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Valuing the health of the support worker in the aged care sector
- Authors:
- GEORGE Esther, HALE Leigh, ANGELO Jennifer
- Journal article citation:
- Ageing and Society, 37(5), 2017, pp.1006-1024.
- Publisher:
- Cambridge University Press
This study explored aged care support workers’ perceptions of how their health was influenced by their job, highlighting similarities and differences of those working in community-based and institution-based care. Support workers working in two institution-based and three community-based aged care organisations were invited to participate. Semi-structured interviews were undertaken with ten participants. Open-ended questions probed participants’ perceptions of their health as it related to their work. Data were analysed with the General Inductive Approach. Four central themes were identified, many of which related to mental, as opposed to physical health. ‘Love of the job’ described various sources of satisfaction for participants. These factors commonly overrode the negative aspects. ‘Stress’ encompassed the negative influences on all aspects of health. ‘Support’ described the positive influences on health, which supported participants in their job. ‘Physicality’ described the physical nature of the job and the positive and negative impact this had on participants’ health. Support workers perform numerous tasks, which often impact upon their health. Aspects of the job that may impact the health of the worker are improved communication and support from management, as well as recognition for support workers’ contribution to society. These could be targeted to enhance support worker health. Additional training and reduced time pressure may also represent aspects for improvement, to optimise support workers’ physical health. (Publisher abstract)
Daily well-being benefits of physical activity in older adults: does time or type matter?
- Authors:
- WHITEHEAD Brenda R., BLAXTON Jessica M.
- Journal article citation:
- Gerontologist, 57(6), 2017, pp.1062-1071.
- Publisher:
- Oxford University Press
Purpose of the Study: There is little debate that maintaining some level of physical activity in later life conveys positive benefits both physically and psychologically. What is less understood is the extent to which the type of activity or the length of time spent doing it matters when it comes to these benefits on the daily level. Here, the authors investigated (a) whether the presence of daily purposeful exercise (Exercise) or non-exercise physical activity (Activity) is sufficient for experiencing day-level benefits, or if time spent matters, and (b) whether there are differential well-being benefits of Exercise and Activity on the daily level. Design and Methods: Older adults (N = 127; aged 60–95, Mage = 79.4) filled out surveys for 14 days, reporting daily Exercise and Activity behaviours as well as Positive and Negative Affect (PA/NA), Perceived Stress (PS), Perceived Health (PH), and Sleep Quality (SQ). Results: Multilevel regression models showed that for purposeful exercise, more time spent was beneficial for PA, NA, and PH, but for PS, only the presence of exercise was important (time did not matter). For non-exercise activity, time did not have as great an influence as presence—doing any form of activity was beneficial for both PA and SQ. Exercise and Activity had largely independent (additive) effects. Implications: Results reveal that both purposeful exercise and non-exercise activity convey independent daily well-being benefits, and that for some aspects of daily well-being, duration does matter. Findings can be applied in the development of physical activity education or engagement programmes for older adults. (Publisher abstract)
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)
A response framework with untruths as a last resort
- Authors:
- O'CONNOR Edward, JAMES Ian, CAIAZZA Roberta
- Journal article citation:
- Journal of Dementia Care, 25(4), 2017, pp.22-25.
- Publisher:
- Hawker
A report by the Mental Health Foundation (What is truth? and inquiry about truth and lying in dementia care, 2016) set out the pros and cons of using untruths. In this article, the authors describe a practical framework which allows "therapeutic lies" as a last resort. (Edited publisher abstract)
The determinants of informal caregivers' burden in the care of frail older persons: a dynamic and role-related perspective
- Authors:
- MELLO J. de Almedia, et al
- Journal article citation:
- Aging and Mental Health, 21(8), 2017, pp.838-843.
- Publisher:
- Taylor and Francis
Abstract: Research into informal caregivers' burden does not distinguish between different stages of impairment. This study explored the determinants of burden from an in-depth perspective in order to identify which determinants apply to which phases of impairment. Methods: This was a cross-sectional study including frail older persons aged 65 and above. Instruments used were the interRAI Home Care, the Zarit-12 interview and an ad hoc economic questionnaire. A combination of variables from the Stress Process Model and Role Theory and a sub-group analysis enabled refined multivariate logistic analyses. Results: The study population consisted of 4175 older persons (average age: 81.4 ± 6.8, 67.8% female) and their informal caregivers. About 57% of them perceived burden. Depressive symptoms, behavioural problems, IADL impairment, previous admissions to nursing homes and risk of falls yielded significant odds ratios in relation to informal caregivers’ burden for the whole sample. These determinants were taken from the Stress Process Model. When the population was stratified according to impairment, some factors were only significant for the population with severe impairment (behavioural problems OR:2.50; previous admissions to nursing homes OR:2.02) and not for the population with mild or moderate impairment. The informal caregiver being an adult child, which is a determinant from Role Theory, and cohabitation showed significant associations with burden in all strata. Conclusion: Determinants of informal caregivers’ burden varied according to stages of impairment. The results of this study can help professional caregivers gain a greater insight into which informal caregivers are most susceptible to perceive burden. (Edited publisher abstract)
A pilot randomized trial of two cognitive rehabilitation interventions for mild cognitive impairment: caregiver outcomes
- Authors:
- VUC Andrea V., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.e180-e187.
- Publisher:
- Wiley
This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerised brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden. Methods: A randomised controlled pilot trial was performed. Results: At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance. Conclusion: Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30–100 people per group to accurately determine significance. (Publisher abstract)
Cognitive impairment in Parkinson's disease: impact on quality of life of carers
- Authors:
- LAWSON R.A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.1362-1370.
