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Intention to use respite services among informal care-givers of frail older adults in China: the role of care needs change

Published online by Cambridge University Press:  22 May 2020

Qian Sun
Affiliation:
Department of Social Security, School of Public Administration, Hebei University of Economics and Business, Shijiazhuang, China
Nan Lu
Affiliation:
Department of Social Work, School of Sociology and Population Studies, Renmin University of China, Beijing, China
Nan Jiang
Affiliation:
Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
Vivian W. Q. Lou*
Affiliation:
Department of Social Work and Social Administration, Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
*
*Corresponding author. Email: wlou@hku.hk

Abstract

Population ageing in China calls for evidence-based solutions, especially in terms of fulfilling long-term care needs among frail older adults. Respite services are identified as effective resources for alleviating care-giver burden and promoting the wellbeing of both older adults and their family care-givers. However, respite care is often under-used in China. This research aimed to examine factors associated with intention to use respite services among informal care-givers in Shanghai, mainland China. This study was part of the Longitudinal Study on Family Caregivers for Frail Older Adults in Shanghai. Pairs of older adults and their care-givers (N = 583) who successfully completed the 2013 and 2016 waves were included in the data analysis. Two logistic regression models were conducted, one with time-invariant and one with time-variant factors. The model with time-variant factors had greater explanatory power than the original Andersen model with time-invariant factors influencing intention to use respite services among care-givers. Care-givers had higher odds of intending to use respite services if they had higher care-giving burden, were caring elderly people who experienced care-giver transitions, or were caring for elderly people with increased function of ambulation or decreased function of feeding. The findings imply that change in functional health was a significant determinant of intention to use respite care. Relevant policy and service implications will be discussed.

