Relationship Between Home Caregivers and Caregivers Employed at Selected Institutions Providing Assistance to Seniors with Their Care Recipients Suffering from Dementia

Introduction: There are many difficulties connected with caring for an elderly person sufferring dementia. Symptoms such as aggression or apathy, as well as the progressive nature of the disorder, affect the attitude of both home and institutional caregivers towards the people for whom they care. An important element related to the provision of care is the relationship between a senior with dementia and those who provide the care (home and institutional caregivers). The aim of the article is to characterise and compare these relations. Material and methods: The study comprised 124 participants, 57 professional caregivers and 67 home carers. Two standardised questionnaires were used: the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Quality of Carer-Patient Relationship - QCPR Questionnaire. Additionally, the respondents provided socio-demographic data. The study was conducted via electronic media in the first quarter of 2021. Results: It was found that there is a significant difference in the relationship between home and institutional caregivers, with their charges in the dimension of "warmth and attachment" (measured by QCPR). People providing professional care have significantly higher scores in this area. There was also a significant difference between scores in the 'no conflict and criticism' dimension (measured by QCPR) for home and professional caregivers. Institutional caregivers, in relation to their care recipients, have a higher level of this indicator than home caregivers. Conclusions: Relationships between seniors with dementia and institutional or home carers differ with regard to some issues. The differences in relationships with seniors suffering dementia may be due to the time spent caring for this person and the caregiver's response to symptoms of dementia.

"That's Something for Children"

Robotic systems are increasingly seen as possible technical aids against the background of demographic change and the associated pressures on care systems, with increasing numbers of care recipients and a decreasing number of trained caregivers. In human-computer interaction and computer-supported cooperative work, different design paradigms are currently being pursued to explore which features and appearances are favorable for meaningful interactions of humans with robotic systems. One such approach, labeled as "otherware", proposes to conceptualize robots beyond a naive anthropomorphism or zoomorphism, rather developing the idea of a figure that goes beyond the dichotomy between "being alive" and "being a technical artefact". We present an ethnographic study on the perceptions, attitudes, and practices of care attendants and nursing-home residents in their experimenting with off-the-shelf robotic cats and dogs. The three-week study shows specific appropriation practices of the robotic pets, and how the care attendants - partly together with the residents - define their experiences of the robotic pets, i.e., in which situations the robotic pets are considered either as living beings or as technology toys. The study provides practice-based insights into how possible uses of robotic pets could be meaningfully integrated into care practices, but also which ethical reflections were discussed during their use. Finally, this ethnographic study functioned as a collaborative learning process between researchers, care attendants, and residents, and thus also points out possible aspects that arose with regard to future learning spaces of professional and organizational development for dealing with innovative technologies in residential care contexts.

Understanding Burden in Caregivers of Adults With Dysphagia: A Systematic Review

Introduction: A previous review suggested that dysphagia is negatively associated with burden in caregivers of community-dwelling older adults. Other literature suggests similar patterns of burden may be found across adult patient populations. The current study, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, was conducted to determine the impact of dysphagia on caregivers of adults, regardless of etiology. Method: Five electronic databases were searched using terms based on a review by Namasivayam-MacDonald and Shune (2018) but included all adults rather than only older adults. Searches were limited to English-language empirical studies discussing caregiver burden, included caregivers of adult care recipients, had some care recipients with dysphagia, did not include palliative care, and published in a peer-reviewed journal. Results: The search yielded 1,112 unique abstracts, of which 17 were accepted. Across studies, caregiver burden was found to increase due to dysphagia in care recipients. Commonly reported dysphagia-related causes of burden included changes in meal preparation, disruption in lifestyle, effects on social life, lack of support, insertion of feeding tubes, and fear of aspiration. In general, dysphagia-related caregiver burden was a common experience across caregivers, regardless of patient population, caregiver age, and relationship between caregiver and care recipient. Meta-analyses suggest 71% of caregivers of adults with dysphagia experience some degree of burden. Conclusions: These findings support that dysphagia negatively impacts caregiver burden and suggests sources of burden that clinicians can address within dysphagia management to support caregivers. However, more research is needed to better delineate sources of burden, especially those specific to various dysphagia etiologies, to better meet the needs of our patients.

Determinants of home care utilization among the Swedish old: nationwide register-based study

Since the 1990s, Sweden has implemented aging-in-place policies increasing the share of older adults dependent on home care instead of residing in care homes. At the same time previous research has highlighted that individuals receive home care at a higher age than before. Consequently, services are provided for a shorter time before death, increasing reliance on family and kin as caregivers. Previous studies addressing how homecare is distributed rely primarily on small surveys and are often limited to specific regions. This study aims to ascertain how home care services are distributed regarding individual-level factors such as health status, living arrangements, availability of family, education, and socioeconomic position. To provide estimates that can be generalized to Sweden as a whole, we use register data for the entire Swedish population aged 65 + in 2016. The study's main findings are that home care recipients and the amount of care received are among the oldest old with severe co morbidities. Receiving home care is slightly more common among women, but only in the highest age groups. Childlessness and socioeconomic factors play a small role in who receives home care or not. Instead, the primary home care recipients are those older adults living alone who lack direct support from family members residing in the same household.

