Helping Caregivers Where
Laura N. Gitlin and Lisa P. Gwyther
Most persons with dementia or other debilitating conditions are cared for at home by one or more family members (Haley & Bailey, 1999). Family caregivers frequently become the hidden patients who experience dramatic negative consequences. These consequences have been documented to include emotional distress, depression, poor health, fatigue, financial burdens, and higher rates of mortality compared to noncaregivers (Ory, Yee, Tennstedt, & Schulz, 2000; Schulz & Beach, 1999; Schulz, O'Brien, Bookwala, & Fleissner, 1995). Accordingly, family caregivers experience a wide range of service needs that change and evolve over time as caregiving responsibilities increase. The home, as the natural life space and context of caregiving, is an ideal setting in which to provide services to families that are designed to support their efforts to enable older adults to age in place. Nonetheless, although services delivered in the home have become a routine component of long-term care for older patients, families rarely receive formal services in that setting that address their specific requirements.
Why offer services to families in their homes? National health care trends suggest that homes and communities increasingly will serve as the primary setting for delivering a vast array of health and human services to patients and their family caregivers (Spitzer, 1998). For this reason, it is important to understand the benefits and unique challenges of providing in-home help to family members and the delivery characteristics of these types of services. At present, there is no