| Literature DB >> 32057081 |
Theresa A Harvath1, Jennifer M Mongoven1, Julie T Bidwell1, Fawn A Cothran1, Kathryn E Sexson1, Diana J Mason2, Kathleen Buckwalter3.
Abstract
The number of older adults living with functional decline and serious illness is growing exponentially at a time when availability of both family and professional caregivers is strained. Achieving optimal outcomes for this vulnerable population involves advancing the knowledge needed to improve the quality of care delivered by families, health professionals, and community programs. Recent reports from National Institute of Health and the National Academy of Science, Engineering and Medicine have called for the identification of gaps in key areas of family caregiving intervention research. In March 2018, the Family Caregiving Institute at UC Davis convened an invitational meeting of over 50 thought leaders in family caregiving-representing service agencies, funding organizations, and academia-to participate in the Research Priorities in Caregiving Summit: Advancing Family-Centered Care across the Trajectory of Serious Illness. Using an iterative process, attendees identified the top 10 research priorities and created research priority statements that incorporated a definition of the priority topic, rationale for the priority; problem(s) to address; priority population(s); and example research topics. The research priority statements serve as a roadmap for research development that will address the most significant gaps in the caregiving field.Entities:
Keywords: Caregiving-informal; Consensus; Diversity and ethnicity; Heterogeneity; Technology
Mesh:
Year: 2020 PMID: 32057081 PMCID: PMC7019660 DOI: 10.1093/geront/gnz138
Source DB: PubMed Journal: Gerontologist ISSN: 0016-9013
National Reports and Summits on Family Caregiving: Identified Priority Research Topics
| Year | National report/summit | Diversity | Heterogeneity | Trajectory | Technology |
|---|---|---|---|---|---|
| 2016 |
| X | X | X | X |
| 2016 |
| X | X | ||
| 2017 |
| X | X | X | |
| 2017 |
| X | X | X | X |
Note: aRecommendation 1-g: Launch a multiagency research program sufficiently robust to evaluate caregiver interventions in real-world health care and community settings, across diverse conditions and populations, and with respect to a broad array of outcomes” (Schulz & Eden, 2016, p. 269).
Briefing Paper Topics Used as Springboards to a List of Research Priorities
|
|
|
|
|
|
|
|
| Each briefing paper was in white paper form at the time of the summit. The paper on multicultural caregiving was adapted from |
Figure 1.Consensus process.
Research Priorities, Descriptions, and Sample Research Questions
| Research Priorities | Descriptions | Sample Research Questions |
|---|---|---|
|
| Design technology-enabled interventions that facilitate choice and shared decision-making and examine the effects of these interventions on care recipients, family caregivers, and members of the healthcare team. | • What is the impact of choice and shared decision-making on caregivers’ well-being and on their ability to provide care to a loved one? • What type of access to information and specific capabilities can technology offer caregivers in order to facilitate shared decision-making? Does the impact of technology and access to information on shared decision-making vary according to geographic area (rural vs. urban) and socioeconomic status? |
|
| Technology can support family caregiver interventions, but needs to be adaptable to the dynamic and changing needs of caregivers over time. Two areas offer opportunities for exploration: (1) adaptable technology platforms that translate generalizable solutions to tailored interventions; and (2) algorithms that match technologies with caregiving needs across time. | • How can everyday technologies such as smart phones, security devices, environmental control units, and smart speakers be deployed to support family caregivers? • What safeguards or additional features might be necessary as these technologies are adapted? |
|
| Research is needed to address the diversity and heterogeneity of family caregiving according to the care recipient’s illness and the severity of his or her condition; culture; religion; gender; race/ethnicity; sexual orientation; family composition; setting; and socio-economic status. Such research should involve families in the design, consider optimal timing for interventions, and reflect caregivers’ strengths, vulnerabilities, and preferences. | • How do the preferences and needs of diverse families and family caregivers impact the efficacy of interventions across the caregiving trajectory? • How do changes in care recipients and their families interact to affect the physical and emotional well-being of all family members, across diverse populations? |
|
| Research must focus on strategies to identify, assess, and support the unique and varied needs of families who provide care, and assess the subjective experiences of caregivers, including their attitudes, values, preferences, feelings, and expectations. | • What cross-culturally valid, comprehensive assessment tools and methods can be developed, tested, and implemented to elicit caregivers’ subjective experiences, including their willingness to assume the role of caregiver, their attitudes toward different aspects of the role (for example, personal care versus emotional support), their values and preferences regarding goals and shared decision-making, and their needs for services, training, and support? • What best practices for assessment of caregivers along the caregiving trajectory can be developed, tested, and implemented? What is the best timing and frequency of assessment of caregivers’ attitudes, willingness, and readiness for the role? |
|
| Research is urgently needed to accelerate conversion of promising caregiving interventions to practice; to adapt such interventions to meet the needs of diverse communities; and to ensure future scalability and sustainability. | • What are the desired outcomes for family caregiver interventions at individual, family, health system, and community levels? • What domains (e.g., jobs/wages, family functioning, ethical considerations, role choice, or task complexity) should be included in outcome assessments? • What is the business case for promising caregiver interventions? |
|
| There is a need for a comprehensive family caregiving framework or typology that reflects: developmental phases; contextual factors; the dynamic, reciprocal and interdependent nature of the family caregiver-care receiver interface and interactions; and the complexities at various timeframes along the trajectory. | • What domains and factors comprise the conceptual framework and typology of the caregiving trajectory? • How can a conceptual framework and typology of the caregiving trajectory be used to inform and guide development of new interventions? |
|
| The changing needs of caregivers over time call for the right interventions provided at the right time along the caregiving trajectory. | • What are the internal/external factors that influence the family caregiver beyond direct caregiving? • What are the health, economic, and social variables associated with increased risk to family caregiving situations over time? |
|
| As the older adult population becomes more ethnically and culturally diverse, there is an acute need to examine existing intervention models and their suitability and effectiveness for diverse populations. This calls for theoretically-driven research that accounts for community- and individual-level variables, and identifies if, how, and for whom interventions should be adapted, and in what situations new interventions must be developed? | • What formative research methods are most effective in deciding when an evidence-based intervention can be adapted for a specific population and when a new approach needs to be developed? • What are the optimal strategies for identifying the adaptations to interventions necessary for diverse populations? |
|
| This priority calls for foundational research to develop new measures and methodological studies designed to evaluate existing measures for diverse populations and adapt them as needed. | • How do we know that a potential intervention worked from the perspective of caregivers from diverse backgrounds? • What constitutes a meaningful outcome from the perspective of diverse caregivers? |
|
| Research must account for differences in how individuals providing care to an older adult define “family” and for situations where more than one person is providing care. | • How do the divergent configurations of families affect outcomes? How do these caregivers communicate healthcare information to each other? • What interventions would help educate healthcare providers about culturally-based definitions of family, and how would clinicians’ grasp of these definitions affect outcomes for both care recipients and caregivers? |