Perform Care Tasks Research Articles

Electrocardiogram and respiration recordings show a reduction in the physical burden on professional caregivers when performing care tasks with a transfer support robot

ABSTRACT In this study, we assessed the physical burden on professional caregivers when using a transfer support robot, “Hug,” to transfer and move a care recipient. We compared heart rate (HR), heart rate variability (HRV), and the time-series synchronization between HRV and respiration in caregivers using the robot or a normal wheelchair as control. Under both conditions, a commercial wearable device was used to simultaneously obtain electrocardiogram and respiration signals while performing care tasks, which comprised transfer from a bed to a wheelchair or to the robot, movement to a remote location, and transfer to a chair. We found that HR was significantly higher and HRV and wavelet coherence were significantly lower in the control than with Hug during at least the first 30 seconds of rest after the task (p < 0.05). This suggests that Hug could reduce the increase in HR and thereby maintain a more constant rhythm between HRV and respiration during care tasks. A post-task questionnaire also revealed that caregivers felt the physical burden of the tasks was reduced using Hug. Our results suggest that the introduction of transfer support robots can reduce the physical burden for caregivers of daily transfer assistance tasks.

Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study.

Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.

Duet or Solo? An Analysis of Paternal Involvement in Childcare in Korea by Couples’ Co-Participation Perspective

This paper examines father involvement in childcare from the perspective of couples’ co-participation in care tasks and factors associated with fathers’ childcare time performed by fathers alone. Drawing on the Korean Time Use Survey 2014, and a sample of dual-earner parents with preschool aged children, results show that the time spent in childcare alone by the father was considerably less than that of mothers. About 80% of mothers’ total childcare time was performed alone compared with 59.5% for fathers. For routine care, about 64.8% of fathers’ routine care time was performed alone by fathers. OLS regression results indicate that work hours of both mothers and fathers primarily shape the context in which fathers’ sole charge of care tasks occur. The egalitarian gender role attitude fathers hold was found to be another significant determinant of the total amount of time fathers spent on performing care tasks alone and the amount of time fathers spent on performing routine care tasks alone. Level of fathers’ educational attainment did not make differences to their solo care time.

“We Have to Advocate so Hard for Ourselves and Our People”: Caring for a Trans or Non-Binary Older Adult with Dementia

This article reports on empirical findings from a Canadian study examining the experiences of carers who support a trans or non-binary person with dementia. Using a trans-affirmative, critical disability, anti-ageist, and intersectional approach, these findings fill an important gap in the literature. The narrative interviews with four participants reveal that there are unique features to caring for a trans or non-binary person with dementia, namely, becoming a carer due to marginalized status, performing care tasks linked to gender identity and expression, and managing multiple and specific forms of discrimination. Three of the four carers were themselves trans or non-binary, pointing to pathways into care that are linked to a shared marginalized identity. In addition to the traditional tasks of dementia care, the participants engaged in gender-related tasks such as gendered body care, sustaining the gendered self, and advocacy and future planning linked to gender identity and expression. The carers also had to manage numerous forms of cisgenderist, ageist, and cogniticist discrimination and violence directed at both the trans or non-binary person with dementia and themselves. This discrimination dramatically reduced care options, placing more responsibility on the shoulders of carers. The article ends with practical recommendations.

Effectiveness of an educational intervention to reduce the burden on home care workers and facilitating factors: A pre-post study

