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Community Services and Caregivers of à Demented Relative: Users and Those Perceiving à Barrier to Their Use

Published online by Cambridge University Press:  29 November 2010

Louise Lévesque ,
Sylvie Cossette ,
Louise Potvin  and
Mike Benigeri
Louise Lévesque
Affiliation:
Université de Montréal and Institut universitaire de gériatrie de Montréal
Sylvie Cossette
Affiliation:
Université de Montréal
Louise Potvin
Affiliation:
Université de Montréal
Mike Benigeri
Affiliation:
Université de Montréal
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Abstract

This study aimed at identifying the factors associated with caregivers' use of three community services (day care centre, attendant care at home and home help), and those associated with caregivers' nonuse of these services due to a perceived barrier. The sample consisted of primary caregivers (n = 265) cohabiting with a demented relative. Using polychotomous nominal logistic regression analyses, a group of users and of nonusers perceiving a barrier was contrasted with a group of nonusers reporting no need for these services. Across the three services, under high relatives' needs (high ADL impairments or frequent dysfunctional behaviours), caregivers with high psychological distress, compared to those with low psychological distress, were more likely to be nonusers reporting no need for a service than to be users or nonusers due to a barrier, suggesting that psychological distress may impede service utilization, despite a relative's high needs. Vulnerability factors (caring for a relative with frequent dysfunctional behaviours or experiencing high psychological distress and caring for a relative with low ADL impairments) were associated with the use of day care centre or attendant care. These factors were also associated with nonuse due to a barrier, meaning that some caregivers with the same characteristics of vulnerability did not draw on these two services. In addition, caregivers with less informal support who were caring for a relative with high ADL impairments were more likely to be nonusers perceiving a barrier to attendant care.

Résumé

Le but de l'étude consistait à identifier les facteurs liés à l'utilisation de trois services communautaires (centre de jour, répit à domicile et aide ménagère) et ceux liés à leur non utilisation due à une barrière empîchant le recours à ces services. L'échantillon comprenait 265 aidants cohabitant avec un parent souffrant de démence. Pour chacun des services, des analyses de régression logistique polytomique ont été effectuées où un groupe d'utilisateurs et un groupe de non utilisateurs percevant une barrière ont été contrastés avec un groupe de non utilisateurs rapportant ne pas avoir besoin des services. Pour les trois services, lorsque le parent présente une condition de santé particulièrement fragile (perte d'autonomie fonctionnelle élevée ou comportements dysfonctionnels fréquents), les aidants ayant une détresse psychologique élevée, comparés à ceux ayant une faible détresse psychologique, ont plus tendance à rapporter ne pas avoir besoin de l'un ou l'autre service, suggérant que la détresse psychologique peut nuire à l'utilisation des services, mîme si la condition du parent est détériorée. Des facteurs de vulnérabilité (prendre soin d'un parent ayant de fréquents comportements dysfonctionnels ou avoir une détresse psychologique élevée et prendre soin d'un parent ayant une perte d'autonomie peu élevée) sont liés à l'utilisation du centre de jour ou du répit à domicile. Ces mêmes facteurs sont aussi liés à la non utilisation de ces services à cause d'une barrière, indiquant que des aidants avec les mêmes caractéristiques de vulnérabilité n'utilisent pas ces deux services. De plus, les aidants ayant peu de soutien informel et qui prennent soin d'un parent ayant une perte éleéee d'autonomie avaient plus tendance à percevoir une barrière à l'utilisation du répit à domicile.

Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , Issue 2 , Été/Summer 2000 , pp. 186 - 209
Copyright
Copyright © Canadian Association on Gerontology 2000

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