Aktuelle Befunde zu „distance caregiving“

Was wissen wir und was (noch) nicht?

Current findings on distance caregiving

What do we know and what do we not (yet) know?

Zusammenfassung

Hintergrund

Demografischer Wandel, zunehmende Arbeitsmobilität und veränderte Familienmuster führen zu sozialen Beziehungen oft über große Entfernungen hinweg. Die Unterstützung von Angehörigen auf Distanz ist aber ein im deutschsprachigen Raum kaum diskutiertes Thema. Das Projekt „DiCa“ (2016–2019) untersucht verschiedene Dimensionen von Distance caregiving.

Ziel der Arbeit

Die aktuelle Forschung zu Merkmalen dieser Pflegearrangements ist dargestellt, u. a. dahinterstehende Herausforderungen, Strategien, Rahmenbedingungen.

Material und Methode

Systematische Literaturanalyse.

Ergebnisse

Die fast ausschließlich angloamerikanischen Studien zeichnen ein klares Bild, wer Distance caregivers sind – nämlich vornehmlich gut ausgebildete (Schwieger‑)Töchter, die neben Besuchen vor Ort wesentliche organisatorische, koordinierende und emotionale Leistungen erbringen. Die Distanz erschwert den Informationsfluss über den Gesundheitszustand der Pflegebedürftigen und schränkt die Möglichkeiten ein, kurzfristig auf Bedürfnisse oder Krisen zu reagieren. Distance caregivers sind häufig verstärkt finanziell und auch emotional durch fehlende Kontrolle vor Ort belastet, auch wenn sich einige Strategien zur Unterstützung im Pflegealltag und zur Vereinbarkeit von Pflege und Beruf zeigen, wie Notfallmanagement, Netzwerke vor Ort oder flexible Arbeitszeiten.

Schlussfolgerung

Im deutschsprachigen Raum fehlt einschlägige Forschung zu Distance caregiving. Prävalenzzahlen sind international nicht immer eindeutig, und es mangelt an fundiertem Wissen über die Bewertung der Pflegearrangements seitens der Distance caregivers, die tatsächliche Rolle der Distanz, Barrieren, Konflikte, effektive Strategien und Lösungsoptionen. Dies gilt für Personen im familiären Pflegesetting, aber auch Versorgungseinrichtungen und Arbeitgeber.

Abstract

Background

Demographic change, increasing work mobility as well as changed family patterns lead to social relationships over long distances; however, support from relatives from a distance is hardly debated in the German-speaking region. The project “DiCa” (2016–2019) studies various dimensions of long-distance caregiving.

Objective

This article presents the state of the art in research on specific characteristics of care arrangements from a distance. In addition, it presents the underlying challenges, strategies, and supportive as well as hindering conditions.

Material and methods

Systematic literature review.

Results

These studies, conducted largely in the Anglo-American region, draw a clear picture of who distance caregivers are (in general well-educated daughters or daughters-in-law) and that they make a substantial contribution to care in terms of organization, coordination, and emotional support in addition to visits. Distance impedes the flow of information about the health condition of the person in need of care and limits the possibilities to react to the needs at short notice or in crisis situations. Distance caregivers are often faced by financial as well as emotional burdens due to the care situation and lack of control even if there are some support strategies and compatibility between care and occupation, e.g. emergency management, local support networks, flexible working arrangements.

Conclusion

In the German-speaking region, pertinent studies on long-distance caregiving are missing. Internationally, the numbers of cases are not always clear and there is a lack of sound knowledge on the assessment of the care arrangements on the part of the distance caregiver, the actual role of the distance, specific barriers, conflicts, effective strategies and solution options. This applies to people in family homecare as well primary care facilities and employers.

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Notes

  1. 1.

    https://www.destatis.de/DE/ZahlenFakten/LaenderRegionen/Internationales/Thema/Tabellen/Basistabelle_BNE.html.

Literatur

  1. 1.

    Baldock C (2000) Migrants and their parents. Caregiving from a distance. J Fam Issues 21(2):205–224

    Article  Google Scholar 

  2. 2.

    Benefield LE, Beck C (2007) Reducing the distance in distance-caregiving by technology innovation. Clin Interv Aging 2(2):267–272

    PubMed  PubMed Central  Google Scholar 

  3. 3.