AimsTo determine if a training program, aimed at home care workers, for caring for the elderly and for providing their own self-care is effective for reducing workers burden in the short and long terms and to identify the associated variables that can influence burden across 12 months. BackgroundAn increasing number of older adults rely on home care workers as a complement to the care received from family caregivers. However, these workers do not usually have any formal training in nursing care and occasionally suffer burden. DesignA pre- and post-intervention study with a follow-up at 12 months including 86 participants. MethodsAn 85-hour training course, which included a practical module lasting 35 h, was offered on five separate occasions between 2014 and 2017 in Barcelona (Spain). The care burden was measured according the Zarit Burden Interview and care knowledge and perceived difficulty performing care tasks were assessed. We also gathered data on the physical and psychological status of the care recipients. ResultsThe educational intervention was effective after training (−7.45% p = .020) and although the initial burden on caregivers did not worsen significantly despite spending 12 months caring for people with moderate physical and psychological dependence, the decrease in the burden was not maintained over time. Associated variables that can influence the burden over 6 months were the caregivers’ baseline perception of lacking knowledge and/or having no difficulty with care tasks. The variable that could influence overburden in caregivers at 12 months was becoming ill before the intervention. ConclusionsFor the first time, the effectiveness of home workers-specific training has been demonstrated: a reduction in the perceived burden was observed immediately following training completion, but this reduction was not sustained at 6/12 months. The practical interpretation is that a remedial/follow-up training course may be needed. Whether difficulty in providing care or having sufficient knowledge and having an illness influence self-care maintenance requires further verification.

Family participation in the care of older hospitalised patients: Patients', family caregivers' and nurses' preferences on family caregivers performing care tasks.

It is estimated that there are 101 million older care-dependent people (60+). This group is expected to double by 2050 due to the ageing of the world's population and the rise in life expectancy. Although people tend to live longer, there is little evidence that they live their later years in better health. In the future, this might put even more stress on an already overburdened acute care health system. Hospitals therefore need to focus on preventive measures to avoid rehospitalisation of older people. Family participation could be part of the solution. This study aimed to gain insight into the preferences of family caregivers, patients and nurses towards family caregivers taking up care tasks during hospitalisation, after receiving education. Data were collected using a cross-sectional survey of nursing staff, family caregivers and older patients in nine wards for older people within three hospitals. Data collection ran from October 2019 till March 2020 using a questionnaire of 25 care tasks with three answer options (perform alone, together with a nurse, do not perform). A consecutive sample of 330 patients and 133 family caregivers (81 dyads could be formed) next to a convenience sample of 67 nurses was obtained. Patients (65%) are more prepared to let their family caregiver perform tasks alone than family caregivers (59%) and nurses (52%). Only few patients (3.8%) and family caregivers (13%) prefer the family caregiver to perform a task together with a nurse. The latter answer thus rather dichotomously, while nurses answer more dynamically over the three answer options. Of all family caregivers, 50% indicate willingness and ability to perform tasks on a regular basis. Significant correlations indicate that patients, family caregivers and nurses agree on which care tasks would be more preferable to be performed by a family caregiver. Looking at the dyads, preferences of a patient are not suspected to be more similar with his family caregiver than with a random family caregiver. Patients, FCGs and nurses indicate to be prepared to engage in family participation. Further research needs to concentrate on the different attitudes and perceptions towards performing care tasks through qualitative research and how a successful implementation can be set up. Our study indicates that implementation of family participation in physical care within the hospital could be viable. The study protocol was approved by the ethical committee of the Ghent University Hospital (B670201940430).

Parentification Among Young Carers: A Concept Analysis.

There are approximately 1.4 million young carers in the United States alone. Being a young carer can result in parentification, a type of role reversal that occurs when children take on the roles and responsibilities of the adult. The purpose of this concept analysis is to provide a better understanding of the phenomenon of parentification among young carers through a description of its antecedents, attributes, and consequences using the steps of Rodgers' evolutionary method. The databases CINAHL, PubMed, PsycINFO, and Scopus were searched to identify 25 articles. The antecedents of the concept include the dependency of the care receiver and the child's adoption of a caregiving role. The attributes include fairness, obligation, resiliency, individuation, confidence in performing care tasks, cultural normalcy, family system functioning, support system, family resources, caregiver-care receiver relationship, and awareness of the child's needs. Parentification has both positive and negative consequences that impact the young carer. The antecedents, consequences, and identifiable attributes of the concept are presented through this work to provide a comprehensive picture of parentification among young carers. These findings showcase the multidimensional nature of parentification and the broad impact that it can have on young carers. While these findings do provide greater insight into young carers, the fact remains that little is known about this underserved and underacknowledged population. This concept analysis provides a foundation of understanding that specifies potential targets for intervention development, as well as modifiable outcomes, that can be explored through future research and intervention work.

