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Live-in versus live-out home care in Israel: satisfaction with services and caregivers’ outcomes
- Authors:
- AYALON Liat, GREEN Ohad
- Journal article citation:
- Gerontologist, 55(4), 2015, pp.628-642.
- Publisher:
- Oxford University Press
Purpose: This study provides a preliminary examination of the relationship between the type of home care services (live-in vs. live-out; i.e., round the clock vs. several hours per week), the caregiver’s satisfaction with services, and the caregiver’s burden, distress, well-being, and subjective health status within a conceptual framework of caregiving outcomes. Design and Methods: A random stratified sample of family caregivers of older adults more than the age of 70 who receive live-in (442) or live-out (244) home care services through the financial assistance of the National Insurance institute of Israel was selected. A path analysis was conducted. Results: Satisfaction with services was higher among caregivers under the live-in home care arrangement and positively related to well-being. Among caregivers, live-in home care was directly associated with higher levels of subjective health and indirectly associated with better well-being via satisfaction with services. Implications: The study emphasises the potential benefits of live-in home care services for caregivers of older adults who suffer from high levels of impairment and the importance of assessing satisfaction with services as a predictor of caregivers’ outcomes. (Edited publisher abstract)
Intervening to reduce distress in caregivers of impaired elderly people: a preliminary evaluation
- Authors:
- HARPER David J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 8(2), February 1993, pp.139-145.
- Publisher:
- Wiley
Preliminary results from a longitudinal study of distress in carers receiving home care support has indicated that simplistic models of stress and coping need to be replaced by research which considers diversity in caregiver distress and the subtle changes in distress over time.
Can domestic helpers moderate distress of offspring caregivers of cognitively impaired older adults?
- Authors:
- CHONG Alice M.L., et al
- Journal article citation:
- Aging and Mental Health, 21(10), 2017, pp.1023-1030.
- Publisher:
- Taylor and Francis
Objective: This study examined the moderating effect of domestic helpers on distress of offspring caring for parents with cognitive impairments and with or without behavioural problems. Method: This secondary analysis of data involved 5086 Hong Kong Chinese adults aged 60 or older applying for public long-term care services from 2010 to 2012. All variables were measured using the mandatory Hong Kong version of the Minimum Data Set-Home Care 2.0. Results: Regarding taking care of parents with cognitive impairments, 10.7% of offspring primary caregivers were aided by domestic helpers, 55.54% reported distress, and 75.70% lived with their parents. Assistance from domestic helpers reduced offspring caregiver distress if the offspring provided psychological support to parents and were not living with parents. Conclusion: These findings might suggest: a) the positive effects of audience on psychological responses to stress; b) caregiving is usually less stressful for informal caregivers not residing with care recipients. Conversely, having a domestic helper could add to caregiving distress if offspring caregivers live with their parents, most likely because offspring may witness difficulties that domestic helpers face in providing dementia care. (Edited publisher abstract)
Caregiver psychological characteristics predict discontinuation of care for disabled elderly at home
- Authors:
- OKHAMOTO K., HASEBE Y., HARASAWA Y.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(11), November 2007, pp.1110-1114.
- Publisher:
- Wiley
This study sought to determine the predictors of discontinuation of care for the disabled elderly at home using multivariate regression analysis. In January to February 2005, using a self-administered questionnaire, data were collected from 193 caregivers of frail elderly listed on a roster for utilization of day service or short stay service from two Home Visit Nursing Care Stations. Family caregivers were defined as co-resident family members who provided a minimum of 1 h of daily care for at least 3 months. Multiple stepwise logistic regression analysis was performed to detect predictors of a discontinuation for the disabled elderly at home. The mean age of caregivers was around 59.0 years, accounting for about 80% of the women among caregivers. Of those caregivers, the proportion of desire to institutionalization (high DI) (56.8%) was higher than that of desire to care at home (low DI) (43.2%). Among the following three factors selected by multivariate stepwise logistic regression analysis, the strength of the relationship was stronger in frequent mood swings and irritability as carerecipient characteristic than in no advanced or skilled care and a high caregiver burden as caregiver's one. These results suggest that the carerecipients' psychological characteristics may be more strongly related to the decision to continue care for disabled elderly at home than that of the caregivers'.
Easing the burden of caregiving: the impact of consumer direction on primary informal caregivers in Arkansas
- Authors:
- FOSTER Leslie, et al
- Journal article citation:
- Gerontologist, 45(4), August 2005, pp.474-485.
