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澳大利亚痴呆症患者家庭照顾者对“小屋”式暂托模式的看法:与老年护理机构提供的传统住宿式暂托模式相比。

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.

机构信息

Centre for Positive Ageing, HammondCare, Sydney, NSW, Australia.

School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.

出版信息

Health Soc Care Community. 2020 May;28(3):850-861. doi: 10.1111/hsc.12916. Epub 2019 Dec 20.

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.

摘要

大多数患有痴呆症的人居住在社区中,通常依赖于非正式护理者的支持。家庭护理者在支持痴呆症患者居家方面面临许多挑战,短期暂息护理是一项有价值的服务,可让他们暂时摆脱护理角色。疗养院提供类似于住宅的短期护理,客户人数有限,是一种更灵活的服务获取方式。澳大利亚疗养院暂息服务的使用不成比例,表明这种模式比传统的疗养院暂息服务更受欢迎,但目前关于这两种模式的比较研究有限。本研究旨在了解使用疗养院暂息服务的护理者的看法,比较这两种模式,并探讨疗养院暂息服务对支持护理者继续履行职责并维持其护理对象(CR)居家生活的作用。研究人员对 126 名在 2 年内使用过新南威尔士州的两个疗养院暂息之一的家庭护理者进行了半结构化访谈;其中 67 人还使用过疗养院长期护理。主题分析揭示了疗养院暂息的四个主要益处主题:(a)有效的基本服务,(b)灵活性,(c)熟悉感和(d)适宜性,特别是对于早期或年轻发病的痴呆症。护理者表示,疗养院暂息服务中更像家庭、更熟悉、更亲密的疗养院模式更受青睐,而不是更大、机构式的疗养院长期护理设置。护理者认为疗养院暂息服务模式通过将他们对永久性住宿的需求延迟了 12 个月以上。疗养院暂息模式为满足痴呆症患者的个体需求提供了重要途径,有可能延迟永久性安置,并应更广泛地提供,以便人们有更多的选择来满足其护理需求。

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