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PubMed1983

Home care for the dying: homemakers' perspectives.

Homemakers are important members of the health care team providing hospice care at home, yet there is little information about their views and experiences. This paper summarizes findings of a survey of homemakers working with a newly-developed program for providing home care for dying patients and their families. Results indicate that homemakers perform multiple roles, which they report tend to be more demanding physically and psychosocially than other kinds of homemaking. Being able to provide comfort in a time of extreme need is satisfying to homemakers, although frustrations exist as well. Implications for program planning and future research are discussed.

Alberta↗
PubMedDate not supplied

The use of homemaker-home health aides' perinatal care of high-risk infants.

The Homemaker-Home Health Aide program for high-risk neonates started in late 1982. Funded by a grant from the March of Dimes Birth Defects Foundation, several agencies in Pinellas County, Florida, set up a special training program for the aides in the care of high-risk infants and their families during the difficult transition period after release from the neonatal intensive care unit.

Florida↗
PubMed2002

Rural families caring for a relative with dementia: barriers to use of formal services.

Planning for the care of increasing numbers of elderly persons with dementia has become an urgent health services concern in Canada and elsewhere, yet little is known about the challenges of providing appropriate dementia care in rural areas. A community-based approach was used to obtain input from decision-makers and others to develop the objectives and design for a study of rural dementia care in the province of Saskatchewan, Canada. The resulting study design, which used both qualitative and quantitative methods, was then pilot tested in one rural health district (16,000 km2, population 20,000). This paper describes the study development process and reports selected findings from focus groups conducted with home care staff and family members, focussing on the theme of low use of formal supportive services such as home care and support groups by family caregivers. Participants identified eight barriers to the use of formal services, described consequences of low service use, and suggested strategies for addressing this concern.

Adult↗
PubMed2004

Barriers to and unmet needs for supportive services: experiences of Asian-American caregivers.

This study examined service barriers to and unmet needs for in-home and community-based supportive services and identified risk factors that were related to unmet service needs reported by Asian American caregivers. Data were extracted from the Family Caregiving in the U.S. Survey, conducted by the National Alliance for Caregivers (NAC) and the American Association of Retired Persons (AARP) in 1997. The sample included 157 Asian American caregivers whose care receivers used supportive services in the past 12 months. Nearly one half of Asian American caregivers reported service barriers. The barriers they identified most often were related to personal issues that caregivers often felt "too proud to accept it" or "didn't want outsiders coming in." Other frequently reported barriers were related to service providers, including "service is not available," "bureaucracy too complex," or "can't find qualified providers." With respect to unmet service needs, more than one half of caregivers reported that services provided did not meet care receivers' needs. The service needs that caregivers most frequently reported as unmet were adult day care, meal services, and personal care. Results from a negative binomial regression analysis showed that elderly persons' chronic conditions, caregivers' educational attainment, and levels of informal assistance were significantly related to unmet service needs.

Adult↗
PubMed2001

Perspectives of elderly people receiving home help on health, care and quality of life.

From a nursing perspective it is important to have information about the type of care needed, the reasons care is needed and quality of life among the most elderly people living in their own homes, in order to support their independence and maximise their quality of life. Thus a study was performed to investigate people aged 75 years and older dependent on care from professionals and/or a next of kin, their functional health, diseases, and complaints in relation to quality of life as perceived by themselves. The sample (n = 448) comprised those who, in an age-stratified randomised sample of adults living in their own homes, responded that they were dependent on help from others. The questionnaire covered sex, age, living conditions, civil status and number of children and cohabitation, respondents' health, diseases, quality of life, help from another person, and the type and amount of help received. The number of elderly persons dependent on help ranged from 18.5 to 79.1% in the different age groups. The help came mainly from informal carers (84.1%), and, in 53.1% of cases, from the home help service and home nursing care. Help from formal caregivers was given in combination with that from a next of kin in 38.8% of the cases. More next of kin than formal carers helped in all Instrumental Activities of Daily Living (IADL) and Personal Activities of Daily Living (PADL) tasks, with the exception of cleaning the house and providing a bath/shower. Although the respondents received help themselves, they also helped another person in 6.5% of cases. The elderly reported a median of three diseases and ten different complaints of which pain and impaired mobility were the most frequent. Between 20 and 40% of the respondents in the different age groups reported restricted ability to be alone and one third of them reported low or very low quality of life. Multiple linear regression analysis showed the number of complaints, restricted ability to be alone, living alone and age to have a significant relationship on low quality of life.

Activities of Daily Living↗
PubMed2002

Drawing the line: the boundaries of volunteering in the community care of older people.

