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Das Potenzial neuer Technologien zur Unterstützung von Pflege über eine räumliche Distanz: Literaturstand und qualitative Befunde
Abstract
The potential of technological assistance to support distance caregiving - literature review and empirical results Abstract.Background: Due to demographic change, increasing labour mobility and changing family patterns, social relationships often exist over long distances. Supporting relatives over a distance is therefore a highly topical issue but still little discussed, also in Germany and Switzerland. Aim: The project "DiCa" (2016 - 2019) with an interdisciplinary research team from Germany (EH Ludwigsburg) and Switzerland (Careum School of Health, Zurich) aims to investigate different dimensions of "Distance Caregiving". This paper deals with the possible use of new technologies to support these care arrangements. Methods: Based on a literature review, qualitative interviews were conducted with "Distance Carers" and partner companies in Germany to investigate the use of new technologies in the context of "Distance Caregiving". Results: There are initial approaches concerning technical solutions in home care and in companies. So far communication options via telephone and smartphone and flexible working time and workplace regulations have played an important role. However, the potential of new technologies does not seem to be fully explored. Conclusions: In order to make the most of the various possibilities of innovative technologies in the context of "Distance Caregiving" for those affected but also for companies, well-researched information and independent advice and counseling are required for all parties involved in the care process.
... B. Zeuner und Rettinger 2019). Vergleichsweise wenig ist jedoch in Bezug auf die Lebenssituation pflegender Angehöriger passiert (Brown et al. 2019;Parker et al. 2008), obwohl der Gebrauch einer assistierten Technologie große Chancen zur Verbesserung der Gesundheitskompetenz birgt (Franke et al. 2019 ...
Zusammenfassung
Hintergrund
Aufgrund der älter werdenden Bevölkerung und der Zunahme von Menschen mit chronischen Erkrankungen im Alter, steigt die Zahl der pflegenden Angehörigen sowie deren Wert für die Versorgung. Dabei agieren sie meist ohne Vorerfahrungen im Bereich der Versorgung, haben begrenztes Verständnis für das Gesundheitssystem und erfüllen die Aufgabe neben der Bewältigung des eigenen Alltags. Daher gewinnen technische Unterstützungsmöglichkeiten wie die App Liv (entwickelt im Projekt münster.land.leben) an Bedeutung. Ziel der App Liv ist die Verbesserung der digitalen Gesundheitskompetenz der vulnerablen Gruppe der pflegenden Angehörigen in Deutschland.
Ziel der Arbeit (Fragestellung)
Ziel dieser Studie war, einen Prototyp der App Liv partizipativ mit pflegenden Angehörigen zu testen und das Konzept der App weiterzuentwickeln.
Material und Methoden
Mit 10 pflegenden Angehörigen wurden unter Zuhilfenahme eines Prototyps der App qualitative online Interviews geführt, mittels qualitativer Inhaltsanalyse ausgewertet.
Ergebnisse
Die pflegenden Angehörigen bewerteten das Layout und die Einfachheit der Funktionen insgesamt positiv. Als Voraussetzung für die Nutzung betonten die Interviewten die Einfachheit der Anwendung und eine Vielfalt an Dokumentationsmöglichkeiten. Erweiterungsvorschläge erfolgten in den Bereichen Spezifizierung der Aktivitäten, Hinzufügung von weiteren Kommunikationsformen, Reminder oder Bestätigungen für erledigte oder zu erledigende Aufgaben, Verweis auf weiterführende Informationen, Verknüpfung mit anderen digitalen Systemen und Hinterlegung wichtiger Dokumente.
Diskussion
Aus Sicht der Betroffenen stößt die App auf eine Versorgungslücke. Auf Grundlage der Vorschläge der Interviewteilnehmerinnen werden 6 Erweiterungen für die App diskutiert. Um die App nicht zu überfrachten, müssen diese in einer weiteren Studie auf ihre Nützlichkeit getestet werden.
