Purpose-To demonstrate that assessing quality of informal care involves more than merely determining whether care recipient needs for assistance with activities of daily living (ADLs) are satisfied on a routine basis. Potentially harmful behavior (PHB), adequate care, and exemplary care (EC) are conceptually distinct dimensions of quality of care. We investigated the extent to which these three dimensions also are empirically distinguishable.Design-237 care recipients completed the quality of care measures, and their caregivers completed psychosocial measures of depressed affect, life events, cognitive status, and perceived pre-illness relationship quality.Results-Confirmatory factor analyses indicated that PHB, adequate care, and EC are empirically distinct factors. Although PHB was moderately related to EC, adequate care was not associated with PHB and was only slightly related to EC. Psychosocial variables were not related to adequate care but were differentially associated with PHB and EC, providing further evidence for the distinction between the measures of quality of care used in this study.Conclusions-Assessing quality of informal care is a complex endeavor. ADL assistance can be adequate in the presence of PHB and/or the absence of EC. Declines in EC may signal increases in PHB, independent of adequacy of care. These findings produce a brief, portable, and more comprehensive instrument for assessing quality of informal care.
Keywordscaregiving; elder abuse and neglect; quality of informal careCorrespondence concerning this article should be addressed to Gail M. Williamson, Department of Psychology, University of Georgia, Athens, GA 30602. LGMW@uga.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/rep.
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NIH-PA Author ManuscriptQuality of informal care traditionally has been conceptualized as the extent to which care recipient needs for assistance are routinely satisfied in terms of basic (e.g., bathing, dressing) and instrumental (e.g., handling personal finances) activities of daily living (e.g., MorrowHowell, Proctor & Dore, 1998;Morrow-Howell, Proctor, & Rozario, 2001;Skinner et al., 1999). When viewed this way, care ranges from inadequate (care recipient never receives help) to adequate (care recipient always receives help). Adequacy of care assessments are useful for identifying specific areas of deficiency where additional help might be provided. However, we believe that these measures ignore dimensions of quality of care ...
