Satisfaction with the relationship from the perspectives of family caregivers, older adults and their home care workers

Abstract

Objectives: Given the increasing reliance on both formal (paid) and informal (unpaid) assistance for the care of older adults and the close relationships which are often formed with home care workers, the present study evaluated satisfaction with the relationship from the perspectives of the three members that make up the home caregiving triad: older adults, their family members and their home care workers.

Methods: We relied on a representative sample of 223 complete caregiving triads composed of an older adult, a family member and a home care worker. Each of the members rated his or her level of satisfaction with all other members in the unit, using a seven-item self-report satisfaction with the relationship scale (e.g., satisfaction with communication, intimacy). The Social Relations Model (SRM) was used to partial out the specific variance associated with each of the members as either an actor (i.e., the average satisfaction as a rater, unrelated to whom the person rates) or a partner (i.e., the unique satisfaction level elicited by a person, which is consistent across all ratings of this person).

Results: The structural equations model yielded acceptable results: χ²(3) = 6.94, p = .07. Our analysis revealed that the variability associated with the worker as partner was significantly greater than the variability associated with the older adult as partner (∆χ²[1] = 9.21, p = .002) or with the family member as partner (∆χ²[1] = 8.46, p = .004).

Conclusions: The study highlights the importance of studying satisfaction with the relationship in the home care setting and calls for further examination of the entire caregiving triad. The home care worker plays a key role in ensuring the overall satisfaction in the caregiving triad.

Keywords:

• Home care
• formal care
• caregiving
• social relations model
• triad
• dyadic analysis

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Of the 818 caregiving triads, we were able to interview 223 complete caregiving triads and 335 dyads (e.g., only two members of the same caregiving triad were interviewed; 66 units consisted of a family member and an older care recipient, 190 units consisted of a family member and a home care worker and 79 units consisted of an older care recipient and a home care worker). A total of 260 caregiving triads had only one person interviewed (in 21 units only an older care recipient was interviewed, in 209 units only a family member was interviewed and in 29 units only a home care worker was interviewed). A total of 64 older adults, 43 family members and 56 home care workers completed the questionnaire in Russian and 282 home care workers completed the questionnaire in English. The remaining participants completed it in Hebrew.

2. NA-Dyadic reciprocity was not calculated because the variance of relationship + error was not significantly different from 1 (i.e., unreliable)