P3‐512: Making Decisions About Long‐term Institutional Care Placement Among People With Dementia and Their Caregivers: Systematic Review of Qualitative Studies

Teng, Claris; Loy, Clement T.; Sellars, Marcus; Pond, Dimity; Latt, Mark; Waite, Louise M.; Logeman, Charlotte; Sinka, Victoria; Tong, Allison

doi:10.1016/j.jalz.2019.06.3548

Cited by 8 publications

(11 citation statements)

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“…encompasses the degree to which caregivers feel satisfied in their caregiving role and with their caregiving abilities. We also included institutionalization of the care recipient as a distal variable reflecting ability to provide care; although the decision to institutionalize is complex, qualitative work suggests that caregivers' perceptions of their ability to provide adequate care for the person with dementia (which are in turn informed by many aspects of the care situation, such as available supports, caregiver and care recipient health and needs, and behavioral and psychological symptoms of dementia) are central to the decision to institutionalize (Caron et al, 2006;Couture et al, 2020;Teng et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Outcomes reflecting ability to provide care included measures of self-efficacy (related to care provision, accessing services, and self-efficacy in general), mastery, communication skill and dementia knowledge, problem orientation (the degree to which individuals appraise problems as solvable and feel competent to solve them), and satisfaction with caring, which encompasses the degree to which caregivers feel satisfied in their caregiving role and with their caregiving abilities. We also included institutionalization of the care recipient as a distal variable reflecting ability to provide care; although the decision to institutionalize is complex, qualitative work suggests that caregivers’ perceptions of their ability to provide adequate care for the person with dementia (which are in turn informed by many aspects of the care situation, such as available supports, caregiver and care recipient health and needs, and behavioral and psychological symptoms of dementia) are central to the decision to institutionalize (Caron et al, 2006; Couture et al, 2020; Teng et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

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Does early-stage intervention improve caregiver well-being or their ability to provide care to persons with mild dementia or mild cognitive impairment? A systematic review and meta-analysis.

Bayly¹,

Morgan²,

Elliot³

et al. 2021

Psychology and Aging

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Interventions for caregivers of persons with dementia are well supported, but it remains unclear whether caregivers benefit from early-stage intervention when caring for persons with mild dementia or mild cognitive impairment (MCI). This systematic review and meta-analysis examined whether early-stage interventions for this population positively affect their well-being and ability to provide care and whether effectiveness varies based on intervention or caregiver/recipient characteristics. Searches of four databases (MEDLINE, EMBASE, PSYCINFO, and CINAHL) yielded 20,722 titles and 1,305 full texts were independently screened. Twenty-two reports representing 18 randomized controlled trial (RCT)/controlled early-stage intervention studies were included for meta-analysis, measuring a variety of outcomes for which effect sizes were calculated using standardized mean differences. Findings suggest that early-stage intervention has a small positive effect on both caregiver well-being and ability to provide care, with the largest effects observed for caregiver anxiety and caring-related distress. Moderator analyses showed no statistically significant difference in effectiveness based on type of intervention (counseling/psychotherapy, psychoeducational, or multicomponent) or individual versus group-based interventions. However, interventions that were caregiver only (vs. dyadic) had larger positive effects on caregiver well-being and ability to provide care. None of the caregiver/recipient characteristics examined (sex, type of relationship, and type of dementia) were related to the effectiveness of early-stage interventions. Although published controlled/ RCT trials were limited, findings support efforts to offer early-stage interventions to caregivers of persons with mild dementia or MCI. Further research to determine what intervention types or components are most efficacious would aid the provision of optimal support for caregivers early in their caregiving trajectory.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Does early-stage intervention improve caregiver well-being or their ability to provide care to persons with mild dementia or mild cognitive impairment? A systematic review and meta-analysis.