Volunteers can play important roles in the provision of support and care to frail or confused older people living in their own homes. There are conflicting expectations as to what these roles should be since there are unclear boundaries with those of paid care and with informal care. The present article explores some of these boundaries, drawing on material from a study of 14 volunteer schemes in England. The aim of the research was to explore the roles played by volunteers in the overall care division of labour. The main method used was that of semistructured interviews with organizers and volunteer coordinators of the schemes involved. The findings presented here relate to the limitations on the type of cases taken on, and to the boundaries with professional care, paid manual work and informal care. It concludes that the ways in which these boundaries are established and maintained depends not only on legal and policy constraints at the level of the state, but also on negotiation between organizations and individuals at a local level. The issues raised are of importance not only to research in the area, but to anyone planning similar schemes in the future.

Aged↗
PubMed2002

Informal care: the views of people receiving care.

Informal care is perceived to be the best option for people who require assistance to look after themselves. National and international studies of informal care have focused on the carer, not on the care provided, or the needs and experiences of the care recipients. In the present study, 55 people receiving informal care (21 males and 24 females, mean age = 67.6) were surveyed to determine the type of assistance that they receive, perceptions of the quality of their care, feelings about being looked after by a carer and their perceptions of the services which would be useful. A random sample of 531 households were selected as part of a larger study into informal care in the west of Ireland. A total of 98 carers were identified and 55 of the people they looked after were well enough to participate in the study. Over two-thirds of carers assisted with household chores (e.g. cleaning, preparing meals and shopping). Other activities which carers assisted with included keeping the person safe from household accidents (62%), personal care (42%), and dressing and undressing (31%). Whilst most were very satisfied with the quality of care, a minority reported dissatisfaction, and stated that their carer showed signs of anger and frustration. Common concerns related to the health of the carer, their safety when the carer is not available and the cost of being cared for. Financial support for the person receiving care and the carer were the main priorities for these individuals. The present study points to a need for greater involvement of care recipients in planning services relating to informal care, and support and access to health professionals for people receiving care. People receiving care are also concerned about the level of financial support for themselves and their carers.

Adolescent↗
PubMed2005

Reconsidering substitution in long-term care: when does assistive technology take the place of personal care?

OBJECTIVE: Assistive technology (AT) may improve quality of life and reduce dependence for older persons with disabilities. In this article, we examine tradeoffs between the use of AT and reliance on personal care, with attention to factors that may influence those relationships. METHODS: We jointly modeled hours of formal and informal care with use of AT in order to address the interdependence of these outcomes in ways not taken into account in previous studies. We analyzed a national sample of older persons with difficulty in activities of daily living drawn from Phase 2 of the 1994-1995 National Health Interview Survey (NHIS) Disability Supplement. RESULTS: Our findings show that the use of AT was associated with reductions in informal care hours, especially for those who were unmarried, better educated, or had better cognitive abilities, but appeared to supplement formal care services for these groups. Individuals with cognitive impairment were less likely than others to substitute AT with either type of personal care. DISCUSSION: These models raise the possibility that reductions of informal care hours may be accomplished with a combination of formal care and assistive devices, rather than from either alternative alone.

Activities of Daily Living↗
PubMed1996

Clarification of the constructs of satisfaction and dissatisfaction with home care.

This study examined what elderly clients perceived as being important in contributing to their satisfaction and dissatisfaction with home care. Nineteen guided interactive interviews were conducted with 10 home care clients using storytelling, scenarios, and a rating of the importance of the dimensions of client satisfaction and dissatisfaction. A hierarchical thematic analysis revealed that satisfaction with home care was influenced by client characteristics and was composed of clients' expectations, program characteristics, home care workers' attributes, relationships with the workers, and clients' involvement with planning their care. Dissatisfaction was reported if positive aspects of these dimensions were lacking. This suggests that satisfaction and dissatisfaction are at opposite ends of multiple continua of dimensions.

Aged↗
PubMed2001

The new senior volunteer: a bold initiative to expand the supply of independent living services to older adults.

This article presents findings of the evaluation of the Experience Corps for Independent Living (ECIL) initiative. The ECIL initiative was a two-year demonstration program designed to test innovative ways to use the experience, time, and resources of volunteers over 55 to significantly expand the size and scope of volunteer efforts on behalf of independent living services for frail elders and their caregivers in specific communities. Six demonstration sites were selected to participate in this initiative. The intensive volunteers, the critical component of the program, were more highly skilled than typical volunteers from existing senior volunteer programs. ECIL volunteers collaborated with agency partners to develop new programs, supervise direct service activities, and enhance the performance of the agencies being served. The ECIL initiative was particularly successful in meeting its goals of expanding the supply of independent living services to frail elders and their families in the communities served.

Activities of Daily Living↗