- Publisher:
- Oxford University Press
This study assess the effect of consumer-directed care on the emotional, physical, and financial well-being of the primary informal caregivers of the Medicaid beneficiaries who voluntarily joined Arkansas's Cash and Counseling demonstration. The demonstration randomly assigned beneficiaries to a programme in which they could direct their own disability-related supportive services (the treatment group) or rely on traditional agency services (the control group). Outcome measures were constructed from telephone interviews with 1,433 caregivers who provided beneficiaries with the most unpaid assistance at baseline, and multivariate regression models to estimate programme effects. Interviews occurred between February 2000 and April 2002, 10 months after beneficiaries' random assignment. At follow-up, treatment group caregivers provided fewer hours of assistance than did their control group counterparts, on average, and they reported better emotional, physical, and financial well-being. Permitting interested Medicaid beneficiaries to direct their own in-home supportive services reduces burden on informal caregivers, which may help reduce beneficiaries' nursing home use.
Work-life differences and outcomes for agency and consumer-directed home-care workers
- Authors:
- BENJAMIN A. E., MATTHIAS Ruth E.
- Journal article citation:
- Gerontologist, 44(4), August 2004, pp.479-488.
- Publisher:
- Oxford University Press
Research on home-care outcomes has highlighted the promise of consumer-directed models that rely on recipients rather than agencies to arrange and direct services. However, there has been little research on workers employed directly by recipients. This study examined differences in work-life and worker outcomes between workers in consumer-directed versus agency care as well as between family and nonfamily workers. A random sample of 618 workers in the In-Home Supportive Services program in California was selected and interviewed by telephone between September 1996 and March 1997. Interviews were conducted in English, Spanish, and three Asian languages, with a focus on worker stress and satisfaction. Findings indicate a mixed portrait of worker experience and outcomes. Most model differences disappear when other variables are controlled, but some worker-stress differences persist between models and types of worker. On most dimensions of stress and satisfaction, consumer-directed workers report outcomes equal to or more positive than agency workers. Efforts to improve the work life of home-care workers should acknowledge the strengths of consumer-directed approaches and target all workers across models.
Stress and strain among homecare workers of the frail elderly
- Authors:
- CANTOR Marjorie H., CHICHIN Eileen R
- Publisher:
- Fordham University. Brookdale Research Institute on Aging
- Publication year:
- 1990
- Pagination:
- 244p.,tables.
- Place of publication:
- New York
Looks at pressures on home helps and home care workers in the United States.
Job-related stress and coping among home-care workers with elderly people
- Authors:
- BARTOLDUS Ellen, et al
- Journal article citation:
- Health and Social Work, 14(3), August 1989, pp.204-210.
- Publisher:
- Oxford University Press
Describes stress experienced by a group of home care workers in New York, and suggests ways that social workers and administrators can help to alleviate this.
A triadic perspective on elder neglect within the home care arrangement
- Author:
- AYALON Liat
- Journal article citation:
- Ageing and Society, 36(4), 2016, pp.811-836.
- Publisher:
- Cambridge University Press
The present study evaluates a conceptual model of elder neglect within the home care arrangement that takes into consideration the older adult, his or her family members, and the home care worker. Data from 223 complete care-giving units, which consist of an older adult, a family member and a home care worker, were analysed using structural equation modelling. Overall, 31.5 per cent of the older adults, 18 per cent of the care workers and 32.3 per cent of the family members reported at least one type of elder neglect. The proposed model showed a reasonable fit to the data. There was an inverse effect from type of home care to family member's burden and elder neglect, with live-in (around the clock) care being associated with lower levels of family member burden and elder neglect compared with live-out Israeli home care (provided for several hours per week). The amount of informal assistance provided by family members was inversely related to the amount of burden reported by home care workers, with greater informal assistance being associated with lower levels of worker burden. The findings call for the important role of formal home care by demonstrating a potentially protective effect for live-in migrant home care. The study also emphasises the shared burden between formal and informal sources of care. (Publisher abstract)
Effects of home-based stress management training on primary caregivers of elderly people with dementia in South Korea
- Authors:
- LEE Yoon-Ro, SUNG Kyu-taik, KIM Yang-E
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 11(2), March 2012, pp.171-179.
- Publisher:
- Sage
Concern about dementia among families caring for frail elderly is increasing in South Korea but clinical services for caregivers are said to be sparse. This study evaluated home-based stress management training aimed at reducing the physical and psychological vulnerability commonly associated with caring for a dementia sufferer. It used the multiple-method stress management programme developed by Whitney and Rose. The main difference between this and previous studies is that the intervention was implemented through individual counselling and took place in the client’s own home. The advantages are thought to be the ability to focus for longer on individual concerns and the counsellor being more involved with the whole family and able to more accurately gain insight into and analyse the situation. It also acknowledges Korean caregivers’ strong tendency to provide care for elderly people with dementia within the family setting. A total of 30 primary caregivers were recruited to the training programme (mean age 51 years, 10 female, 5 male in the intervention group). The programme included: relaxation training, cognitive restructuring, modelling sequence, and systematic problem solving. The stress level for the experimental group was significantly reduced, family relationships improved and satisfaction with life was greater. The practice implications and cultural relevance of this type of training are discussed.