Intergenerational Caregiving Patterns, Living Arrangements, and Life Satisfaction of Adults in Mid and Later Life in China

While the health implications of intergenerational caregiving have been broadly investigated in the aging literature, less is known about caregivers in four-generation families and their living arrangements. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study ( N = 12,914 obs.), we document enhanced life satisfaction of grandchild caregivers and sandwich caregivers caring for both grandchildren and parents than non-caregivers. When further taking living arrangements into consideration, we find that parent caregivers also benefit from care provision when not living with their parents and sandwich caregivers only have an advantage when co-residing with care recipients with adult children present in households. By contrast, grandchild caregivers living with grandchildren show substantially higher life satisfaction no matter adult children are present or not. The subgroup comparison suggests that females and rural residents enjoy psychological advantages over their male counterparts and urban counterparts in grandparenting within skipped-generation households and sandwich caregiving.

Profile of Parent-Child Well-Being in Immigrant Families

Earlier caregiving research focused on psychological well-being of either caregivers or care recipients, while less is known about the caregiving pattern with optimal outcome for both caregivers and care recipients. Data were from the PINE and PIETY studies, with 804 parent-child dyads. Depressive symptoms were measured by PHQ-9 with a cutoff of 5 distinguishing happy or depressed. Parent-child dyads were divided into four groups: happy-parent-happy-child (HPHC, n=572, 71.1%), depressed-parent-happy-child (DPHC, n=139, 17.3%), happy-parent-depressed-child (HPDC, n=65, 8.1%), and depressed-parent-depressed-child (DPDC, n=28, 3.5%). Multinomial logistic regression was used to compare the sociodemographic differences among the groups. Compared to the HPHC group, the DPHC group had older parents, more mother-child dyads and lower-income children, the HPDC group had more female children. However, there was no significant difference between the HPHC and the DPDC group. Future research could explore the predictors of parent-child well-being to inform intervention strategies.

Working while Caring for Older Adults with Hearing Impairment and Dementia: Evidence from the NSOC

Age-related hearing loss (HL) and dementia are common among older adults. The implications of caregiving for older adults with dementia is documented. Whether the presence of HL modifies these association is unknown. We used data from the 2011 NHATS/NSOC. Hearing loss and dementia were identified among care recipients (CR). Our outcomes included: hours of care provided, and caregiver’s work activities. Among 1,013 caregivers, 456 assisted individuals without HL or dementia (HL-/D-), 229 with dementia (D+), 193 with HL, and 135 with HL and dementia (HL+/D+). In fully adjusted models, as compared to caregivers of HL-/D-, caregivers of D+ spent 39.1 hours more (95% CI: 13.6,64.6) in caregiving, caregivers of HL+/D+ spent 56.6 more hours (95% CI: 25.1,88.1). We found no differences in work activities between CR groups. The presence of HL increases the caregiving needs of adults with dementia. The additional time does not affect the labor participation of caregivers.

Home Care Resiliency during the COVID-19 Pandemic: Older Adult-Home Care Aide Dyads’ Perspectives

Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID-19 challenges. However, little is known about how COVID-19 has impacted community-dwelling older adults who need assistance with daily activities, including dressing, cooking, and shopping. Guided by the stress process framework, this mixed-method study examined how older homecare recipients experienced the acute and chronic stress during the first eight months of the pandemic, focusing on the role of home care aides (HCAs) in the context of Medicaid-funded in-home services. Thirty-five dyads of care recipients and HCAs participated in a COVID telephone survey as part of a larger study. Care recipients were typically older minority (40% African American, 31% Latinx) women (77%). Their COVID-related anxiety level, assessed by a 6-item Spielberger State Anxiety Inventory (1 “not at all” to 4 “very much”), was 2.2 (SD=0.9). While COVID-19 drastically reduced contacts with family members and healthcare providers, HCAs continued to provide care in person. One care recipient said, “Fortunately, I still have my HCA come and that keeps me sane.” HCAs showed resilience while facing their own family- and work-related stress: “I have followed the rules and just adapted. (COVID) did not affect the activities for my client.” Some dyads, however, experienced care disruptions because of COVID infection or fear in one or both parties. COVID-19 has demonstrated homecare resilience at the person-, dyad-, and organization-levels, calling for equitable, sustainable home-based care for a growing number of older adults who desire to stay in the home.

ADRD Caregiving Experiences and Health by Race, Ethnicity and Care Recipient Geographic Context

Few studies have examined how the intersectionality of geographic context and race/ethnicity influences Alzheimer’s disease and related dementia (ADRD) caregiving. Our aims were to determine whether 1) caregiver experiences and health differed across urban and rural areas; and 2) these links were moderated by caregiver race/ethnicity. We used data from the 2017 National Health and Aging Trends Study and National Study of Caregiving. The sample included caregivers (n=808) of care recipients ages 65+ with ‘probable’ ADRD (n=482). Geographic context was defined as care recipient’s residence in metro (urban) or non-metro (rural) counties. Outcomes included caregiving experiences (burden, gains, life impacts, service/resource use) and health (self-rated, anxiety, depression symptoms, chronic health conditions). Bivariate analyses indicated that non-metro ADRD caregivers were less racially/ethnically diverse (82.7% white) and more were spouses/partners (20.2%). Among racial/ethnic minority ADRD caregivers, non-metro context was associated with having more chronic conditions (p<.01), providing less care (p<.01), and not co-residing with care recipients (p<.001). Amid white ADRD caregivers, non-metro context was associated with not reporting caregiving was more than they could handle (p<.05) and finding financial assistance for caregiving (p<.05). Multivariate regression analyses demonstrated that non-metro minority ADRD caregivers had 3.09 times higher odds (95% CI=1,02-9.36) of reporting anxiety in comparison to metro minority ADRD caregivers. Geographic context shapes ADRD caregiving experiences and caregiver health differently across racial/ethnic groups. Despite higher rates of ADRD and ADRD-related mortality in non-metro areas, findings suggest both positive and negative aspects of caregiving among White, Black, and Hispanic ADRD caregivers.