Factors associated with the non-use of respite services by cognitively impaired older adults and their informal caregivers

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Labun, Nina M.
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The predominance of cognitive impairment among older adults coupled with a shift toward reliance on informal caregiving has increased interest in determining factors associated with the use of community-based service. The challenges of providing care to older adults with cognitive impairment are particularly demanding. It is unclear however, that cognitive impairment results in an increased need for services. Rather it appears that informal caregivers are reluctant to use services. In particular, respite services are the most frequently requested yet consistently under-utilized service. Few studies have explored caregivers' apparent reluctance to use respite services. This study of respite service on-use was a secondary analysis of data from the Manitoba Study of Health and Aging (MSHA-2) conducted in 1996-97. This study used a sub-sample of 132 community-dwelling older adults with cognitive impairment and their informal caregivers. The Stress Process Model was used as an organizing framework to understandthe experiences of caregiving. Multivariate analysis focused on describing the factors associated with the reasons for non-use of four respite services: adult day centre, in-home respite, hospital respite, and personal care home respite. Findings from this study revealed that the majority of caregivers indicated they did not use respite services because they were unaware of the services. Caregivers who were not aware of particular respite services were more likely to be male, married, and have fewer years of formal education. Results of this study provide insights for respite service delivery and the appropriate targeting of services to isolated caregivers that may have never sought formal assistance.