Family Members Of Older Adults Research Articles

Impact of carer burden, social support, and gratitude on quality of life in families of older adults with dementia

This study explores how carer burden, social support, and gratitude affect the quality of life of family members of older adults with dementia. Participants included 156 family members living with older adults diagnosed with dementia. Data were collected using structured self-report questionnaires and analyzed using hierarchical regression analysis. Significant predictors of quality of life were identified as family support, friend support, and gratitude, and the explanatory power of these factors for quality of life was 48.2 %. To enhance the quality of life of families of older adults with dementia, programs promoting supportive familial interactions, activities enhancing support from friends, and initiatives fostering gratitude should be implemented.

Views on advance care planning of family members of older adults with Turkish and Moroccan backgrounds: An exploratory interview study

Background: Significantly fewer individuals with migration backgrounds than native-born individuals undertake advance care planning. Older adults with Turkish and Moroccan backgrounds represent one of the largest ageing non-Western minority groups in Europe. Their relatives could play important roles in facilitating or hindering advance care planning, but their views remain underexplored. Aim: To explore advance care planning knowledge, experience, views, facilitators and barriers among older Turkish and Moroccan adults’ relatives in Belgium. Design: Qualitative thematic analysis of semi-structured interview data. Setting/participants: Twenty-two relatives of older Turkish and Moroccan adults in Brussels, Mechelen and Antwerp, recruited via general practitioners. Results: Participants had limited advance care planning knowledge and had not discussed it with healthcare professionals. Some found discussing end-of-life preferences with relatives beneficial; others opposed the discussion of specific topics or felt discussions were unnecessary, as they felt responsible for caregiving and trusted by their relatives to make future decisions. Barriers included personal and relational characteristics, emotional difficulty and perceived non-urgency. Facilitators included information in older adults’ native languages, general practitioners’ cautious initiation and the involvement of several family members. Conclusions: Relatives of older people with Turkish and Moroccan backgrounds are unfamiliar with advance care planning and have highly variable views on it. People should be given opportunities to discuss advance care planning in a culturally appropriate manner, and the diversity of perspectives regarding whether and how to engage in such planning should be recognised. ClinicalTrials.gov no. NCT05241301.

Information and Communication Technology Adoption Strategies Among Iranian Older Adults: A Qualitative Evaluation.

In today's world, it is unavoidable for older adults to use technology, which causes some challenges for them. In this qualitative study, we used grounded theory to evaluate information and communication technology (ICT) adoption strategies among Iranian older adults. The participants included 18 older adults, five experts, and five family members of older adults. The data collection method included conducting semi-structured interviews, taking field notes, and observation. The data were analyzed using the Corbin and Strauss approach. Three main themes were extracted as follows: support from others, effort for learning, and smart choice. The subthemes of support from others included creativity in educating older adults; having access to an educational supporter; and receiving informational, emotional, and financial support. The subthemes of effort for learning included utilizing aids, adaptive measures, shortcut techniques, and self-learning. The subthemes of smart choice included physical characteristics, technical features, price sensitivity, and availability of an active sales representative. Accordingly, it is essential to teach older adults to increase their ICT adoption rate and continued use of technology. In this respect, developing a standard ICT manual for older adults can be beneficial.

Firearm use risk factors and access restriction among suicide decedents age 75 and older who disclosed their suicidal intent.

A majority of older adult suicide decedents used firearms. In this study, we focused on suicide decedents age 75+ who disclosed their suicidal intent within a month of their injury/death to examine demographic and clinical characteristics associated with firearm use and firearm access restriction attempts by their family members. The 2017-2019 U.S. National Violent Death Reporting System provided data (N = 1,734 suicidal intent disclosers; 1,476 males and 258 females; 21.4% of decedents age 75+). Generalized linear model (GLM) for a Poisson distribution with a log link was used to examine firearm use risk factors. Firearm access restriction attempts by decedents' family members were examined based on coroner/medical examiner and law enforcement (CME/LE) reports. Nearly three quarters of disclosers disclosed their intent to family members, and 82.9% of males and 27.5% of females used firearms. GLM results showed males, non-Hispanic white people, and residents in the South and West regions had higher likelihood of firearm use. CME/LE reports of 140 out of 1,294 firearm decedents included narratives related to firearm restriction attempts or lack thereof. Firearm access restrictions were not attempted in 65 cases because family members did not take suicidal intent disclosure seriously or because decedents promised no self-harm. Partial or complete removal of firearms in 75 cases were not effective as decedents had hidden a firearm or purchased a new one. Others used different lethal methods. The findings indicate a need for: (a) training family members of older adults who are at risk of suicide in effective means safety/access restriction and strategies to prevent means substitution; (b) more comprehensive legislative reforms reducing access to firearms by those at risk of suicide; and (c) more comfort and palliative care and counseling for psychosocial risk factors.

