Johns Hopkins University, Baltimore, MD, USA.
Central Michigan University, Mount Pleasant, USA.
J Appl Gerontol. 2021 Dec;40(12):1722-1732. doi: 10.1177/0733464821990171. Epub 2021 Feb 1.
More than 7.3 million older adults in the United States have difficulty leaving their homes or are completely homebound, yet little data exist on the experiences of homebound older adults and their caregivers. We conducted 30 semi-structured qualitative interviews with homebound older adults and caregivers recruited through home-based medical care practices in Baltimore and San Francisco. Thematic template analyses revealed that homebound older adults experience varying degrees of independence in activities of daily living, although their degree of dependence increases over time. Caregivers have a multifaceted, round-the-clock role. Both patients and caregivers experience burdens including social isolation and guilt. Navigating medical care and caregiving was further complicated by the complexity of the U.S. health care system; however, home-based medical care was viewed as a high-quality alternative to hospitals or nursing homes. Our findings suggest that providers and health care systems should expand the availability and accessibility of home-based care and improve caregiver support opportunities.
美国有超过 730 万的老年人出行困难或完全被困在家中，但有关这些居家老年人及其护理人员的经历的数据却很少。我们通过巴尔的摩和旧金山的上门医疗服务机构招募了 30 名居家老年人及其护理人员进行了 30 次半结构化定性访谈。主题模板分析显示，居家老年人在日常生活活动中都有不同程度的独立性，尽管他们的依赖程度会随时间增加。护理人员的角色是多方面的，并且是 24 小时全天候的。患者和护理人员都承受着包括社会隔离和内疚在内的负担。医疗保健和护理的复杂性进一步增加了导航的难度；然而，上门医疗服务被认为是医院或养老院的一种高质量替代选择。我们的研究结果表明，服务提供者和医疗保健系统应扩大上门护理的可及性，并改善护理人员的支持机会。
