Life of a caregiver simulation: teaching students about frail older adults and their family caregivers

The number of older adults with caregiving needs is rapidly escalating, and the majority of these adults are cared for at home by unpaid family members. Nurse educators must better prepare nurse graduates to meet the needs of this population, as well as to include family caregivers as part of the health care team. This article describes the design, implementation, and preliminary outcomes of a unique learning experience, the Life of a Caregiver Simulation, which uses narrative pedagogy to increase students' awareness and understanding of the needs of older adults, their family caregivers, and the community services they use. Subjective data from students (N = 25) indicated the simulation served as an effective catalyst for students to experience first-hand and understand the stress and burdens of caregiving.     

Social support and strain of family caregivers of older adults

To assess the direct effects and interactive models of social support, caregivers to functionally impaired older adults were identified by hospital personnel. Within a week of referral, family caregivers were interviewed in the home about strain, depressive symptomatology, caregiving appraisal, informal social support, and coping. Caregiving appraisal significantly explained strain and depressive symptomatology. The interaction of social support with strain did not moderate or lessen depressive symptomatology. These findings suggest that nursing continue to examine the effect of home health care on strain and depressive symptomatology of caregivers of older adults.     

Providing delirium education for family caregivers of older adults

Using the Knowledge to Action Process, an education session was developed to teach families of older adults about delirium. Seven sessions were held with 16 eligible participants. A significant increase in delirium knowledge was found following education, and many participants believed others should receive similar education. At follow up, most participants were able to recall information related to risk factors and signs of delirium. Families of older adults form a common communication link for their relatives between health care providers across settings; providing education to family caregivers may in part provide a solution to the problem of delirium.     

Congruity of cancer pain perceptions between Taiwanese patients and family caregivers: relationship to patients' concerns about reporting pain and using analgesics

The purposes of this study were twofold: first, to examine the congruity of cancer pain perceptions between Taiwanese cancer patients and their family caregivers and second, to determine if there was a relationship between this congruity of perception and patients' concerns about reporting pain and using analgesics. A total of 89 dyads of oncology inpatients and their primary family caregivers participated in this study. The instruments completed by patients consisted of Barriers Questionnaire Taiwan Form, the Brief Pain Inventory Chinese version (BPI), the Eastern Cooperative Oncology Group (ECOG) performance status scale, and a demographic questionnaire. Family caregivers completed the Brief Pain Inventory short form and a demographic questionnaire. The Pearson's correlation, intraclass correlation coefficients, and the kappa statistics between family caregivers and patients' pain ratings were statistically significant. Patients in the noncongruent group (difference of >1 on "pain now" scale of the BPI) experienced higher levels of pain and poor levels of performance status. Family caregivers in the noncongruent group were more likely to be older and less educated. A patient's greater concerns about reporting pain and using analgesics were related to a lower level of congruity concerning pain perception between them and their family caregivers. Interventions aimed at overcoming patients' concerns about reporting pain and using analgesics may have beneficial effects on the congruency between pain perceptions of patients and family caregivers.     

Fall prevention program for community-dwelling older adults and their caregivers

Falls are the leading cause of injury and death among community-dwelling older adults. Many of these falls are a result of environmental and internal risk factors. The authors developed a fall prevention program consisting of a self-administered checklist and an audio-visual presentation on ways to reduce or prevent falls for community-dwelling older adults and their caregivers.     

Exploring experiences of family caregivers for older adults with chronic illness: A scoping review

A Scoping Review was conducted to explore key issues that underpin the experiences of family caregivers of older adults with chronic illness. The review aims to identify the gap in literature and synthesise evidence on this topic. Globally, family caregivers of older adults with chronic illness experience burden. Evidence suggests that family caregivers’ needs are poorly understood and remain largely under recognised by healthcare services. Moreover, little is known about the experience of family caregivers caring for older adults with multiple chronic conditions. Data bases used included: (EBSCOhost, CINAHL, Science Direct, SCOPUS, MEDLINE, PubMed, ISI web of science and grey literature. 3352 records were identified, 58 full-text articles were assessed for eligibility, and 11 papers included in the literature review. Data are narratively synthesized. This review provides findings that suggest further research.     

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.     

