Divergent Views of Placement Decision-Making: A Qualitative Case Study

• Published in: Issues in mental health nursing Vol. 35; no. 1; pp. 13 - 20
• Main Authors: Mamier, Iris, Winslow, Betty Wehtje
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-01-2014; Taylor & Francis
• Subjects: Adult; Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - nursing; Alzheimer Disease - psychology; Caregivers - psychology; Decision Making; Disability Evaluation; Female; Grounded Theory; Homes for the Aged; Humans; Interview, Psychological; Longitudinal Studies; Male; Nursing; Nursing Homes; Patient Admission; Professional-Family Relations; Qualitative Research; Social Support; Social Work
• ISSN: 0161-2840; 1096-4673
• DOI: 10.3109/01612840.2013.834014

The purpose of this qualitative case study is to describe the contrasting perspectives between a family caregiver and the caregiver's professional provider in regards to the placement decision-making experience of the caregiver. A qualitative, descriptive, revelatory case study, using a grounded theory approach for data analysis, was conducted to identify and compare major themes drawn from interviews with the caregiver-professional dyad. The case is described on the basis of three interviews, two caregiver interviews (pre- and post-placement) and one health professional interview. The 77-year-old caregiver in this case was a wife caring for her 88-year-old husband who was diagnosed with Alzheimer's disease. The health professional was a social worker who led the support group the caregiver attended. Separate and private interviews were conducted by the principal investigator with the caregiver and health professional. Analysis revealed 11 major emerging categories that were compared from the caregiver's and professional's perspective. The perspectives of the family caregiver and the health professional had some elements that were congruent and some that were incongruent. Professionals may be unaware that they are not providing the kind of help that the situation requires. In particular, anticipatory guidance is needed before crisis events make placement immediately necessary. Further research is needed to identify what kind of conditions contribute to smoother decision-making processes and long-term care transitions for caregivers of relatives with dementia.