Skip to main content
×
Home
    • Aa
    • Aa

Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives

  • GAYATHRI NAGANATHAN (a1), KERRY KULUSKI (a1) (a2), ASHLINDER GILL (a1), LIISA JAAKKIMAINEN (a3) (a4) (a5), ROSS UPSHUR (a2) (a3) (a5) (a6) and WALTER P. WODCHIS (a1) (a5) (a7)...
Abstract
ABSTRACT

This study investigated the perceived value of informal and formal supports for older adults with multi-morbidity from the perspectives of patients, care-givers and family physicians. Semi-structured interviews were conducted with 27 patients, their informal care-givers and their family physicians in an urban academic family health team in Ontario. Analysis was conducted using a General Inductive Approach to facilitate identification of main themes and build a framework of perceived value of supports. Participant views converged on supports that facilitate patient independence and ease care-giver burden. However, important differences in participant perceptions arose regarding these priorities. Physicians and care-givers valued supports that facilitate health and safety while patients prioritised supports that enable self-efficacy and independence. While formal supports which eased care-giver burden were viewed positively by all members of the triad, many patients also rejected formal supports, citing that informal support from their care-giver was available. Such conflicts between patient, care-giver and physician-perceived value of supports may have important implications for consumer and care-giver willingness to accept formal supports when supports are available. These findings contribute to the broader literature on community-based care by incorporating the perspectives of patients, informal care-givers and family physicians to understand better the barriers and facilitators of uptake of supportive services that contribute to successful ageing at home.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Perceived value of support for older adults coping with multi-morbidity: patient, informal care-giver and family physician perspectives
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Address for correspondence: Gayathri Naganathan, Institute of Health Policy, Management & Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON, Canada, M5T 3M6 E-mail: gayathri.naganathan@mail.utoronto.ca
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J. Alwin , B. Oberg and B. Krevers 2010. Support/services among family caregivers of persons with dementia – perceived importance and services received. International Journal of Geriatric Psychiatry, 25, 3, 240–8.

J. Aronson 2004. ‘You need them to know your ways’: service users’ views about valued dimensions of home care. Home Health Care Services Quarterly, 22, 4, 8598.

K. Byrne , K. Frazee , J. Sims-Gould and A. Martin-Matthews 2012. Valuing the older person in the context of delivery and receipt of home support: client perspectives. Journal of Applied Gerontology, 31, 3, 377401.

G. Elwyn , D. Frosch , R. Thomson , N. Joseph-Williams , A. Lloyd , P. Kinnersley , E. Cording , D. Tomson , C. Dodd , S. Rollnick , A. Edwards and M. Barry 2012. Shared decision making: a model for clinical practice. Journal of General Internal Medicine, 27, 10, 1361–7.

R. M. Epstein and E. Peters 2009. Beyond information: exploring patients’ preferences. JAMA: The Journal of the American Medical Association, 302, 2, 195–7.

L. Etters , D. Goodall and B. E. Harrison 2008. Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners, 20, 8, 423–8.

M. Fortin , G. Bravo , C. Hudon , A. Vanasse and L. Lapointe 2005. Prevalence of multimorbidity among adults seen in family practice. Annals of Family Medicine, 3, 3, 223–8.

L. G. Glynn , J. M. Valderas , P. Healy , E. Burke , J. Newell , P. Gillespie and A. W. Murphy 2011. The prevalence of multimorbidity in primary care and its effect on health care utilization and cost. Family Practice, 28, 5, 516–23.

J. Green and N. Thorogood 2009. Qualitative Methods for Health Research. Second edition, Sage, Thousand Oaks, California.

N. Haapanen , S. Miilunpalo , M. Pasanen , P. Oja and I. Vuori 1997. Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. American Journal of Epidemiology, 145, 8, 762–9.

H.-H. König , H. Leicht , H. Bickel , A. Fuchs , J. Gensichen , W. Maier , K. Mergenthal , S. Riedel-Heller , I. Schäfer , G. Schön , S. Weyerer , B. Wiese , H. van den Bussche , M. Scherer and M. Eckardt 2013. Effects of multiple chronic conditions on health care costs: an analysis based on an advanced tree-based regression model. BMC Health Services Research, 13, 219, 113.

D. M. W. Kriegsman , B. W. J. H. Penninx , J. T. M. van Eijk , A. J. P. Boeke and D. J. H. Deeg 1996. Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly: a study on the accuracy of patients’ self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology, 49, 12, 1407–17.

K. Kuluski , C. Bensimon , C. Alvaro , A. Schaink , R. Lyons and R. Tobias 2014. Life interrupted: a qualitative exploration of the impact of complex chronic disease on the daily lives of patients receiving complex continuing care. Illness, Crisis & Loss, 22, 2, 127–44.

K. Kuluski , A. Gill , G. Naganathan , R. Upshur , R. L. Jaakkimainen and W. P. Wodchis 2013 a. A qualitative descriptive study on the alignment of care goals between older persons with multi-morbidities, their family physicians and informal caregivers. BMC Family Practice, 14, 133, 110.

K. Kuluski , S. N. Hoang , A. K. Schaink , C. Alvaro , R. F. Lyons , R. Tobias and C. M. Bensimon 2013 b. The care delivery experience of hospitalized patients with complex chronic disease. Health Expectations 16, 4, e111–23.

