School of Allied Health, 1649Curtin University, Perth, Australia.
Dementia (London). 2021 Oct;20(7):2494-2508. doi: 10.1177/14713012211001265. Epub 2021 Mar 20.
People with dementia usually prefer to live in the community. Research is needed to identify the 'tipping point' for residential care entry and to highlight how people with dementia can be supported to remain at home as long as possible. Few previous studies have examined caregivers' perceptions and explanations for the reasons people with dementia need to enter residential care in Australia.
To explore the factors contributing to people with dementia entering residential care in Perth, Western Australia, from the perspectives of informal carers and care staff.
This phenomenological study used purposive sampling to recruit informal and formal caregivers of people with dementia. Semi-structured in-depth interviews were conducted with 13 family carers and 11 home care staff. Data were thematically analysed to identify individual, carer and contextual factors that impact on residential care entry.
The majority of participants identified a combination of factors as the 'tipping point' to residential care entry; a few also identified the cause as a sudden event or specific issue. Factors identified included deterioration related to worsening cognition, changed behaviours and a decline in the performance of activities of daily living; co-occurring health conditions; safety concerns; carer no longer able to meet care needs; impact of providing support becoming too much for the informal carer; lack of family or social support and needing assistance from services that were unavailable or inaccessible. Factors assisting people with dementia to remain living at home longer were family and social support, formal services and dog ownership.
This study identified individual, carer and contextual factors that contribute to people with dementia entering residential care in Australia. The 'tipping point' was recognised as when the needs of a person with dementia outweigh the capacity of their informal and formal carers, services and supports to care for them.
痴呆症患者通常更喜欢在社区中生活。需要研究来确定进入养老院的“临界点”，并强调如何尽可能长时间地支持痴呆症患者留在家里。以前很少有研究探讨过澳大利亚痴呆症患者的照顾者对他们需要进入养老院的原因的看法和解释。
从非专业护理人员和护理人员的角度探讨导致西澳大利亚珀斯的痴呆症患者进入养老院的因素。
本现象学研究采用目的性抽样招募痴呆症患者的非专业和专业护理人员。对 13 名家庭护理人员和 11 名家庭护理人员进行了半结构化深入访谈。对数据进行主题分析，以确定影响入住养老院的个人、护理人员和环境因素。
大多数参与者认为有多种因素共同构成了入住养老院的“临界点”；少数人也认为原因是突然发生的事件或特定问题。确定的因素包括认知能力恶化、行为改变以及日常生活活动能力下降相关的恶化；同时存在的健康状况；安全问题；护理人员不再能够满足护理需求；为提供支持对非专业护理人员的影响过大；缺乏家庭或社会支持，以及需要无法获得或无法获得的服务的帮助。有助于痴呆症患者更长时间在家居住的因素包括家庭和社会支持、正规服务和养狗。
本研究确定了导致澳大利亚痴呆症患者进入养老院的个人、护理人员和环境因素。“临界点”被认为是当痴呆症患者的需求超过他们的非专业和专业护理人员、服务和支持照顾他们的能力时。
