Long-Term Dementia Care: Modeling the Decision Process

摘要

Prior to a crisis situation, family members often state that they will not have a loved one placed in a long-term care facility (nursing home care); however, when the situation arises, what enables some family members to hold true to this statement and others unable to follow through? This paper explores the complex decision-making process that family members may go through while caring for a loved one with dementia. Decisions may fluctuate as the challenges resulting from behavioral changes characteristic of different stages of dementia (specifically Alzheimer's disease) occur. This paper combines system dynamic modeling and agent-based modeling to represent a notional model of older adults with dementia and their associated caregivers. A caregiving stress and coping paradigm and current policy provisions are used to inform the decision-making process family members may experience while making the decision to become caregivers and maintain community-based caregiving responsibilities. Experimentation of different levels of relief showed that certain levels alleviate caregiver stress. Implications of these findings are discussed.