[Difficulties faced by caregivers at group homes for elderly with dementia and related factors]

To identify difficulties that caregivers at group homes for elderly with dementia (hereafter "GH") have in dealing with residents and related factors, and to study how to best provide support to GH caregivers.

An anonymous, self-administered questionnaire was distributed to 600 caregivers working at 47 GHs in "A" City, Fukuoka Prefecture. Analysis was conducted on 333 responses. The questionnaire consisted of 14 items for basic attributes and facility environments, and 27 items for difficulties caregivers perceive in dealing with the demented elderly. These 27 were derived from semi-structured interviews with 10 GH caregivers conducted in advance and their factor structure was determined by factor analysis. In addition, relationships of total subscale scores for each factor with basic attributes and facility environments were analyzed.

The difficulties perceived by GH caregivers were subsumed into 4 categories, namely "conflict with the demented elderly," "support system at workplace," "conflict among staff members," and "sense of burden." The Cronbach's alphas of individual factors were found to be in the range from 0.75 to 0.82, confirming their internal consistency. The items significantly related to "conflict with the demented elderly" were anxiety for the future, care-giving experience, understanding the wishes of residents' families, and understanding the GH facility principles. The items significantly related to "support system at workplace" were thoughts of quitting their job and a cooperative system, while those for "conflict among staff members" were anxiety for the future, thoughts of quitting their job, a cooperative system, and information sharing. The items significantly related to "sense of burden" were anxiety for the future, thoughts of quitting their job, information sharing, and wishes regarding working schedule arrangements.

The GH caregivers had various difficulties in dealing with the demented elderly. It became clear that, for alleviation of the difficulties caregivers perceive, the educational system needs to be improved to help the caregivers have better understanding of GH facility principles and the wishes of the residents' families. It was also clarified that organizational efforts to promote information sharing and a cooperative system among staff members, as well as to provide support to individual caregivers by addressing the difficulties encountered, are of great importance.