K. H. Kwag , P. Martin , D. Russell , W. Franke and M. Kohut 2011. The impact of perceived stress, social support, and home-based physical activity on mental health among older adults. International Journal of Aging and Human Development, 72, 2, 137–54.

B. M. Kwan , S. Dimidjian and S. L. Rizvi 2010. Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression. Behaviour Research and Therapy, 48, 8, 799804.

T. Lehnert , D. Heider , H. Leicht , S. Heinrich , S. Corrieri , M. Luppa , S. Riedel-Heller and H.-H. König 2011. Review: health care utilization and costs of elderly persons with multiple chronic conditions. Medical Care Research and Review, 68, 4, 387420.

M. B. Lilly , C. Robinson , S. Holtzman and J. L. Bottorff 2012. Can we move beyond burden and burnout to support the health and wellness of family caregivers to persons with dementia? Evidence from British Columbia, Canada. Health & Social Care in the Community, 20, 1, 103–12.

R. P. Lopez , K. M. Mazor , S. L. Mitchell and J. L. Givens 2013. What is family-centered care for nursing home residents with advanced dementia? American Journal of Alzheimer's Disease and Other Dementias, 28, 8, 763–68.

H. Maier and P. L. Klumb 2005. Social participation and survival at older ages: is the effect driven by activity content or context? European Journal of Ageing, 2, 1, 31–9.

A. Martin-Matthews and J. Sims-Gould 2008. Employers, home support workers and elderly clients: identifying key issues in delivery and receipt of home support. Healthcare Quarterly, 11, 4, 6975.

A. H. Maslow 1943. A theory of human motivation. Psychological Review, 50, 4, 370–96.

K. Mercer 2008. Facilitating organizational mergers: amalgamation of community care access centres. Journal of Health Services Research & Policy, 13, supplement 1, 4651.

A. G. Money , J. Barnett , J. Kuljis and J. Lucas 2013. Patient perceptions of epinephrine auto-injectors: exploring barriers to use. Scandinavian Journal of Caring Sciences, 27, 2, 335–44.

Y. Okura , L. H. Urban , D. W. Mahoney , S. J. Jacobsen and R. J. Rodeheffer 2004. Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. Journal of Clinical Epidemiology, 57, 10, 1096–103.

H. Qian , G.-b. Li , H.-x. Chen and D.-l Zhang . 2011. An exploratory research of patient perceived value in China. Journal of Medical Marketing: Device, Diagnostic and Pharmaceutical Marketing, 11, 4, 277–83.

A. Rizza , V. Kaplan , O. Senn , T. Rosemann , H. Bhend and R. Tandjung 2012. Age- and gender-related prevalence of multimorbidity in primary care: the Swiss FIRE project. BMC Family Practice, 13, 113, 19.

G. Shier , M. Ginsburg , J. Howell , P. Volland and R. Golden 2013. Strong social support services, such as transportation and help for caregivers, can lead to lower health care use and costs. Health Affairs (Project Hope), 32, 3, 544–51.

J. Sims-Gould and A. Martin-Matthews 2010. We share the care: family caregivers’ experiences of their older relative receiving home support services. Health & Social Care in the Community, 18, 4, 415–23.

A. Surbone , L. Baider and M. Kagawa-Singer 2010. Cultural competence in the practice of patient–family-centered geriatric oncology. Journal of Geriatric Oncology, 1, 2, 45–7.

D. R. Thomas 2006. A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27, 2, 237–46.

J. Tomaka , S. Thompson and R. Palacios 2006. The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of Aging and Health, 18, 3, 359–84.

B. W. Ward and J. S. Schiller 2013. Prevalence of multiple chronic conditions among US adults: estimates from the National Health Interview Survey, 2010. Preventing Chronic Disease, 10, E65.

L. M. Warner , J. P. Ziegelmann , B. Schüz , S. Wurm , C. Tesch-Römer and R. Schwarzer 2011. Maintaining autonomy despite multimorbidity: self-efficacy and the two faces of social support. European Journal of Ageing, 8, 1, 312.

C. Watsford and D. Rickwood 2014. Young people's expectations, preferences, and experiences of therapy: effects on clinical outcome, service use, and help-seeking intentions. Clinical Psychologist, 18, 1, 4351.

A. P. Williams , J. M. Lum , R. Deber , R. Montgomery , K. Kuluski , A. Peckham , J. Watkins , A. Williams , A. Ying and L. Zhu 2009 b. Aging at home: integrating community-based care for older persons. Healthcare Papers, 10, 1, 821.

D. Yach , C. Hawkes , C. L. Gould and K. J. Hofman 2004. The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA: The Journal of the American Medical Association, 291, 21, 2616–22.

S. Zhu , J. Hu and J. T. Efird 2012. Role of social support in cognitive function among elders. Journal of Clinical Nursing, 21, 15/16, 2118–25.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Ageing & Society
  • ISSN: 0144-686X
  • EISSN: 1469-1779
  • URL: /core/journals/ageing-and-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 31
Total number of PDF views: 266 *
Loading metrics...

Abstract views

Total abstract views: 389 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 29th June 2017. This data will be updated every 24 hours.