Home care service use by family caregivers in Taiwan and their perceived nursing care needs

Over the next decade Taiwan's population will become, by far, the oldest in the world. Numerous scientific studies have demonstrated that informal care for the disabled elderly is a heavy burden for family caregivers. The research presented in this study focuses on the complex relationship between need (elder's disabilities and caregiver burden), enabling (secondary informal help), and psychosocial factors (home care service satisfaction) and two key home care service use outcomes---the intensity of personal care and homemaking service use---by family caregivers of elders in Taiwan. Theoretically models are adapted, drawing on a framework of long-term care service utilization, and appropriate inferential statistical procedures are implemented to identify the importance of the proposed relationships in a sample of 264 caregivers taking care of elderly family members in Taiwan.;This cross-sectional study followed the Andersen-Newman framework (2005). The design of this study is a descriptive-correlational survey. Primary family caregivers of impaired elders were interviewed at home using a series of questionnaires. Information on the frequency and hours of formal home care service use was prospectively retrieved from the service notes recorded by the home care service agencies for the three months after the survey interview.;Two structural models were evaluated. Model 1 examined the effect of factors on the intensity of personal care service use, while Model 2 examined the influence of factors on the intensity of homemaking service use. Statistically significant estimates indicated that the need factor plays a key role in predicting the intensity of both personal care and homemaking service use. Intriguingly, the influence of elder's disabilities, specifically memory and behavioral symptoms, as a predictor of formal care use differs dramatically depending on the type of home care service used.;An additional objective of this study was the exploration of caregivers' need for professional nursing care while receiving services through the home care service program (HCSP). Among Taiwanese family caregivers, there is a need for professional nursing care related to numerous caregiving issues. Evidence suggests that the caregivers face challenges in providing care for disabled elders. Overall, the current evidence identified in this study indicates that the HCSP designed for frail older people and their caregivers in Taiwan can be improved if the HCSP addresses the unmet needs of the elders and their caregivers.