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Purpose The aim of this study was to understand how Thai families care for dependent older adults. Design and Methods The methodology used for the study was grounded dimensional analysis. Participants were 30 adult family members from 15 families who were involved in caregiving. A total of 46 interviews were conducted. Data were collected and analyzed in three phases: (a) calling up dimensions, (b) assigning relative value to each of the dimension considers, and (c) inferring. Findings In Thai families, 'natural caregiving' precedes care of dependent older persons (dependent caregiving). Dependent caregiving begins when dependency is first noticed and care needs are identified. Dependent caregiving is a dynamic process integrating three major processes: (a) mobilizing family members, (b) performing dependent care, and (c) maintaining continuity of care. The consequences of performing dependent care and unpredictable changes lead to care remobilizing. Conclusions Dependent care for older adults varies across and is influenced by many conditions. Health personnel need to assess and monitor these varying conditions in order to support Thai families caring for dependent older adults. Clinical Relevance The conceptual model developed from the findings of this study provide a starting place for increasing our understanding of how to help Thai families care effectively and continuously for their older family members. [ABSTRACT FROM AUTHOR]

Thailand is a Buddhist country located on the mainland of southeast Asia, where 3-generation homes are still common. Care of older adults is primarily a family responsibility. Recent policy changes mean that all Thais are now eligible for services through the national health care system. Almost half the population has no retirement pension, leaving responsibility for support of older adults largely to extended family. Long-term care is becoming a serious concern as the population ages, women move into the workforce, and family size decreases. Thai researchers have focused on issues related to health and nutrition, income security, housing, general population aging, local and community care and services, information and education, and quality of life. There is currently no formal long-term care system. [ABSTRACT FROM AUTHOR]

Background: Functional decline has been identified as a leading negative outcome of hospitalization for older person. Functional decline is defined as a loss in ability to perform activities of daily living including a loss of independent ambulation. In the hospital literature, a patient's loss in ability to independently ambulate during the hospital stay varies between 15 and 59%. Lack of ambulation and deconditioning effects of bed rest are one of the most predictable causes of loss of independent ambulation in hospitalized older persons. Nurses have been identified as the professional most capable of promoting walking independence in the hospital setting. However, nurses do not routinely walk patients. Objective: The purpose of this study was to explore the relationship between nurses' attributions of responsibility for ambulating hospitalized patients and their decisions about whether to ambulate. Methods: A descriptive, secondary analysis of data gathered for a parent study was conducted. Grounded dimensional analysis was used to analyze the data. Participants consisted of 25 registered nurses employed on medical or surgical units from two urban hospitals in the United States. Results: Nurses fell into two groups: those who claimed ambulation of patients within their responsibility of practice and those who attributed the responsibility to another discipline. Nurses who claimed responsibility for ambulation focused on patient independence and psychosocial well-being. This resulted in actions related to collaborating with physical therapy, determining the appropriateness of activity orders, diminishing the risk and adjusting to resource availability. Nurses who attributed the responsibility deferred decisions about initiating ambulation to either physical therapy or medicine. This resulted in actions related to waiting, which involved, waiting for physical therapy clearance, physician orders, risks to decrease, and resources to improve before ambulating. Conclusions: Nurses who claimed responsibility for ambulating patients within their domain of practice described actions that promoted patient independent function and were more likely to get patient s up to ambulate. [ABSTRACT FROM AUTHOR]