Type
Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Alzheimer's Disease International (2015) World Alzheimer Report 2015: The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. Available at https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf.Google Scholar
Andersen, RM (1995) Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior 36, 110.CrossRefGoogle ScholarPubMed
Beijing Committee on Ageing and China Philanthropy Research Institute (2017) White Book on Ageing Career Development and Pension System. Available at http://www.bjmzj.gov.cn/attached/file/20181026/20181026140555_117.pdf.Google Scholar
Brandão, D, Ribeiro, O and Martín, I (2016) Underuse and unawareness of residential respite care services in dementia caregiving: constraining the need for relief. Health and Social Work 41, 254262.CrossRefGoogle ScholarPubMed
Caldwell, L, Low, LF and Brodaty, H (2014) Caregivers’ experience of the decision-making process for placing a person with dementia into a nursing home: comparing caregivers from Chinese ethnic minority with those from English-speaking backgrounds. International Psychogeriatrics 26, 413424.CrossRefGoogle ScholarPubMed
Callahan, JJ (2015) Ageing in Place. Amityville, NY: Baywood.Google Scholar
Chang, YP, Schneider, JK and Sessanna, L (2011) Decisional conflict among Chinese family caregivers regarding nursing home placement of older adults with dementia. Journal of Aging Studies 25, 436444.CrossRefGoogle Scholar
Chen, JH and Bian, HQ (2018) Research on the social support theory of respite care involved in disability elderly family. Economic Research Guide 7, 6066. (In Chinese)Google Scholar
Chou, KR, Jiann-Chyun, L and Chu, H (2002) The reliability and validity of the Chinese version of the caregiver burden inventory. Nursing Research 51, 324331.CrossRefGoogle ScholarPubMed
Diduk-Smith, RM (2017) Unmet Needs and Service Utilization by Informal Caregivers (PhD dissertation). Health Services Research, Old Dominion University, Norfolk, VA.Google Scholar
Fu, YY, Guo, Y, Bai, X and Chui, EWT (2017) Factors associated with older people's long-term care needs: a case study adopting the expanded version of the Andersen Model in China. BMC Geriatrics 17, 38.CrossRefGoogle Scholar
Huang, S, Griva, K, Bryant, CA and Yap, P (2017) Non-use of day care services for dementia in Singapore – a dilemma for caregivers. International Psychogeriatrics 29, 455466.CrossRefGoogle Scholar
Jiang, N, Lou, VW and Lu, N (2018) Does social capital influence preferences for ageing in place? Evidence from urban China. Aging & Mental Health 22, 405411.CrossRefGoogle ScholarPubMed
Lawton, MP and Brody, EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist 9, 179186.CrossRefGoogle ScholarPubMed
Li, Y and Lu, S (2017) A review of the development of the Anderson Model's theoretical construction and analysis path. Chinese Health Service Management 5, 324334.Google Scholar
Litwak, E (1985) Helping the Elderly: The Complementary Roles of Informal Networks and Formal Systems. New York, NY: The Guilford Press.Google Scholar
Lou, VWQ, Chui, EWT, Leung, AYM, Tang, KL, Chi, I, Leung Wong, EKS and Kwan, CW (2011) Factors affecting long-term care use in Hong Kong. Hong Kong Medical Journal 17, 812.Google ScholarPubMed
Lu, S and Ottervik, MG (2017) Transforming long-term care of the elderly in three Chinese societies. In Tan NT, Chan S, Mehta K and Androff D (eds), Transforming Society: Strategies for Social Development from Singapore, Asia and Around the World. New York, NY: Taylor & Francis, pp. 144168.CrossRefGoogle Scholar
Lum, T, Lou, VWQ, Chen, Y, Wong, GHY, Luo, H and Tong, TLW (2016) Neighborhood support and ageing-in-place preference among low-income elderly Chinese city-dwellers. Journals of Gerontology: Psychological Sciences and Social Sciences 71, 98105.CrossRefGoogle Scholar
Mahoney, FI and Barthel, DW (1965) Functional evaluation: the Barthel Index. Maryland State Medical Journal 2, 6165.Google Scholar
McCabe, M, You, E and Tatangelo, G (2016) Hearing their voice: a systematic review of dementia family caregivers’ needs. The Gerontologist 56, e70e88.CrossRefGoogle ScholarPubMed
McKenzie, SJ, Lucke, JC, Hockey, RL, Dobson, AJ and Tooth, LR (2014) Is use of formal community services by older women related to changes in their informal care arrangements? Ageing & Society 34, 310329.CrossRefGoogle Scholar
Moholt, JM, Friborg, O, Blix, BH and Henriksen, N (2018) Factors affecting the use of home-based services and out-of-home respite care services: a survey of family caregivers for older persons with dementia in Northern Norway. Dementia. Available online doi:1471301218804981.CrossRefGoogle Scholar
Morris, JN, Fries, BE and Morris, SA (1999) Scaling ADLs within the MDS. Journals of Gerontology: Biological Sciences and Medical Sciences 54A, M546M553.CrossRefGoogle Scholar
Neville, C, Beattie, E, Fielding, E and MacAndrew, M (2015) Literature review: use of respite by carers of people with dementia. Health and Social Care in the Community 23, 5163.CrossRefGoogle ScholarPubMed
Njegovan, V, Man-Son-Hing, M, Mitchell, SL and Molnar, FJ (2001) The hierarchy of functional loss associated with cognitive decline in older persons. Journals of Gerontology: Biological Sciences and Medical Sciences 56A, M638M643.CrossRefGoogle Scholar
O'Shea, E, Timmons, S, O'Shea, E, Fox, S and Irving, K (2017) Key stakeholders’ experiences of respite services for people with dementia and their perspectives on respite service development: a qualitative systematic review. BMC Geriatrics 17, 282.CrossRefGoogle Scholar
Phillipson, L and Jones, SC (2012) Use of day centers for respite by help-seeking caregivers of individuals with dementia. Journal of Gerontological Nursing 38, 2434.CrossRefGoogle ScholarPubMed
Phillipson, L, Jones, SC and Magee, C (2014) A review of the factors associated with the non-use of respite services by carers of people with dementia: implications for policy and practice. Health and Social Care in the Community 22, 112.CrossRefGoogle ScholarPubMed
Qiu, X, Sit, JW and Koo, FK (2018) The influence of Chinese culture on family caregivers of stroke survivors: a qualitative study. Journal of Clinical Nursing 27, e309e319.CrossRefGoogle ScholarPubMed
Robinson, A, Elder, J, Emden, C, Lea, E, Turner, P and Vickers, J (2009) Information pathways into dementia care services: family carers have their say. Dementia 8, 1737.CrossRefGoogle Scholar
Robinson, A, Lea, E, Hemmings, L, Vosper, G, McCann, D, Weeding, F and Rumble, R (2012) Seeking respite: issues around the use of day respite care for the carers of people with dementia. Ageing & Society 32, 196218.CrossRefGoogle Scholar
Shanghai Municipal People's Government (2016) The 13th Five-year Plan for the Development of Shanghai's Ageing Industry. Available at http://www.shanghai.gov.cn/nw2/nw2314/nw2319/nw12344/u26aw49971.html.Google Scholar
Shi, J, Chan, K, Ferretti, L and McCallion, P (2017) Caregiving load and respite service use: a comparison between older caregivers and younger caregivers. Journal of Gerontological Social Work 61, 3144.CrossRefGoogle ScholarPubMed
Silva, AL, Teixeira, HJ, Teixeira, MJC and Freitas, S (2013) The needs of informal caregivers of elderly people living at home: an integrative review. Scandinavian Journal of Caring Sciences 27, 792803.CrossRefGoogle Scholar
State Council of China (2017) The 13th Five-year Plan for the Elderly Care. Available at http://www.gov.cn/zhengce/content/2017-03/06/content_5173930.htm.Google Scholar
Stensletten, K, Bruvik, F, Espehaug, B and Drageset, J (2016) Burden of care, social support, and sense of coherence in elderly caregivers living with individuals with symptoms of dementia. Dementia 15, 14221435.CrossRefGoogle ScholarPubMed
Tian, BH and Wang, CY (2014) Structural characteristics and determinant factors of the demand of the elderly for social care services: based on the analysis on the replacement mechanism of family supporting for the elderly. China Rural Survey 4, 217.Google Scholar
World Health Organization (2017) Integrated Care for Older People: Guidelines on Community-level Interventions to Manage Declines in Intrinsic Capacity. Available at https://apps.who.int/iris/bitstream/handle/10665/258981/9789241550109-eng.pdf.Google Scholar
Zeng, L, Xu, X, Zhang, C and Chen, L (2019) Factors influencing long-term care service needs among the elderly based on the latest Andersen model: a case study from the middle and upper reaches of the Yangtze River. Healthcare 7, 157170.CrossRefGoogle Scholar
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