes a qualitative content analysis of assisted living emergency rules, revised regulations, and executive orders responding to the COVID-19 pandemic. Using key search terms, we identified 36 states that enacted policies between February and October 2020. The following themes occurred most frequently: testing, infection control, access restrictions, suspension of requirements, and reporting. The convoys of care model recognizes internal, external, formal, and informal caregivers as essential members of an AL resident’s care network. We found that non-staff care providers, including external formal caregivers (e.g. home health and hospice) and informal caregivers (e.g. family), were most often addressed in policies limiting access. Informal caregivers were the least often specifically addressed in these policies. Given the importance of these network members in the AL context, these policies have implications for the wellbeing of the resident and care network.

Self-Perceptions of Aging Among Dementia Caregivers: Evidence from the UK Protect Study

Contact with older adults impact the perceptions people have towards their own aging self (Jarrott & Savla, 2015) and how they prepare for their own age-related change (Kornadt et al., 2015). Caregivers have close, intimate contact with older adults, yet no research explores how that contact may impact caregivers’ perceptions of their own aging. In this exploratory study, we compare perceptions of one’s own aging between current and previous formal caregivers, non-formal caregivers, and never-caregivers. We utilized data from 1978 informal caregivers, 247 formal caregivers, and 5586 never-caregivers of the 2019 wave of the UK Protect Study. We conducted ANCOVA tests to compare global levels of Awareness of Age-Related Change (AARC) gains and losses, AARC gains and losses specific to cognition, attitudes towards one’s own aging, and felt age across the three subgroups of participants with different caregiving roles. Omnibus results suggested that there were significant group differences (p&lt;.05) in global levels of AARC gains and losses, AARC gains specific to cognition, and attitudes towards one’s own aging (p&lt;.05) for female, but not male, caregivers. However, effect sizes were either small or negligible. Therefore, despite frequent contact with older adults, dementia caregivers may not have better or worse self-perceptions of aging than non-caregivers. Such findings may be reflective of intergenerational ambivalence, and future work should consider how the nature of the caregiving situation (i.e. relationship quality, intensity of the care, caregiver burden) shapes caregivers’ perceptions of their own aging, especially over time as caregivers navigate their own aging processes.

Reinventing Housing Care: Environmental Negotiations Made in Congregate Settings During COVID-19

The COVID-19 pandemic prompted an urgent reconsideration of space and place within congregate housing. Research has only underscored the need for health-promoting physical alterations to residential environments (Peters & Halleran, 2020), but also generated lasting questions about the relationships between congregate environments and their residents, visitors, and workforce —among them, what ways can environments be negotiated to reduce risk (Dosa et al., 2020)? How can environments enact care for formal caregivers (Chen & Chavalier, 2021)? Who might be challenged by this care which may question the dangers associated with proximity (Lynn, 2020)? This symposium focuses on the ways stakeholders within congregate housing observed, related to, and negotiated changes to space and place during the pandemic. Paper 1 presents an organizational case study investigating provider perspectives of how housing and healthcare responses to COVID have shaped palliative care with unhoused patients during the pandemic. Paper 2 highlights the collaborative work of a multi-sector coalition working to address timely needs of residents in low-income senior buildings. Paper 3 reflects on the formation of a cross-national senior housing network and the interdisciplinary exchange of best practices and policy recommendations that emerged. The collective findings of these papers challenge previous notions of care in congregate environments, illuminate how provider networks respond to crises and share emergent knowledge, and consider how institutional decisions about the pandemic have re-placed and re-spaced provider and patient experiences. This symposium offers observations and strategies that may assist in envisioning successful congregate care during COVID-19 and beyond.