An evaluation of social work support groups with informal caregivers to prevent elder abuse and neglect : a Namibian perspective

PhD (Social Work), North-West University, Potchefstroom Campus, 2014The general objectives of the study were to evaluate a social work support group programme with informal caregivers that aimed to enhance the quality of care provided to older persons in an urban and rural community setting in Namibia. In order to achieve the general objectives of the study, the following specific objectives were formulated: * To explore how informal care giving situations in urban and rural communities lead to elder abuse and neglect. * To describe existing literature on the various factors that contribute to elder abuse and neglect within community settings. * To develop a support group programme for informal caregivers of older persons in urban and rural community settings that aimed at preventing elder abuse and neglect. * To implement and evaluate the effectiveness of the support group programme for informal caregivers that aimed at preventing elder abuse and neglect. The thesis consists of 5 sections: Section A consists of the problem statement, research objectives, central theoretical argument and the theoretical approaches that underpin the study. Furthermore, the research methodology, the definition of key concepts and the limitation of the study are presented. Section B contains four articles that together formed part of the research outcomes. Each article can function independently with it’s own objectives and distinctive content. However, each article is also a sub-project of the umbrella research study. Therefore, some of the data have to be repeated in different sections. The four articles are: Article 1: Informal care giving, elder abuse and neglect in urban and rural areas of the Khomas region in Namibia: A needs assessment A needs assessment on informal caregiving situations and how it may lead to elder abuse and neglect of older persons from an urban and rural constituency in the Khomas region was explored. Data was collected through in-depth interviews with professional and community leaders. In addition, focus group discussions were held with older persons and informal caregivers in the urban and rural constituency. Article 2: Factors contributing to elder abuse and neglect in community settings In this article, a comprehensive review of the literature pertaining to the risk and protective factors to elder abuse and neglect was done. The ecological theory was worthwhile to describe the risk factors to elder abuse and neglect. Article 3: Designing a social work support group programme with informal caregivers of older people in Namibia. A social work support group programme was developed for informal caregivers of older persons in community settings. The eight-week support group programme was developed based on a needs assessment and a comprehensive literature review, and included the following topics; the normal processes of aging, handling of difficult care giving situations, caregiver stress, self-care of the caregiver, elder abuse and neglect and caregiver grief and loss. The planning model for group work was also utilised to design the group. Article 4: Evaluation of the effectiveness of a support group programme with informal caregivers to prevent elder abuse and neglect An eight-week support group programme with ten female informal caregivers from an urban group and twelve informal caregivers from a rural group setting was implemented and evaluated. Standardized measuring instruments that assessed the outcome of the group at pre-test, post-test and postponed post-test were the Zarit Burden Interview (ZBI), Potentially Harmful Behaviour (PHB) scale and the Caregiver Abuse Screen (CASE). The Group Engagement Measure (GEM) assessed the group processes at the fourth, sixth and eight group sessions. In addition, open-ended questions were used to collect qualitative data. The quantitative and qualitative evaluations indicated that both the urban and rural groups gained knowledge on aging and care giving, and caregivers acquired vital qualities such as patience, compassion and communication skills. The process evaluation showed that caregivers from the urban group were more engaged in the group process than the rural group. Elder abuse was under reported in the study, while personal stress of caregivers reduced significantly because of the intervention. Section C consists of the summary of the most important findings and conclusions to the research study. In addition recommendations are provided. Section D consists of the annexures to the research report, such as the measuring instruments and interview schedules used for data collection. Section E contains a consolidated list of references.Doctora