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Predictors of family involvement in residential long-term care
- Authors:
- GAUGLER Joseph E., ANDERSON Keith A., LEACH Corrine L.
- Journal article citation:
- Journal of Gerontological Social Work, 42(1), 2003, pp.3-25.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
While much of the gerontological literature emphasizes the institutionalization of an older adult as an endpoint of family care, research has emerged illustrating the continued involvement of family members in the lives of residents. The purpose of the present study was to determine how resident setting, family context, resident background, staff background, and resident function influence the provision of family involvement in three long-term care environments: nursing homes, assisted living facilities, and family care homes. Five nursing homes, five assisted living facilities, and 16 family care homes and residents (N = 112) in the state of Kentucky were randomly selected. Results showed that type of facility was less important in accounting for different dimensions of family involvement than family context, family orientation of facilities, or resident need. The findings demonstrate the complex process of family involvement across the long-term care landscape, and have several research and practice implications for the facilitation of family integration in residential long-term care. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Caregiving and institutionalisation of cognitively impaired older people: utilising dynamic predictors of change
- Authors:
- GAUGLER Joseph E., et al
- Journal article citation:
- Gerontologist, 43(2), April 2003, pp.219-229.
- Publisher:
- Oxford University Press
The purpose of this study was to identify reliable predictors of nursing home entry over a 3-year period in a sample of 3,944 persons with dementia who resided in a home setting at baseline. Strengths of the analysis include a multiregional recruitment strategy, incorporation of salient caregiver characteristics, and a 3-year prospective design that allows for the modeling of change in important variables (e.g., care recipient functional status or caregiving indicators) when time to institutionalization is predicted. Data were derived from the control sample of the Medicare Alzheimer's Disease Demonstration Evaluation (MADDE). A Cox proportional hazards model was used to predict time to institutionalization among individuals with dementia (baseline was enrollment into MADDE). Predictors included care recipient demographics, caregiver demographics, and time-varying measurements of care recipient functional status, caregiving indicators, and service utilization. Indicators of change were also incorporated to capitalize on the prospective data available. Although several results were consistent with prior findings, caregiving indicators (i.e., burden and self-rated health) and community-based service use were significant predictors of earlier placement. Change in caregiver instrumental activities of daily living and care recipient activities of daily living were also related to expedited institutionalization. The findings emphasize the importance of incorporating both care recipient and caregiver function and service use patterns when targeting programs designed to prevent or delay institutionalization for people with dementia.
Adult day service use and reductions in caregiving hours: effects on stress and psychological well-being for dementia caregivers
- Authors:
- GAUGLER Joseph E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(1), January 2003, pp.55-62.
- Publisher:
- Wiley
The objective of this study was to determine whether adult day service use interacts with decreases in primary caregiving hours (i.e. the time caregivers spent on activities of daily living/instrumental activities of daily living, memory problems, and behavior problems for patients) to alleviate caregiver stress and negative mental health over time. The findings suggest that adult day services are potentially effective in restructuring caregiving time and providing respite to family members.