The Research on How Social Media Affects Active Ageing: Chinas Perspectives

A few years ago, the issue of aging started to become an important obstacle to global development that cannot be ignored, and China, as one of the world's countries with the largest population, is in fact particularly affected by the negative effects of aging. Compared to other measures to alleviate the aging problem, society seems to pay less attention to the situation of elders on social media. Because of this, it is of great significance to examine the aging issue from the perspective of social media. This paper uses social media platforms and existing active aging systems as research subjects, employing methods such as relevant interviews and literature analysis to discover ways to make social media more relevant to older adults, thereby better promoting active aging. According to the research, creating a social media platform that is friendly to older adults and thus achieving positive aging on social media requires the collaboration of multiple parties, including the government, media, family members of older adults, and older adults themselves. The implementation of active aging on social media benefits not only the elderly but the entire society.

Difficulties in the Lives of Family Members of Older Adults With Dementia During a Disaster and Through the Mid- And Long-Term Aftermath

Difficulties in the Lives of Family Members of Older Adults With Dementia During a Disaster and Through the Mid- And Long-Term Aftermath

SELF-TAILORED SUCCESSFUL AGING: OLDER ADULTS’ POINTS OF VIEW

Abstract The study aimed to map out the main constructs involved in aging successfully, as perceived by older adults, and highlight the importance of self-management. This qualitative study was comprised of eighteen interviewees and sixty participants across nine focus groups, including: Independent older adults aged 65 to 84 years living at home, health professionals working with older adults, and family members of older adults. Participants shared experiences concerning their everyday occupations and routines. Focus groups were recorded, transcribed verbatim, and qualitatively analyzed, using the constructivist grounded theory principles. Results: Three successful aging theoretical categories emerged: self-management abilities, daily lifestyle, and individual differences. An example for self-management abilities can be described by a 67-year-old man’s son, who said: “He is a very busy man, he doesn’t have any commitments, but he always creates things for himself to do”. Results revealed diversity in how older adults perceive successful aging. For example, a 68-year-old woman said: “Retirement is like heaven, I enjoy every moment, there’s a lot to do”, whereas a 69-year-old man claimed: “Nobody needs you anymore… I retired a year ago and I still haven’t succeeded in organizing a daily schedule”. Additional results and quotes reflecting the categories will be represented. Conclusion: Older adults who succeed in managing their daily life, and experience control of their own life, delineate successful aging. The diversity accentuates that each older adult needs to tailor their own self fitted “suit” to wear as they stride successfully into their aging years.

Death Anxiety and Interment Stress Family Interventions for Filipino Older Adults.

The overall intent of this research is to determine the preferred death anxiety and interment stress family interventions for Filipino older adults. 214 Filipino respondents (18-75 years old) participated in this conjoint analysis study. Results showed that cognitive state (23.272%) is most important and spiritual state (17.256%) as least important family intervention. Part-worth of the attributes shows medical routines and procedures (.342) as most preferred for physical state; mental health awareness (.266) for cognitive state; livelihood trainings (.051) for social state; family therapy (.022) for psychological state; and church activities (.017) for spiritual state. Spiritual state, age, and number of children have marked associations. Respondents aged 60-75 with a higher number of children in the family, cope with death anxiety and interment stress through spirituality. Significant findings of this study will greatly contribute to the knowledge base of geriatric mental health care; including caregivers and family members of older adults.