... Wissenschaftler*innen kritisieren wiederholt, dass "Early Adopters", also Personen, die Techniken besonders früh anwenden und als Vorreiter eine treibende Rolle spielen, in untersuchten Szenarien der Gesundheitsversorgung praktisch nicht existent waren (vgl. Franke et al., 2019;Klobucnik et al., 2017 (Braeseke et al., 2020;Hülsken-Giesler et al., 2019;Kuhlmey et al., 2019). Gleichzeitig muss attestiert werden, dass noch große Potenziale im Wissen über die technologischen Möglichkeiten, der experimentierfreudigen Anwendung sowie der Praxisvalidierung bestehen. ...
Zusammenfassung
Das folgende Kapitel stellt einleitend zentrale Problemfelder vor, die im Forschungs- und Themenbereich Active Assisted Living bereits identifiziert wurden, jedoch bis heute nicht zufriedenstellend gelöst sind. Im Fokus stehen vorhandene Marktbarrieren, die es strategisch und methodisch zu überwinden gilt.
... Demnach werden die beiden zuletzt genannten Gruppen weniger in die Entscheidung miteinbezogen, obwohl auch sie von dem Technikeinsatz direkt oder indirekt betroffen sind. Hier ist noch einmal darauf hinzuweisen, dass der Einbezug aller an der Betreuungs-und Pflegearbeit beteiligten Personen wichtig ist, um neue technische Dinge, die unmittelbar auch den Wohnalltag der Bewohnerinnen und Bewohner beeinflussen, einzuführen (Franke et al., 2019;Grates & Krön, 2016;Hahn & Thilo, 2017;Merkel & Kucharski, 2019;Rüegger et al., 2016 Neben den Fragen zur Mitentscheidung konnten noch drei weitere Aussagen in Bezug auf den Entscheidungsprozess vorgelegt werden. Die erste Aussage bezog sich auf den Entscheidungsrahmen der Leitungsebene -also darauf, inwieweit die Leitungen selbst entscheiden können. ...
... Demnach werden die beiden zuletzt genannten Gruppen weniger in die Entscheidung miteinbezogen, obwohl auch sie von dem Technikeinsatz direkt oder indirekt betroffen sind. Hier ist noch einmal darauf hinzuweisen, dass der Einbezug aller an der Betreuungs-und Pflegearbeit beteiligten Personen wichtig ist, um neue technische Dinge, die unmittelbar auch den Wohnalltag der Bewohnerinnen und Bewohner beeinflussen, einzuführen (Franke et al., 2019;Grates & Krön, 2016;Hahn & Thilo, 2017;Merkel & Kucharski, 2019;Rüegger et al., 2016 Neben den Fragen zur Mitentscheidung konnten noch drei weitere Aussagen in Bezug auf den Entscheidungsprozess vorgelegt werden. Die erste Aussage bezog sich auf den Entscheidungsrahmen der Leitungsebene -also darauf, inwieweit die Leitungen selbst entscheiden können. ...
Eine Sonderauswertung liegt für den Altersbereich vor. Der entsprechende Bericht diskutiert und kontextualisiert ausgewählte Ergebnisse unter Berücksichtigung des aktuellen Forschungsstandes.
Eine Studie im Auftrag von CURAVIVA Schweiz.
... Lösungswege beziehen alle Akteure/Akteurinnen und Bedürfnisse ein und berücksichtigen ebenfalls die Autonomie und Selbstbestimmung der pfle- Angehörigengruppen und "peer support", verbunden mit gezielten Erholungsphasen wie Spaziergängen, körperlicher Aktivität, Treffen mit Freunden sowie Zeit in der Partnerschaft und mit der Familie [9,42]; 4 Therapie bei emotionalen Konflikten und Spannungen innerhalb der Familie [29]; 4 Kommunikationsstrategien zur Klä-rung von Verantwortlichkeiten, einer vertrauensvollen Kooperation aller Beteiligten und für konkrete Absprachen innerhalb der Familie [9,29,40]; 4 technische Unterstützung durch heutige Informations-und Kommunikationstechnologien (Videotelefonie, Chats, Messanger-Programme) zu Austausch sowie Verbundenheit zwischen Angehörigen, ihren Nächsten und dem weiteren Helfernetz. Informationstechnik(IT)-Systeme und entsprechende Infrastruktur (Computer, Scanner, Internet, IT-Support) dienen auch dem Austausch von gesundheitsbezogenen Unterlagen und Parametern [2,8,17,18,23,32,33,44]; ...
