Perspectives of Australian family carers of people with dementia on the 'cottage' model of respite: Compared to traditional models of residential respite provided in aged care facilities

Abstract

The majority of people living with dementia reside in the community and are often reliant on the support of informal carers to do so. Family carers face many challenges in supporting the person with dementia to remain at home, and short‐term respite care is a valued service that offers a temporary break from the role. Respite cottages provide short‐term care in a residential home‐like setting with a limited number of clients and is a more flexible approach to accessing the service. Disproportionate use of cottage respite in Australia suggests this model is preferred over traditional respite within residential aged care facility (RACF) settings, yet limited research exists to compare these models. This study sought to understand the perceptions of carers who had used cottage respite in comparison to other models, and explore the contribution of cottage respite for supporting carers to continue in their role and maintain their care recipient (CR) living at home. Semi‐structured interviews were conducted with 126 family carers who had used one of two New South Wales‐based respite cottages within a 2‐year period; 67 of whom had also used RACF respite. Thematic analysis revealed four main themes around the benefits of cottage respite: (a) an effective essential service, (b) flexibility, (c) familiarity and (d) appropriateness, especially for early stage or younger onset dementia. Carers indicated that the more homely, familiar and intimate cottage model of respite care was preferential to that of the larger, institutional‐style RACF respite setting. Carers credited the cottage model of respite service with delaying their need for permanent residential placement by over 12 months. The cottage respite model provides an important avenue to supporting the individual needs of dementia dyads, with potential to delay permanent placement, and should be offered more broadly to provide people with more choice about their care.

Transition for people with dementia from day respite services to permanent residential care: a realist synthesis

“…Organisational structures that support the establishment of care goals and forward planning for emergent care needs are key (17), including advance care directives, while practices to support shared decision-making ease negative emotions associated with transition (18). The contextual scans of Phase 1 (b) revealed the bene t of co-located services such as retirement living with residential care services and/or community-based activities within the residential care home, to support familiarity, acclimatisation and seamless transition, as supported by Harkin et al (32).…”

“…From a structural context perspective, traditional models of respite care (of time away from each other) were not necessarily restorative nor resilience building (9), with non-institutional environments promoting connection to more homely, familiar settings (29,32) and dyad restoration (4). The contextual scans highlighted the bene ts of co-located retirement living and residential care programs as promoting comfort and familiarity with staff and residents.…”

“…Importantly, education and support included acknowledging and validating both positive and negative aspects of respite care and transition to permanent care, plus guidance on shared decision-making with the person with dementia (18). Resources that contextualise current experiences and events through valued history, promoting dignity and autonomy are critical to ensuring meaningful activity for the person with dementia (25,32).…”

Competency development for a volunteer navigation program to support caregivers of people living with dementia: A modified e-Delphi method

“…There are several common barriers to accessing existing respite, which contributes to care-partners’ underutilization of these services (Bieber et al, 2019; Vandepitte et al, 2016). These barriers include care-partners’ concerns for the comfort of the person living with dementia when placed in long-term care or receiving home supports, guilt regarding leaving the person living with dementia, as well as the inadaptability, high cost, and lack of awareness of services (Gresham et al, 2018; Harkin et al, 2020; Vandepitte et al, 2016). Further, care-partners may be unaware of or unwilling to acknowledge their own needs and ask for help and lack support to help them do so (Zwingmann et al, 2019).…”

Two-Step Floating Catchment Area Model-Based Evaluation of Community Care Facilities’ Spatial Accessibility in Xi’an, China

“…Research on urban aged care facilities in recent years has mainly focused on the discussion of old-age care models and policies [ 12 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] and investigation of the living needs of the elderly and the environment [ 39 , 40 , 41 , 42 , 43 , 44 ]. Most of these studies use observation, questionnaires, and interview methods, amongst other approaches, to obtain data.…”