Emotional Stress Experience of Care Professionals for Older Adults with Dementia: A Qualitative Interpretive Meta-synthesis

ABSTRACT Emotional stress is a common problem for many professionals in dementia care. Although a plethora of quantitative studies have examined the factors that affect care professionals’ emotional stress, little qualitative research has provided in-depth understanding of professional stress experiences. To magnify the voices of professionals who share their experiences of stress in caring for older adults with dementia, a qualitative interpretive meta-synthesis of five qualitative studies was conducted. Guided by Pearlin’s stress process model, four themes were identified: (1) emotional attachments to older adults with dementia; (2) difficulties in dementia care; (3) stressful working environment; and (4) conflicts with family members of older adults with dementia. Findings further highlighted that professionals’ genuine concern for the well-being of older adults with dementia reinforced the perception of stressors identified in each of the preceding themes. These results could inform the improvements of emotional support for care professionals in practice and policy arenas.

Development and validation of a questionnaire to evaluate the knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care.

To develop and validate a questionnaire on knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. A descriptive study design and STROBE checklist were applied in this research. The theoretical framework of the questionnaire was knowledge-attitude-behaviour model. An additional dimension of palliative care preference of family members was set up in the questionnaire. Items were generated from a rapid review of international literature and interviews with 61 family members of the older adults living either in an aged care service organization or the community. The content validity was examined by five experts. A preliminary questionnaire with 69 items was then set up, and its psychometric property was assessed. A final version of questionnaire with 42 items under four dimensions was constructed. The content validity index of the overall questionnaire was 0.93 and of each item ranged 0.80-1.00. The factor loading of all items was higher than 0.50 as per exploratory and confirmatory factor analysis; the average variance extracted for each dimension was higher than 0.50; the composite reliability was higher than 0.90; and the absolute value of the correlation coefficient of each dimension was <0.50 and less than the square root of the average variance extracted. The Cronbach's alpha value and the split-half reliability value of the overall questionnaire were 0.93 and 0.97, respectively. This questionnaire has good validity and reliability, but needs further testing in multi-centered settings.

The Challenges Faced By Long-Term Care Residents and Their Families During COVID-19

The present research aims to examine the effects of protective measures due to the coronavirus disease (COVID-19) within long-term care (LTC) settings on the residents and their family members. Open-ended qualitative interviews were conducted with 14 family members of older adults who resided in LTC settings during the first wave of the pandemic in Israel. The first theme identified is Rupture, including physical disconnect; the disruption in routine treatment to residents; and decline in the satisfaction with the setting. The second theme is Response, including sharing viewpoints and involvement in decision making, as well as an intense ambivalence shared by family members. Our findings highlight the distress caused to residents and family members by the isolation and restrictions in LTC settings during the pandemic, and underscore values and priorities that are central to them and their family members, including maintaining continuity, transparency, and working in unison with their families.

Within-person Variation In Emotional Exhaustion Among Caregivers For Older Adults

Caregiving is everyday life for family members of older adults. Care recipients’ care requirements, service usage, and caregivers’ physical and emotional conditions differ day by day. Little is known how the differences and variances relate to informal caregivers’ mental health. This study aimed to examine informal caregivers’ day-to-day fluctuation in emotional exhaustion and discuss the within-person effects on mental health among informal caregivers. We developed the Caregiving Visualization Project toolkit (Care VIP), a software program for tracking on daily basis components of care experiences such as care task of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living, service usages, and caregiving burden, as well as eight items of caregivers’ emotional exhaustion. We recruited study participants between May 2018 to March 2019 who provided instrumental help to community-dwelling older adults. A total of 75 participants, who accessed the Care VIP every day by using tablets or computers and completed a one-month study, were analyzed in this study. Females comprised 80.0%, and the average age of caregivers was 52.7 years (SD=9.1). The majority were those who provided care to parents (69.3%), and those who provided to parents-in-law and spouses were 16.0% and 5.3%, respectively. The average score of the eight items on the emotional exhaustion scale, with a 4-point Likert scale, was 23.4 (SD=4.9); however, each question showed different variations. Within-person effects on mental health among informal caregivers will be discussed.

"I Didn't Meet My Mother; I Saw My Mother": The Challenges Facing Long-Term Care Residents and Their Families in the Age of COVID-19.

