Given the stress involved in caring for elders, the propensity for abuse among the older adult population continues to be a problem, as the number of caregivers providing care in the home is increasing to meet the demand of an increasing population of older adults. One solution is to implement video surveillance in the home. The purpose of this phenomenological, retrospective and prospective study was to describe the perceptions and experiences of caregivers that affect stress in the home care setting and to describe participants' perceptions about the impact of video surveillance in the home environment on caregiver stress and elder abuse. Using a lens of critical ecological framework and privacy theory, the research questions inquired about the specific experiences of stress and the perceptions of the use of home surveillance of caregivers in the home. A sample of 9 older adult home caregivers were recruited from the United Jewish Council of the East Side Home Attendant Service Corp. Findings revealed that increased family, community, and agency involvement and support may offset the feelings of isolation of the home care environment and ensure the caregiver is given opportunities to engage in strategies designed to help cope with the inherent stressors of the job. In addition, video camera surveillance in the home care setting may provide social support through observation of the situation in the home, supporting both social control on the behavior of the caregiver and direct evidence of quality of care for the caregiver. The findings of the study help to highlight effective intervention strategies based on the specific stressors and stress relievers identified, serving to reduce the potential for older adult abuse and neglect in the home care setting.

Improvements in technology have allowed people with tracheostomies to live at home on mechanical ventilation (HMV). Quality of life (QOL) for HMV users has been studied quantitatively, but few qualitative studies have been published. The purpose of this phenomenological study was to explore QOL for individuals with tracheostomies on prolonged HMV focusing on activities of daily living (ADLs) and the role of decision- making. The Roper, Logan, and Tierney activities of living theory were used to categorize activities. Ten participants, 18 years and older, with a tracheostomy and on HMV for at least 6 months were enrolled using purposive sampling. Data were collected through structured, in-depth, face-to-face interviews. Themes that emerged were (a) autonomy, (b) significance of ventilator for well-being, (c) feeling tied up, (d) creating meaning, (e) tipping point, (f) reminiscence, (g) building trust and confidence, (h) adjusting to technology, (i) family support and relationships, and (g) meaning of life. The participants were relatively healthy and their QOL was improved when they were on HMV compared to the hospital. The participants felt empowered that they had control in their daily lives at home when they had competent caregivers and family members for continuity of care. Recommendations for future research would include exploring improved methods of collaboration among health care workers and families in providing holistic care and reducing role strain and isolation in young HMV users. The study may promote positive social change through education for family, health care workers, and the public about strategies to promote independence and subsequent improvement in QOL for individuals on HMV.