- Publisher:
- Wiley
Background: The quality of life (QoL) of informal caregivers of people with Parkinson's disease (PD) (PwP) can be affected by the caring role. Because of cognitive symptoms and diminished activities of daily living, in addition to the management of motor symptoms, carers of PwP and cognitive impairment may experience increased levels of burden and poorer QoL compared with carers of PwP without cognitive impairment. This study aimed to investigate the impact of cognitive impairment in PD upon QoL of carers. Methods: Approximately 36 months after diagnosis, 66 dyadic couples of PwP and carers completed assessments. PwP completed a schedule of neuropsychological assessments and QoL measures; carers of PwP completed demographic questionnaires and assessments of QoL. Factor scores of attention, memory/executive function and global cognition, as derived by principal component analysis, were used to evaluate cognitive domains. Results: Hierarchical regression analysis found lower Montreal Cognitive Assessment was a significant independent predictor of poorer carer QoL, in addition to number of hours spent caregiving, carer depression and PD motor severity. Attentional deficits accounted for the largest proportion of variance of carer QoL. Carers of PwP and dementia (n = 9) had significantly poorer QoL scores compared with PwP and mild cognitive impairment (n = 18) or normal cognition (n = 39) carers (p < 0.01). Conclusions: Attentional deficits were the strongest predictor of carer QoL compared with other cognitive predictors. Carers for those with PD dementia reported the poorest QoL. Interventions such as respite or cognitive behavioural therapy to improve mood and self-efficacy in carers may improve carer QoL. (Publisher abstract)
An evaluation of Cognitive Stimulation Therapy sessions for people with dementia and a concomitant support group for their carers
- Authors:
- BAILY Jan, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(8), 2017, pp.985-1003.
- Publisher:
- Sage
This research aimed to ascertain the impact of a pragmatic Cognitive Stimulation Therapy course of 10 sessions on the cognitive function of people living with dementia and whether attending a concomitant carers support group was beneficial to carers. A mixed method quasi-experimental approach was adopted; data were collected pre- and post-intervention. The quantitative arm utilised three validated questionnaires rated by the carers. Qualitative data were collected via semi-structured interviews with carers regarding their perceptions of the impact of Cognitive Stimulation Therapy and the carers support group. Quantitative data analysis found no statistically significant differences within or between groups. The qualitative data demonstrated that carers perceived Cognitive Stimulation Therapy had some benefits for the people living with dementia, especially social benefits. Carers also perceived that attending the carers support group was beneficial for them in terms of gaining a better understanding of dementia, developing coping skills and having peer support. The study was limited in scale and further research with a larger sample, using direct measures of the impact of Cognitive Stimulation Therapy with people living with dementia and supplementary research exploring which characteristic of carers support groups are effective would be worthwhile. (Publisher abstract)
A comparison of working in small-scale and large-scale nursing homes; a systematic review of quantitative and qualitative evidence
- Authors:
- VERMEERBERGEN Lander, et al
- Journal article citation:
- International Journal of Nursing Studies, 67, 2017, pp.59-70.
- Publisher:
- Elsevier
Background and objective: Ongoing shortages of care workers, together with an ageing population, make it of utmost importance to increase the quality of working life in nursing homes. Since the 1970s, normalised and small-scale nursing homes have been increasingly introduced to provide care in a family and homelike environment, potentially providing a richer work life for care workers as well as improved living conditions for residents. ‘Normalised’ refers to the opportunities given to residents to live in a manner as close as possible to the everyday life of persons not needing care. The study purpose is to provide a synthesis and overview of empirical research comparing the quality of working life – together with related work and health outcomes – of professional care workers in normalised small-scale nursing homes as compared to conventional large-scale ones. Design: A systematic review of qualitative and quantitative studies. Data sources: A systematic literature search (April 2015) was performed using the electronic databases Pubmed, Embase, PsycInfo, CINAHL and Web of Science. References and citations were tracked to identify additional, relevant studies. Review methods: The review identified 825 studies in the selected databases. After checking the inclusion and exclusion criteria, nine studies were selected for review. Two additional studies were selected after reference and citation tracking. Three studies were excluded after requesting more information on the research setting. Results: The findings from the individual studies suggest that levels of job control and job demands (all but “time pressure”) are higher in normalised small-scale homes than in conventional large-scale nursing homes. Additionally, some studies suggested that social support and work motivation are higher, while risks of burnout and mental strain are lower, in normalised small-scale nursing homes. Other studies found no differences or even opposing findings. The studies reviewed showed that these inconclusive findings can be attributed to care workers in some normalised small-scale homes experiencing isolation and too high job demands in their work roles. Conclusion: This systematic review suggests that normalised small-scale homes are a good starting point for creating a higher quality of working life in the nursing home sector. Higher job control enables care workers to manage higher job demands in normalised small-scale homes. However, some jobs would benefit from interventions to address care workers’ perceptions of too low social support and of too high job demands. More research is needed to examine strategies to enhance these working life issues in normalised small-scale settings. (Edited publisher abstract)
Acculturative stress and depressive symptoms among Korean immigrant elders residing in non-Korean ethnic enclaves
- Author:
- RHEE Stephanie L.
- Journal article citation:
- Journal of Ethnic and Cultural Diversity in Social Work, 26(4), 2017, pp.347-365.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This cross-sectional structured survey examined the relationships of personal factors, acculturative stress, and depressive symptoms among Korean immigrant elders (N = 108) residing in areas without any Korean ethnic enclave. Multiple regression and path analyses indicated that personal factors such as levels of acculturation and socioeconomic status might influence acculturative stress and depressive symptoms negatively; however, acculturative stress was the most significant risk factor for depressive symptoms. Culturally relevant programmes and services are important vehicles through which to enhance personal resources and reduce lingual and cultural barriers among Korean immigrant elders residing in non-Korean ethnic enclaves. (Publisher abstract)