Opting out of own homes for residential care homes: Decision-making experiences of family members of older adults with moderate dementia

Abstract

Statement of the Problem: Residential care home services play an important role in supporting Chinese older adults with dementia and their family members. However, it is still the intention of the Hong Kong Government to promote ageing in place so that older people can remain in their own homes and supported by community care services for as long as possible. Indeed, there is a dearth of knowledge about the decision-making experiences of family members particularly at what point they reconsider their own roles and responsibilities of caring for their community-dwelling older relatives with moderate dementia and consider residential care homes instead.

Methodology: As part of a main grounded theory study that explores decision-making experiences of family members caring for older people with dementia, this paper presents the data of around 50 family caregivers who described their decision-making experiences of caring for their older relatives with moderate dementia at home and in residential care homes. Purposive sampling was used to recruit the immediate family caregivers who provided physical and psychosocial care. They were matched against their older relatives who were diagnosed with dementia, had an MMSE score of 11 to 20, or an AMT score of < 7. Interviews lasted 40-45 minute, and data were content-analyzed.

Results: In-depth experiences of family caregivers who underwent a range of memorable circumstances and incidents of caring for their older relatives with moderate dementia at home that catalyzed the affirmative decision to move them into four residential care homes in Hong Kong will be described. Once the older persons became residents, family members were asked about the decisionmaking experiences they were now engaged in so that a comparison could be made about their changing roles and responsibilities before entry and after entry into residential care homes.

Conclusion: Findings can provide an understanding of the preliminary processes that family members went through as they begun taking care of the older family member with dementia at home. For various changing circumstances and incidents that have been described, the process of how family members then considered opting out of caring in their own homes for residential care homes can be delineated. The need to further support family caregivers of older relatives with dementia is highlighted.