Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine & Public Health, Madison, WI, USA.
University of Wisconsin-Madison Institute for Clinical and Translational Research, Madison, WI, USA.
J Alzheimers Dis. 2021;84(1):169-177. doi: 10.3233/JAD-210609.
Family caregivers of people living with dementia benefit from supportive service use to address care needs associated with caregiving. Yet, research consistently demonstrates low rates of service use. Existing research has focused on barriers and facilitators to service use, with few studies examining the influence of caregivers' environmental context which often patterns social advantage and health services accessibility.
To describe the perspectives of caregivers residing in socially disadvantaged areas have in regards to utilizing supportive services.
Ten informal caregivers residing in socially disadvantaged areas participated in in-depth interviews that were analyzed using thematic analysis.
Across all interviews, caregivers spontaneously described common precedents of service use (crisis or accumulation of unmet needs) and a distinct sequence of stages (seeking, initiating, and utilizing) surrounding service engagement. Major themes characterizing caregivers' experiences throughout service engagement highlight the varied influence of personal, familial, health, and social system-related factors. Findings demonstrate that caregivers may have different service needs as dementia progresses and that gerontological social work practice can facilitate service use.
While preliminary, these findings provide important insights into new domains that can be further examined in future research and intervention efforts to improve supportive service use in socially disadvantaged and underserved communities.
照顾痴呆症患者的家庭成员可以通过使用支持性服务来满足与护理相关的需求。然而,研究一致表明,服务利用率很低。现有研究侧重于服务使用的障碍和促进因素,很少有研究关注照顾者的环境背景的影响,而环境背景往往影响社会优势和卫生服务的可及性。
描述居住在社会劣势地区的照顾者在利用支持性服务方面的看法。
10 名居住在社会劣势地区的非正式照顾者参与了深入访谈,采用主题分析方法进行分析。
在所有访谈中,照顾者自发地描述了服务使用的常见先例(危机或未满足需求的积累)和围绕服务参与的明确阶段顺序(寻求、启动和利用)。描述照顾者在服务参与过程中体验的主要主题突出了个人、家庭、健康和社会系统相关因素的不同影响。研究结果表明,随着痴呆症的发展,照顾者可能有不同的服务需求,老年社会工作实践可以促进服务的使用。
尽管初步,但这些发现为进一步研究和干预努力提供了重要的见解,以改善社会劣势和服务不足社区的支持性服务使用。