Exploring Care Providers' Perceptions and Current Use of Telehealth Technology at Work, in Daily Life, and in Education: Qualitative and Quantitative Study.

BackgroundA telehealth technology education curriculum designed to integrate information technology and telecommunication well has great potential to prepare care providers for health care delivery across space, time, and social and cultural barriers. It is important to assess the readiness level of care providers to use and maximize the benefits of telehealth technology in the health care delivery process. Therefore, this study explored care providers’ existing experience using technology in various use contexts and compared their familiarity with telehealth technology’s relevant features.ObjectiveThis study’s objective was to explore care providers’ familiarity with using technology in different settings and their perceptions of telehealth-driven care performance to lay a foundation for the design of an effective telehealth education program.MethodsThe study used quantitative and qualitative analyses. The online survey included four items that measured care providers’ perceptions of care performance when using telehealth technology. Advanced practice registered nurse students rated each item on a 7-point Likert scale, ranging from 1 (“strongly disagree”) to 7 (“strongly agree”). They also responded to three open-ended questions about what kinds of health information technology they use at work, after work, and in their current educational program.ResultsA total of 109 advanced practice registered nurse students responded to the online survey and open-ended questionnaire. Most indicated that using telehealth technology enhances care performance (mean 5.67, median 6.0, SD 1.36), helps make their care tasks more effective (mean 5.73, median 6.0, SD 1.30), improves the quality of performing care tasks (mean 5.71, median 6.0, SD 1.30), and decreases error in communicating and sharing information with others (mean 5.35, median 6.0, SD 1.53). In addition, our qualitative analyses revealed that the students used the electronic health records technology primarily at work, combined with clinical decision support tools for medication and treatment management. Outside work, they primarily used video-text communication tools and were exposed to some telehealth technology in their education setting. Further, they believe that use of nonhealth technology helps them use health information technology to access health information, confirm their diagnoses, and ensure patient safety.ConclusionsThis research highlights the importance of identifying care providers’ existing experience of using technology to better design a telehealth technology education program. By focusing explicitly on the characteristics of care providers’ existing technology use in work, nonwork, and educational settings, we found a potential consistency between practice and education programs in care providers’ requirements for technology use, as well as areas of focus to complement their frequent use of nonhealth technologies that resemble telehealth technology. Health policymakers and practitioners need to provide compatible telehealth education programs tailored to the level of care providers’ technological familiarity in both their work and nonwork environments.

Social support for elderly people over 65years in Spain.

To determine what social support is available in Spain to people over 65 who also dedicate hours of their time to the care of others who are older. Demographic and social changes are leading to growth of the population. The social support available to older people in the final stage of life affects their health. A cross-sectional study was conducted involving the records of older, non-institutionalized individuals residing in Spain, obtained from the European Health Survey of 2014. The method of collecting information used in the European Survey was personal interviews assisted by a computer. The records of 6520 older people were studied; 40.1% of the participants studied had expressed the possibility of having three to five people available in case of a serious problem, and 83.6% reported that the rest of the people around them were very interested in what happens to them. With respect to care, only 7% of the older people studied mentioned performing care tasks. Social support is beneficial to older people, regardless of whether they perform care tasks, because it acts as a protective factor against problems such as loneliness, stress and depression. The profile of a primary caregiver in this age range is a married, middle-class woman with primary schooling who is caring for a first-degree relative. These data suggest that it is necessary for nurses to know about the needs of older people to implement societal measures of health promotion, prevention and education that favour social cohort. In addition, health policymakers should establish programmes that improve the social support of non-institutionalized older people.

