“I Am the Home Care Agency”: The Dementia Family Caregiver Experience Managing Paid Care in the Home

Jennifer M. Reckrey, Deborah Watman, Emma K. Tsui, Emily Franzosa, Sasha Perez, Chanee D. Fabius and Katherine A. Ornstein
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Jennifer M. Reckrey: Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1216, New York, NY 10029, USA
Deborah Watman: Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1070, New York, NY 10029, USA
Emma K. Tsui: Department of Community Health & Social Sciences, CUNY Graduate School of Public Health and Policy, 55 W. 55th St., New York, NY 10027, USA
Emily Franzosa: Geriatrics Research, Education, and Clinical Center, James J Peters Veterans Affairs Medical Center, 130 W. Kingsbridge Road, Bronx, NY 10468, USA
Sasha Perez: Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1070, New York, NY 10029, USA
Chanee D. Fabius: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
Katherine A. Ornstein: Department of Geriatrics and Palliative Medicine, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1070, New York, NY 10029, USA

IJERPH, 2022, vol. 19, issue 3, 1-11

Abstract: As the locus of long-term care in the United States shifts from institutions to the community, paid caregivers (i.e., home health aides, personal care attendants) are providing more hands-on care to persons with dementia living at home. Yet, little is known about how family caregivers engage with paid caregivers. We conducted in-depth, semi-structured interviews ( n = 15) with family caregivers, of persons living at home with severe dementia, and enriched our findings with data from a second cohort of family caregivers of persons with dementia ( n = 9). Whether paid caregivers were hired privately or employed via a Medicaid-funded agency, family caregivers reported that they needed to manage paid caregivers in the home. Core management tasks were day-to-day monitoring and relationship building with family caregivers; training paid caregivers and coordinating care with homecare agencies was also described. In order to support family caregivers of individuals with dementia at home, it is important consider their preferences and skills in order to effectively manage paid caregivers. Support of efforts to build a high-quality paid caregiving workforce has the potential to improve not only care delivered to persons with dementia, but the experiences of their family caregivers.

Keywords: family caregiving; paid caregiving; home care workers; caregiver burden; home and community-based services (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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