Family Caregivers for Seniors in Rural Areas

Monahan, Deborah J.

doi:10.1080/10522158.2012.747461

Cited by 11 publications

(12 citation statements)

References 26 publications

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“…Previous research has shown that rural older adults experience more impairment compared with more urban elders (Laditka, Laditka, Olatosi, & Elder, 2007) and primarily rely on family members for care (Morgan et al, 2002). The challenges of providing care in rural regions are potentially greater because of vast distances (Monahan, 2013; Morgan et al, 2002), fewer resources (Monahan, 2013), and greater proportions of older adults (Glasgow, 2000). An additional environmental context related to the challenges some caregivers experience is navigating multiple systems (e.g., VA and Indian Affairs Commission).…”

Section: Discussionmentioning

confidence: 99%

Challenges Faced by Family Caregivers: Multiple Perspectives on Eldercare

et al. 2018

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The focus of this study was to identify challenges to family eldercare provision from the perspectives of both caregivers and community stakeholders. This qualitative study used data from 306 family caregivers and 116 stakeholders (aging, social, and health service professionals who work with older adults and their families) in North Dakota. Data sources included an American Association of Retired Persons-ND survey of 110 caregivers, a survey by the ND Family Caregiver Support Program (196 participants), and a Statewide Caregiving Stakeholder Survey (116 participants). Thematic analysis identified five themes: (a) financial burden of providing eldercare, (b) insufficient access to respite care, (c) difficulty finding and navigating available services and programs, (d) lack of knowledge and training on care provision, and (e) challenges related to environmental context of caregiving. Implications for working with family caregivers and developing policies for eldercare are discussed.

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Section: Discussionmentioning

confidence: 99%

Challenges Faced by Family Caregivers: Multiple Perspectives on Eldercare

et al. 2018

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“…Together, these findings show a heavy reliance on informal care and an underutilization of formal care for people with dementia in rural Hispanic communities. Our findings suggest that patients and caregivers in these communities face unique challenges in accessing formal health and social services because of, as reported in the literature, their ethnic minority background and residence in rural areas [34,39-44]. Heavy reliance on informal care will likely become an even more serious challenge in the future.…”

Section: Discussionmentioning

confidence: 57%

“…Rural residents tend to be poorer, older, and sicker than their urban counterparts [37,38]. Rural services are often spread over long distances, and the cost of transportation and time often drastically decrease their use [39,40]. Rural nursing homes often lack a diversity of health services or health care professionals for people with dementia [41].…”

Section: Introductionmentioning

confidence: 99%

“…Fewer local health services and providers are available, including palliative care and hospice services [42-44]. Rural caregivers have fewer formal services for support and often rely more on informal services [39] and report greater financial burden [45]. Other unique barriers to the use of formal services include stigma of dementia, lack of privacy, beliefs and attitudes, lack of awareness of services, and less acceptability and accessibility of services [46].…”

Section: Introductionmentioning

confidence: 99%

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Mobile Health, Information Preferences, and Surrogate Decision-Making Preferences of Family Caregivers of People With Dementia in Rural Hispanic Communities: Cross-Sectional Questionnaire Study

