RESUMEN
Background: Spanish-speaking family caregivers of persons living with dementia (PLD) have limited resources in Spanish to aid in psychological coping with caregiver burden. They often have difficulty attending in-person training due to barriers such as transportation costs, identifying substitute care, and ongoing COVID-19 pandemic containment measures. There are few studies identifying Spanish language caregiver unique needs and preferences regarding desired caregiving skills and stress-reduction interventions. In this study, we sought to identify the unmet needs of Spanish-speaking family caregivers of PLD in the greater Boston area, as well as their preferences for virtual intervention frequency and duration. Method(s): We conducted two virtual focus groups with twelve Spanish language family caregivers of PLD (ages 37 to 87 years) recruited from the greater Boston area. Participants were asked semi-structured questions regarding their unmet needs for caregiver skills training and stress reduction. We employed an inductive and deductive driven mixed method analytic approach. A taxonomy was created to organize results based on participant responses. Result(s): Three major thematic clusters emerged. First, caregivers noted a desire to develop skills for managing stress, emotional reactivity, frustration, and grief. Second, there was an expressed need for education regarding disease-specific knowledge such as stages of dementia, common manifestations, management of challenging symptoms and communication strategies with the PLD;how to navigate the health care system;and finding additional resources for care in the community. Third, there was an interest in learning about interventions for the PLD, such as specific activities to help keep them engaged and active. A particular interest was expressed in any interventions that might slow disease progression. Regarding frequency and duration for virtual intervention, caregivers most commonly preferred weekly sessions for 6-10 weeks. Conclusion(s): Unmet needs of Spanish language family caregivers of PLD in the greater Boston area include education regarding disease-specific symptoms and their management, and resources to enhance well-being both in the caregiver and the PLD. Based on these results, we will develop a comprehensive virtual therapeutic intervention incorporating stress reduction techniques to facilitate emotion regulation, caregiver skills training, psychoeducation regarding dementia and caregiver resources, and healthful activities for the PLD. Copyright © 2022 the Alzheimer's Association.
RESUMEN
Background: Quality improvement project undertaken by the Ageing and Complex Medicine team to improve the quality and quantity of communication with patients' relatives. Introduction: Visitation restrictions at RAEI since the onset of the COVID pandemic have created barriers to effective communication between patients' relatives and the medical team. Patients' relatives were frequently receiving poorly structured information, incorrect information, or even no information. This problem was hospital wide and likely to have affected other trusts. It particularly affected elderly care wards, where the cohort of patients were often less able provide their relatives with updates themselves. We therefore agreed a service standard whereby the medical team would provide a medical update via phone to the patients' next of kin within 24 hours of admission followed by twice weekly updates by any member of the wider MDT. Our aim was to improve the quality and quantity of communication with the patients' relatives. Method: So far 6 data capture cycles have seen us implement change in various ways such as utilisation of a white board to highlight when updates are due, a staff feedback survey to highlight barriers to providing the service and a relative feedback survey to evaluate their experience. Results: Compared to baseline data we have seen an improvement in the quantity of relative updates with most cycles. Conclusion: We have improved the quantity of relative updates and embedded it as established culture on Astley ward. Barriers to success include staffing levels, time burden, and low confidence levels amongst junior doctors. Cycle 7 will see implementation of a teaching session for new junior doctor cohorts to improve their confidence. I would like to share our learning and success with the wider hospital and see implementation of the service standard across all wards within the trust.