Home and Community Care Digest

Home and Community Care Digest 7(2) November -0001

Psycho-social Factors and Home Care Utilization by Family Caregivers of Persons with Dementia

Abstract

This Belgian study indicates that social and psychological factors affect family caregivers' utilization of home care services for persons with dementia. Structured interviews determined that co-residence, positive attitude towards home care service use, and increased problem-solving coping were direct predictors of the use of diverse home care services. On the other hand, living apart, lower burden of behaviour problems and increased avoidance of coping were associated with increased volume of services. Understanding these factors will help target interventions that facilitate appropriate use of community services to support informal caregiving.
Background: The purpose of this study was to investigate whether selected social and psychological characteristics of family caregivers of patients with dementia are related to community-based service use in Belgium. Family caregivers of persons with dementia who live in the community are potential users of homecare services, as they require services to provide care to their loved ones.

Methods: A cross-sectional survey of family caregivers of elderly patients with dementia was conducted to determine whether psychological and social characteristics impact home care utilization by family caregivers. Participants were identified though the patient records of organizations providing home-care services in the selected region. Structured interviews were conducted to determine the relationship of certain characteristics of family caregivers and the diversity and volume of home-care utilization. The characteristics of family caregivers included the socio-demographic profile of family caregivers and persons with dementia, patient functional status and the burden on family caregiver, patients' cognitive impairment, living arrangement, relationship quality, awareness of home-care services, coping style and diagnosis knowledge.

Findings: A total of 168 family caregivers were recruited with an average age of almost 62 years. A majority of participants were women (68%), and cared for a parent (52%) or a spouse (39%). In terms of living arrangement, 60% of the family caregivers lived together with the person with dementia. Almost everybody (74%) received practical help from formal caregivers, such as home or visiting nurses, home care services, day care in a nursing home and social services. Co-residence, positive attitude to home care service use, and increased problem-solving coping (i.e. efforts to do something active to alleviate stressful circumstances) were direct predictors for use of diverse home care services; whereas living apart, lower burden of behaviour problems, and increased avoidance of coping were associated with increased volume of services. The study showed that social and psychological factors have a significant impact on home-care utilization by family caregivers, whereas functional status and behaviour problems of patients with dementia did not show strong relation to use of services by their family caregivers.

Conclusions: This study indicated that social (e.g., co-residence of caregiver and person with dementia) and psychological factors (e.g., coping style) had a significant effect on utilization by family caregivers of persons with dementia. Understanding family caregiver characteristics can help understand utilization and target interventions at supporting appropriate use of community services. Increasing awareness of relevant services, improving positive attitudes towards home care services, and supporting problem-solving coping in family caregivers may promote diverse use of services to support informal caregiving in the community.

Reference: Roelands M, Oost P, Depoorter A. Service use in family caregivers of persons with dementia in Belgium. Health and Social Care in the Community. 2008; 16(1): 42-53.

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