HOME CARE FOR ELDERLY AND HOMEBOUND: PROPOSAL FOR A TRAINING MODULE FOR INFORMAL CAREGIVERS

Abstract

Introduction: As people grow older, they become at risk for chronic diseases and illnesses if they already do not suffer from one; thus, their health needs increase and require access to health services to fulfill those needs and get treatment. Unfortunately, not all elderlies and homebound have access to health services, especially in Lebanon. This is due to the economic situation that results in decreasing access to healthcare for the elderlies who are jobless and have unemployed children. As a result, they become the most vulnerable and lose all sources of support. In addition, the absence of primary health care centers in some areas play a major role in the accessibility of health services for the elderlies. Purpose: The purpose of the project is to propose a training program that provides home care services for elderly and homebound by their own primary caregivers through assessment, education, and training. Methods: Three articles out of 35 were chosen from PubMed, CINHAL, and google scholar databases based on the following inclusion and exclusion criteria. The inclusion criteria included articles focusing on key areas that need to be included in the training of informal caregivers for home care of elderlies, whereas the exclusion criteria included key areas for training informal caregivers of non-elderly population. Five articles out of 27 were chosen from CINHAL and PubMed concerning the functional, cognitive, and environmental tools that are used in the assessment of elderlies based on the following inclusion and exclusion criteria. The inclusion criteria included articles that focused on recent assessment tools used in home care to assess the physical, cognitive, and environmental conditions of elderlies including the validation of each in Arabic. The exclusion criteria included assessment tools used for non-elderly population, not easily used in home care, and not validated in Arabic. In addition, from google scholar database one article out of 10 was selected based on the following inclusion and exclusion criteria. The inclusion criteria mainly focused on articles that developed an actual training program for informal caregivers for elderlies in home care, specified the basis of such program, and was proven effective and beneficial after its evaluation. The exclusion criteria included training programs that were not mainly specific to the informal caregivers for elderlies, were not detailed and proven effective. Results: A training module for informal caregivers was proposed. It includes 12 sessions given over a duration of 12 days, which tackles the basics of home care services that can be provided and the assessment tools that can be used. This training module mainly targets informal caregivers including family members, relatives, or neighbors. Discussion: The training programs for the informal caregivers have effects on both the elderlies and the caregivers. It improves the quality of lives of the elderlies by allowing them to receive their care at home. Moreover, for the caregivers it improves their confidence in providing care, increases their satisfaction in the caregiving role, and decreases the depression and the burden they feel. However, challenges may be faced when implementing such programs. For example, some caregivers will not take the training seriously and may not abide by the materials given and some will not participate since they think they already know the material. More research is recommended about the factors that can affect their participation and develop a program to work on improving those factors. Conclusion: In Lebanon, the majority of the population in the community are the elderlies. This population is more susceptible to chronic illnesses that require frequent visitation to health care center, which is sometimes hard because of the lack of financial capability, and accessibility to health care. That is why sometimes family caregivers or informal caregivers (like neighbors) provide the care needed to elderlies without having the necessary knowledge and skills. Therefore, a training program with educational sessions about the basics of home care is proposed to train and educate the caregivers and improve their caring abilities. As a result, the elderly will receive a good quality of care that will positively affect their quality of life, and the caregivers will gain more confidence in their skills, which will decrease their stress, anxiety, and the feeling of burden.