Paper
Thursday, 20 July 2006
This presentation is part of : Care for Person's with Alzheimer's
Distance Caregiving of Elders with Alzheimer's Disease in Special Care Units
Lazelle Benefield, PhD, RN, College of Nursing, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
Learning Objective #1: Describe distance caregiving issues and concerns of (1)distance family caregivers of elders with Alzheimer's Disease residing in special care units and (2) unit administrators.
Learning Objective #2: Discuss the major categories of concerns as well as recommendations for adressing these concerns.
Background/Purpose: Informal family caregivers care for ~ 3 million adults in the US with cognitive impairment and, of these, > 200,000 with Alzheimer’s disease (AD) residing in nursing homes. Healthcare and family costs are significant. In 1/3 of families caregiving occurs from afar with family members > 60-minutes travel time to the elder coordinating care provision, maintenance of independence, and socialization for the elder. Distance caregiving further complicates caregiving roles and caregivers may experience role strain and increased isolation. Nursing staff communicate with distance caregivers to explain changes and respond to a range of caregiver emotions, requests, and demands.    The exact nature of distance caregiving needs for families is unexplored, yet essential for planning clinically significant interventions. The aims of this preliminary, descriptive study: 1) describe and prioritize caregiving concerns / facilitators of distance caregivers and 2) identify SCU administrator-perceived concerns and facilitators to support working with distance family caregivers. Method: Individual interviews with a purposive sample of 12 distance caregivers  across the US were qualitatively analyzed using content analysis to identify caregiving concerns / facilitators. Likewise, data from focus group meetings with 16 purposively selected SCU administrators were used to identify concerns / facilitators related to working with distance family caregivers. Results: Major categories of cargiving concerns include maintaining a sense of connectedness between family and elder, promoting elder safety and comfort, and negotiating the healthcare system. Administrators identified concerns related to distance caregiver guilt and limited knowledge of the trajectory of decline. Facilitators included using technology aids for staff-family and family-elder communication and caregiver use of supportive relationships within social and healthcare networks. Conclusions: The unique distance caregiving needs and perspectives of SCU administrators provide evidence to inform interventions to support distance caregiving needs and foster clear and meaningful communication between nursing staff and the distance family caregiver.

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