Background
Demographic change, increasing work mobility as well as changed family patterns lead to social relationships over long distances; however, support from relatives from a distance is hardly debated in the German-speaking region. The project “DiCa” (2016–2019) studies various dimensions of long-distance caregiving.
Objective
This article presents the state of the art in research on specific characteristics of care arrangements from a distance. In addition, it presents the underlying challenges, strategies, and supportive as well as hindering conditions.
Material and methods
Systematic literature review.
Results
These studies, conducted largely in the Anglo-American region, draw a clear picture of who distance caregivers are (in general well-educated daughters or daughters-in-law) and that they make a substantial contribution to care in terms of organization, coordination, and emotional support in addition to visits. Distance impedes the flow of information about the health condition of the person in need of care and limits the possibilities to react to the needs at short notice or in crisis situations. Distance caregivers are often faced by financial as well as emotional burdens due to the care situation and lack of control even if there are some support strategies and compatibility between care and occupation, e.g. emergency management, local support networks, flexible working arrangements.
Conclusion
In the German-speaking region, pertinent studies on long-distance caregiving are missing. Internationally, the numbers of cases are not always clear and there is a lack of sound knowledge on the assessment of the care arrangements on the part of the distance caregiver, the actual role of the distance, specific barriers, conflicts, effective strategies and solution options. This applies to people in family homecare as well primary care facilities and employers.
Involvement of employees, residents, and relatives in digital transformation at long-term care institutions for older adults - A cross-sectional survey Abstract. Background: Long-term care institutions for older adults are currently undergoing a digital transformation process. But who are the decision-makers in this transformation process?
Aim:
The aim of the study was to determine the role of employees, residents, and their relatives in the provision of the technical solutions used in long-term care institutions.
Methods:
The standardized online survey was conducted at 466 long-term care institutions throughout Switzerland. The respective managers were surveyed.
Results:
The majority of the managers surveyed saw more advantages than disadvantages in the use of technical solutions. Nevertheless, the results also show that while 52 % involve their staff in decisions about the acquisition of technology, only 11 % involve their residents, and 8 % involve the residents' relatives. This involvement depends on how much technology has been used so far and what leeway the managers themselves have in making such decisions.
Conclusions:
It is apparent that residents and their relatives are involved very little in decision-making processes. This can mean that the organization's digital transformation ultimately depends on just one person, the manager, and that the wishes of the people who are directly affected by these technical innovations are not considered in such decisions.
In dem vorliegenden Open-Access-Buch identifizieren Studierende und Lehrende interprofessionell Entwicklungen und Problemfelder der Assistiven Technologien. Diese halten zunehmend Einzug ins Leben versorgungsbedürftiger, häufig älterer Menschen. Nach einigen Jahren der Entwicklung kann konstatiert werden, dass der Transfer von Entwicklung zur Anwendung im Alltag infolge unterschiedlicher Perspektiven und Zielsetzungen nur unzureichend stattfindet. Die Beitragsautoren bieten kreative Lösungsansätze, die zu einer nachhaltigen Umsetzung führen sollen.
Die Herausgeber
Marcel Sailer ist Prodekan Gesundheit, Studiengangsleiter für Angewandte Gesundheits- und Pflegewissenschaften an der Dualen Hochschule Baden-Württemberg Heidenheim.
Seit mehr als 30 Jahren ist er als Krankenpfleger, Pflegepädagoge und Humanbiologe in verschiedenen ambulanten und stationären Einrichtungen des Gesundheitssystems tätig. Seit 2013 belegt er den Lehrstuhl für Gesundheits- und Pflegewissenschaften. Er arbeitet als Berater für Gesundheits- und Bildungseinrichtungen und Coach für Führungskräfte.
Andreas Mahr ist Prorektor Forschung und Dekan der Fakultäten Technik und Gesundheit an der Dualen Hochschule Baden-Württemberg Heidenheim. Seit 20 Jahren ist er als Professor an der Hochschule und zuvor am Deutschen Krebsforsungszentrum in Heidelberg tätig. Als langjähriger Studiengangsleiter in der Medizinischen Informatik betreute er Kliniken in Süddeutschland und erhielt einen vertieften Einblick in die wachsende Rolle und Bedeutung der Informationstechnologien in Krankenhaus und Gesellschaft.
