Needs of family caregivers in home care for older adults.
Carla Cristiane Becker Kottwitz Bierhals, Naiana Oliveira Dos Santos, Fernanda Laís Fengler and 3 others
PMID 28403338WHAT IT FOUND
Family caregivers of older adults in home care reported needing information and support for medication care, dressing, diaper changing and bathing.
Observation found essential steps not performed or incomplete, especially in medication care and dressing, even when caregivers did not report needing information.
Key findings
01Caregivers reported felt needs for information about care and for support with difficulties such as needing a second person, devices, lack of knowledge, caregiver health problems, total dedication, impaired social life and accepting role inversion.
02Systematic observation identified normative needs, meaning essential care steps were not performed or were incompletely performed, in 50.00% of observed medication care, 50.00% of observed dressing, 37.50% of observed diaper changing, 33.33% of observed shower bathing and 18.18% of observed bed bathing.
03Some caregivers did not report felt needs for information but still had normative needs, especially in medications care, where observed normative needs were greatest and did not match reported felt needs.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The study was exploratory and small, with only 16 caregivers observed, so it does not show what happens in other home care services or prove that any education would improve care. The sample changed across phases: 39 older adults and caregivers in records, 21 caregivers interviewed and 16 observed, and some were excluded because relatives died, were hospitalized, could not be contacted or refused. The service was in southern Brazil, and the older adults had higher mean age, education and income than in other Brazilian studies, so results may not apply to poorer or less developed regions. The observation guide was designed for this study by expert consensus, and the paper does not report how well it measured caregiver performance. The study reported caregivers' needs and observed tasks, not patient outcomes or whether guidance changed health.
Declared interests
The supplied text says the paper was extracted from a Master's thesis at Universidade Federal do Rio Grande do Sul. It does not give a funding source or a conflict-of-interest declaration.
The easy way to misread this
Do not conclude that caregivers lack knowledge or that the guidance given was ineffective. The study did not test an intervention or measure patient outcomes, and it only describes what caregivers reported and what was observed in a small home care sample.