Xie¹,

Champion²,

Kwak³

et al. 2018

J Med Internet Res

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BackgroundMobile health (mHealth) technology holds promise for promoting health education and reducing health disparities and inequalities in underserved populations. However, little research has been done to develop mHealth interventions for family caregivers of people with dementia, particularly those in rural Hispanic communities, who often serve as surrogate decision makers for their relatives with dementia.ObjectiveAs part of a larger project to develop and test a novel, affordable, and easy-to-use mHealth intervention to deliver individually tailored materials in rural Hispanic communities, in this pilot study, we aimed to examine (1) characteristics of people with dementia and their family caregivers in rural Hispanic communities, (2) caregivers’ preferences for types and amounts of health information and participation in surrogate decision making, and (3) caregivers’ mobile device usage and their desire for receiving information via mobile devices.MethodsThis was a cross-sectional survey. A convenience sample of 50 caregivers of people with dementia was recruited from rural health care facilities in Southwest Texas during 3 weeks of April 2017 to May 2017 via word-of-mouth and flyers posted at the facilities.ResultsMore women than men were in the patient group (χ21=17.2, P<.001) and in the caregiver group (χ21=22.2, P<.001). More patients were on Medicare and Medicaid; more caregivers had private insurance (P<.001 in all cases). Overall, 42% of patients did not have a power of attorney for their health care; 40% did not have a living will or advance directive. Caregivers were interested in receiving all types of information and participating in all types of decisions, although on subscales for diagnosis, treatment, laboratory tests, self-care, and complementary and alternative medicine, their levels of interest for decision-making participation were significantly lower than those for receiving information. On the psychosocial subscale, caregivers’ desire was greater for surrogate decision-making participation than for information. Caregivers did not differ in their interests in information and participation in decision making on the health care provider subscale. All but 1 caregiver (98%) owned a mobile phone and 84% had a smartphone. Two-thirds wanted to receive at least a little dementia-related information via a smartphone or tablet. The amount of dementia-related information caregivers wanted to receive via a mobile device was significantly greater for women than for men (U=84.50, P=.029). Caregivers who owned a tablet were more likely to want to receive dementia-related information via a mobile device than those who did not own a tablet (U=152.0, P=.006).ConclusionsCaregivers in rural Hispanic communities were interested in receiving a wide range of information as well as participating in making decisions for their relatives with dementia. There is much need for effective mHealth interventions that can provide information tailored to the needs and preferences of these caregivers.

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“…Defining rural as non-urban or using specific racial groups in rural settings may limit the application of the findings to different classifications of rural that are present with rural classification schema [25]. The use of broad definitions of rural, focusing on specific ethnic and racial groups, limits knowledge related to the rural family caregiving experience [26]. Rural caregiving studies that address cultural groups located in isolated rural areas in the U.S. are limited.…”

Section: Introductionmentioning

confidence: 99%

A Model of Health for Family Caregivers of Elders

Weierbach¹,

Chen²

2016

Healthcare

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Family members who provide care to their loved ones experience changes in their own health. The caregiver health model (CGHM) is a new model that identifies health holistically and identifies four determinant(s) that contribute to the health status of the family caregiver. The purpose is to introduce the CGHM: Hypothesis 1: the determinants of health in the CGHM contribute to the health of the Caregiver, Hypothesis 2: the determinants of health contribute to changes in the caregivers’ health at 8 and 16 weeks, and Hypothesis 3: a change in health occurs from baseline to 8 and 16 weeks. Methods: A descriptive, longitudinal design used three data collection points and five survey instruments. Community recruitment (N = 90) occurred through word of mouth and newspapers. Inclusion criteria consisted of being a family caregiver, living in a rural residence, and providing care to elders with necessary activities of daily living (ADLs) and/or instrumental ADLs (IADLs). Following a participant generated phone call to provide consent, caregivers received an initial study packet, additional packets were sent upon return of the previous packet. Analysis for the three hypotheses included multiple backwards stepwise linear regression, generalized estimating equations (GEE), and analysis of variance (ANOVA) α = 0.05. Results: A significant decrease in mental (p < 0.01) but not physical health at 8 weeks (p = 0.38) and 16 weeks (p = 0.29) occurred over time. Two determinants displayed significant (p < 0.05 or less) changes in mental and/or physical health at one or more time points. Study limitations include caregiver entry at varying times and self-report of elder nursing needs and medical conditions. Conclusions: Findings support two of the four determinants contributing to caregiver health.

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Family Caregivers for Seniors in Rural Areas

Cited by 11 publications

References 26 publications

Challenges Faced by Family Caregivers: Multiple Perspectives on Eldercare

Challenges Faced by Family Caregivers: Multiple Perspectives on Eldercare

Mobile Health, Information Preferences, and Surrogate Decision-Making Preferences of Family Caregivers of People With Dementia in Rural Hispanic Communities: Cross-Sectional Questionnaire Study

A Model of Health for Family Caregivers of Elders

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