Pilot test of a learned resourcefulness program for older family caregivers in Taiwan

Learned resourcefulness, a theory-based education intervention, can be applied to provide strategies to improve the health status and reduce caregiver burden for older family caregivers. We developed a culturally relevant SOURCE program and designed a pilot study to its effect and feasibility for older family caregivers living in Taiwan. Using a quasi-experimental study with one-group, pre-test and post-test design, we recruited a convenience sample of 30 older family caregivers who received home-care services from a regional hospital in southern Taiwan. The older family caregivers participated in and completed the four-week SOURCE program. Effectiveness and feasibility data were collected after the completion of the program. Results indicated that the SOURCE program significantly improved caregiving burden (t = 3.05, p = .005) and revealed that the program was helpful and useful to older family caregivers. The next step will be to use the SOURCE program with more older family caregivers.     

The association among knowledge of and confidence in home health care services,acculturation, and family caregivers' relationships to older adults of Mexican descent

The purposes of this study were to examine the relationships among knowledge of and confidence in health care services (HHCS), acculturation, characteristics of family caregivers of Mexican descent, and differences by caregivers' relationship (spouse or adult child). A sample of Mexican-descent older adults and their caregivers was recruited (n?=?74 dyads) in Arizona. Each participant completed questionnaires on knowledge, confidence, and acculturation. There were moderate but significant associations among higher Anglo Orientation with Knowledge and with Confidence. Fear of HHCS was positively associated with higher Anglo Orientation and English Language Preference; and negatively associated with Mexican Orientation and Spanish Language Preference. For Spouse caregivers, Fear of HHCS was positively correlated with higher Anglo Orientation and English Language Preference; for Offspring caregivers, Fear of HHCS was negatively correlated with Mexican Orientation and Spanish Language Preference. Results support assessing caregiver cohort and socio-cultural context to decrease HHCS use disparities by Mexican-descent caregiving families.     

Quality of life in caregivers of a family member with serious mental illness: Evidence from China

Purpose

To evaluate the quality of life (QoL) and social support among family caregivers of a family member with a mental illness and to identify factors associated with the QoL.

Attitude and burden in families of depressed elderly patients: strategies for care

Family members and others who must care for depressed older adults have received relatively little clinical and research attention, despite their extensive special needs and burden. Attitudes and burden of caregivers affect the initial assessment and continuing treatment of depressed elderly patients. Clinicians can focus evaluation and therapeutic efforts to include the needs of family and patient. Certain strategies for clinical work with caregivers and patients can facilitate optimal care.     

Effect of an innovative model of complexity care on family caregiver experience: Qualitative study in family practice

ObjectiveTo investigate the experiences of family caregivers who participated in an innovative model of interprofessional team–based care specifically designed for elderly patients with complex care needs.DesignQualitative study.SettingLarge academic family practice in Toronto, Ont.ParticipantsFamily caregivers of elderly patients who had attended the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic (N = 13).MethodsIndividual semistructured interviews, which were conducted face-to-face, audiorecorded, transcribed verbatim, and analyzed using the constant comparative method.Main findingsFamily caregivers who attended the IMPACT clinic believed it enhanced caregiver experience and capacity. Caregivers experienced increased validation and engagement with the treatment team. Feelings of isolation were reduced, resulting in increased confidence and greater feelings of empowerment in their caregiver role.ConclusionWhile the needs and value of caregivers are increasingly acknowledged, health care teams continue to struggle with how to relate to and engage with family caregivers—how best to support them and work with them in the context of their family members’ care. Interprofessional teams who adopt the IMPACT model—providing synchronous, real-time interventions that include the caregiver—can facilitate increased caregiver capacity, confidence, and empowerment.     

Feasibility of mobile mental wellness training for older adults

Mobile technology has been increasingly adopted in promotion of mental health among older people. This study assessed the feasibility of a mobile mental wellness training application for individual use and for group work from the perspectives of older adults and social care professionals. The older individuals recruited for the study were participants in a Circle of Friends group and family caregivers' peer support group offered by the communal senior services. The qualitative and quantitative results of interviews, questionnaires, observation, and application usage were reported. Seven older adults started using the application independently at home in parallel with the group activity. This study revealed new information regarding the barriers to the older adults' full adoption of such mobile technologies. The results indicated that there may be potential in the incorporation of mobile technologies in promotion of mental health of older people at group settings.     

