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Deciding on Institutionalization for a Relative with Dementia: The Most Difficult Decision for Caregivers*

  • Chantal D. Caron (a1), Francine Ducharme (a2) and Jennifer Griffith (a1)

Abstract

The decision to move a family member with dementia to a nursing home is a difficult experience for caregivers. Complex psychosocial factors are involved and knowledge of predictive factors alone is insufficient. Using grounded theory, this study explores the decision-making process with regards to institutionalization, from the perspective of family caregivers. Fourteen people who moved a relative to long-term care in the preceding 6 months were interviewed. Data analysis using comparative analysis and line-by-line dimensional analysis was used to develop a theoretical model of the decision-making process. Three factors within the model were central to the process: (a) caregivers' perceptions of their ability to provide care, (b) caregivers' evaluations of their relatives' ability to make care decisions, and (c) the evolving influence of contextual factors and interactions with healthcare professionals. The contribution of these findings to new conceptualizations of institutionalization is discussed.

La décision d'institutionnaliser un proche âgé atteint de démence, est décrite comme étant la plus difficile à prendredans l'expérience des aidants familiaux (AF). Plusieurs facteurs psychosociaux sont impliqués dans le processusdécisionnel et la connaissance des facteurs prédictifs au placement n'est pas suffisante. Cette étude qualitative(théorisation ancrée) a permis l'émergence d'un modèle théorique axé sur l'expérience des AF impliqués dansle processus décisionnel. Des entrevues en profondeur ont été réalisées auprès de quatorze AF qui avaientinstitutionnalisé un proche âgé dans les derniers six mois. L'analyse comparative et dimensionnelle des données a étéutilisée pour développer un modèle théorique du processus décisionnel. Trois facteurs du modèle se sont révéléscentraux au processus décisionnel : (a) la perception des AF en regard de leur capacité à prendre soin de leur procheâgé ; (b) l'évaluation que les AF font de la capacité de leur proche âgé à prendre des décisions qui les concernent ;(c) l'influence des facteurs contextuels et des interactions avec les intervenants professionnels sur ce processuscomplexe. L'impact de ces résultats sur la conceptualisation du processus décisionnel lié à l'institutionnalisation d'unproche atteint de démence est discuté.

Copyright

Corresponding author

Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Chantal Caron, RN, Ph.D, Research Centre on Aging, 1036, rue Belvédère Sud, Sherbrooke, QC J1H 4C4. (Chantal.Caron@USherbrooke.ca)

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*

This research was funded in part by the Canadian Institutes of Health Research.

Footnotes

References

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