Why carers of frail older people are not using available respite services: an Australian study

Abstract

Aim. The purpose of this study was to explore the limiting and motivating factors that influence carers' use of respite services and the ability of currently available respite services to meet the needs of carers of frail older people. Background. The development of community carer support services, their availability and usage and the common barriers that affect or impact on carers' use of community services in general and respite services in particular need to be examined to ensure they meet client needs. Design. A qualitative descriptive approach informed by critical social theory was used to expose the inequities inherent in community services. Methods. A qualitative examination of carer relationships with respite services was informed and guided by critical theory. Sixteen carers took part in four focus groups. A purposeful sampling strategy was adopted to engage with carers not currently using respite services. Study participants were recruited from a state-wide carer support organisation and a community service organisation in Queensland, Australia. Results. Three themes emerged from the data: 'Commitment' characterised by reciprocity, role definition and role frustration, 'Needing Help' discussed in terms of trust, confidence in service, fear and resistance, and 'Support' discussed in relation to informal networking, misinformation and lack of knowledge. Conclusion. This study improves our understanding of the caring role, its significance in carer's lives and how this shapes their formal service expectations and use. The findings suggest that further investigation of the factors involved in carers' service expectations and service-seeking is warranted to develop a deeper understanding of how care giving influences the ways carers seek help from formal services. Relevance to clinical practice. Service delivery changes towards a model of care, which engages and promotes user control and fosters genuine participatory relations between informal and professional carers may improve uptake of respite services. Key words: community, family care, nursing, older people, qualitative, respite Accepted for publication: 20 July 2009