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Family carers of people with dementia have reported increased caring demands during the COVID-19 pandemic. The aim of this qualitative study is to explore seven family carers’ accounts of dementia caregiving one year into the COVID-19 pandemic in England in relation to carer resilience. Themes describe the complex challenges of caring during the pandemic, with interviewees burned out and ‘caring beyond capacity’ due to unmet needs within the caring role, therein highlighting the limitations of building individual resilience only. Timely practical support for carers is essential to protect their well-being and to ward against the potential consequences of carer burnout.
Across Western nations, ‘ageing in place’ policies rely on having a sufficient and skilled aged care workforce. In Australia, due to the impact of successive policy reforms, this workforce including the sector that provides community-based services has declined in number and skills. At the same time the need to upskill and sustain this workforce has intensified as the frailty and health needs of consumers have increased. This paper reports on an integrative literature review undertaken during 2021 to describe workforce needs and peer reviewed reports of programs instituted in aged care settings that aimed to address these needs.
The review sought to examine programs implemented in both long-term and community care settings and to draw from these elements that may be utilised in future program design across the sector. It focussed primarily on workforce deficits in the community aged care sector and on the capacity of rurally-based services to meet and respond to growing consumer demand. The findings emphasise current workforce deficits while they also reveal a paucity of peer-reviewed reports of implemented programs across the sector as a whole. Nevertheless, the few programs examined in this review provide examples of the capacity and willingness of workers and providers to trial measures that aim to increase the recruitment, retention, skill and job-satisfaction of direct care workers. We propose that the key elements of the programs identified in this paper provide the foundation for the development of strategically designed programs that address particular workforce needs such as those shaped by rural contexts.
This study represents the experiences of informal carers of people with dementia concerning periods of transition into formal care. Retrospective interviews with 18 carers identified the key narratives: ‘This is why I had to’, ‘They said I need to’ and ‘It was a last resort’. These indicate a sense of carers’ responsibility in decision making and the undesirable assumptions around the move. However, the narrative of ‘I made the right decision’ was common after transition. Findings represent the nuanced carer experience around transitions, providing insight into the experiences of families living with dementia and informing future care planning.
Spinal cord injury paraplegia is a significant health problem in Sri Lanka. This study explores the psychological experiences of family carers of people with such a condition. A descriptive phenomenological study was conducted with 17 parent, sibling, spouse and adult carers. Thematic analysis revealed four themes related to: carer emotions regarding the caring process; feelings related to the family member’s condition; beliefs beyond the physical world; and behaviour changes due to psychological distress. The findings will help develop interventions for the psychological needs of Sri Lankan carers and may provide insight into the experiences of similar Asian communities living globally.
In this study of older migrants living in informal settlements in Harare, we seek to understand what care and caring means for older people ageing far from their place of origin in conditions of informality in a country with no formal care infrastructure. We find that care relations derive from histories of migration, community, kinship, aspiration, displacement and disenfranchisement, with the provision of security within insecure systems core to the very idea of care. Further action is needed at all levels to foreground how older migrants are living on Zimbabwean society’s margins and to facilitate their daily practices of care.
Indications of a care deficit for older adults in Africa and the need for long-term care that is acceptable for recipients and providers is well established, as are calls for its format to be ‘home-grown’. However, there is a discrepancy between the desire for evidenced African solutions, and the framing of both the problem and possible solutions derived from the Global North. This article draws on qualitative data from men and women needing and providing care in rural southern Malawi to challenge the implied universalism of the key terms of reference in the African long-term care discourse: ‘care’ and ‘family’.
Namibia’s lengthy colonial history and current high levels of inequality foreshadow care in the context of poverty and marginalisation, and within families that are diverse and whose care capacities are poorly understood. Focus group interviews with family carers of older people in two marginalised communities provide insights into their experiences of care. We highlight three findings: first, contexts of care perpetuate and entrench marginalisation; second, care is not widely shared within families, raising questions of what it means to ‘do family’; and, third, care has negative consequences for carers and their families, foreshadowing generational replication of carer exclusion.
The United Nations Decade of Healthy Ageing (2020–30) states that reliance on family care alone is unsustainable. This scoping review synthesises knowledge on family beliefs about care for older people in Central, East, Southern and West Africa and Latin America. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and 35 articles published from 2010 to 2020 were included. The review highlights the challenges arising from embedded beliefs in family obligations to care.
The article highlights the heterogeneity of employed women’s experience of family care for older persons by focusing on multigenerational households. First, I argue that care for older persons must be understood in the context of multiple family responsibilities. Second, I show that care for older persons occurs in a context of inequalities that remain in post-colonial settings where there is highly uneven access to material resources, high levels of unemployment, poverty and limited social welfare provision. From this understanding of care, I argue that women’s position within wider care relations reveals elements of differentiation between women who occupy different class and racial positions.
Drawing on qualitative interviews and focus groups with 35 community leaders, this article investigates how community leaders understand norms of care for older people in Zambia. I ask what leads older people in Zambia to receive good care from family. The findings show that across both rural and urban settings, respondents related profoundly powerful norms of reciprocity in both family and community care, with older people viewed as reaping what they have sown in terms of religious and economic contributions throughout their lives. The study raises challenging questions from a rights-based perspective as to who is deserving of care.