Assessing pain in cognitively impaired older adults with cancer

Assessing pain in cognitively impaired older adults with cancer presents a challenge to healthcare providers. As the age and number of older adults with cancer and cognitive impairments increase, so does the need for appropriate methods and instruments to adequately assess pain in this population. Oncology nurses report pain control to be one of the more challenging aspects of caring for patients with cancer. This article discusses methods and tools used by healthcare providers to accurately assess pain in cognitively impaired older adults with cancer, specific behavioral indicators that healthcare providers should recognize to assess pain accurately among this population, and the most appropriate pain scales to use when assessing pain in this population.     

A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers

Aims. To test the effectiveness of a discharge planning program for dyads of older stroke survivors and their family caregivers in Taiwan. Background. Family caregivers of stroke survivors often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. However, little information could be found on discharge planning programs for caregivers of stroke survivors in Asian families. Design. A randomised experimental design was used to explore the effects of a discharge planning program for 158 dyads of older stroke patients and their family caregivers. Methods. The control group (n = 86 dyads) received only routine hospital discharge planning services and the experimental group (n = 72 dyads) received routine hospital discharge planning services plus the caregiver‐oriented discharge planning program. Outcome variables were measured at baseline, before discharge and one month after hospital discharge. Variables were measured by the Nurse Evaluation of Caregiver Preparation Scale, Preparedness for Caregiving Scale, Caregiver Discharge Needs Satisfaction Scale and Perception of Balance between Competing Needs Scale. Results. Caregivers in the experimental group had significantly better nurse evaluation and self‐evaluation of preparation after the program than before, and greater satisfaction of discharge needs one month after discharge than before discharge. Caregivers in the experimental group had significantly better nurse evaluations and self‐evaluations of preparation and better satisfaction of discharge needs after the program compared with the control group. However, no significant difference was found between caregiver groups in perceived balance of competing needs. Conclusions. This discharge planning program benefited family caregivers of older stroke patients during the transition from hospitalisation to one month after discharge. Relevance to clinical practice. This caregiver‐oriented discharge planning program, with its emphasis on individualised health education and home visits following discharge may improve caregivers’ preparation and the satisfaction of their needs during the discharge transition.     

Barriers to the analgesic management of cancer pain: a comparison of attitudes of Taiwanese patients and their family caregivers

The purposes of this study were as follows: (1) to compare the attitudes which were considered to be barriers to cancer pain management held by Taiwanese cancer patients and their family caregivers; (2) to determine if these barriers were related to patient hesitancy to take analgesics and/or family caregiver hesitancy to administer analgesics: and (3) to determine if attitudinal barriers by patients and/or family caregivers predicted the adequacy of analgesics that patients used. A total of 159 dyads of oncology outpatients and their primary family caregivers (n = 318) participated in this study. The instruments completed by patients consisted of the Barriers Questionnaire-Taiwan form, the Brief Pain Inventory-Chinese version, the ECOG performance status scale, and a demographic and medication questionnaire. Family caregivers completed the Barriers Questionnaire-Taiwan form and a demographic questionnaire. The data in this study revealed that patients and family caregivers had attitudinal barriers to pain management and these concerns were positively correlated between patients and caregivers. Patient concerns were related to their hesitancy to take analgesics and, similarly, caregiver concerns were related to their hesitancy to administer analgesics. Most importantly, patient and caregiver concerns had an impact on how the patients' pain was managed: (1) patients and their family caregivers with higher levels of concerns used inadequate analgesics as compared to patients using adequate analgesics; (2) family caregiver barriers (concerns) were a significant predictor of inadequate management of cancer pain (after controlling for demographic and disease variables). Therefore, educational interventions for overcoming these barriers for both patients and their family caregivers may have potential for improving the management of cancer pain in Taiwan.     

Factors of positive appraisal of care among Japanese family caregivers of older adults

The purpose of this study was to examine factors of positive appraisal of care among Japanese family caregivers of older adults. The Positive Appraisal of Care (PAC) scale used in this study is a multidimensional Japanese measure and has four domains: relationship satisfaction, consequential gain, role confidence, and normative fulfillment. Three hundred and thirty-seven caregivers participated in this survey. Multiple regression analyses revealed that social support and caregiver belief in caregiving had a consistent impact on all domains of the PAC, whereas the impact of caregiver and care recipient characteristics varied among the domains. For example, caregiver age had a significant impact on role confidence and normative fulfillment but not on relationship satisfaction and consequential gain. The differential impact of caregiver and care recipient characteristics on the domains of the PAC underlines the usefulness of a multidimensional measurement.