Psychological,physical, social,and spiritual well-being similarities between Korean older adults and family caregivers

There is a growing recognition that the similarities between older adults and family caregivers has both practical and research implications; caregivers' well-being influences older adults' well-being and vice versa. There has been a paucity of studies that explore the similarities between Korean older adults and their caregivers. This study aims to examine psychological, physical, social, and spiritual well-being similarities among 157 older adult-caregiver dyads in Seoul, Korea. There was a significant degree of similarities between older adults and their caregivers with respect to psychological, social, and spiritual well-being, but not to physical well-being. Present findings suggest that nurses and other health care professionals should be involved and collaborate with family caregivers to take care of older adults; to understand the dynamic, caring relationships between older adults and their family caregivers; and to improve the well-being of older adults as well as their family caregivers.     

Caregiver Stress in the Older Adult

Stress created in the caregiver of the older adult is an area of health care generally neglected by researchers in the past. Family caregivers of disabled older adults have been ignored by health care professionals even though they are the hub around which the future of the patient revolves (Sanford, 1975). If the stressors experienced by family caregivers of older adults were identified, families could be prepared to anticipate problem areas and assisted to cope with them. Some problems that have been identified that cause stress in family caregivers include: level of disability; fecal and urinary incontinence; caretakers' health; finances; and safety problems (Archbold, 1980; Goldstein, Regnery, & Wellin, 1981; Sanford, 1975; Schneider, 1977).     

Contemplating, caring, coping, conversing: a model for promoting mental wellness in later life

This article is based on the premise that mental wellness for older adults can be promoted through communication and presents a model drawing on the constructs of contemplating, caring, coping, and conversing. The importance of interpersonal communication processes in the care of older adults and some barriers to communication and mental wellness are briefly reviewed. This article challenges nurses to develop awareness of their own caregiving styles and communication processes, and to assist others (e.g., family caregivers, care receivers) to communicate and interact more effectively to advance mental wellness for older adults.     

Caregiver perspectives on safety in home dementia care

Home safety is a significant problem for caregivers of people with Alzheimer's disease and other dementias. This focus group study is designed to gain insight into caregivers' experiences of managing safety issues and to explore application of the transtheoretical model of health behavior change (TTM) to this problem, toward development of interventions to improve safety care. Caregivers identified safety problems and management strategies, as well as barriers and factors facilitating management, that can help guide the development of interventions. Caregivers described different stages of adopting actions to prevent accidents and injuries consistent with the TTM. The TTM warrants further study for understanding how to help caregivers make changes to promote safe care.     

What Are the Educational Needs of Prospective Family Caregivers of Newly Disabled Adults?

What are the needs of family caregivers of newly disabled adults? Research to date has focused on the needs of family members of patients in critical care units and of family members who have been in the caregiver role at home for some time. No studies could be found on the perceptions of individuals facing the decision to assume the family caregiver role for a newly disabled adult anticipating discharge from a physical rehabilitation or medical-surgical nursing unit. Watson's philosophy of science and caring provided the theoretical basis for this study. The Elaine Matthis Educational Wants of Family Caregivers of Disabled Adults Questionnaire was used to assess the perceptions of prospective family caregivers visiting newly disabled adults in an urban medical center. The results of this research are offered to help nurses understand the feelings of uncertainty about the new and unexpected role that family caregivers face and to help nurses meet the needs of families preparing to take disabled adult relatives home.     

Communicating Caregivers' Challenges With Cancer Pain Management: An Analysis of Home Hospice Visits

Context

Family caregivers (FCGs) of hospice cancer patients face significant challenges related to pain management. Addressing many of these challenges requires effective communication between FCGs and hospice nurses, yet little empirical evidence exists on the nature of communication about pain management between hospice nurses and FCGs.

