Individualized and Ecological Analyses of the Needs of Family Caregivers of Older Adults with Dementia: The Phenomenological Approach.

Dementia is a worldwide public health challenge. Caring for a person with dementia
affects different caregivers in diverse ways. Using an integration of the
Model of Human Occupation (MOHO) and Bronfenbrenner’s ecological systems
theory (EST), this study aimed at documenting the dynamic interaction among
the five specific stages of caregiving (seeking understanding, stabilization,
preparation, implementation, and adaptation) through individuals’ occupations
and receive input and output; and to analyze how the social environments are
synergistic with each other in the present medical-social collaboration model.
Using the purposeful sampling strategy and a combination of closed-and-open-ended questions, four focus groups were conducted in four different districts. A
phenomenological explanation approach was used to examine the participants’
caring experiences and their needs. The research team assessed the cognitive
functions of care-recipients by the Hong Kong version of Montreal Cognitive
Assessment (HK-MoCA) and all recruited caregivers were given the Chinese
Version of the Revised Caregiving Self-Efficacy Scale (C-RCSES) to determine
their level of caregiver self-efficacy. Eighty family caregivers (FCGs) of people
with dementia were recruited. Seeking understanding, stabilization, preparation,
implementation, and adaptation were the themes identified for analysis. The results indicated caregiving is a demanding task, both mentally and physically.
Being older, having a lower socioeconomic status and lower levels of informal
support were related to higher levels of stress and poorer coping strategies in
FCGs. Moreover, active service provision can be started in the initial stages of
caring and should be accompanied with the active involvement of service in the
volitional aspects of the FCGs..