AN ORGANIZATIONAL APPROACH TO BURNOUT IN ADULT FOSTER HOME CAREGIVERS IN HAWAI`I

Abstract

Caregiver burnout is an adverse psychological event that a person experiences in relation to long-term and emotional stress that is brought about by work that entails helping other people. Caregiver burnout may compromise patient safety by affecting patients’ mortality rates and increasing their risk for abuse and neglect, and it may impact the physical and mental health of caregivers, reduce their eagerness to help patients, and increase caregivers’ turnover rates. Clients living in adult foster homes are a vulnerable population who are often explicitly dependent on their caregivers; they are unable to perform ADLs, prepare their own meals, comply with medications, and/or verbally express their needs. Caregiver burnout in adult foster home caregivers must be investigated especially as the elderly population increases and as more adults with disabilities are placed in adult foster homes. This project examined burnout in adult foster home caregivers in Hawai`i, determined its effects on caregivers and client care, and identified organizational means for its prevention and management. Adult foster home caregivers from three case management agencies in Hawai`i were asked to complete an anonymous sociodemographic online survey on Survey Monkey and to participate in three online focus groups through Zoom. The online survey contained five Likert-scale questions that inquired about caregivers’ age, sex, number of adult foster home clients in their homes, years of caregiving experience, and the number of hours spent caregiving per week. Three (N=3) caregivers responded to the survey, and their responses were not analyzed. Thirteen (N=13) caregivers participated in the online focus groups. These caregivers were asked to respond to ten questions about burnout, job demands and resources, and case management agencies’ management of burnout. Their responses were manually transcribed verbatim, manually analyzed using thematic analysis, and electronically analyzed using MAXQDA. Four themes were identified: caregivers’ impression of burnout, relief, training, and support. Data gathered from the focus groups were combined with data from the literature to develop a presentation about the organizational management of burnout in adult foster home caregivers. The presentation was sent to 21 case management agencies in Hawai`i. These agencies were asked to respond to anonymous online pre- and post-tests on Survey Monkey before and after reviewing the presentation. The surveys contained two Likert-scale questions about agencies’ knowledge about burnout and their likelihood of implementing interventions to manage burnout among adult foster home caregivers. Three (N=3) responses were collected and analyzed using paired-samples t-test with JASP 0.14.1 software. The results from the pre-test and post-test indicate that case management agencies’ review of the burnout presentation did not result in any significant improvement in their knowledge or likelihood of implementing organizational methods of managing burnout. Based on the data collected in this study, a combination of the JD-R model and the action research framework is recommended in the development of organizational interventions to manage burnout among adult foster home caregivers. Case management agencies should identify adult foster home caregivers’ most valuable job resources and provide enough of these resources to caregivers on an ongoing basis to manage burnout and to protect caregivers and clients from the consequences of caregiver burnout.