Modeling family caregivers' willingness to continue care in community for older persons with dementia

Abstract

This study aimed to model the process and its relevant variables in predicting the willingness in home care and actual institutionalization of older persons with dementia in a Hong Kong context. This was a secondary data analysis of a previous research study which collected 122 sample of Chinese caregivers and their older care recipients with clinical diagnosis of dementia, all of whom recruited from a local NGO. Participants were assessed on a battery of instruments that collected both caregivers and patients' characteristics, including demographic details, patients “physical states affected by dementia, caregivers” perceived burden. The period of study was 12 months, with follow up phone calls on state of care every 6 months. Only a very weak relation was shown between expressed intention to care and actual placement at 12M. Higher odds in intention for home care was significantly predicted by male gender in caregiver gender and lower caregiver burden (ZBI score); ZBI was a total mediator between patients' agitation (CMAI score) and willingness. Higher odds of actual institutionalization was related to the use of day care centre. Results called for a need to carefully distinguish the genuinely effective services in helping to delay nursing home placement; rather than assuming all to be useful. While caregivers training was not popular among current sample, current model showed the importance of caregivers' perceived burden in altering objective environmental stress' effect on caregiving outcomes. While more than half of the current sample was using day care centre, model suggested day care centre could have encouraged placement. More resources should be allocated in programmes that aimed to manage caregivers' stress and cognition. There should also be more promotions to heighten awareness and participation of such programmes amongst caregivers of HKG.