Formal Caregiver Burden in Nursing Homes: An Integrative Review

Formal caregivers in nursing homes provide care to vulnerable older adults with chronic conditions. Caregiver burden affects formal caregivers. The purpose of this integrative review was to explore formal caregiver burden among nursing staff in nursing homes. Specific aims were to gain an understanding of the attributes, definitions, measures, and primary outcomes. A systematic search of CINAHL, PubMed, PsycINFO, and Embase was completed. The sample included 19 articles, which were published in English between January 1980 and April 2020. Attributes varied; however, perceived stress was frequently identified, consistent with the formal caregiver burden definition. Psychometric measures employed in the studies indicated heterogeneity. Primary outcomes included differences in burden, resident behavior, occupational and personal factors, and resident care. Research is needed to gain an understanding of this recently defined concept. Formal caregiver burden in nursing homes has emerged as a priority for research during the pandemic with new challenges and guidelines.

Exploring Formal Caregiver Burden Within Nursing Homes: An Integrative Review

The purpose of this integrative review was to explore formal caregiver burden in nursing homes among direct care nursing staff. The aim was to gain an understanding of the state of the science of formal caregiver burden, it’s measurement, and its effect on resident care. Based on PRISMA guidelines, a systematic search of CINAHL, PubMed, PsycINFO and Embase databases was conducted using terms from the definition of formal caregiver burden, three conceptual models, and the thesaurus feature of each database for years ranging from 1979-2019. Inclusion criteria consisted of peer-reviewed articles in English that focused on the key terms of formal caregiver burden among direct care nursing staff only in nursing home facilities. Out of 925 citations, 20 articles met criteria; 15 quantitative and 5 qualitative studies. Sample sizes ranged from 11-1283, number of facilities from 1-55, and bed size from 31-203. Psychometric measures used in the studies reported lower validity and reliability, a variety of conceptual definitions interchangeably, and primarily studied nursing assistants (n=19). Five studies included nurses as formal caregivers, and one studied only nurses. Variables used to identify burden were racial disparities (n=2), trauma experience (n=1), depression (n=4), distress (n=3), mental health (n=1), stress (n=2), health complaints (n=1), and alienation (n=1). Two studies evaluated the effect on resident care, one finding significant results of in-service training contributing to positive attitudes of formal caregivers toward confused residents. Current limitations in the understanding of formal caregiver burden limit the advancement of research.

Experiences of Formal Caregivers Providing Dementia Care to American Indians

Alzheimer’s disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest aging populations in the United States and the smallest, most underrecognized, and most culturally diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study sought to document formal caregiver and AI dementia beliefs about AD. Data came from four in-depth interviews that included three Western and one AI formal caregiver. These interviews explored the variability of cultural beliefs regarding AD and dementia among a sample of formal caregivers who minister to AI patients; in the interviews, these participants also provided examples of challenges they faced, providing a better cultural understanding of AI dementia. The findings included using a bicultural approach to AD, illuminating interactions between patient and provider, and fostering awareness of cultural competency. Research on this topic is critical in advancing cultural, public health, and evidence-based health practices regarding AI dementia patients. The potential implications for social change include enhancing cross cultural provider–patient interactions and advancing public health policy and practice for this underserved population. Many of the issues and challenges explored may have implications for other ethnocultural minority groups.

The Perceived Caregiver Burden Among Turkish Family Caregivers Providing Care for Frail Older Adults

Purpose: The older population has reached to 8.5%, and the prevalence of frailty is reported as 39.2% in Turkey. The purpose of the study was to assess caregiver burden in families who care for frail older adults in Turkish culture. Method: This descriptive study was conducted in Turkey between June and October 2017. Frail older adults who had no severe cognitive impairment were included. Data were measured using the Older Adult Information Form, Edmonton Frailty Scale, Caregiver Information Form, and Zarit Burden Interview. Results: In total, 131 older person/caregiver dyads were analyzed; the Zarit Burden Interview mean score was 37.59 ± 18.20. Caregivers with less education and providing care more than 8 hours experienced a higher burden ( p < .05). The severity of frailty significantly correlated with the caregiver scores ( R = .36, p < .01). Conclusion: The caregiver burden in Turkish family caregivers was found mild to moderate and correlated with the degree of frailty. Policymakers should focus on culture-specific formal caregiver services.