Care Setting Transitions for People With Dementia: Qualitative Perspectives of Current and Former Care Partners
Care Setting Transitions for People With Dementia: Qualitative Perspectives of Current and Former Care Partners
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DOI：
10.1177/10499091231155601
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发表时间：
2023-02-02
影响因子：
1.9
通讯作者：
Harrison, Krista L.
中科院分区：
文献类型：
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作者：
Radcliffe, Kate G.;Halim, Madina;Harrison, Krista L.
痴呆症患者（PWD）的护理伙伴（CP）报告说，有关护理设置的决定得到了医疗保健提供者的支持。然而，提供者往往准备不足，无法提供充分的咨询。这项定性研究旨在确定提供者的支持将有助于CP在整个痴呆症旅程中做出与护理环境相关的决策。我们进行了半结构化的采访，目前的CP的残疾人和前CP的死者。我们利用不断比较的方法，以确定主题的喜好周围的护理环境的PWD进展从诊断到生命结束。与会者为31名缔约方，包括16名现任和15名前任缔约方。CP的平均年龄为67岁，主要为白色（n = 23/31）、女性（n = 21/31）和配偶（n = 24/31）。主题一：目前的CP讨论了与护理设置有关的压倒性的不确定性，表达了“我不知道什么时候我需要计划更多的护理”，并希望了解“我们处于什么阶段”。“主题二：在疾病的后期，前CP希望医疗保健提供者在机构安置方面提供指导（“我肯定会喜欢一些帮助找到更好的地方”）或支持留在家里（“医生必须来家里”）。CP希望从医疗保健提供者那里获得与家庭和长期护理之间的过渡有关的早期具体指导。在病程早期，针对预后和预期病程的咨询有助于CP制定计划。后来，护理人员希望帮助确定地点或机构或寻找家庭护理资源。
Care partners (CP) of people with dementia (PWD) report that decisions about care setting are aided by the support of healthcare providers. However, providers are often underprepared to offer adequate counseling. This qualitative study aimed to identify what support from providers will assist CPs in making decisions related to care setting throughout the dementia journey. We conducted semi-structured interviews with current CPs of PWD and former CPs of decedents. We utilized the constant comparative method to identify themes regarding preferences around care setting as the PWD progressed from diagnosis to end-of-life. Participants were 31 CPs, including 16 current and 15 former CPs. CPs had a mean age of 67 and were primarily white (n = 23/31), female (n = 21/31), and spouses (n = 24/31). Theme 1: Current CPs discussed overwhelming uncertainty pertaining to care setting, expressing "I don't know when I need to plan on more care," and a desire to understand "what stage we are at." Theme 2: Later in the disease, former CPs wanted guidance from healthcare providers on institutional placement ("I sure would've loved some help finding better places") or support to stay in the home ("a doctor had to come to the house"). CPs want early, specific guidance from healthcare providers related to transitions between home and long-term care. Early in the disease course, counseling geared toward prognosis and expected disease course helps CPs make plans. Later, caregivers want help identifying locations or institutionalization or finding home care resources.