APOYO PSICOSOCIAL A FAMILIAS DE PERSONAS CON ENFERMEDAD MENTAL GRAVE Y PROLONGADA

Abstract:Family quality of life is affected when one member shows high support needs. Variables such as social support and sense of coherence appear to mediate the impact of care on quality of life. In the present study we analyzed the support perceived by caregivers, the meaning given to care, and the changes experienced in quality of life after assuming the role of caregiver. Participants consisted of 50 family members of individuals with mental illness who responded to a questionnaire to analyze the experience of caring and the perceived supports and quality of life. Although the results indicate that caregivers spend many hours performing care tasks, for a substantial percentage the quality of the relationship has improved after being caregiver. On average, the different dimensions of quality of life experienced a significant decline when dealing with care giving tasks. However, previous rela-tionship quality with the person receiving care, the handling of this task, or the existence of personal care time, affect ratings on quality of life.Keywords: Family quality of life, Social support; Sense of Coherence, Mental IllnessResumen:La calidad de vida de las familias se ve afectada cuando uno de sus miembros presenta elevadas necesidades de apoyo. Variables como el apoyo social y el sentido de coherencia parecen mediar en el impacto del cuidado sobre la calidad de vida. En el presente estudio analizamos los apoyos percibidos por los cuidadores, el significado otorgado al cuidado y los cambios experimentados en la calidad de vida tras asumir el rol de cuidador. Los participantes han consistido en 50 familiares de personas con enfermedad mental, a quienes se les ha aplicado un cuestionario para analizar la experiencia de cuidar, los apoyos y la calidad de vida. Aunque los resultados indican que los cuidadores invierten muchas horas a las tareas de cuidado, para un porcentaje sustancial la relación ha mejorado tras asumir las tareas de cuidador. En promedio, diferentes dimensiones de calidad de vida experimentan un descenso significativo al tener que hacer frente a las tareas de cuidado. No obstante, la calidad de la relación mantenida previamente con la persona cuidada, la manejabilidad de esta tarea, o la existencia de tiempos para el cuidado personal, afectan a las valoraciones de la calidad de vida.Palabras clave: Calidad de vida familiar, Apoyo social, Sentido de coherencia, Enfermedad mental

Bridging language barriers in multilingual care encounters

AbstractThe present case study demonstrates how the multilingual practices of a linguistically diverse workforce contribute to the functioning of a modern workplace. Based on ethnographic fieldwork and recordings in a residential home for elderly people with dementia in Sweden, the article explores how multilingual immigrant care workers creatively use their language skills to overcome linguistic boundaries and communicate with an elderly Kurdish resident. It is shown that despite the fact that the participants do not, or only to a limited extent, share a common language, the care workers manage to create multilingual encounters that allow them to perform care tasks in an activity context where empathy and efficiency are of great importance. Although the data in this study manifest the struggle of multilingual care workers to bridge language barriers, the study also highlights the complexity of providing adequate and well-functioning care in today’s diverse society, where linguistic and cultural matching of clients and caregivers cannot always be obtained. These results are discussed in the light of new demands on Swedish (and more broadly Western) care systems to adapt to the increasing number of multilingual older people, who will become residents in care facilities.

Family Strategies in Hungary: The Role of Undocumented Migrants in Eldercare

In Hungary until recently there are no research data on undocumented migrants working in the field of eldercare. Qualitative research conducted in 2009–2011 examined this ‘invisible’ segment working in long-term care. One of the target groups this study was families employing undocumented migrants including ethnic Hungarians from neighbouring Romania (Transylvania) and Ukraine (Subcarpathia). The paper explores this data to address where the employment of invisible migrants appears in the long-term eldercare strategies of Hungarian families. In addition, this paper examines the role of Hungarian non-migrant carers who are also present on the illegal (black) labour market providing eldercare. Based on analysis of macro data and empirical research, the paper identifies several care strategies utilised by families caring for older people in Hungary: 1. Active family carer; 2. Inactive family carer; 3. Family carer receiving a care allowance; 4. Family care with shared responsibility; 5. Family employing legal carer; 6. Family employing undocumented non-migrant carer; 7. Family carer also with earnings on the black market; and 8. Family employing undocumented migrant carer. This paper also highlights that a decline in the trend of migration in the near future will bring an erosion of the existing care source that has not been anticipated by policy related to eldercare. The increase in the retirement age causes women’s later exit from the labour market, aggravating the problem of balancing care and work. This increase in the retirement age, considered to be essential for ensuring the sustainability of the pension system, will inevitably result in a shortage of services with all its financial and structural implications. As women will no longer be able to perform care tasks, the formal care system will be unable to cope with the extra demand.

