Constructing Normalcy in Dementia Care: Carers' Perceptions of Their Roles and the Supports They Need.


Journal

The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327

Informations de publication

Date de publication:
15 07 2020
Historique:
received: 27 06 2019
pubmed: 14 11 2019
medline: 18 11 2020
entrez: 14 11 2019
Statut: ppublish

Résumé

People with dementia are critically dependent on their carers when accessing and utilizing health care. To inform health care development and delivery, we aimed to explore carers' perceptions of their role in caring for a family member with dementia and to identify carers' skills and attributes and factors impacting on care. We used semistructured interviews to collect data from 25 carers supporting older adults with dementia. Data were thematically analyzed and the paradigm model was used to guide theory development. "Constructing normalcy" was central to all carers did, impacted by stage of life and relationship status and driven by a holistic focus on their care-recipient's quality of life. Goals guiding care were: keeping the peace; facilitating participation, happiness and independence; and ensuring safety. Enablers included: social contact; knowledge; and quality social services. Barriers included health and legal issues; symptoms of dementia; and reduced knowledge. These goals kept the peace and reduced stress for the cared-for person, but often at the cost of unrelenting responsibility and loss of carers' original roles. Discussion and Implications: As carers are so critical to the access and uptake of health care of those with dementia, health professionals and services need to support carers in their quest to construct normalcy. Our findings provide guidance to assist in ensuring appropriate support and understanding of carers work in order to optimize dementia health care delivery.

Sections du résumé

BACKGROUND AND OBJECTIVES
People with dementia are critically dependent on their carers when accessing and utilizing health care. To inform health care development and delivery, we aimed to explore carers' perceptions of their role in caring for a family member with dementia and to identify carers' skills and attributes and factors impacting on care.
RESEARCH DESIGN AND METHODS
We used semistructured interviews to collect data from 25 carers supporting older adults with dementia. Data were thematically analyzed and the paradigm model was used to guide theory development.
RESULTS
"Constructing normalcy" was central to all carers did, impacted by stage of life and relationship status and driven by a holistic focus on their care-recipient's quality of life. Goals guiding care were: keeping the peace; facilitating participation, happiness and independence; and ensuring safety. Enablers included: social contact; knowledge; and quality social services. Barriers included health and legal issues; symptoms of dementia; and reduced knowledge. These goals kept the peace and reduced stress for the cared-for person, but often at the cost of unrelenting responsibility and loss of carers' original roles. Discussion and Implications: As carers are so critical to the access and uptake of health care of those with dementia, health professionals and services need to support carers in their quest to construct normalcy. Our findings provide guidance to assist in ensuring appropriate support and understanding of carers work in order to optimize dementia health care delivery.

Identifiants

pubmed: 31722390
pii: 5624935
doi: 10.1093/geront/gnz151
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

905-915

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Leigh Hale (L)

School of Physiotherapy, Dunedin, New Zealand.

Elizabeth Mayland (E)

School of Physiotherapy, Dunedin, New Zealand.

Matthew Jenkins (M)

School of Physiotherapy, Dunedin, New Zealand.

Yvette Buttery (Y)

School of Physiotherapy, Dunedin, New Zealand.

Pauline Norris (P)

Centre for Pacific Health, University of Otago, Dunedin, New Zealand.

Mary Butler (M)

School of Occupational Therapy, Otago Polytechnic, Dunedin, New Zealand.

Michelle Holland (M)

School of Occupational Therapy, Otago Polytechnic, Dunedin, New Zealand.

Esther Ngocha-Chaderopa (E)

Department of Management, University of Otago, Dunedin, New Zealand.

Barbara Mckenzie-Green (B)

School of Clinical Sciences, New Zealand.

Karol Czuba (K)

Centre for Person Centred Research, Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand.

Ann Sezier (A)

Centre for Person Centred Research, Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand.

Nicola Kayes (N)

Centre for Person Centred Research, Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand.

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Classifications MeSH