The present research examines the effects of protective measures due to the coronavirus disease 2019 (COVID-19) pandemic within long-term care (LTC) settings on residents and their family members. Open-ended qualitative interviews were conducted with 14 family members of older adults who resided in LTC settings during the first wave of the pandemic in Israel. The first theme identified is Rupture, including the physical disconnect; the disruption in routine treatment to residents; and decline in the satisfaction with the setting. The second theme is Response, including sharing viewpoints and involvement in decision-making, as well as an intense ambivalence shared by family members. Our findings highlight the distress caused to residents and family members by the isolation and restrictions in LTC settings during the pandemic and underscore values and priorities that are central to them and their family members, including maintaining continuity, transparency, and working in unison with their families, staff, and management.

70-LB: Continuous Glucose Monitoring Data Sharing in Older Adults with Type 1 Diabetes and Their Care Partners

Background: Family members of older adults with type 1 diabetes (T1D) regularly become part of the diabetes care team yet often lack knowledge about how to become involved to prevent hypo- and hyperglycemia. Real-time continuous glucose monitoring (RT-CGM) with data sharing could facilitate diabetes management among older adults with T1D and their family members. Methods: Older adults with T1D (n=20) and their care partners (n=20) received a RT-CGM data sharing intervention called SHARE. SHARE included dyadic communication strategies, problem-solving strategies, and action planning. People with diabetes (PWD) wore the RT-CGM for 12 weeks while sharing their glucose data with a care partner. Feasibility data were obtained on intervention dose, implementation processes, satisfaction, and diabetes-related quality of life using RT-CGM. Descriptive statistics were used to examine feasibility, satisfaction, and demographic data. Results: The SHARE intervention was feasible, had high self-reported satisfaction for PWD and their care partner, and high adherence (96±6.8%) with wearing the RT-CGM. We found broad improvements in diabetes-related quality of life using RT-CGM in PWD and their care partners. Although the majority of PWD were willing to share hyperglycemia data (55%), several chose not to. The majority of PWD were willing to talk about glucose numbers with a care partner (n=70%). For this feasibility study, the SHARE intervention was not targeted at improving glucose levels but rather on communication and problem-solving strategies. There were no significant trends in the RT-CGM data (e.g., time in range) between baseline and 12 weeks. Conclusion: Older adults with T1D diabetes and their care partners identified the positives of RT-CGM with SHARE as having someone else aware of glucose levels and working together with a partner on diabetes self-management. SHARE may improve dyadic communication and problem-solving around glucose management in older adults. Disclosure N. A. Allen: Research Support; Self; Dexcom, Inc. M. L. Litchman: Research Support; Self; Abbott Diabetes. J. Chamberlain: Speaker’s Bureau; Self; Abbott Diabetes, Dexcom, Inc. E. Grigorian: None. E. Iacob: None. C. Berg: None. Funding University of Utah Center on Aging; University of Utah One U Caregiving Initiative; Dexcom, Inc.

Predictors of Satisfaction with Care Services among Family Members of Older Adult Residents of Long-Term Care Facilities.

This study identified predictors of satisfaction with care services among family members of older adults residing in long-term care facilities (LTCFs). In this cross-sectional descriptive study, the participants were 330 family members of older adult residents of LTCFs in Seoul, Gyeonggi, Gangwon, Gyeongbuk, and Chungnam, Korea. Data were collected from July to October 2018 using a structured self-report questionnaire. Data were analyzed using descriptive statistics, independent t-testing, one-way ANOVA, Kruskal–Wallis testing, Pearson’s correlation coefficients, and hierarchical multiple regressions. The most important predictors of satisfaction with care services were satisfaction with the physical housing environment (β = 0.49, p < 0.001), caregiving stress (β = −0.30, p < 0.001), the facility’s size (β = −0.13, p = 0.001), the number of visits to the facility (β = −0.10, p = 0.024), and the number of family members who participated in the decision to place the relative in a facility (β = 0.09, p = 0.033). This study is significant because it provides fundamental data for qualitatively improving care services in LTCFs. Based on the results, strategies should be developed to relieve caregiving stress among family members and improve satisfaction with the physical housing environment.

