Convoys of Care: Developing Collaborative Care Partnerships in Assisted Living

护理车队：发展辅助生活领域的协作护理伙伴关系

基本信息

批准号：
8593494
负责人：
Candace Lynn Kemp
金额：
$ 41.38万
依托单位：
GEORGIA STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-01 至 2018-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8593494
关键词：
Address Adult Children Affect Age Aging Assisted Living Facilities Caregivers Caring Characteristics Cognitive Communities Data Data Analyses Data Collection Development Elderly Environment Ethnic Origin Family Family Process Fees Frail Elderly Friends Future Gender Goals Health Health Personnel Healthcare Market Individual Industry Influentials Intervention Studies Interview Knowledge Lead Learning Life Light Location Long-Term Care Marital Status Mediation Medical Methods Modeling Never Married Nursing Homes Outcome Participant Personal Satisfaction Physical Function Physical environment Play Policies Policy Maker Population Process Public Health Public Policy Qualitative Methods Quality of life Race Recording of previous events Relative (related person)Religion Research Research Personnel Resources Role Site Social Environment Spouses Structure Time Variant Work base care delivery caregiving cognitive function collaborative care design expectation experience improved innovation insight marital age member policy implication public health relevance response social theories trend

项目摘要

DESCRIPTION (provided by applicant): Assisted living (AL) is the fastest growing segment of the long-term care industry and preferred greatly over the more costly and medical nursing home environment. Informal caregivers play a critical role in residents' ability move to and remain in these non-medical residential care settings and also affect residents' and caregivers' quality of life. Our recent work shows that most AL residents have care convoys that include family and friends and evolve in response to resident decline and family, friend, and facility transitions. In recent years, however, AL residents have grown older and frailer and require higher levels of care, a trend that is apt to alter the demand for informal care and the configuration of care roles. Informal caregivers typically are adult children and occasionally spouses, who may have multiple competing demands and may be experiencing their own health problems. Some residents lack these traditional helpers and may rely on other family and friends or have no one. Despite the changing needs of this population and variations in the availability of support, as well as the significant public health and policy implications of learnig how to develop collaborative care partnerships in AL, research has yet to address fully the complexity of informal care in these settings, particularly how it is organized among and between care partners and unfolds over time. The overall goal of this five-year study is to learn how to support informal care and care convoys in AL in ways that promote residents' ability to age in place with optimal resident and informal and formal caregiver quality of life. The specific aims are: (1) To understand how informal care in AL is experienced, organized, and negotiated within care convoys over time; (2) To understand the factors that influence informal care work in AL and how they operate to support or hinder the development of care partnerships that promote aging in place with optimal resident and informal and formal caregiver quality of life; and (3) To determine successful strategies for building care partnerships in AL. This study will use participant observation and informal and formal interviewing in 8 AL settings that vary by key individual-, facility-, and community-level factors, collecting data in 2 waves of 4 sites each Fifty residents diverse in age, marital and parental statuses, race and ethnicity, and cognitive and physical functioning will be purposively selected, interviewed, and followed over 24-months. Their convoy members also will be identified, interviewed, and followed over the same time period. Following residents' care convoys prospectively will enhance understandings of care as a dynamic process and shed light on the ways families and friends negotiate amongst themselves and with other convoy members, including paid care workers. Grounded Theory Method will guide data collection and analysis, which will provide significant insight into the car process. This knowledge will help us identify strategies for developing and supporting collaborative care partnerships between informal and formal caregivers and recipients.

描述（由申请人提供）：辅助生活 (AL) 是长期护理行业中增长最快的部分，并且比成本更高的医疗疗养院环境更受青睐。非正式护理人员在居民搬入和留在这些非医疗住宿护理机构的能力方面发挥着关键作用，也影响居民和护理人员的生活质量。我们最近的研究表明，大多数 AL 居民都有包括家人和朋友在内的护理车队，并随着居民人数的减少以及家人、朋友和设施的过渡而不断发展。然而，近年来，阿拉巴马州居民变得越来越老、越来越虚弱，需要更高水平的护理，这一趋势很容易改变对非正式护理的需求和护理角色的配置。非正式照顾者通常是成年子女，偶尔是配偶，他们可能有多种相互竞争的需求，并且可能遇到自己的健康问题。一些居民缺乏这些传统的帮手，可能依赖其他家人和朋友，或者没有人。尽管该人群的需求不断变化，支持的可用性存在差异，以及学习如何在 AL 中建立协作护理伙伴关系对公共卫生和政策产生重大影响，但研究尚未完全解决这些环境中非正式护理的复杂性，特别是它是如何在护理合作伙伴之间组织起来并随着时间的推移而展开的。这项为期五年的研究的总体目标是了解如何支持 AL 的非正式护理和护理车队，以提高居民就地养老的能力，并提供最佳居民以及非正式和正式护理人员的生活质量。具体目标是： (1) 了解 AL 中的非正式护理是如何随着时间的推移在护理车队内经历、组织和协商的； (2) 了解影响 AL 非正式护理工作的因素，以及这些因素如何支持或阻碍护理伙伴关系的发展，从而促进就地老龄化，并提供最佳居民以及非正式和正式护理人员的生活质量； (3) 确定在 AL 建立护理伙伴关系的成功策略。本研究将在 8 个 AL 环境中使用参与观察以及非正式和正式访谈，这些环境因关键个人、设施和社区层面的因素而异，在 2 批 4 个地点收集数据，每个地点 50 名年龄、婚姻和父母状况各异的居民、种族和族裔以及认知和身体功能将被有目的地选择、访谈并跟踪超过 24 个月。他们的车队成员也将在同一时间段内被识别、采访和跟踪。前瞻性地跟踪居民的护理车队将增强对护理作为一个动态过程的理解，并揭示家人和朋友之间以及与其他车队成员（包括付费护理人员）谈判的方式。扎根理论方法将指导数据收集和分析，这将为汽车制造过程提供重要的见解。这些知识将帮助我们确定发展和支持非正式和正式护理者与接受者之间协作护理伙伴关系的策略。