Help-seeking by older husbands caring for wives with dementia

AIM: This paper reports a study to gain understanding of the help-seeking process of older husbands caring for wives with dementia. BACKGROUND: Men comprise 41% of spousal caregivers. However, few reports describe older husbands' caregiving experiences and none specifically explore help-seeking in men caring for wives with dementia. METHOD: A grounded theory design was used to discover a theory of help-seeking by older caregiver husbands. Audiotaped interviews were conducted during 2004 and 2005 with nine husband participants. The interviews were analysed by a research group to discover the core category and the relationships of related categories to develop a theory of help-seeking that was grounded in the data. Margaret Newman's theory of Health as Expanding Conscious provided a theoretical perspective for interpretation of the findings. FINDINGS: The core category, 'Doing the best I can', was preceded by the antecedent of 'changing patterns'. Husbands made choices to use action/interaction strategies of 'Relinquishing', 'Reaching out' and 'Shouldering' which were influenced by a variety of internal, relational, situational, and experiential facilitating or hindering intervening conditions. The consequence of help-seeking process was 'Continuing on', which had categories of: 'Keeping at home', 'Staying together', and 'Taking care of myself'. CONCLUSION: Help-seeking by older husband caregivers is complex and gender-specific. Interventions to assist these caregivers must also be gender-specific and complement already existing help-seeking patterns. Focusing on helping caregivers to discover their patterns of relating and help-seeking empowers them to find new ways of interacting and to discover possibilities for action.     

Family involvement in the care of a hospitalised child: a questionnaire survey of Mozambican family caregivers

Background

Previous research from Western and Eastern countries shows that parents of a sick child want to be involved and to participate during a child's hospitalisation. However, the stay can be stressful and parents have their own needs. Conditions and cultural constructs are different among countries.No published study on parents’ or close family caregivers’ involvement and participation during paediatric hospitalization has been found for an African population.

Objective

The aim of this study was to articulate Mozambican family caregivers’ expressed needs, expectations and experiences of hospital care and hospital staff.

Setting and participants

The study was conducted at the Paediatric Clinic at the Central Hospital in Maputo, Mozambique. A sample of 100 family caregivers was chosen, representing one third of all family caregivers of hospitalised children over a one-month period.

Design and method

A cross-sectional study was conducted, using a questionnaire.

Results

Participating Mozambican family caregivers have, for the most part, a low level of education and reduced socio-economic conditions. This made the admission to and the time in hospital hard to cope with, and difficult for them to understand. The study showed that they were badly informed of anything to do with hospitalisation. They needed explanation and support to make the hospital situation less intimidating.Hospital staff's behaviour was to some extent characterised by attentiveness, kindness, and sympathy, but it was also shown that the family caregivers had experiences of communication difficulties and of being neglected.

Conclusion

The result, in this Sub-Saharan African context, shows that parents or family caregivers have a desire to be involved in the care of their hospitalised child, much the same as has been shown in studies in Western and Eastern countries. But Mozambican family caregivers’ expectations, needs and experiences are rooted not only in poverty, their household situation and the health system, but also in the hierarchical construct of their culture. All these factors influence their communication and relationships. Hospital staff is perceived to be superior. To empower the family caregivers to take part in the caring process in a cultural sensitive way is therefore of great importance.     

Features of problematic eating behaviors among community-dwelling older adults with dementia: Family caregivers' experience

This study aimed to explore family caregivers' experience of the problematic eating behaviors among community-dwelling older adults with dementia, and how these caregivers cope with these problems. An exploratory qualitative study using purposive sampling recruited family caregivers of community-dwelling older adults with dementia in southern Taiwan. In-depth interviews were carried out with a semi-structured interview guide. Data were saturated when the number of participants reached a certain number. The following three features were derived from the content analysis: fundamental deviations of eating behaviors, expressing needs through eating behaviors, and loss of eating ability. The results also show that caregivers often derived their own ways of coping with the problems they faced, and tended to have negative attitudes and behaviors with regard to coping with the demands of older adults with dementia. The findings of this study can provide valuable information to family caregivers with regard to the problematic eating behaviors of older adults with dementia, so that early recognition and understanding of such behaviors facilitate appropriate responses, thus reducing the burden shouldered by caregivers.