DEPRESSIVE SYMPTOM SEVERITY AMONG FAMILY MEMBERS OF OLDER ADULTS WITH HETEROGENEOUS COGNITIVE VULNERABILITY

Introduction Cognitive vulnerability among community-dwelling older adults (age > 65) refers to living with cognitive impairment due to dementia, experiencing delirium which is associated with longer-term cognitive impairment, and/or living with depression which is a known risk factor for cognitive impairment. Family members of older adults with dementia often report considerable levels of depressive symptoms, and many interventions for these family members aim to reduce their depressive symptoms. However, much less is known about depressive symptoms among family members of older adults with depression or recent episodes of delirium. Therefore, in this study we compared levels of depressive symptoms among family members of older adults based on type and severity of older adults’ cognitive vulnerability. Methods This study utilized baseline data from an ongoing randomized clinical trial testing the efficacy of an in-home multidisciplinary team care management intervention for older adults with cognitive vulnerability. During eligibility assessment, older adults are determined to have dementia based on score of 16 on the Center for Epidemiologic Studies Depression (CESD) Scale, and recent delirium based on the informant version of the Confusion Assessment Method (FAM CAM). Family members of older adults are required to join the clinical trial if older adults have dementia or recent delirium, and they are invited to join if older adults have depression without dementia or delirium. Baseline data are collected during in-person, in-home interviews conducted separately with older adults and with family members; this study includes baseline data from the first 259 dyads enrolled in the trial. We measured older adults’ cognitive vulnerability in 3 ways: (1): whether their eligibility determination was dementia, depression, and/or delirium; groups sizes were dementia only (n=76); depression only (n=70); depression and dementia (n=56); and delirium plus depression and/or dementia (n=57); (2) cognitive impairment severity based on TICS score; and (3) depressive symptom severity based on CESD score. Family member depression severity was measured based on their CESD score. In 3 separate multivariate regression models, family caregiver depression severity was regressed on each of the three measures of cognitive vulnerability; covariates in all models included family member sex, familial relationship of family member to older adults, and number of hours per week the family member reported caring for the older adult. Results Among older adults, 57% were female, mean/sd age=77/6.9, and 91% were White; among family members, 63% were female, mean/sd age=66/13.8, 90% were White, 54% spouses, 24% daughters, 9% sons, the remainder other family members. Controlling for covariates, we found that family member depressive symptom severity was: (1) least severe if older adults had dementia only (CESD adjusted mean=5.6) and most severe if older adults had depression only (CESD adjusted mean score=9.8) (b=4.2; p Conclusions Family members of older adults report greater depressive symptoms when their older relatives also have depression compared to when their older relatives have dementia, even after accounting for familial relationship and how much care family members provide to their older relatives. We conclude that family members of older adults with depression deserve greater clinical and research attention to address their own depressive symptoms. This research was funded by: Patient-Centered Outcomes Research Institute (PCORI Award # IHS-1502-27171)

Examining the benefits and harms of Alzheimer\u2019s disease screening for family members of older adults: study protocol for a randomized controlled trial

BackgroundMultiple national expert panels have identified early detection of Alzheimer’s disease and related dementias (ADRD) as a national priority. However, the United States Preventive Services Task Force (USPSTF) does not currently support screening for ADRD in primary care given that the risks and benefits are unknown. The USPSTF stresses the need for research examining the impact of ADRD screening on family caregiver outcomes.MethodsThe Caregiver Outcomes of Alzheimer’s Disease Screening (COADS) is a randomized controlled trial that will examine the potential benefits or harms of ADRD screening on family caregivers. It will also compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening. COADS will enroll 1800 dyads who will be randomized into three groups (n = 600/group): the ‘Screening Only’ group will receive ADRD screening at baseline and disclosure of the screening results, with positive-screen participants receiving a list of local resources for diagnostic follow-up; the ‘Screening Plus’ group will receive ADRD screening at baseline coupled with disclosure of the screening results, with positive-screen participants referred to a dementia collaborative care program for diagnostic evaluation and potential care; and the control group will receive no screening. The COADS trial will measure the quality of life of the family member (the primary outcome) and family member mood, anxiety, preparedness and self-efficacy (the secondary outcomes) at baseline and at 6, 12, 18 and 24 months. Additionally, the trial will examine the congruence of depressive and anxiety symptoms between older adults and family members at 6, 12, 18 and 24 months and compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening between the two groups randomized to screening (Screening Only versus Screening Plus).DiscussionWe hypothesize that caregivers in the screening arms will express higher levels of health-related quality of life, lower depressive and anxiety symptoms, and better preparation for caregiving with higher self-efficacy at 24 months. Results from this study will directly inform the National Plan to Address Alzheimer’s Disease, the USPSTF and other organizations regarding ADRD screening and early detection policies.Trial registrationClinicalTrials.gov, NCT03300180. Registered on 3 October.

