A systemic review on care giving among the aging population: Person-Centered Practice Dissertation, QMU, Singapore

Dissertation Project – MSc Person-Centred Practice

 SYNOPSIS

 Title: A systemic review on caregiving among the aging population: A person-centered care approach

 Introduction:

The region is experiencing population aging at an unprecedented pace, with the number of older persons expected to more than double, from 535 million in 2015 to about 1.3 billion by 2050 (Addressing the Challenges of Population Ageing in Asia and the Pacific: Implementation of the Madrid International Plan of Action on Ageing, 2021). Healthy aging is defined as the process of developing and maintaining the functional ability that enables wellbeing in older age(Ageing: Healthy aging and functional ability, 2021).

Decreased fertility and increased life expectancy are the factors of an aging population. Changing marriage behavior and family structures also are impacting the fertility rate and, consequently, population aging (Addressing the Challenges of Population Ageing in Asia and the Pacific: Implementation of the Madrid International Plan of Action on Ageing, 2021). Along with the global population aging phenomenon, there has been an increase in the diversity of family structures and households across the globe(Yochim and Woodhead, n.d.).

According to the reports by the Ministry of Social and Family Development(2021) providing care to an older person, especially to those experiencing limitations in their ADLs, is often an arduous activity due to the resources required and the nature of tasks involved in care provision.

Informal caregiving is defined as the act of providing unpaid assistance and support to family members or acquaintances who may have physical, psychological, or developmental needs(Yochim and Woodhead, n.d.).

Informal caregivers face several challenges while caring for their relatives with dementia and hence there is a clear demand to address their unmet needs for information, services, respite, and emotional and financial support(Vaingankar et al., 2021). However, a study found that informal social support, but not formal social support, was associated with a lower caregiver burden (PMC, 2021).

For caregivers, greater social support is associated with a higher quality of life and improved mental health. Other than informal relationships, social support could also be provided through caregivers’ formal relationships (Family caregivers of people with dementia, 2021). Insufficient and unhelpful support giving was exacerbated with the perception of family members’ limited understanding of the demands of caregiving (Basnyat and Chang, 2021).

While caregiver resources such as a positive appraisal of caregiving and social support have been recognized as moderators between stressors and caregiver burden, the impact of formal support service utilization on the relationship between stressors and burden is rarely examined (Chan et al., 2021). Using a combination of the knowledge and strategies from community development and empowerment-oriented social work has enabled the development of a range of collective programs that address food security, shelter needs, caregiving needs, healthcare needs, caregiver needs, and support, as well as the development of strategies to address policy that threatens basic needs (Inaba, 2016).

Research Aim

The aim of the survey is to explore the needs of the older adult (care recipient) aged 65 years and above who requires assistance with at least one activity of daily living and the challenges faced by their informal caregiver in relation to the person-centered concept of care. The findings of this review will provide a clear understanding to the biopsychosocial needs of an older adult (care recipient), impacts and barriers of caregiving.

The related literature reviews were analysed based on the following:

• Identify the biopsychosocial or spiritual needs of the care recipient and caregiver.
• Evaluate the impacts of caregiving.
• To relate the findings of the literature review to a person-centred care approach.
• To provide an understanding of caregiving among the ageing population using person-centred care.
• Identify needs for support and policy changes using an evidence-based person-centered care approach.

Review questions:

1. How does the ageing population impact caregiving?
2. What is the influence of person-centered care approach in providing care and support to older adults (care recipients and caregivers)?

Inclusion / exclusion criteria

The review is inclusive of studies using qualitative and/or quantitative design. These studies in all published in the English language dated from the year 2000 – 2021.

Further search on studies included terms such as “caregiver support”, “needs of older adults and “dementia” and the others were excluded.

Type of intervention

The review will focus on studies on how a rapidly aging population causes dependency in care support thus result in expanding the need for caregivers.

Outcome Measures

The outcome measures include caregiver stress, preference of care recipients, and impact of caregiving support networks.

Search Strategies

Research articles were searched extensively to obtain the best-supported literature reviews. Key terms such as “caregivers”, “informal caregiver”, “older adults”, “aged care”, “ageing”, “care recipients” will be used in the search of review articles.

The search strategy was done via a computerized database. Databases such as PubMed, Science Direct, CINAHL, EBSCO, ProQuest, and Wiley Online Books were widely used. The articles were also manually appraised using the guidelines from The Joanna Briggs Institute 2017.

The flow chart from PRISMA 2020 assisted in mapping out information such as sample size, inclusion and exclusion criteria. The findings and data collection methods will be further assessed in the reviews.