With the deepening of aging population degree, long-term care for disabled elderly has become a challenging problem gradually. On the one hand, the disabled elderly hope to stay at home ; Nevertheless, due to the weakening of family function and the limited support family providing , it is difficult to fully realize the home-based long-term care for the disabled elderly, which eventually leads to the increasing demand for community care  .
Family caregivers and community-based care service can combine the advantages of both good family care and community professional services . Some studies have shown that creating a positive and friendly social environment can promote the positive interaction between family and community, effectively improve the quality of care for the disabled elderly at home, and reduce the burden of family and society [34–36].
Studies have reported the importance of the quality of social interactions between family and formal care providers in residential care settings, and less is known about such relationships in community-based care settings in which the majority of disabled older adults [37, 38]. We conducted semi-structured interviews with community nurses and family caregivers of disabled elderly to collect information regarding their experiences and attitudes toward interaction. Based on the data collection and thematic analysis, three overarching themes: Establish a collaborative relationship, Get professional support; Factors that promote and hinder the interaction.
Collaboration is one of characteristics of social interaction between family caregivers and community-based service providers . If family caregivers are able to build a collaborative and reciprocal relationship with the community caregivers, which will enable them to better provide care for the disabled elderly people, while reduce the burden on the family caregivers . And being well connected can enhance this collaborative relationship between family caregivers and community nurses . However, at present, caregivers have access to limited the help and resources of community nurses, and no building good collaboration relationship. Other family caregivers said community nurses often had very limited time of services provided to unable to communicate deeply with them. Therefore, caregivers hope to increase the frequency of communication with community nurses, as well as provide multiple forms of communication to achieve effective communication .
Getting professional support includes emotional support, information sharing, and practical behavioral support. Family caregivers who perceived higher levels of support reported significantly higher levels of satisfaction with professional providers . Family caregivers, who are mostly non-medical practitioners, want the community to provide an information-sharing platform for health counseling to get more information about the care of the disabled elderly. In terms of practical help, there are still deficiencies in the quality and quantity of services provided by community nurses. As many disabled elderly people suffer from long-term chronic diseases, community nurses should visit regularly to monitor their health status for a long time . Due to the health problems of the disabled elderly, the lack of relevant care skills and heavy burden of caregivers, they are eager to have professional nursing staff to provide services to reduce their burden . Moreover, caregivers also raised the problem of difficulty in seeing a doctor, hoping that community nurses can assist in seeing a doctor. However, community-based service agencies often focus on physical aspects of caregiving, such as the number of hours served and tasks completed, rather than the social or emotional aspects . Caregivers have heavy psychological load and cannot be released under high psychological pressure for a long time [46, 47]. Therefore, caregivers urgently need some psychological counseling and psychological counseling to relieve caregivers' pressure and maintain their good emotional state. Previous studies showed the importance of provider support on the psychological well-being of family caregivers . When the caregivers' efforts are affirmed and praised by community nurses, their self satisfaction and sense of honor will be improved, which will help to provide better care for the disabled elderly.
Factors that promote and hinder the interaction the interaction. At present, the participation of community nurses in the care of disabled elderly at home is low. In the interactions between nurses and family caregivers, nurses usually lack initiative . In order to promote the interaction between caregivers and community nurses, the participation of community nurses should be increased, and community nurses should be more active in the home care of the disabled elderly. Moreover, community nurses and family caregivers should tolerate each other, reduce conflict, take the health of the elderly as a common goal, and actively promote partnerships . However, there are insufficient community nurses in the health management of the disabled elderly, and the professional quality of community nurses is uneven. There are also some family caregivers with poor physical condition or low cooperation and low attention, resulting in inadequate care. These all will hinder interaction between family caregiver and community nurses. Interventions to facilitate positive interactions such as support and collaboration between family and nursing home care providers have been developed and tested . Such interventions can be adapted for community-based care settings. Family members are more likely to provide a larger share of caregiving tasks in community settings compared to nursing home settings [39, 52].
In light of the implications of the findings of this study, future research could further advance this field by developing interventions to enhance interactions between home caregivers and community nurses to help them to effectively collaboration and support each other. Bsides, government and social organizations should create and provide a suitable environment where family caregivers and community nurses can focus on strengthening their interactive relationships to bring the highest quality of care to older adults with disabilities.
This was the qualitative study to explore the interaction experiences between family caregivers and community nurses for disabled elderly people at home. We collected the voices and feelings about interaction directly from participants. Despite this study’s important contribution to home care of disabled elderly people, two limitations should be mentioned. The conduct of our study has been greatly affected due to the COVID-19. There were some difficulties in recruiting and contacting eligible participants. Therefore, the study had small samples, which limits the generalizability and representativeness. Our sampling method may have resulted in selection and response bias. Family caregivers were recruited via purposive sampling through community nurses. Those participants were more likely to have a better relationship with community nurses. We communicated with community nurses in advance, in order to avoid having their present which could cause response bias. However, in a few cases, community nurses were present for a portion of the interview, and family caregivers could have felt more inclined to give a positive evaluation of interaction with community nurses.