CAREGIVER DEPRESSIVE SYMPTOM SEVERITY AMONG OLDER ADULTS WITH COGNITIVE VULNERABILITY

While caregivers of older adults with dementia often report considerable levels of depressive symptoms, much less is known about depressive symptoms among family members of older adults with depression or recent delirium. As part of an ongoing randomized clinical trial testing an in-home multidisciplinary team intervention for older adults with cognitive vulnerability due to dementia, depression, and/or delirium (care recipients, or CR) and their caregivers, in this presentation we report baseline data from the first 211 dyads enrolled in the trial to determine how caregiver depressive symptom severity is related to: CR diagnoses; CR cognitive impairment severity; and CR depressive symptom severity. CR diagnostic groups: Depression Only (n=49); Dementia Only (n=61); Depression and Dementia Only (n=47); Delirium Plus (n=54). Depressive symptom severity was measured using the Center for Epidemiologic Studies Depression Scale; CR cognitive symptom severity was measured using the Telephone Interview for Cognitive Status. Among CR, 57% were female, mean/sd age=77/6.9, 93% White; among caregivers, 64% were female, mean/sd age=66/13.7, 91% White, 55% spouses, 25% daughters, 9% sons. In multivariate linear regression models, which included covariates caregiver gender, relationship to CR, and number of hours/week providing care, we found that caregiver depressive symptom severity was less severe among caregivers of CR with Dementia Only compared to CR with Depression Only (b=-3.32; p=0.06); not associated with CR cognitive symptom severity; and significantly associated with CR depressive symptom severity (b=0.14; p<0.01). We conclude that family members of older adults with depression deserve greater attention to address their own depressive symptoms.

ENGAGING AFRICAN AMERICAN FAMILIES IN END OF LIFE DISCUSSIONS: CHALLENGES AND FACILITATORS

Our previous study, African American Preferences Around End of Life, identified that AA Elders wanted to talk to their family about their preferences, but their family tended to avoid discussing end of life topics. We found that African American families often have a difficult time broaching the subject of end of life for a variety of emotional, cultural and religious reasons. Therefore, the purpose of this qualitative descriptive study was: To better understand the challenges and facilitators that influenced end of life conversations within the African American family. Methods: In this qualitative descriptive study, we interviewed 15 AA family caregivers of older adults. Participants were family members of older adults enrolled in an urban Program of All-inclusive Care for the Elderly. Individual interviews lasted on average 50 minutes. Data analysis was completed using conventional content analysis. Results: The majority of participants were between 55 - 65 years of age and adult children of the AA older adult. Two themes emerged for challenges: I’m not comfortable and We just don’t talk about it. For facilitators again, two themes emerged: Another person took the initiative (e.g. health care provider led the conversation) and participants’ previous experience with death led them to initiate EOL conversations. In addition, three participants reported that after participating in the interview they planned to talk to their loved one to find out their end of life preferences. The results of this study provide insight into how health care providers can facilitate these important end of life preferences conversations.

Developing the Family Involvement Questionnaire-Long-Term Care: A Measure of Familial Involvement in the Lives of Residents at Long-Term Care Facilities.

Existing measures designed to assess family involvement in the lives of older adults residing in long-term care facilities are basic, using visitation frequency as the prominent gauge of involvement in a situation specific fashion. The purpose of this study was to design and validate a measure of family involvement that could be used to gauge more aspects of family involvement than visitation alone and be useful in a variety of settings for both researchers and long-term care facility administrators. Long-term facility staff were asked to assist in creating a 40-item questionnaire that used 4-point Likert scales to measure various aspects of family involvement. The finalized Family Involvement Questionnaire-Long-Term Care (FIQ-LTC) was distributed to the family members of older adults residing in long-term care facilities around the country. A total of 410 participants responded. Researchers found that the FIQ-LTC was highly reliable (α = .965). Results also indicated that a significant correlation between distance and overall involvement (r = -.121, p = .015) was no longer significant (r = .17, p = .740) when the effect of a question asking the frequency of visitation was controlled for. These results indicate that existing measures that use visitation frequency as the sole measure of involvement are insufficient. The newly developed FIQ-LTC can serve as a more complete measure of family involvement.