    Bevan JL, Sparks L (2011) Communication in the context of long-distance family caregiving: an integrated review and practical applications. Patient Educ Couns 85(1):26–30

    Article  PubMed  Google Scholar 

  4. 4.

    Bevan JL, Vreeburg SK, Verdugo S, Sparks L (2012) Interpersonal conflict and health perceptions in long-distance caregiving relationships. J Health Commun 17(7):747–761

    Article  PubMed  Google Scholar 

  5. 5.

    Bischofberger I (2011) Angehörige als wandelnde Patientenakte: Ausgewählte Ergebnisse aus einem Projekt zur Klärung der Rolle der Angehörigen. Care Manag J 4(5):27–29

    Google Scholar 

  6. 6.

    Bischofberger I, Otto U, Franke A, Schnepp W (2017) Pflegebedürftige Angehörige über Landesgrenzen hinweg unterstützen: Erkenntnisse aus zwei Fallstudien. Pflege Ges 22(1):84–93

    Google Scholar 

  7. 7.

    Bledsoe LK, Moore SE, Collins WL (2010) Long distance Caregiving: an Evaluative review of the literature. Ageing Int 35(4):293–310

    Article  Google Scholar 

  8. 8.

    Bohnet-Joschko S, Stahl T (2019) Telegeriatrische Modelle: Einblick in die Zukunft der Versorgung. Pflegezeitschrift 72(1–2):50–53

    Article  Google Scholar 

  9. 9.

    Brossoie N (2018) Long-distace care-giving: five steps to providing effective care. https://vtechworks.lib.vt.edu/bitstream/handle/10919/88937/FCS-%20133.pdf?sequence=1. Zugegriffen: 14. Mai 2019

    Google Scholar 

  10. 10.

    Buhr GT, Kuchibhatla M, Clipp EC (2006) Caregivers’ reasons for nursing home placement: clues for improving discussions with families prior to the transition. Gerontologist 46(1):52–61

    Article  PubMed  Google Scholar 

  11. 11.

    Cagle JG (2008) Informal caregivers of advanced cancer patients: the impact of geographic proximity on social support and bereavement adjustment. Virginia Commonwealth University, Virginia (Dissertation)

    Google Scholar 

  12. 12.

    Cagle JG, Munn JC (2012) Long-distance caregiving: a systematic review of the literature. J Gerontol Soc Work 55(8):682–707

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Collins WL, Holt TA, Moore SE, Bledsoe LK (2003) Long-distance caregiving: a case study of an African-American family. Am J Alzheimers Dis Other Demen 18(5):309–316

    Article  PubMed  Google Scholar 

  14. 14.

    Dewit DJ, Wister AV, Burch TK (1988) Physical distance and social contact between elders and their adult children. Res Aging 10(1):56–80

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Douglas SL, Mazanec P, Lipson A, Leuchtag M (2016) Distance caregiving a family member with cancer: a review of the literature on distance caregiving and recommendations for future research. World J Clin Oncol 7(2):214

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Edwards M (2014) Distance caregivers of people with Alzheimer’s disease and related dementia: a phenomenological study. Br J Occup Ther 77(4):174–180

    Article  Google Scholar 

  17. 17.

    Franke A (2018) Long distance caregiving. Peer review on “improving reconciliation of work and long-term care”. https://ec.europa.eu/social/main.jsp?langId=en&catId=89&newsId=9173&furtherNews=yes. Zugegriffen: 11. Mai 2019 (Host Country Discussion Paper 7–11)

    Google Scholar 

  18. 18.

    Franke A, Otto U, Kramer B, Jann PM, van Holten K, Zentgraf A, Bischofberger I (2019) Das Potenzial neuer Technologien zur Unterstützung von Pflege und Sorge über eine räumliche Distanz. Pflege 6.

  19. 19.

    Glaser K, Tomassini C (2000) Proximity of older women to their children: a comparison of Britain and Italy. Gerontologist 40(6):729–737

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Greenwell L, Bengtson VL (1997) Geographic distance and contact between middle-aged children and their parents: the effects of social class over 20 years. Journals Gerontol Ser B 52(1):13–26

    Article  Google Scholar 

  21. 21.

