Unmet Home Care Service Needs of Rural Older Adults With Alzheimer's Disease: A Perspective of Informal Caregivers

Li, Hong; Kyrouac, Gregory A.; McManus, Dennis Q.; Cranston, Robert E.; Hughes, Susan L.

doi:10.1080/01634372.2011.650318

Cited by 29 publications

(27 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…29,30 Unmet needs cover all areas, including activities of daily living (especially fall management), mental health, accompanying acute health problems, family caregiver burden, transportation, housing, and general practitioner lack of knowledge. 25,[29][30][31] Concerns are raised about the resultant impact, such as increased nursing home admissions (eg, patients are 1.8 more times likely to be admitted when they have unmet needs). 29 A lack of recognition of self-harm ideation and untreated depression leads to increased morbidity and mortality, increased nursing home institutionalization, and increased caregiver distress.…”

Section: Unmet Needs (15 Studies)mentioning

confidence: 99%

Homecare user needs from the perspective of the patient and carers: a review

Keeling¹

2014

SHTT

View full text Add to dashboard Cite

There is a global shift towards a blending of care delivery within formal and informal environments in direct response to economic and demographic pressures. Homecare is at the hub of this activity, enabling people to age in place and keeping families intact. However, our understanding of patient and carer needs is fragmented; understandably so, given the complexity of these needs. This descriptive review offers a content analysis of papers focused on patients' and carers' needs and homecare published between January 2010 and October 2013. It is evident that homecare is an intensely researched area, yet it is disjointed. Emerging research emphasizes the need to take a holistic approach. Firstly, incorporating emotional psychosocial and cultural elements will help to draw together our current understanding within a more cohesive framework. Secondly, tensions that hinder communication and collaboration between stakeholders must be resolved. Thirdly, information and communications technology is rapidly becoming synonymous with homecare, and offers solutions for facilitating care delivery, collaboration, and training of future professionals. The rate of international activity promises much for future research collaborations to compare, contrast, and identify best practices for the future of homecare as we endeavor to meet the ever-increasing pressures on health and social care systems.

show abstract

Section: Unmet Needs (15 Studies)mentioning

confidence: 99%

Homecare user needs from the perspective of the patient and carers: a review

Keeling¹

2014

SHTT

View full text Add to dashboard Cite

show abstract

“…In addition to the mental and physical effects, rural caregivers face additional challenges in caring for an individual with dementia or Alzheimer's disease. Notably, rural caregivers indicate that their family member faces unmet service needs (Li, Kyrouac, McManus, Cranston, & Hughes, 2012) and limited availability and accessibility of services (O'Reilly & Strong, 1997b). In addition, they face potential stigma associated with dementia and fear the lack of privacy in a small community (Morgan, Semchuk, Stewart, & D'Arcy, 2002).…”

Section: Articlementioning

confidence: 99%

Mental Health in Rural Caregivers of Persons With Dementia

et al. 2015

View full text Add to dashboard Cite

Informal caregiving for dementia is common and often affects caregiver mental health. In addition to typical stressors faced by caregivers of persons with dementia (PWDs), rural caregivers often face additional stressors associated with living in more remote locations; unfortunately, this group is largely understudied. Ninety-three caregiver-PWD dyads completed measures of social support, perceived control, self-efficacy, burden, and cognitive functioning. Measures of PWD activities of daily living and mental functioning were also collected. These variables were hypothesized to predict caregiver self-reported symptoms of depression, anxiety, and stress. Contrary to predictions, only caregiving-related self-efficacy and caregiver burden predicted the caregiver's mental health. Future interventions for improving rural caregiver self-reported mental health should target cognitions associated with caregiving self-efficacy and caregiver burden. Health care providers for rural families should focus on ways to reduce feelings of caregiver burden and provide caregivers with useful skills and tools for caregiving.

show abstract

“…16,17 The effects on the needs for early diagnosis, financial and legal aspects of the disease, and meaningful activities were not studied. CM was not found to have any effect on patients' daily activities, cognition and depression.A meta-analysis of the effects of CM (Figure 1 and Supplemental Appendix 4, available at http:// 61,62,66,73,74,76,81,85,91,93,95,97 Canada 84 USA [14][15][16] Europe (21 studies) UK 20,52,53,64,69,72,77,78,83,84,99 The Netherlands The effect on depression of caregivers was uncertain (SMD -0.23, 95% CI, -0.46 to 0.01, P = .06), 14,17,18 and there was no effect on caregivers' burden (SMD 0.17, 95% CI, -0.18 to 0.52, P = .34). …”

mentioning

confidence: 99%

“…Assistance with ADL/IADL 57,68,74,76,79,84,85,87,88,91,97 Need for help with ADL (commonly for bathing/dental care, dressing, and walking) and with IADL (commonly for housekeeping, meal preparation, and transportation).…”

mentioning

confidence: 99%

Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

Khanassov

Vedel

2016

Ann Fam Med

View full text Add to dashboard Cite

PURPOSE Dementia case management (CM) in primary care is a complex intervention aimed at identifying the various needs of patients with dementia and their caregivers, as well as the organization and coordination of care. A key element of CM is the collaboration of family physicians with case managers. We conducted a systematic mixed-studies review to identify the needs of the patientcaregiver dyad and the effects of CM. METHODSWe searched MEDLINE, PsycINFO, and EMBASE up to October 2014, regardless of the study design. Our main outcomes were needs of patients and their caregivers and the effects of CM on these needs. We used narrative syntheses to develop a taxonomy of needs and to describe the effects of CM on those needs. We used meta-analysis to calculate the prevalence of needs and the standardized mean differences to evaluate the effects of CM on the needs identified.RESULTS Fifty-four studies were included. We identified needs of the patientcaregiver dyad and needs of the patient and caregiver individually. CM addressed the majority of the identified needs. Still, some very common needs (eg, early diagnosis) are overlooked while other needs (eg, education on the disease) are well addressed. Fully establishing the value of CM is difficult given the small number of studies of CM in primary care.CONCLUSIONS There is good evidence that case managers, in collaboration with family physicians, have a pivotal role in addressing the needs of the patientcaregiver dyad. 2016;14:166-177. doi: 10.1370/afm.1898. Ann Fam Med INTRODUCTIONT he proportion of people with dementia is growing dramatically. According to the US Alzheimer's Association, by 2030, 50% of Americans aged 65 years and older will be diagnosed with dementia. 1 In Canada in 2011, 747,000 Canadians lived with cognitive impairment.2 Today, the combined costs are $33 billion per year, 1 and they are projected to increase to $872 billion by 2038. 3,4 Worldwide, dementia is the main contributor to disability-adjusted life years (11.2%), representing a greater burden than cerebral vascular accident (9.5%), heart disease (5.0%), or cancer (2.4%). 5People with dementia need help with challenging changes in behavior, memory, physical disability, and mood. 6 The main source of help is family caregivers, who often suffer from the burdens of caregiving and from depression and health problems. 7 It has been shown that early intervention makes the greatest difference in management of symptoms. 1 The World Health Organization states that it would be challenging to intervene without effective involvement of primary care. 8 Dementia case management (CM) interventions are becoming a central component of primary health care organizations in North America and Europe. [9][10][11][12] According to the 167Case Management Society of America, case management is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communi...

show abstract

Unmet Home Care Service Needs of Rural Older Adults With Alzheimer's Disease: A Perspective of Informal Caregivers

Cited by 29 publications

References 38 publications

Homecare user needs from the perspective of the patient and carers: a review

Homecare user needs from the perspective of the patient and carers: a review

Mental Health in Rural Caregivers of Persons With Dementia

Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

Contact Info

Product

Resources

About