Paid Caregiver Communication With Homebound Older Adults, Their Families, and the Health Care Team
Paid Caregiver Communication With Homebound Older Adults, Their Families, and the Health Care Team
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DOI：
10.1093/geront/gnz067
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发表时间：
2020-05-15
期刊：
影响因子：
5.7
通讯作者：
Brody, Abraham A.
中科院分区：
文献类型：
--
作者：
Reckrey, Jennifer M.;Geduldig, Emma T.;Brody, Abraham A.
背景和目的虽然有偿照顾者（例如，尽管有许多家庭保健助理和家庭护理工作者为家中患有严重疾病的居家老年人提供基本护理，但人们对有偿护理人员如何以及向谁传达他们遇到的健康需求知之甚少。这项研究探讨了如何支付照顾者（i）沟通时，老年人的经验症状或临床变化和（ii）与医疗团队互动。研究设计和方法我们进行了单独的一对一，半结构化的采访（n = 30）持续40-60分钟与居家老年人（或他们的代理人，如果他们有认知障碍）和他们的付费照顾者（提供他们与老年人每周工作>= 8小时>= 6个月）。访谈进行了录音、转录和编码。结果主位分析发现4个主位：（i）老年人或其家人是有偿照护者与医疗团队沟通的把关者;（ii）当关系密切时，老年人、其家人和有偿照护者之间的沟通得到加强;（iii）有偿照护者回应医疗团队的询问，但很少主动沟通;大多数老年人、家庭和有偿照顾者对现有的有偿照顾者与卫生保健团队的沟通感到满意。讨论和影响，而不是讨论与医疗保健团队的关注，支付照顾者直接与老年人或他们的家人沟通，他们遇到的健康需求。了解家庭中的沟通方式是最大限度地发挥有偿照顾者对居家老年人健康的潜在积极影响的第一步。
Background and Objectives Although paid caregivers (e.g., home health aides and home care workers) provide essential care for homebound older adults with serious illness in their homes, little is known about how and to whom paid caregivers communicate about the health needs they encounter. This study explored how paid caregivers (i) communicate when older adults experience symptoms or clinical changes and (ii) interact with the health care team. Research Design and Methods We conducted separate one-on-one, semi-structured interviews (n = 30) lasting 40-60 min with homebound older adults (or their proxies if they had cognitive impairment) and their paid caregivers (provided they had worked with the older adult for >= 8 hr per week for >= 6 months). Interviews were audio-recorded, transcribed, and coded. Results Thematic analysis identified four themes: (i) older adults or their families were the gatekeepers to paid caregiver communication with the health care team; (ii) communication between older adults, their families, and paid caregivers was enhanced when close relationships were present; (iii) paid caregivers responded to health care team inquiries but rarely communicated proactively; and (4) most older adults, families, and paid caregivers were satisfied with existing paid caregiver communication with the health care team. Discussion and Implications Rather than discuss concerns with the health care team, paid caregivers communicated directly with older adults or their families about the health needs they encounter. Understanding how communication occurs in the home is the first step to maximizing the potentially positive impact of paid caregivers on the health of older adults living at home.