Table 3:

The Impact of Paid Caregivers in Home-Based Dementia Care

Theme 4: Stability Impacts on People with Advanced Dementia and Their Families
Caregiver	Benefits to People with Advanced Dementia	Benefits to Family Caregivers
Caregiver 20, Daughter	He’s much more tranquil and even when he gets agitated, [the paid caregivers] know how to work with him. He immediately calms down… They work with him differently, and it’s stable. The stability helps a lot because it’s more routine. They know what they already know: what he likes to eat, his mannerisms, and what gets him upset.	It impacts your life in every social aspect, in [every] financial aspect, in every way…. you’re trying to juggle it all and eventually you get exhausted, you break down. And then that doesn’t help the senior at all because now they don’t have the people that they need to be able to be there for them. So, yes, the home attendant really relieves that pressure.
Caregiver 21, Cousin	She eats better, sleeps better, she’s cooperative…. and the ladies, they sing with her because the thing that calms her down the most is [when] they sing and dance with her…. She has a good life with them.	[The paid caregivers] are security. They let me sleep at night. They provide stability. I could not possibly do it without them. She would be in a facility. We could not take care of her without them-- impossible.
Caregiver 18, Daughter	I feel [my mother] would notice [her paid caregiver] and light up…. She knew who she was and she was so happy to hear her. And that’s great when you see that.	I felt confident enough that I could leave and that my mother was going to be well here. If I didn’t have that service - well, the two that I have here, which like I said before, we’ve created a bond-- I don’t know what I would’ve done [without them]. I think I would have to leave my job.
Caregiver 9, Daughter	When [the paid caregivers] come in, she smiles. [My mother] was like, “I remember you,” from her eyes. You can see that she remembers them. The fact that she allows them to feed her in the morning, that means she trusts them.	You as a caregiver, you won’t get to rest. It could give you depression. Sometimes, I thought I was going to have a nervous breakdown from lack of sleep and just overthinking everything. When it clicks, it clicks well, but when it doesn’t click, it’s like the worst feeling in the world.
Caregiver 12, Daughter	Besides taking care of [my mother], feeding her, bathing her, and clothing her, [the paid caregivers] do all that, they sustain her… They sit with her. They talk to her. They laugh with her… I don’t know what more to say except that they just do I think what they would do for their own mother. You know what I mean? They’re doing what they would do for their own parent.	I feel just a sense of peace because [my mother] is being taken care of by two women…. They allow us, as a family, to have our own lives and to be able to keep going. It makes us better people, because I remember in the beginning, I was so frustrated with my mother… I was so angry because I was so tired… I had a lot of resentment. I felt like I was taking it out on [my mother], like I was mean to her. I hated myself for that.