    Harrigan MP, Koerin BB (2007) Long-distance Caregiving: personal realities and practice implications: personal realities and practice implications. Reflections 13(2):5–16

    Google Scholar 

  22. 22.

    Jähnke A, Liebert-Keller Y, Käppeli A, van Holten K, Bischofberger I (2017) „Wachsam? Aber sicher!“ Gesundheitsfachpersonen als fachkundige Angehörige und ihre Rolle in der Patientensicherheit. Pflege 30(6):375–386

    Article  PubMed  Google Scholar 

  23. 23.

    Klobucnik T, Weber D, Steinle J, Winter MH‑J, König P (2017) Bedeutung technischer Assistenzsysteme in der Pflegeberatung und ambulanten Versorgung. In: Kunze C, Kricheldorff C (Hrsg) Assistive Systeme und Technologien zur Förderung der Teilhabe für Menschen mit Hilfebedarf. Ergebnisse aus dem Projektverbund ZAFH-AAL. Pabst, Lengerich, S 133–151

    Google Scholar 

  24. 24.

    Koerin BB, Harrigan MP (2003) PS I love you: long-distance caregiving. J Gerontol Soc Work 40(1–2):63–81

    Article  Google Scholar 

  25. 25.

    Lee GR, Dwyer JW, Coward RT (1990) Residential location and proximity to children among impaired elderly parents. Rural Sociol 55(4):579–589

    Article  Google Scholar 

  26. 26.

    Mahoney DMF, Mutschler PH, Tarlow B, Liss E (2008) Real world implementation lessons and outcomes from the worker interactive networking (WIN) project: Workplace-based online caregiver support and remote monitoring of elders at home. Telemedicine E‑health 14(3):224–234

    Article  PubMed  Google Scholar 

  27. 27.

    Mayring P (2015) Qualitative Inhaltsanalyse. Grundlagen und Techniken. Beltz, Weinheim

    Google Scholar 

  28. 28.

    Mazanec P, Daly BJ, Ferrell BR, Prince-Paul M (2011) Lack of communication and control: experiences of distance caregivers of parents with advanced cancer. Oncol Nurs Forum 38(3):307–313

    Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Mazanec P (2012) Distance caregiving a parent with cancer. Semin Oncol Nurs 28(4):271–278

    Article  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Menack J (2009) Working with long-distance families: tools the care manager Can use. In: Cress CJ (Hrsg) Care managers: working with the aging family. Jones & Bartlett Publishers, Burlington, S 35–89

    Google Scholar 

  31. 31.

    MetLife Mature Market Institute, National Alliance for Caregiving (2004) Miles away: The Metlife study of long-distance caregiving. http://www.caregiving.org/data/milesaway.pdf. Zugegriffen: 10. Okt. 2017

    Google Scholar 

  32. 32.

    Meurer J, Müller C, Simone C, Wagner I, Wulf V (2018) Designing for Sustainability: key issues of ICT projects for ageing at home. J Comput Support Coop Work 27(3):495–537

    Article  Google Scholar 

  33. 33.

    Mickus MA, Luz CC (2002) Televisits: sustaining long distance family relationships among institutionalized elders through technology. Aging Ment Health 6(4):387–396

    CAS  Article  PubMed  Google Scholar 

  34. 34.

    Minahan J, Cimarolli VR, Horowitz A, Hicks S, Jimenez D, Falzarano F (2018) Service use and needs among long-distance caregivers. Innov Aging 2(1):201–202

    Article  PubMed Central  Google Scholar 

  35. 35.

    National Alliance for Caregiving, AARP (2015) Caregiving in the U.S.: final report. https://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-unitedstates-2015-report-revised.pdf. Zugegriffen: 20. Febr. 2018

    Google Scholar 

  36. 36.

    Parker MW, Call VRA, Dunkle R, Vaitkus M (2002) “Out of sight” but not “out of mind”: Parent contact and worry among senior ranking male officers in the military who live long distances from parents. Mil Psychol 14(4):257–277

    Article  Google Scholar 

  37. 37.

