Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-17T00:18:01.407Z Has data issue: false hasContentIssue false
  • English
  • Français

Why do patients and their families not use services for dementia? Perspectives from a developed Asian country

Published online by Cambridge University Press:  30 May 2012

June Lim ,
Jenny Goh ,
Hui Ling Chionh  and
Philip Yap
June Lim
Affiliation:
Department of Epidemiology and Public Health, University College London, London, UK
Jenny Goh
Affiliation:
Department of Medical Social Service, Khoo Teck Puat Hospital, Singapore
Hui Ling Chionh
Affiliation:
Geriatric Centre, Khoo Teck Puat Hospital, Singapore
Philip Yap*
Affiliation:
Geriatric Centre, Khoo Teck Puat Hospital, Singapore Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
*
Correspondence should be addressed to: Dr. Yap Lin Kiat Philip, B. Soc. Sci (Hons), Senior Consultant, Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central Singapore, Singapore768826. Phone: +6565558000; Fax: +6566023767. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Despite the need for community services to support the intensive levels of care provided by dementia family caregivers, findings consistently indicate low rates of service utilization. This study aims to explore the extent of service use and examine the factors that may influence the use of services in a sample of family caregivers of Persons With Dementia (PWD).

Methods: Two hundred and seventy-two family caregivers completed a questionnaire assessing caregiver burden, knowledge and use of services, dementia severity, frequency of problem behaviors and socio-demographic characteristics.

Results: The rate of service use was modest with 39.9% using any of the available services. Reasons for non-use included lack of time (26.2%), perceived lack of need (18.5%), and presence of domestic help (21%). Separate regression models were evaluated to identify factors associated with caregiver service use and PWD service-use. Caregiver employment status (OR = 0.53, CI = 0.30–0.94) and knowledge of available services (OR = 4.22, CI = 2.23–7.98) contributed significantly to the model distinguishing caregiver service users from non-users. Knowledge of available services (OR = 2.14, CI = 1.23–3.71) was the only significant predictor of service use targeted at the PWD.

Conclusions: Given that knowledge significantly increased the odds of service use, strategies should be designed to raise awareness about the availability of dementia support services in the community and provide a deeper understanding about the value of such services. Future research should employ larger sample sizes and explore factors not measured in this study that might potentially better explain use of services.