Relatives as paid care-givers: how family carers experience payments for care

ABSTRACTPayments for care, by which people in need of long-term care directly employ care workers, have been introduced in many European countries. In The Netherlands, care dependants are allowed to use these payments to hire relatives to perform care tasks. Care-givers who are employed by their relatives are in a hybrid position, because they are contracted as employees in the informal setting of a family home and its affective care relationships. This paper reports a qualitative study of relatives' experiences of payments for care and how these affect their care-giving. In-depth interviews were undertaken with 17 paid carers: they were asked to respond to three fictional vignettes of contrasting care trajectories. It was found that the cash nexus had mixed and partly contradictory implications for the paid care-givers. On the one hand, the care-givers were satisfied with the arrangement, as the payments recognised and raised their status as carers, and were seen as reward and reciprocation for their care work. Some carers had found that the contract helped manage strained relationships, by enabling a clearer differentiation of care tasks from affection. On the other hand, some who regarded themselves as employees and saw their role as equivalent to formal carers felt a greater obligation to provide high-quality care, and found that they were thanked less often and received fewer tokens of gratitude.

Family Involvement and Helping Behavior in Teams

Helping behavior at work has become increasingly important, with organizations making more and more use of cooperative work practices. The difficulty is that employees are facing growing demands beyond the workplace. This study investigates the mechanisms by which family involvement (family structure, family tasks, family support) affects helping behavior in teams. Based on a sample of 495 team members, the results show that having a supportive partner and performing care tasks increase helping behavior via enhanced fulfillment and skills. Having young children is directly and negatively related to helping behavior. The authors also conducted separate analyses for men and women.

A Navigation System for Assistant Robots Using Visually Augmented POMDPs

Assistant robots have received special attention from the research community in the last years. One of the main applications of these robots is to perform care tasks in indoor environments such as houses, nursing homes or hospitals, and therefore they need to be able to navigate robustly for long periods of time. This paper focuses on the navigation system of SIRA, a robotic assistant for elderly and/or blind people based on a Partially Observable Markov Decision Process (POMDP) to global localize the robot and to direct its goal-oriented actions. The main novel feature of our approach is that it combines sonar and visual information in a natural way to produce state transitions and observations in the framework of Markov Decision Processes. Besides this multisensorial fusion, a two-level layered planning architecture that combines several planning objectives (such as guiding to a goal room and reducing locational uncertainty) improves the robustness of the navigation system, as it's shown in our experiments with SIRA navigating corridors.

‘He will finish up caring for me’: people with learning disabilities and mutual care

SummaryUntil recently, the carer's perspective has dominated research on families who include someone with a learning disability and recent legislation has underlined the carer's rights. Previous research has found that some more able people with learning disabilities were very aware of their parents' growing needs, and were taking on responsibilities within the family to help and support their carer/parents. However, recent legislation still dichotomizes family members into carers and cared‐for people. The present paper is based on a research study of the impact of the UK Carers Act 1995 on families with someone with a learning disability. It involved canvassing the views of people with learning disabilities about their experience of assessments and their relationships within the family. The present authors found that many people with learning disabilities expressed empathy for their carer's point of view and that several people (including some who had high support needs themselves) were performing care tasks for their elderly parents. However, no one appeared to recognize the situation as one of mutual care, and parents generally carried on defining themselves as carers since they took responsibility and exercised control. The present authors conclude that mutual caring is far more common than is recognized and includes people with severe learning disabilities. A more holistic approach to assessment of needs is required that can take into account the complex web of interdependence within a family. Rather than categorizing people into ‘carers’ and ‘cared‐for’, the present authors suggest a model that recognizes mutually supportive partnerships within the family.