Respite for kin caregivers of cognitively impaired and physically impaired elders

Abstract

A qualitative grounded theory approach was used to examine factors that facilitate or inhibit the use of respite by family caregivers. Thirty caregivers (15 caring for cognitively impaired and 15 caring for physically impaired elders) were interviewed three times over a six month period. Caregivers were spouses, adult children, or siblings who lived with the recipient. An open-ended interview was conducted in the caregiver's home and addressed questions about the ease or difficulty of obtaining respite from both informal and formal sources. Responses were analyzed using constant comparative analysis. Measures of physical, social, and psychological health also were administered at each of the three interview occasions. Comparisons between the two caregiver groups were conducted.The core category for the grounded theory, Processes in Utilizing Respite, was identified as Conservation of Resources and Energy. The salient processes used by the caregivers for identifying factors that inhibited or facilitated respite were Knowing, Imposing, and Matching. Conservation of Energy and Resources was a screen used by a caregiver to judge whether a respite source was acceptable. Overall, respite was used infrequently by this sample. There were no significant differences between the two groups on the quantitative measures. Qualitative findings revealed that caregivers of cognitively impaired elders experienced difficulty in using respite in finding a match between the respite source and the recipient-either because helpers could not manage the recipient's behavior or because the recipient became agitated when situations or people were unfamiliar. Caregivers of physically impaired elders experienced difficulty in overcoming the recipient's resistance to being cared for by someone other than the caregiver. Implications of the findings for formal programs and informal sources of respite are provided and the potential usefulness of the Processes of Utilizing Respite theory for nursing and health services are discussed.