Zusammenfassung
Seit etwas mehr als 6 Jahren beschäftige ich mich mit AAL. Bei der Unternehmensberatung, bei der ich damals arbeitete, war es das übriggebliebene Thema, nachdem andere Kolleg*innen die Zukunftsfelder Mobilität, eHealth, Internet der Dinge bereits besetzt hatten. Ich war neu und bei Weitem der Älteste in der Firma, ein Mittfünfziger. Da war es ja auch quasi naheliegend, mich mit diesem „Älterwerdenthema“ zu betrauen. Tue was du liebst und liebe was du tust.
Zusammenfassung
Der demographische Wandel stellt die wohl nachhaltigsten Anforderungen an die Gesellschaft und deren Sozialsysteme, respektive auch an das Gesundheitssystem. Nicht zuletzt deshalb werden demographische Entwicklungen initial zu allen gesundheitspolitischen Herausforderungen referenziert.
Zusammenfassung
Kap. 6 beschäftigt sich auf Basis der identifizierten Herausforderungen und dargestellten Anwendungsszenarien mit theoretischen und praktischen Lösungsansätzen. Hierzu gehört, dass kunden- und marktorientierte AAL-Systeme (Beitrag 6.1) geschaffen werden, welche „Nutzen“ erzeugen.
Migration and ageing are two of the main contemporary phenomena challenging modern societies. This special issue brings to the fore some important research topics emerging at the multiple intersections of these two phenomena: the shortage of social and health care workforce, which contributes to the immigration of (often late-in-life) labour migrants being employed in care services for the older population; the ageing of the migrant population and their specific needs; and lastly the engagement in mobility patterns late in life either in search for a better life, to receive care abroad or to provide care to family members living in another country. It contributes to this complex field of research by distinguishing four analytical perspectives that focus on vulnerability, policy, transnationalism and care.
Achieving the sustainability of IT-based solutions is a challenge. We will argue in this paper that it is helpful to conceptualize designing for sustainable IT-based solutions as taking place in a multi-dimensional space. It requires thinking about how a project is framed; the perspectives and commitments of the project partners; the type of innovation that is foregrounded; the motivations and needs of the user group; and the level of sustainability a project or research program may achieve. The paper describes some of the challenges and possible solutions by revisiting a portfolio of projects that developed IT support for elderly people who continue living in their own homes.
Zusammenfassung. Aufgrund von demografischen Prozessen, Wertewandel und veränderten Fami-lienstrukturen leben An- und Zugehörige oft räumlich (auch weit) entfernt. Dennoch wird von ihnen häufig erhebliche Unterstützung für zuhause lebende Pflegebedürftige geleistet. Dieses Phänomen des Distance Caregiving ist gesellschaftlich und wissenschaftlich noch wenig thematisiert. Es bezieht sich auf eine große Bandbreite an Unterstützung. Es steht für neuere Typen informeller Unterstützung jenseits der bisher vor-rangigen Figur der hochinvolvierten " Hauptpflegeperson vor Ort ". Das Unterstützungsarrangement berührt wesentlich die Vereinbarkeit von informeller Pflege-und Erwerbstätigkeit, kann durch assistive Technik stark gestützt werden, verlangt aber auch von den Vor-Ort-Fachkräften systematisches Umdenken in Rich-tung Koproduktion in gemischten Sorgesettings.
Ein wesentliches Ziel der Telemedizin ist es, den Zugang zu medizinischen Angeboten durch Einsatz von Informations- und Kommunikationstechnologien (IKT) zu vereinfachen und nicht zuletzt in ländlichen Regionen neue Versorgungsmodelle für alle PatientInnen zu ermöglichen. Vor dem Hintergrund der demografischen Entwicklungen werden Wege und Hilfsmittel gesucht, PatientInnen dort zu betreuen, wo sie leben – in Übereinstimmung mit dem verbreiteten Wunsch, so lange wie möglich zu Hause zu leben, auch bei Älteren, die in ihrer Mobilität eingeschränkt sind oder mehr und mehr nicht auf nahe lebende Angehöriger
zurückgreifen können. Weil zunehmend komplexe Krankheitsbilder und Multimorbidität eine Betreuung durch mehrere ÄrztInnen und Fachkräfte sowie informelle Unterstützung erfordern, ist eine hohe intersektorale Vernetzung der AkteurInnen im Gesundheitssystem nötig. Neue Strategien verfolgen dieses Ziel u.a. durch den Aufbau von elektronischen PatientInnenakten, integrierten Versorgungsmodellen und ähnliche Lösungen.
