Burden and training effects in home aides caring for dementia patients

Abstract

Home care for the frail elderly is becoming a critical concern as a growing population of those requiring care is overwhelming the informal family caregiving system and placing increased demands on an inadequately prepared long-term care system. The most commonly discussed problems associated with caregiving at home include burden (the emotional strain experienced by family caregivers), little or inadequate training for paid workers, turnover, poorly understood motivational and reward factors involved in the work, and quality of care. This study explored feelings of burden (job strain) among paid home care workers and whether a structured training program reduced this burden and enhanced job satisfaction. The program involved didactic and experiential training about the behavior and management of patients with dementia, along with ongoing emotional support. Two similar groups of trainees were compared, one (N = 30) before their training began, the other (N = 31) after their training was completed. The study found that, overall, home care workers did not report much burden, perhaps indicating that burden may not be the appropriate concept to study in paid caregiving. Older workers (48 yrs.+) reported less burden than younger ones, and level of emotional involvement with the patient was inversely related to burden. Comparing the two groups, those with training reported less burden and greater intrinsic job satisfaction than those without training, suggesting that training could reduce burden and increase job satisfaction. Additionally, indications for a career path with skills training to retain motivated workers and establish reliable paid care to assist overwhelmed family caregivers were discussed.