Home-Based Assessment for Family Carers: A Preventative Strategy to Identify and Meet Service Needs

Abstract

Objective. To identify unmet need for services among family carers and their frail or disabled relatives and to facilitate links to services. Design. Intervention study with a subgroup of carer dyads from a random statewide survey of family carers, followed by telephone 2 months post intervention. Setting. Carer dyads in general community; urban and rural Victoria. Participants. All 186 identified carers were approached. One‐third of the dyads were ineligible; of the remainder, 67 (53%) participated, matching refusals on sociodemographic characteristics. Carers were typically married, middle‐aged women looking after parents or spouses. Almost half of the care recipients were aged ≥80; most had multiple disorders and impairments. Follow‐up rate was 94%. Intervention. One off, multidisciplinary home‐based assessment of dyad by research team and regional aged care assessment service (ACAT). Main outcome measures. ‘Unmet need’: % dyads recommended new services; number services per dyad via ACAT; increases in service range; extension of pre‐existing services. Service linkage: % dyads linked to new services; perceived usefulness of linkages. Main results. Dyads recommended a new service (93%); increased range (73%); extensions (41%). Average two services requiring ACAT implementation; commonly respite care, aids and paramedical services. Recommendations related to impairment severity and carer stress. ACAT implemented recommendations (90% relevant dyads); links rated useful (75% relevant dyads). Three‐quarters of the carers rated intervention as helpful. Conclusion. A preventative programme of needs assessment for carer dyads has considerable potential; (a) identifying needs and engaging new services; (b) providing emotional support. © 1997 John Wiley & Sons, Ltd.

Family Care as Collaboration: Effectiveness of a Multicomponent Support Program for Elderly Couples with Dementia. Randomized Controlled Intervention Study

“…Well-established working principles influenced by awareness of problems in current service systems that have been identified in many previous studies guided the intervention. [20][21][22][23] Client-centeredness was emphasized. All of the coordinated services were planned in collaboration with the families, respecting the autonomy and enhancing empowerment of the couples.…”

Alzheimer’s Patients’ Spouses Critiques of the Support Services

“…Although caregiving leads to strain and burden, families of dementia patients are often reluctant to use the services offered [2, 9–13]. Only one third of caregiving families use these services [10].…”

“…Formal services are typically engaged when informal services are unavailable or only in moments of crisis [13]. The literature on caregiving has suggested several reasons for this.…”

How Do Officially Organized Services Meet the Needs of Elderly Caregivers and Their Spouses With Alzheimer's Disease?

“…6,9 Finally, these families value their autonomy, privacy, and dignity even in very stressful situations and therefore they are reluctant to use the services. 7,9 Thus, there is friction between the service system and the caregiving families.…”

“…2,[4][5][6][7] Formal services are typically engaged when informal services are not available or only if a crisis arises. 7 Caregiving literature has suggested several reasons for this. First, families are often unaware of available services, and they have a great need for information.…”