Die Telemedizin stellt hierbei einen wichtigen Baustein dar, mit erheblichem Potenzial gerade für Ältere. Sie zeigt sich als offenes Konstrukt, dessen Angebote und Massnahmen in einem ständigen Entwicklungsprozess erweitert werden.
Die Antreiber für diesen Prozess sind zum einen ein verstärkter Einsatz von technischen Hilfsmitteln in der Medizin und zum anderen ein verstärktes Bedürfnis nach patientInnenorientierter Versorgung. Gerade im Kontext heute oftmals frühzeitiger Entlassungen aus Krankenhäusern sind technologisch gestützte
Massnahmen zur Nachbetreuung von PatientInnen ein mögliches Mittel zur Risikoverminderung und Qualitätssteigerung von Behandlungen. Wesentliche Herausforderungen sind zudem die Orientierung an Selbstmanagementförderung, und an intersektoraler und interdisziplinärer Kooperation. Begünstigt werden die genannten Entwicklungen im Bereich der Telemedizin dadurch, dass aktuell trotz bisher oftmals konstatierter Vorbehalte von Älteren gegenüber Technik eine rasche Entwicklung zu einer höheren Vertrautheit Älterer mit einschlägigen elektronischen Geräten und Anwendungen stattfindet.
Der Artikel bietet neben einer notwendigen Begriffsklärung einen Überblick über verschiedene Aspekte und deren Einsatzgebiete mit einem Fokus auf Anwendungsbeispiele für die ältere Bevölkerung und bildet aktuelle Entwicklungen in der Thematik ab. Abgerundet werden die Erläuterungen durch eine knappe Sammlung bisher vorliegender Erkenntnisse aus Evaluationen und Metastudien zu Wirkungen, Kosten und Nutzen von Telemedizin in der Praxis.
Increasing numbers of middle-aged adults provide long-distance care for their parents, yet relatively few studies have addressed their experiences. Particularly neglected themes include siblings' communication and division of labor when one or more live at a distance from the parent. The researchers interviewed 22 adult children (10 women and 12 men) aged 37 to 65. Participants were members of sibling groups numbering two to seven. Using open-ended questions, the researchers addressed aspects of caregiving including: coordination of care, division of labor, distant siblings' views of caregiving activities, and caregiving and sibling relationships. The researchers used QSR Nu*dist software to assist with coding and analysis of the qualitative data. The study showed different experiences and expectations of hometown siblings compared with long distance siblings. Participants' perceptions of their siblings' caregiving competencies, willingness to care, financial ability to help, and personal relationships with the parent affected caregiving decision making and division of labor.
To discuss the new phenomenon of distance caregiving, with an emphasis on the experience of adult children providing distance caregiving to a parent with cancer.
Literature review and author research.
Although the research is limited, it forms the foundation for beginning to describe the phenomenon and the associated psychosocial burdens that distance caregivers are struggling with.
With the growing population of distance caregivers, it is important for nurses to address these burdens. Interventions for clinical practice are recommended.
A comprehensive and evaluative review of empirical research published between 2000 and 2010 specific to long distance caregiving
is provided to identify what is known about this subgroup of caregivers and to identify gaps in knowledge. We searched peer-reviewed
journals included in the following databases: Academic Search Premier (EBSCO), PROQuest Direct, Social Work Abstracts, CINAHL,
MEDLINE, and PsychInfo. Searches were restricted to English language publications between 2000 and 2010. Search terms included:
‘review + caregiving + dementia’, ‘meta-analyses + caregiving + dementia,’ ‘caregiving + dementia + not institutional,’ ‘informal
+ caregiving,’ ‘family + caregiving’, ‘caregiving + technology’. Any searches including the term ‘dementia’ were repeated
without that term. These same searches were repeated with the term ‘distance’ added to each. Empirical research specific to
long distance caregiving is reviewed in detail. A brief review is provided of other closely related research. Long distance
caregivers report being heavily involved in the care of their family member, regardless of distance and surprisingly, are
often the only or primary caregiver. The specific needs for future research to inform best practice that goes beyond description
of this important subgroup of caregivers is discussed.
