Indiana University-Purdue University Indianapolis (IUPUI) / As healthcare increasingly shifts to home and community-based settings, informal
caregiver responsibilities are increasing beyond assistance with activities of daily living
to include complex care procedures previously performed by licensed caregivers in
clinical settings. With an aging population, increasing numbers of older adults are
assuming a caregiving role, a trend that is projected to continue into the foreseeable
future. These older caregivers performing complex care procedures such as wound care.
The purpose of this dissertation study was to understand how older adult caregivers
manage complex wound care procedures. Aims were to 1) develop a theory for how
caregivers manage; 2) identify themes related to resources needed, and 3) determine
resources available through the existing Medicaid 1915(c) waivers program. Aims 1 and
2 were achieved using qualitative analysis of interviews with 18 older adult caregivers
aged 65 and older who were performing wound care in the home for a care recipient.
Grounded theory methods were used to develop a theoretical framework describing the
process of how the participants managed caregiving. The resultant theory, Pushing
Through, consisted of five phases: 1) accepting the role, 2) lacking confidence, 3)
creating a system, 4) trusting in self, 5) owning the outcomes. Secondary analysis of the
interview data used thematic analysis methods to identify resources used or needed for
the caregiver role. The resultant themes were (a) connection to a healthcare professional,
(b) written instructions, (c) access to wound care supplies, (d) access to durable medical equipment, (e) financial resources, (f) personal care coverage, and (g) socialization and
emotional support. Aim 3 used descriptive analysis of Medicaid 1915(c) home- and
community-based services waivers for adults aged 65 and older for all 50 states plus the
District of Columbia to identify the frequency and type of waiver services available for
supporting caregivers. Results revealed that the number of services offered by state
Medicaid waiver programs varied greatly across the country. Respite in varying forms
was the most frequently available service. Findings from this dissertation will contribute
to the development of evidence-based strategies to sustain older adult caregivers within
their caregiving role.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/30483 |
| Date | 10 1900 |
| Creators | Swartzell, Kristen Leigh |
| Contributors | Fulton, Janet S., von Gaudecker, Jane R., Bartlett Ellis, Rebecca J., Huber, Lesa |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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