Academic journal article Family Relations

The Care Continues: Responsibility for Elderly Relatives before and after Admission to a Long Term Care Facility

Academic journal article Family Relations

The Care Continues: Responsibility for Elderly Relatives before and after Admission to a Long Term Care Facility

Article excerpt

The Care Continues: Responsibility for Elderly Relatives Before and After Admission to a Long Term Care Facility*

Interviews with 214 family members are analyzed to investigate how caregiving changes from the community to the long term care (ltc) facility and to understand family member's responsibility toward elderly relatives in ltc facilities. Family responsibilities can be categorized as `indirect' including an overseer of care or `direct' including performing specific tasks. Findings suggest that emotional support needs to be incorporated into measures of caregiving. Research implications include the need for increased education for family on health care issues and a greater recognition of their resourcefulness for staff.

Key Words: family support, long term care, nursing homes, responsibilities.

Most elderly persons live independently in the community and those that need assistance obtain it from their family and friends and, occasionally, formal services. One of the most difficult decisions for an elderly person and his/ her family to make is whether or not to enter a long term care (ltc) facility. Consequently, institutionalization of an aging relative is usually a last resort only after all resources-family and formal providers-have been exhausted. The proportion of elderly persons who receive care in an institutionalized setting is low (Statistics Canada, 1997). Factors affecting the likelihood of admission include advanced age and decreasing health status (Carriere & Pelletier, 1995; Glazebrook, Rockwood, Stolee, Fisk, & Gray, 1994; Keefe & Blain, 1995; Young, Forbes, & Hirdes, 1994); being without a spouse (Shapiro & Roos, 1987); and the inability of the family caregiver to cope (Keefe & Blain, 1995).

Most of the research on family caregiving has focused on community assistance. While it is true that residents of Itc facilities are less likely to have a spouse or children (Shapiro & Roos, 1987), many of the residents have been cared for by family members prior to their admission and continue to be cared for following placement. This has sparked an interest in the ways in which families may remain involved once their elderly family member has moved to a ltc facility. In this paper, data from indepth interviews with 214 family members are analyzed to explore changes in the caregiving relationship when an elderly relative enters a ltc facility. The perception of responsibility by these family members toward the care of their elderly relative is investigated.

Literature Review

Involvement by Family Members

Institutionalization is thought to enable a transition of caregiving responsibility and burden from the informal to the formal system of care. A growing body of research (see Fancey & Keefe, 1994) however, suggests that responsibilities of family members continue after an elderly member has been admitted to a ltc facility, but perhaps in an altered way. This literature reinforces the centrality of the family in caring for its elderly members, regardless of their place of residence, and disputes the myth that family members abandon their elderly relatives following admission to a ltc facility.

Visitation is the most common means of maintaining ongoing family relations. Using national representative data, Keefe and Fancey (1997) found that 45%o of adult children visit their institutionalized parent at least weekly. Other research suggests that visitation by family members has positive consequences on the well being of the resident (Greene & Monahan, 1982; Noelker & Harel, 1978) and the spousal relationship (Gladstone, 1995). However, families face several challenges in maintaining their continued caregiving responsibilities in ltc facilities. Family members commonly experience guilt and anxiety over the decision, which can affect relations with the older family member (Brody, 1990; Matthiesen, 1989; Greenfield, 1984). …

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