KeywordsLong distance caregiving-Review-Dementia-Older persons-Methodological issues
The objective of this study was to explore the role of videophone technology in enhancing the distant caregiving experience of and communication between residents of a long-term care facility and their family members. Ten participants-4 residents of an independent retirement facility and 6 family members-were recruited. A videophone was installed in each resident's apartment, and another was mailed to the remote family member. Participants were asked to conduct a videocall at least once per week for 3 months. Exit interviews assessed general impressions of videophone communication, the relationship between residents and family members, stress, burden, and isolation. Participants were enthusiastic and emphasized a sense of closeness, the inclusion of the resident in family interactions, and reduced feelings of guilt and isolation as key benefits. New models of care are needed to challenge the existing paradigm, which often excludes distant caregivers from the care process. Technology can facilitate this process by bridging geographic distance.
To explore the new and complex phenomenon of distance caregiving in the advanced cancer population.
Qualitative.
A large comprehensive cancer center in the midwestern region of the United States.
14 distance caregivers of parents with advanced cancer.
Patients with advanced lung, gastrointestinal, and gynecologic malignancies consented to have their distance caregiving adult children contacted to participate in the study. Responses to three open-ended questions guided the tape-recorded telephone interviews with the distance caregivers. Following transcription, content analysis with inductive coding was performed.
Two major themes, communication and control, and five subthemes, benefits and burdens of distance caregiving, dealing with uncertainty, direct action through information seeking, protecting, and staying connected, emerged from the data.
Distance caregivers experience some of the same stressors that local caregivers of patients with cancer experience. In addition, they have unique psychosocial needs related to the burden of geographic distance.
Distance caregivers could benefit from nursing interventions targeted at their unique needs. Innovative interventions using Web-based computer technology for improved communication, as well as supportive care interventions, may be helpful.
Family caregivers are responsible for the home care of over 34 million older adults in the United States. For many, the elder family member lives more than an hour's distance away. Distance caregiving is a growing alternative to more familiar models where: 1) the elder and the family caregiver(s) may reside in the same household; or 2) the family caregiver may live nearby but not in the same household as the elder. The distance caregiving model involves elders and their family caregivers who live at some distance, defined as more than a 60-minute commute, from one another. Evidence suggests that distance caregiving is a distinct phenomenon, differs substantially from on-site family caregiving, and requires additional assistance to support the physical, social, and contextual dimensions of the caregiving process. Technology-based assists could virtually connect the caregiver and elder and provide strong support that addresses the elder's physical, social, cognitive, and/or sensory impairments. Therefore, in today's era of high technology, it is surprising that so few affordable innovations are being marketed for distance caregiving. This article addresses distance caregiving, proposes the use of technology innovation to support caregiving, and suggests a research agenda to better inform policy decisions related to the unique needs of this situation.
BACKGROUND
Little is known about family caregivers in the context of adverse events that occur during the care of their significant others. Nurses as family caregivers can draw on expert specific knowledge and nursing skills.
AIM
To explore how family carers who are also trained nurses experience and deal with adverse events that occur during the care of their significant others.
METHOD
As part of a larger research project using a sequential mixed methods design, 30 semi-structured interviews were conducted with health professionals, who were also family caregivers, of whom 20 were qualified nurses. All interviews were theoretically coded, dimensionalized and contextualized. Based on the nurses’ data a model was developed.
RESULTS
The model illustrates the dilemma the interviewed nurses experienced when they need to deal with safety-relevant problems. As family caregivers with expert knowledge and skills, they were vigilant in surveilling the care provided. They were quick to identify risks and vulnerable points in the system of care being delivered. However, before taking action, they carefully considered the advantages and disadvantages of intervening, and also whether or not to admit that they were health care professionals.