Keywords

dementiacaregivingcarerservice useservice non-use
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 10 , October 2012 , pp. 1571 - 1580
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer's Disease Association (2010). Support Services. Singapore: Alzheimer's Disease Association.Google Scholar
American Psychiatric Association (1987). American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 3rd edn, revised, Washington, DC: APA.Google Scholar
Bass, D. M. and Noelker, , , L. S. (1987). The influence of family caregivers on elder's use of in home services: an expanded conceptual framework. Journal of Health and Social Behaviour, 28, 184–196.Google Scholar
Beaton, D. et al. (2000). Guidelines for the process of cross-cultural adaptation of self-reported measures. SPINE, 25, 3186–3191.CrossRefGoogle Scholar
Bookwala, J. et al. (2004). Concurrent and long- term predictors of older adults’ use of community-based long- term care services: the caregiver health effects study. Journal of Aging and Health, 16, 88–115.Google Scholar
Brodaty, H. et al. (2005). Why caregivers of people with dementia and memory loss don't use services. International Journal of Geriatric Psychiatry, 20, 537–546.CrossRefGoogle ScholarPubMed
Butcher, H. K., Holkup, P. A. and Buckwalter, K. C. (2001). The experience of caring for a family member with Alzheimer's disease. Western Journal of Nursing Research, 23, 33–55.Google Scholar
Chappell, N. and Blandford, , , A. (1991). Informal and formal care: exploring the complementarity. Ageing Society, 11, 299–317.Google Scholar
Collins, C. et al. (1991). Knowledge and use of community services among family caregivers of Alzheimer's disease patients. Archives of Psychiatric Nursing, 5, 84–90.Google Scholar
Dello-Buono, M. et al. (1999). Community care for patients with Alzheimer's disease and non-demented elderly people: use and satisfaction with services and unmet needs in family caregivers. International Journal of Geriatric Psychiatry, 14, 915–924.Google Scholar
Gaugler, J. et al. (2003). Respite for dementia caregivers: the effects of adult day service use on caregiving hours and care demands. International Psychogeriatrics, 15, 37–58.Google Scholar
Gaugler, J. E. et al. (2005). Early community-based service utilization and its effects on institutionalization in dementia caregiving. Gerontologist, 45, 177–186.Google Scholar
Gill, C., Hinrichsen, G. and DiGiuseppe, R. (1998). Factors associated with formal service use by family members of patients with dementia. Journal of Applied Gerontology, 17, 38–52.CrossRefGoogle Scholar
Gitlin, L. et al. (2001). A randomized controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia. Gerontologist, 41, 4–14.Google Scholar
Juva, K. et al. (1994). Staging the severity of dementia: comparison of clinical (CDR, DSM-III-R), functional (ADL, IADL) and cognitive (MMSE) scales. Acta Neurologica Scandinavica, 90, 293–298.CrossRefGoogle ScholarPubMed
Kosloski, K., Montgomery, R. and Karner, T. (1999). Differences in the perceived need for assistive services by culturally diverse caregivers of persons with dementia. Journal of Applied Gerontology, 18, 239–256.CrossRefGoogle Scholar
Kosloski, K., Montgomery, R. and Youngbauer, J. (2001). Utilization of respite services: a comparison of users, seekers, and nonseekers. Journal of Applied Gerontology, 20, 111–132.Google Scholar
Markle-Reid, M. and Browne, , , G. (2001). Explaining the use and non-use of community-based long-term care services by caregivers of persons with dementia. Journal of Evaluation in Clinical Practice, 7, 271–287.CrossRefGoogle ScholarPubMed
Mohide, E. et al. (1990). A randomized trial of family caregiver support in the home management of dementia. Journal of American Geriatric Society, 38, 446–454.CrossRefGoogle ScholarPubMed
Papastavrou, E. et al. (2007). Caring for a relative with dementia: family caregiver burden. Journal of Advanced Nursing, 58, 446–457.CrossRefGoogle ScholarPubMed
Pedlar, D. and Biegel, , , D. (1999). The impact of family caregiver attitudes on the use of community services for dementia care. Journal of Applied Gerontology, 18, 201–221.Google Scholar
Robinson, K., Buckwalter, K. and Reed, D. (2005). Predictors of use of services among dementia caregivers. Western Journal of Nursing Research, 27, 126–140.Google Scholar
Roth, D. L. et al. (2003). Psychometric analysis of the Revised Memory and Behavior Problems Checklist: factor structure of occurrence and reaction ratings. Psychology and Aging, 18, 906–915.Google Scholar
Schulz, R. et al. (2006). Predictors of complicated grief among dementia caregivers: a prospective study of bereavement. American Journal of Geriatric Psychiatry, 14, 650–658.Google Scholar
Sun, F. et al. (2007). Formal services utilization by family caregivers of persons with dementia living in rural southeastern USA. Rural Social Work and Community Practice, 12, 22–30.Google Scholar
Teri, L. et al. (1992). Assessment of behavioral problems in dementia: the Revised Memory and Behavior Problems Checklist. Psychology and Aging, 7, 622–631.Google Scholar
Toseland, R. et al. (2002). Predictors of health and human services use by persons with dementia and their family caregivers. Social Science and Medicine, 55, 1255–1266.CrossRefGoogle ScholarPubMed
Weuve, J., Boult, , Morishita, C., , L. (2000). The effects of outpatient geriatric evaluation and management on caregiver burden. Gerontologist, 40, 429–436.Google Scholar
Winslow, B. W. (2003). Family caregivers’ experiences with community services: a qualitative analysis. Public Health Nursing, 20, 341–348.Google Scholar
Yeoh, B. S. and Huang, , , S. (2010). Foreign domestic worker and home-based care for elders in Singapore. Journal of Aging and Social Policy, 22, 69–88.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist, 20, 649–655.Google Scholar