    Parker M, Church W, Toseland R (2006) Caregiving at a distance. In: Berkman B, D’Ambruoso S (Hrsg) Handbook of social work in health and aging, Bd. 2006. Oxford University Press, New York, S 391–404

    Google Scholar 

  38. 38.

    Phillips JE, Bernard M, Chittenden M (2002) Juggling work and care: the experiences of working carers of older adults. The Policy Press for the Joseph Rowntree Foundation, Bristol

    Google Scholar 

  39. 39.

    Phillips JE, Bernard M (2008) Work and care: blurring the boundaries of space, place, time and distance. In: Martin-Matthews A, Phillips JE (Hrsg) Aging and caring at the intersection of work and home life. Blurring the boundaries. Psychology Press, New York, S 85–105

    Google Scholar 

  40. 40.

    Roff LL, Toseland R, Martin JA, Fine C, Parker M (2003) Family-social tasks in long distance caregiving. Geriatr Care Manag J 13(1):29–35

    Google Scholar 

  41. 41.

    Roff LL, Martin SS, Jennings LK, Parker MW, Harmon DK (2007) Long distance parental Caregivers’ experiences with siblings: a qualitative study. Qualitative Social Work 6(3):315–334

    Article  Google Scholar 

  42. 42.

    Rosenblatt B, van Steenberg C (2003) Handbook for long-distance caregivers: an essential guide for families and friends caring for ill or elderly loved ones. Family Caregiver Alliance, San Francisco

    Google Scholar 

  43. 43.

    Schoonover CB, Brody EM, Hoffman C, Kleban MH (1988) Parent care and geographically distant children. Res Aging 10(4):472–492

    CAS  Article  PubMed  Google Scholar 

  44. 44.

    Seifert A, Doh M, Wahl H‑W (2017) They also do it: Internet use by older adults living in residential care facilities. Educ Gerontol 43(9):451–461

    Article  Google Scholar 

  45. 45.

    Silverstein M (1995) Stability and change in temporal distance between the elderly and their children. Demography 32(1):29–45

    CAS  Article  PubMed  Google Scholar 

  46. 46.

    Silverstein M, Conroy SJ, Gans D (2008) Commitment to caring. Filial responsibility and the allocation of support to by adult children to older mothers. In: Szinovacz ME, Davey A (Hrsg) Caregiving contexts: cultural, familial, and societal implications. Springer, New York, S 71–91

    Google Scholar 

  47. 47.

    Thompsell A, Lovestone S (2002) Out of sight out of mind? Support and information given to distant and near relatives of those with dementia. Int J Geriatr Psychiatry 17(9):804–807

    Article  PubMed  Google Scholar 

  48. 48.

    van den Broek T, Dykstra PA (2017) The impact of siblings on the geographic distance between adult children and their ageing parents. Does parental need matter? Popul Space Place 23(6):1–13

    Google Scholar 

  49. 49.

    Vasireddy S, Sanidad I, Nitz LH (2017) Impact of informal care, travel distance, and stress on retirement decision making. Innov Aging 1(1):606

    Article  PubMed Central  Google Scholar 

  50. 50.

    Wagner DL (1997) Caring across the miles: findings of a survey of long-distance caregivers. National Council on the Aging, Washington, DC (Final report)

    Google Scholar 

  51. 51.

    Watari K, Wetherell JL, Gatz M, Delaney J, Ladd C, Cherry D (2006) Long distance caregivers: characteristics, service needs, and use of a long distance caregiver program. Clin Gerontol 29(4):61–77

    Article  Google Scholar 

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Correspondence to Prof. Annette Franke.

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Interessenkonflikt

A. Franke, B. Kramer, P.M. Jann, K. van Holten, A. Zentgraf, U. Otto und I. Bischofberger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Franke, A., Kramer, B., Jann, P.M. et al. Aktuelle Befunde zu „distance caregiving“. Z Gerontol Geriat 52, 521–528 (2019). https://doi.org/10.1007/s00391-019-01596-2

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Schlüsselwörter

  • Angehörige
  • Pflegende
  • Kommunikationsbarrieren
  • Soziale Unterstützung
  • Sozioökonomische Faktoren

Keywords

  • Relatives
  • Caregivers
  • Communication barriers
  • Social support
  • Socioeconomic factors