A Qualitative Study on Carer-Resident Relationship and Functional Status Change in Older Adults Receiving Residential Long-term Care
Refereed conference paper presented and published in conference proceedings


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AbstractObjective: Hong Kong has a high elderly institutionalization rate, with nearly 7 % of its elders living at long-term care (LTC) homes (Chui, 2009). Apart from dementia and certain physical health conditions, institutional-living has been regarded as a predictor of functional decline (McCusker et al., 2002). However, it is unclear whether the interpersonal or social support elements within an institutional care environment have any linkage with the change of functional capacity for residents of LTC homes. The aim of this exploratory qualitative study was to gain an understanding of whether there is a possible association between carer-resident relationship and the functional status change in elders receiving residential long-term care.

Methods: 6 elderly residents from a government subvented long-term care home who had scored 60+ in Barthel ADL Index (BI) at the point of home admission, and did not have dementia or physical risk factors which are known to be associated with functional decline were recruited for the study. In this study, functional status change was measured in terms of the difference of BI scores between care home admission and the latest functional status assessment after admission. Sampling was done purposefully to include 3 possible scenarios, so that of the 6 residents recruited, 2 had shown improvement in ADL, 2 had no change in ADL scores, while the remaining 2 had manifested decline in ADL scores. To assess the carer-resident relationship, individual qualitative interviews were conducted separately with both recruited LTC residents and staff-carers who were chosen by participating residents for having the most frequent contact. In addition, family members were invited for phone interviews to provide 3rd party appraisal of the relationship between the resident and the staff-carer.

Results: Of the 6 residents recruited, 3 were males and 3 were females. Their age were between 72 and 95, and their length of stay ranged from 1-8 years (mean= 3.3 years). The 6 staff-carers interviewed were mostly nursing/personal care staff, and the only exception was a social worker. Of the 6 family members approached, 2 refused to be interviewed. Apparently, our findings seem to suggest that carer-resident relationship is positively associated with residents’ functional change. Thematic analysis revealed that a positive carer-resident relationship could 1) enhance staff-carer’s sensitivity towards residents’ physical health or emotional change; 2) increase residents’ willingness to express to the Home their personal needs and concerns; 3) promote alignment between residents’ expectations and staff-prescribed activities, and 4) provide more opportunities and encouragement for residents to join relevant programs. We believe that these factors may help to motivate residents’ participation in both social and health-promoting activities.

Conclusion: The carer-resident relationship may help to facilitate and motivate long-term care elders’ activity participation which may contribute to positive functional status change in LTC home residents. It is plausible that a care model which emphasizes interpersonal support and person-centered care, in addition to standardized physical and social care, may help to mediate the negative impact of institutional living on the maintenance of functional capacity.

References:
Chui, EWT. (2009). Elderly Commission's study on residential care services for the elderly: final report.
McCusker, J., Kakuma, R., & Abrahamowicz, M. (2002). Predictors of functional decline in hospitalized elderly patients a systematic review. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57(9), M569-M577.
Wade, D. T., & Collin, C. (1988). The Barthel ADL Index: a standard measure of physical disability?. International disability studies, 10(2), 64-67
All Author(s) ListCheuk-Yan Karin Chu, Kar C. Chan
Name of Conference2016 International Psychogeriatric Association (IPA) Asian Regional Meeting
Start Date of Conference09/12/2016
End Date of Conference11/12/2016
Place of ConferenceTaipei
Country/Region of ConferenceTaiwan
Proceedings Title2016 International Psychogeriatric Association (IPA) Asian Regional Meeting - Abstract Book
Year2016
Place of PublicationTaipei
Pages278 - 279
LanguagesEnglish-United States
KeywordsLong Term Care Home, Older Adults, Cognitive Decline, Carer-resident Relationship

Last updated on 2018-11-06 at 09:12