A qualitative inquiry on the effective support for the use of social services by the older adults with dementia and their family

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The purpose of this study was to elucidate the process of social service use by the older adults with dementia and their family and to conceptualize effective support for them. We have recruited study participants through various social service agencies such as home care nursing stations. Upon acquiring consent to participate the study, we have conducted qualitative interviews to the family members and their care managers.We have interviewed 16 pairs of family/care managers. The barriers of social service use were categorized into 4 groups : 1) issues around care manager, 2) issues around the older adult, 3) issues around the family, and 4) issues around the service systems/others. The details of the barriers and how they take effect in each case as well as how the family members dealt with the barriers were different according to the types of social services. There are multiple factors that relate to the differences. First, some families have difficulty in finding and connecting to the care manager. Second, the willingness of the older adult is a significant factor of service use but how much it influences the actual service use depends upon the type of kin relationship between the older adult and the primary family caregiver. It was also suggested that both older adult and the family must accept aging of the older adult before they can move on to use the service. Some families refer to the financial burden of service use.There was a variety of approach by the side of the care managers in assisting older adults and their family in using social services. Typically the service use is gradually increased in the amount so that the older adult and the family can gradually get used to the service. Multiple non-nurse care managers discussed their difficulty in estimating future physical condition of the older adults, while other non-nurse care managers do not have such a difficulty.