Families' experiences of caring for technology-dependent children: a temporal perspective.

In the present study, families' experiences of caring for a technology-dependent child were examined from a temporal perspective. This involved exploring the multiple 'technological', 'social' and 'natural' rhythms and routines around which the families' lives were variously structured. A purposive sample of 36 families with technology-dependent children who used one or more medical devices on a daily basis was recruited. Devices included feeding pumps, suction machines, dialysis machines and ventilators. Using mainly qualitative methods, children, parents and siblings were interviewed to establish what the care routines involved and how these impacted on family members. The authors found that the rhythms and routines of care varied across the sample, depending on the type and number of devices used, the individual child's needs, and who provided technical care during the day and/or at night at home and in other settings. While the children's health and quality of life benefited from the technology, the time demands of the care routines and lack of compatibility with other social and institutional timeframes had some negative implications for the children and their families, limiting their participation in school, employment and social life in general. The need to use and oversee the use of some medical technologies at night also meant that many parents suffered regular disruption to their sleep. In conclusion, the authors argue that the care of technology-dependent children at home places considerable time demands on families. Families have little or no access to suitably trained carers who can provide technical care required in the home or away from the home to give parents and the whole family a break from caring where required. More trained carers and short-term care provision, better coordination of services and improvements in the design of devices would all help to reduce the negative effects of the care routines on families.

[1]  G. Gurvitch,et al.  The Spectrum of Social Time , 1963 .

[2]  P. Sloper,et al.  Experiences and support needs of siblings of children with cancer. , 2000, Health & social care in the community.

[3]  L. Spencer,et al.  Qualitative data analysis for applied policy research , 2002 .

[4]  A. Giddens The Constitution of Society , 1985 .

[5]  Eviatar Zerubavel,et al.  Patterns of Time in Hospital Life: A Sociological Perspective. , 1980 .

[6]  D. Lawton,et al.  Acknowledging the extra care parents give their disabled children. , 2001, Child: care, health and development.

[7]  D. Southall,et al.  The experiences and views of parents who care for ventilator-dependent children. , 1999, Journal of clinical nursing.

[8]  H. Nowotny,et al.  Time: The Modern and Postmodern Experience , 1996 .

[9]  R. Olsen,et al.  Dilemmas in the provision of own-home respite support for parents of young children with complex health care needs: evidence from an evaluation. , 2001, Journal of advanced nursing.

[10]  R. Townsley,et al.  Food for Thought: Effective Support for Families Caring for a Child Who Is Tube Fed , 2000 .

[11]  M. Getty,et al.  A comparative study of the attitudes of users and non-users towards computerized care planning. , 1999, Journal of clinical nursing.

[12]  J. Noyes Life as a young 'ventilator dependent' person , 1999 .

[13]  L. Aday,et al.  Home care for ventilator-assisted children: implications for the children, their families, and health policy. , 1988, Children's health care : journal of the Association for the Care of Children's Health.

[14]  D. Watson,et al.  Exploring multi-agency working in services to disabled children with complex healthcare needs and their families. , 2002, Journal of clinical nursing.

[15]  Barbara Adam,et al.  Time and Social Theory , 1990 .

[16]  P. Mckeever,et al.  Mothers' experiences caring for children with disabilities who require a gastrostomy tube. , 1998, Journal of pediatric nursing.

[17]  M. Young,et al.  The metronomic society : natural rhythms and human timetables , 1989, Psychological Medicine.

[18]  J. Morse,et al.  Absolute involvement: the experience of mothers of ventilator-dependent children. , 1998, Health & social care in the community.

[19]  P. Sloper,et al.  Multi‐Agency Care Coordination and Key Worker Services for Disabled Children , 2003 .

[20]  C. Robinson,et al.  Children's hospices: where do they fit? , 2003 .

[21]  C. Petr,et al.  Home care for children dependent on medical technology: the family perspective. , 1995, Social work in health care.

[22]  S. Kirk,et al.  Technology-dependent children in the community: definitions, numbers and costs. , 2001, Child: care, health and development.

[23]  E. Zerubavel Hidden Rhythms: Schedules and Calendars in Social Life , 1981 .

[24]  Barbara Adam,et al.  Timewatch: social analysis of time , 1995 .

[25]  Ruth Townsley Ba(hons),et al.  More than just a health issue: a review of current issues in the care of enterally-fed children living in the community. , 1999, Health & social care in the community.

[26]  S. Manns Life after SCBU: the long term influence on mothers' at home with a child with bronchopulmonary dysplasia on home oxygen , 2000 .

[27]  S. Kirk Families' experiences of caring at home for a technology-dependent child: a review of the literature. , 1998, Child: care, health and development.

[28]  Ruth Townsley Ba,et al.  More than just a health issue: a review of current issues in the care of enterally-fed children living in the community. , 1999 .

[29]  M. Flanigan,et al.  Tidal peritoneal dialysis vs. continuous cyclic peritoneal dialysis: children's preference. , 1992, ANNA journal.

[30]  Joost van Loon,et al.  Time, the Modern and Postmodern Experience , 1995 .