CONCLUSIONS
In the case of events relevant to the health and safety of their significant others, family carers who are trained nurses are most likely to use their expert knowledge, in situations with a perceived high risk to health, to minimise the potential harm.
This is an ethnographic account of the transnational caregiving experiences and practices of Australian migrants and refugees, caring for their elderly parents in Europe, the Middle East, Asia and New Zealand. It describes how people respond to unprecedented mobility (both voluntary and forced), globalized job markets and an ageing population. © loretta Baldassar, Cora Vellekoop Baldock and Raelene Wilding 2007. All rights reserved.
Introduction
This research study focused on exploring the lived experience of people caring for someone with Alzheimer's disease and related dementia from a distance (defined as 2 or more hours' distance by car) to help shed light on this caregiving population.
Method
Ten participants (all adult children caring for a parent with Alzheimer's disease and related dementia) were involved in this qualitative, phenomenological study. Each participant took part in two individual interviews, the first interview in person with a follow-up interview by telephone phone. After the interviews were transcribed, data were analysed using Moustakas's (1994) modified Van Kaam Method.
Findings
Six general themes were derived from quotations from participants, revealing different aspects of the distance caregiving experience. Findings indicated that participants spent much time managing and coordinating the care of their relative. Participants indicated a wish to provide information on their relative that could help healthcare professionals provide effective care, and felt that the process of providing care to their relative impacted their professional and personal lives, including developing deeper connections with their relative and others. According to participants, the experience of caregiving, and balancing caregiving demands with other life demands, led to personal changes and growth.
Conclusion
Occupational therapists and other healthcare professionals need to interact and communicate with distance caregivers of people with Alzheimer's disease and related dementia to better support the caregivers and the care being provided to the person with dementia.
p>The objective of this study was to explore the role of videophone technology in enhancing the distant care-giving experience of and communication between residents of a long-term care facility and their family members. Ten participants—4 residents of an independent retirement facility and 6 family members—were recruited. A videophone was installed in each resident’s apartment, and another was mailed to the remote family member. Participants were asked to conduct a videocall at least once per week for 3 months. Exit interviews assessed general impressions of videophone communication, the relationship between residents and family members, stress, burden, and isolation. Participants were enthusiastic and emphasized a sense of closeness, the inclusion of the resident in family interactions, and reduced feelings of guilt and isolation as key benefits. New models of care are needed to challenge the existing paradigm, which often excludes distant caregivers from the care process. Technology can facilitate this process by bridging geographic distance.</p
A long distance caregiver program was developed by the Alzheimer's Association of Los Angeles to provide services to caregivers living at a distance from Los Angeles. Data on demographic characteristics and service use were compared between 90 long distance and 187 local caregivers. Similar to local caregiving families, the most frequently used services by long distance families included written materials, the website, and the telephone helpline. Satisfaction with services was high. Open-ended responses provided further information on unmet service needs and barriers. Results demonstrate the feasibility of a program to provide family consultation for long distance caregivers of a relative with dementia. Future work needs to focus on assisting long distance caregivers with family disagreements about care and long distance care recipients who live alone.
This article reports findings from exploratory interviews with migrants involved in caregiving for elderly parents who have remained “back home.” The findings indicate that such distant carers make an important contribution to the caring process through letters, phone calls, and caregiving visits. This is a contribution that has not been recognized in literature on aged care. The study also shows that such caregiving may involve an ongoing dialogue with the home country over many years and even the consideration of remigration as the consequence of family obligations and the perceived need for caregiving of family members in the home country.
Traditional models of geriatric assessment have not considered the cultural and demographic changes that have affected women's ability to provide parent care in the 21st century. The United States has the world's highest fulltime employment rate and the longest workweek. These factors have an important impact on women's ability to provide care for aging parents. A life course assessment and intervention model currently employed at the US Army and Air War Colleges that helps female and male officers prepare proactively for parent care is described. The usefulness of the model is supported by data from a longitudinal survey of the needs of military families. The life course model provides a unique framework to guide social workers who help women within and outside the armed forces to manage 21st century commitments to family and work.
