Decision-making for receiving paid home care for dementia in the time of COVID-19: a qualitative study
Decision-making for receiving paid home care for dementia in the time of COVID-19: a qualitative study
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DOI：
10.1186/s12877-020-01719-0
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发表时间：
2020-09-09
期刊：
影响因子：
4.1
通讯作者：
Gabbay, Mark
中科院分区：
文献类型：
--
作者：
Giebel, Clarissa;Hanna, Kerry;Gabbay, Mark
背景 英国 3 月 23 日实施的封锁以及相关的社交距离公共卫生措施可能对护理服务产生了巨大影响。本研究的目的是探讨在 COVID-19 疫情期间为痴呆症提供持续付费家庭护理支持的决策过程。方法 照顾痴呆症患者 (PLWD)、在 COVID-19 之前获得付费家庭护理并居住在英国的无薪护理人员有资格参加。参与者接受了电话采访，并询问了他们在 COVID-19 之前和之后使用付费家庭护理服务的经历，以及自疫情爆发和公共卫生限制以来他们获得付费家庭护理的决策过程。结果 分析中纳入了 15 名无薪护理人员，他们在 COVID-19 之前也在为 PLWD 获取有偿护理支持。主题分析确定了三个总体主题：（1）风险； （二）做出艰难的选择和风险管理； (3) 对无薪护理人员的影响。由于感染风险，许多无薪护理人员决定停止带薪护理人员进入家中，导致无薪护理人员不得不占用护理时间来支持痴呆症患者。结论 这是第一项报告 COVID-19 对痴呆症付费家庭护理变化影响的研究。研究结果对为有偿护理人员提供更好的个人防护设备以及更好地支持无偿护理人员发挥作用提出了影响，因为在可预见的未来，这种流行病可能会持续存在。
Background The lockdown imposed in the UK on the 23rd of March and associated public health measures of social distancing are likely to have had a great impact on care provision. The aim of this study was to explore the decision-making processes of continued paid home care support for dementia in the time of COVID-19. Methods Unpaid carers caring for a person living with dementia (PLWD) who were accessing paid home care before COVID-19 and residing in the UK were eligible to take part. Participants were interviewed over the phone and asked about their experiences of using paid home care services before and since COVID-19, and their decision-making processes of accessing paid home care since the outbreak and public health restrictions. Results Fifteen unpaid carers, who were also accessing paid care support for the PLWD before COVID-19, were included in the analysis. Thematic analysis identified three overarching themes: (1) Risk; (2) Making difficult choices and risk management; and (3) Implications for unpaid carers. Many unpaid carers decided to discontinue paid carers entering the home due to the risk of infection, resulting in unpaid carers having to pick up the care hours to support the person living with dementia. Conclusions This is the first study to report on the impact of COVID-19 on paid home care changes in dementia. Findings raise implications for providing better Personal Protective Equipment for paid carers, and to support unpaid carers better in their roles, with the pandemic likely to stay in place for the foreseeable future.