Family and Friends as Respite Providers

Study Aim/Purpose: The purpose of this study was to compare the in-home respite experiences of caregivers using the direct pay mode of California’s Caregiver Resource Centers (CRCs) respite program (which is consumer-directed and gives caregivers vouchers to hire and manage their own respite workers) to pay family or friends to provide respite with caregivers who hired respite aides from a homecare or other agency. 

Summary of Methods: Questionnaires were mailed to eligible family caregivers who were responsible for the day-to -day care of a cognitively impaired adult living in the community and receiving in-home respite from a CRC at the time of the study. Completed data were received from 168 respondents, 39 of whom hired family or friends as their respite provider and 77 of whom hired respite aides from a homecare or other agency. Questionnaires collected information on the characteristics of the respite users and care receivers, respite preferences, level of caregiver involvement in supervising his or her aide, satisfaction with respite care, and level of caregiver distress and depression (the latter measured by the Center for Epidemiological Studies Depression Scale). Caregiver respite use and cost data were obtained from the CRC automated data system used to track service usage and expenditures. 

Summary of Results: Caregivers who hired family and friends as respite aides were found to be very similar in their demographic characteristics and levels of mental health and distress to caregivers who hired respite aides from agencies, with a few exceptions: caregivers who hired family and friends were slightly more likely to report worse current health than five years previously, to report “health problems getting in the way of doing things,” to have slightly higher levels of satisfaction with the respite assistance they received, and to have exercised more control and choice in the day-to-day management of their in-home respite aides. The study findings also indicate that hiring family and friends was less costly per hour of service than hiring service providers ($8.48 per hour versus $12.67 per hour) and that these caregivers received more hours of respite assistance per week (9.1 hours versus 7.7 hours per week). 

Study Limitations (as cited by authors): None cited. 

Authors’ Discussion/Conclusions: The authors conclude by saying, “To meet the changing needs of family caregivers, practitioners must offer families access to a range of service delivery options, assess for the caregivers’ preferences and abilities to direct the day-to-day management of in-home respite care, and give the caregivers the choice to hire family and/or friends as respite aides.”