Bayly¹,

Morgan²,

Elliot³

et al. 2021

Psychology and Aging

View full text Add to dashboard Cite

show abstract

“…Therefore, their informal caregivers will often take on a more active and central role during the transition process [ 14 , 15 ]. Often, informal caregivers tend to postpone nursing home admission until the older person is no longer safe at home and they or other informal caregivers are mentally and physically drained [ 6 , 12 , 16–19 ]. This can cause a crisis to unfold, possibly leading to urgent, uncoordinated and fragmented transitions, which in turn can lead to outcomes that are even more negative for both older persons (e.g.…”

Section: Introductionmentioning

confidence: 99%

The paradoxes experienced by informal caregivers of people with dementia during the transition from home to a nursing home

et al. 2022

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Background The transition from home to a nursing home is a common care process experienced by older persons with dementia and their informal caregivers. This transition process is often experienced as fragmented and is paired with negative outcomes for both older persons (e.g. mortality) and informal caregivers (e.g. grief). Due to the central role that informal caregivers play, it is crucial to capture their experiences throughout all phases of the transition. Methods A secondary data analysis was conducted using an interpretative phenomenological design. A total of 24 informal caregivers of older persons with dementia, moving to a nursing home, participated in in-depth interviews. Data were collected between February 2018 and July 2018 in the Netherlands. Data were analysed using Interpretative Phenomenological Analysis. Results The transition experiences are characterised by three paradoxes: (i) contradicting emotions during the transition process; (ii) the need for a timely transition versus the need to postpone the transition process and (iii) the need for involvement versus the need for distance. All paradoxes are influenced by the healthcare system. Conclusions The identified paradoxes show the impact of the healthcare system and the importance of timely planning/preparing for this transition on the experiences of informal caregivers. In addition, it provides healthcare professionals insight into the thought processes of informal caregivers. Future research can use these paradoxes as a foundation to develop innovations aiming to improve the transition process from home to a nursing home for informal caregivers and, consequently, older persons.

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“…Out-of-pocket caregiving costs [ 35 ] and difficulty navigating health and community systems [ 33 , 36 , 37 , 38 ] are also identified as factors that contribute to family caregiver workload and anxiety [ 33 , 36 , 37 , 38 ]. In 2012, one in five Canadian caregivers were experiencing financial hardship [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

Family Caregiving during the COVID-19 Pandemic in Canada: A Mediation Analysis

Anderson

Parmar

L’Heureux

et al. 2022

IJERPH

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Family caregiving is a public health issue because of caregivers’ significant contribution to the health and social care systems, as well as the substantial impact that giving and receiving care has on the health and quality of life of care receivers and caregivers. While there have been many studies that associate caregivers’ care work, financial difficulty, navigation, and other caregiving factors with family caregivers’ psychological distress, we were interested not only in the factors related to family caregiver anxiety but also in hypothesizing how those effects occur. In this study, we used Andrew Hayes’ PROCESS moderation analysis to explore the link between caregiver frailty, weekly care hours, and perceptions of financial difficulty, social support, and anxiety. In this analysis, we included 474 caregivers with relatively complete data on all of the variables. In regression analysis after controlling for gender and age, social loneliness (β = 0.245), frailty (β = 0.199), financial difficulty (β = 0.196), care time (β = 0.143), and navigation confidence (β = 0.131) were all significant. We then used PROCESS Model 6 to determine the significance of the direct, indirect, and total effects through the serial mediation model. The model pathway from frailty to care time to financial difficulty to social loneliness to anxiety was significant. The proportions of family caregivers who were moderately frail, anxious, and experiencing social loneliness after eighteen months of the COVID-19 pandemic found in this survey should be of concern to policymakers and healthcare providers.

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P3‐512: Making Decisions About Long‐term Institutional Care Placement Among People With Dementia and Their Caregivers: Systematic Review of Qualitative Studies

Cited by 8 publications

References 0 publications

Does early-stage intervention improve caregiver well-being or their ability to provide care to persons with mild dementia or mild cognitive impairment? A systematic review and meta-analysis.

Does early-stage intervention improve caregiver well-being or their ability to provide care to persons with mild dementia or mild cognitive impairment? A systematic review and meta-analysis.

The paradoxes experienced by informal caregivers of people with dementia during the transition from home to a nursing home

Family Caregiving during the COVID-19 Pandemic in Canada: A Mediation Analysis

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