Predictors of the Use of Respite Services by Caregivers of Alzheimer’s Patients Racial and Generational Differences This research applies one prominent model of service utilization (the Andersen Newman Model) to better understand the way in which family care givers utilize respite services when caring for older relatives. Specifically, this research examines racial (black and white) and generational (spouse and adult-child) differences between caregivers of Alzheimer's patients and the volume and type of respite services used. The sample (N= 359) is drawn from six Northeast Ohio programs in a consortium that uses a personal computer-based information system to collect intake, assessment, service use, and program satisfaction data from respite clients. Racial differences are found in client attrition and turnover. Results also show adult-child caregivers are the greatest users of day care. These generational differences persist despite the similarities in patient and caregiver need. Fee subsidy and relationship strain between the caregiver and elder predict the amount of service used. Findings suggest that practitioners need to take into account racial and generational factors in addition to traditional patient and caregiver needs when formulating care plans. Read more
Respite Use and Caregiver Well-Being in Families Caring for Stable and Declining AD Patients The current controversy about respite's value centers on consistent reports of no significant reduction in caregiver strain with respite service use. In this study one explanation for the inability of prior research to document respite's impact is offered. This research demonstrates that respite may well reduce depression, reported health problems and family relationship strain in families caring for stable AD patients and may stabilize caregiver strain in families of declining AD patients. Read more
Predicting the Volume of Health and Social Services Integrating Cognitive Impairment into the Modified Andersen Framework This investigation examined cognitive impairment as a predictor of the volume of community services used by older adults. Predictors of service volume were selected according to the modified Andersen framework and tested with 97 health care and 246 social service clients of a large multiservice agency. Results for health care clients showed that the effects of four predictors differ depending on clients’ level of cognitive impairment: living arrangement, presence of secondary caregivers, client depression, and task burden of the primary caregiver. No differences in predictors of social service use were observed for cognitively impaired and lucid clients. Read more
The Influence of Caregiving and Bereavement Support on Adjusting to an Older Relative’s Death This study examines the influence of both caregiving social support to an impaired older relative and bereavement social support to a surviving caregiver on that caregiver's bereavement adjustment. Although past research has considered the link between bereavement support and adjustment to a loved one's death, the influence of support to the care recipient has not been investigated. Analyses of prospective panel data from 73 spouse and adult-child caregivers show caregiving support characteristics to be more important for bereavement adjustment than support provided to the surviving caregiver after their relative's death. Read more
Using Information System Technology to Coordinate Specialized Services for the Elderly In mid-1988 six of Cuyahoga County’s non-profit providers of respite service to caregivers of persons with Alzheimer’s disease began a project (SISTERS: Shared Information System Technology to Evaluate Respite Services) to develop an interagency database. This grew out of an existing PC-based information system at The Benjamin Rose Institute that was designed to improve the operation of its specialized respite program and facilitate its monitoring. The SISTERS project’s aims include: improving the design and delivery of community respite services using information system technology; improving the effectiveness of each participating program through standardized forms and documentation via a PC-based system to track clients, monitor service delivery, and provide for quality assurance; and disseminating the design and technology of this system as a model for coordinating and evaluating respite programs. Read more
Home Care for Elderly Persons Linkages Between Formal and Informal Caregivers Prior research has generally focused on characteristics of elderly persons that predict contact with community services or the volume of services used. In contrast, this study investigates how personal care and home health services are used in relation to assistance from primary kin caregivers. A typology was developed based on task sharing or segregation between kin caregivers and service providers, and four types of informal-formal linkages around these tasks were identified: kin independence, formal service specialization, dual specialization, and supplementation. Findings regarding predictors of the types showed that caregiver and care recipient variables were most significant in differentiating among them, although caregiver gender also had some discriminatory power. Read more
Criteria for Admission to Detoxification Treatment Factors Influencing Staff Judgments This paper examines the formal triage process used by an alcohol/drug detoxification center to determine a client’s need for treatment. The analysis tests various types of client characteristics for their influence on admission decisions. In accord with the policy of the agency and the medical model of addiction, symptoms of acute physiological withdrawal should determine whether a client is admitted for treatment during the triage period. Societal reaction theory presents an alternative perspective suggesting that a person’s history of substance abuse and socio-demographic characteristics will influence the likelihood of admission into a treatment program. Results offer support for both a medical model and societal reaction approach in the physiological withdrawal symptoms, history of abuse characteristics, and socio-demographic makeup each independently influence staff’s assessment of the need for treatment. Read more
The Hospice Ideology and Success of Hospice Care Hospice is a concept of terminal care based on an ideology that specifies a particular way for patients and families to deal with death and dying. This article describes this ideology and attempts to assess its success for hospice patients. Finding show that hospice care is more successful for patients who are more aware of their terminal status, who are older, and who have a primary caregiver who experiences fewer difficulties with the caregiver role. Read more
Social Determinants of the Passage to Hospice Care Entering a hospice program signifies an important transition in the career of a patient's illness. This study identifies several social factors which influence when during the illness career patients are labeled terminally ill and promoted to hospice care. A multiple regression analysis performed on data from 726 hospice patients shows the relative survival rate of the patient's primary disease, the number of family members or friends who assist with patient care, race of the patient, and the specialty area of the patient's primary physician explain significant variation in the timing of when patients are labeled terminally ill and admitted to hospice programs. The effects of these variables are calculated while controlling for the physical condition of the patient. Read more
