Caregiving during the Time of COVID ‐19: A Multi‐State Qualitative Study of Family Caregiver Experiences and Decision‐Making

作者：Tonie Sadler, Kevin Yan, Harold A. Pollack, Daniel J. Brauner, R. Tamara Konetzka · 发表于：Health Services Research · 年份：2021 · DOI：10.1111/1475-6773.13732 · 被引用次数：12 · 研究领域：Geriatric Care and Nursing Homes、Family and Patient Care in Intensive Care Units、Intergenerational Family Dynamics and Caregiving

Research Objective COVID‐19 poses unique challenges to family caregivers. This study explores how family caregivers for older adults with cognitive impairments experience and make decisions about caregiving during a global pandemic. Study Design Using purposive sampling, family caregivers participated in open‐ended qualitive interviews (2019–2020), until thematic saturation was reached. Questions broadly examined caregivers' experiences and decisions, focusing on decisions made around type of care setting. Questions about responses to the Pandemic were added as events unfolded. States were selected to represent variation in Home and Community Based Service (HCBS) expenditures as a percentage of total Medicaid long‐term services and support expenditures. They include; Arkansas, Florida, Illinois, Minnesota, New York, North Carolina, and Oregon. All participants were actively involved in the care of someone with dementia or another cognitive impairment over the age of 60. Population Studied 63 family caregivers were interviewed across eight states. About 89% of participants were female, 78% white, 10% black, 5% Asian, 3% biracial, 2% Native American. 36% of respondents reported that those they care for receive Medicaid. Principal Findings This analysis focused on several COVID‐related caregiver decisions: changes in care, challenges with care utilization and access, and policies or changes in care that were helpful during the pandemic were of focus. Four key themes emerged. Fir...