Application of MOHO to Address Caregiving Dilemmas for People with Dementia in Hong Kong

Introduction : The successfulness of dementia care is heavily depended on the readiness of care-givers for dementia (CGD). Nevertheless, the readiness and preparedness to be CGD is doubtful. The unforeseeable care stress had adverse impact on the care-givers and their families, including their physical and mental health. Numerous evidence showed CGDs can easily burn out if the pressures are not assuaged. Moreover, caring for dementia can have an impact on care-givers’ physical health and anxiety levels. The “throughput” system of Model of Human Occupation (MOHO) is an useful tool to assess the preparedness of care-givers. Through individualized needs analysis, CGDs’ knowledge, attitudes and values in dementia care would be assessed as “volition” sub-system to determine their conscious choices for occupational behaviors. Activity scheduling, perceived stress and mental health condition would be assessed as the “habituation” sub-system. Perceived handling skills in neuropsychiatric symptoms would be grouped as “performance” sub-system. Objectives : These three sub-systems were used to assess CGDs’ occupational functioning and to analyze their encountered occupational dilemmas. Study was conducted from rehabilitation to community phrase. Methodology : Qualitative research methodology employed for this study. Result & Outcome : Results: Thirty CGDs were recruited (20 high occupational functioning;10 low occupational functioning). CGDs with better knowledge in caring shown better quality of life and lesser mental health issues (p< .05). Moreover, CGDs with better knowledge in social support shown with lesser caring stress and occupational dilemmas in caring (p< .01). Furthermore, CGDs with positive attitude in caring shown with fewer mental health issues and significantly lesser occupational dilemmas (p< .01). Outcomes: The components of the volition subsystem, personal causation, values, and interests in CGDs correlated with their choices for occupational behavior. Roles and habits are the components of the habituation subsystem that serve to maintain occupational behavior. Significant improvement in “relationships”, “interest”, and “daily responsibility”, but not in “occupation” and “mind, body and spirituality” activities. Appropriate level of social service support and care-givers support strategies can be developed for different types of CGDs and PWDs.