This study explores variables that influence worry and parent contact among senior military officers who face frequent moves, restricted housing, and overseas assignments, and who have been geographically separated from their parents most of their adult lives. Data on predictors of officer worry and parent contacts were collected from 277 senior ranking male officers (40 to 49 years old). A structural equation model of worry and parent contact among male officers showed that previous parental illness, parent's age, and the tendency among officers to have an angry temperament increased their worry. Conversely, number of siblings and satisfaction with a "parent care plan" decreased worry about parents. Number of siblings also decreased contact with parents. Quality of interpersonal relationships and branch of service (Army and Marine Corps) increased contacts with parents. This research underscores the importance of examining the invisible "anguish" of adult sons who are precluded from visiting their parents by distance or employment situations, lends quantitative support to previous qualitative findings, and indicates that satisfaction with a realistic parent care plan reduces worries about elderly parents.
There are an estimated 5-7 million long-distance caregivers (LDCs) in the United States, but little is known about this growing population. This study reviewed the literature on LDCs and examined 16 identified studies. Although studies defined LDCs differently, a composite description of who LDCs are and what they do is presented. LDCs make substantial contributions in terms of physical, financial, and social support. Distance complicates communication about care recipients' health and care needs, as well as the types of care that can be provided. Related to this, geographic separation can exacerbate care-related stressors. Implications for future research were also identified.
A growing number of Americans are managing and monitoring long-distance caregiving for an elderly parent. The authors offer a first-hand experience of caregiving involving an African-American family, which will be useful to both caregivers and practitioners. The challenges that result from long-distance caregiving are discussed. A detailed case study and assessment is followed by suggested strategies for lessening caregiver stress.
Three phases of thought in the literature on intergenerational contact, especially between the elderly and their adult children, are discussed in an attempt to understand the disparate conclusions reached in each period. A number of methodological problems contribute to the contradictory problems. Specifically, we find ordinal-level data used in multivariate analyses, weak descriptive measures, and inappropriate construction of indices of interaction, and mispecification of a linear model in many studies. Using data from 454 elderly residents in a mid-size Canadian city, we examine the relationship between geographic distance and several indicators of intergenerational contact, controlling for a number of important sociodemographic variables. Our findings are that distance is the most important predictor of all forms of contact, and that a curvilinear (quadratic) model generally provides the best fit to the data. It is argued that the complexity of the relationship needs to be examined in further studies of interaction between the elderly and their adult children.
Understanding how geographic distance impacts how individuals communicatively negotiate family caregiving is important for a number of reasons. Though long-distance caregiving (LDC) is a growing phenomenon with serious relational and health implications, this topic has yet to be approached from a communication perspective. In this review, LDC is thus considered as a communication context to offer caregiving scholars practical applications for contributing to this emerging research area.
Review of the literature from 1999 to 2009 that studied aspects of distance caregiving communication obtained through searching Academic Search Premier, EBSCO, Communication and Mass Media Complete, PsycArticles, PsycInfo, PubMed/Medline, and Health Source: Nursing/Academic Edition online databases.
Eight published original research studies were included in the review.
The extent to which LDC communication is studied by caregiving researchers has the potential to provide helpful guidance for distant caregivers and care recipients to achieve successful health and relational outcomes.
Upon reviewing distance caregiving communication research findings, four applications are discussed: (1) defining distance as a subjective experience; (2) encouraging the use of mediated communication in LDC; and examining (3) interpersonal conflict and (4) topic avoidance processes in the LDC context.
The role of social support in the health of older persons is well documented. This support is particularly important for isolated nursing home residents. The purpose of this study was to test the feasibility of using low-cost videophones to enhance communication between nursing home residents and their families. Ten pairs of residents and family members received videophones and engaged in regular televisits for six months. All participants completed brief survey instruments prior to and after the study period to determine the effects of the televisits on the frequency and quality of contacts. A post-study survey assessed ease and satisfaction with using videophones. Findings include identification of technical and design problems, possible solutions, factors affecting actual use of equipment, and conditions under which benefits of use may be optimal. Categories for estimating potential actual users are suggested. Importantly, the study demonstrates that videophones can be used successfully by a wide range of frail nursing home residents and can enhance social interactions, regardless of distance. Affordable videophone technology offers the potential for reduced isolation among institutionalized elders and others with distance and mobility barriers.
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