Factors Affecting Frontline Workers’ Satisfaction with Supervision Objective: This research was guided by a stress and support model to examine the effects of frontline workers’ background characteristics, personal stressors, job-related stressors, and workplace support on satisfaction with supervision. Methods: Survey data were collected from 644 workers in 49 long-term–care settings that employed them. Regression analysis were used to determine the effects of worker level and then Hierarchical Linear Modeling (HLM) and organizational factors on the outcome. Results: Although all four variable categories made significant contributions to explaining satisfaction with supervision, the most powerful were personal stressors and job-related stressors. Results from HLM analysis showed frontline workers in nursing homes and those employed in for-profit organizations had lower levels of satisfaction with supervision. Discussion: Findings suggest organizational interventions to address workers’ financial and health issues and management practices such as better training programs and peer mentoring could enhance workers’ satisfaction with supervision. Read more
Informal Caregivers Communication and Decision Making Communicating about care preferences can improve the well-being of caregivers and care recipients. Read more
Decision-Making Involvement Scale for Individuals with Dementia and Family Caregivers This report describes the development and preliminary psychometric properties of the Decision-Making Involvement Scale for individuals with dementia and family caregivers. Data were collected from 217 individuals with dementia and their respective caregivers. Principal axis factor analysis, Kendall τ, and Pearson correlations were used to determine the Decision- Making Involvement Scale’s psychometric properties, mean differences of caregiver and individual with dementia, and the relationship between scores of Decision-Making Involvement Scale and measures of well-being. Analyses support a reliable, 1-factor solution of the Decision-Making Involvement Scale for both individuals with dementia and caregivers. Sociodemographic, impairment, and well-being variables are differentially related to the perceptions of how involved the individual with dementia is in decision making. The Decision-Making Involvement Scale provides useful information about daily decision making of an individual with dementia, and it shows promise as a means for understanding the relationship between decision-making involvement and well-being of individuals with dementia and caregivers. Read more
What is the Relationship Between Background Characteristics and the Dyadic Strain Experienced by Individuals with Dementia This article examines how the background characteristics of an individual with dementia (IWD) are related to the dyadic relationship of the caregiver and IWD. Results indicate that selected background characteristics of IWDs (n = 119), such as marital status, living arrangement, and education level, influence the relationship that the IWD has with his or her caregiver. Findings provide family caregivers, researchers, and practitioners with a broader understanding of how an IWD’s background affects the relationship between the caregiver and the IWD. Use of this knowledge has potential to expand the breadth and depth of new and innovative interventions for IWDs. Read more
Consistency of Information From Persons with Dementia An Analysis of Differences by Question Type This analysis examines the ability of persons with mild to moderate dementia (MMSE scores 13–30 and/or a dementia diagnosis) to provide consistent and accurate information. Data come from interviews with 213 persons with dementia (PWDs) and their family caregivers (CG). Consistency was assessed by determining agreement between responses provided by PWDs during two in-person interviews. Accuracy was assessed by determining agreement between PWD responses and CG responses. Overall, PWDs provided consistent and accurate responses to fact-based questions and were consistent in their responses to state-dependent items. Less impaired respondents were more consistent in their responses to fact-based items. Among respondents with more severe impairment, there were no significant differences in consistency by question type. This work responds to the need to gain a better understanding of the opinions and experiences of dementia and offers further evidence that many PWDs can provide consistent and accurate information. Findings support increased involvement of individuals with dementia in research and care planning. Read more
The Impact of Stress and Support on Direct Care Workers’ Job Satisfaction Purpose: This research applies a stress and support conceptual model to investigate the effects of background characteristics, personal and job-related stressors, and workplace support on direct care workers’ (DCW) job satisfaction. Design and Methods: Researchers collected survey data from 644 DCWs in 49 long-term care (LTC) organizations. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. We examined the influence of components of the LTC stress and support model on DCW job satisfaction. Initially, we ran a multiple regression analysis by entering individual-level DCW predictors with job satisfaction as the outcome. Subsequently, we used hierarchical linear modeling to examine the influence of organizational factors on DCW job satisfaction after controlling for significant individual-level DCW variables. Results: Components of the model explained 51% of the variance in DCW job satisfaction. Background characteristics of DCWs were less important than personal stressors (e.g., depression), job-related stressors (e.g., continuing education), and social support (e.g., interactions with others) in predicting job satisfaction. Results from hierarchical linear modeling analysis showed that nursing homes compared to the two other types of LTC organizations had lower average DCW job satisfaction rates, as did organizations offering lower minimum hourly rates and those reporting turnover problems. Implications: Study findings underscore the importance of targeting both DCW-level and organizational-level factors to increase DCW job satisfaction. Read more
Dyadic Relationship Scale A Measure of the Impact of the Provision and Receipt of Family Care Purpose: This study evaluated the psychometric properties of the Dyadic Relationship Scale (DRS), which measures negative and positive dyadic interactions from the perspective of both the patient and the family caregiver. An important aspect of evaluating the DRS was that it be statistically sound and meaningful for both members of the dyad. Design and Methods: The study used a cross-sectional design. Survey packages were mailed to home health care patients and their family caregivers. The unit of analysis was the dyad, and exploratory and confirmatory factor analyses were conducted. We examined the reliability, discriminant, and concurrent validities of the instrument. Results: The data supported a two-factor DRS that included negative dyadic strain (patient a = .84; caregiver a = .89) and positive dyadic interaction (patient a = .86; caregiver a=.85). The analysis supported the DRS’s construct, discriminant, and concurrent validity, as well as its reliability for both patients and family caregivers. Implications: Using the DRS to measure the impact of family care on positive and negative interactions inclusive of patients and caregivers can assist in identifying areas of difficulty and guide interventions to improve outcomes for both members of the dyad. Read more
Caregiving and Caring Caregiving is the act of providing assistance or care to a family member, friend, or client with a chronic illness or disability so that she or he can maintain an optimal level of independence with dignity. This assistance can be instrumental or hands-on, affective, financial, or otherwise of value or necessity to the care receiver. Caregiving varies in its intensity and duration, ranging from 1 hour per day, or one weekend per year, to 24 hours a day for years at a time. Caregiving can occur within a community or home setting, an institutional or assisted living setting, or from a distance. Although providing care can be stressful to both caregivers and care recipients, the effects on caregivers can be long term, lasting for many years after care responsibilities have ended. Read more
Decision-Making Involvement of Individuals with Dementia Purpose: Research underscores how autonomy and decision-making involvement may help to enhance the quality of life of older adults; however, individuals with dementia are often excluded from decision making that is related to their daily functioning. In this study we use a modified version of the Stress Process Model to consider the stress process of individuals with chronic illness, and in particular to explore the predictors of decision-making involvement among individuals with dementia (n = 215). Design and Methods: We collected data from individual with dementia (IWD)– family caregiver dyads. Relying primarily on data from the IWD, we used hierarchical multiple regression analysis to determine the predictors of the IWD’s decision-making involvement. Results: Results indicate that individuals who report more decision-making involvement are younger, female, have more education, have a nonspousal caregiver, have fewer months since their diagnosis, exhibit fewer problems with activities of daily living and fewer depressive symptoms (based on caregiver report), and place more importance on autonomy/self-identity. Implications: In our discussion we examine the importance of autonomy and impairment levels for understanding the decision-making involvement of persons with dementia. Read more
