Background: Dementia is a growing global public health challenge, with affected individuals projected to rise from 57.4 million in 2019 to 152.8 million by 2050 due to population growth and aging. Family caregivers play a crucial role in dementia care but face significant challenges that can adversely affect both themselves and those they care for. Traditional paradigms like the stress process model focus on the negative impacts of caregiving stress, leading to burnout and premature institutionalization of care recipients. However, recent research highlights the importance of both positive and negative aspects of caregiving. This study proposes a novel paradigm, “successful caregiving,” offering a comprehensive framework that integrates these dual aspects.

Objective: This study aims to develop a theoretical construct of successful caregiving in dementia care, addressing both caregivers’ needs and the caregiving environment. Using literature review, qualitative interviews, and expert consensus via a Delphi study, successful caregiving is defined as providing high-quality care while preserving caregivers’ well-being. It involves leveraging resources and adapting strategies to balance caregiving demands with personal well-being.

Methods: The study used thorough literature review and semi-structured interviews with family caregivers, practitioners, and scholars to develop a framework for successful caregiving, resulting in 57 preliminary items. These were evaluated through a four-round online modified Delphi process with 20 experts from Hong Kong and mainland China. The Delphi process involved two rounds of discussions and surveys to build consensus, with items rated on clarity, relevance, and importance. Consensus was defined as an average score of seven or higher, a 90% agreement rate, and an interquartile range of two or fewer. This process finalized 21 items across three layers: person-environment fit, role competency and harmony, and self-identity resilience.

Results: The study highlights the dynamic nature of successful caregiving, focusing on aligning caregivers with their environment, balancing roles, and maintaining self-identity. It developed a three-layer framework: person-environment fit, role competency and harmony, and self-identity resilience. In the Delphi study, 20 panelists participated, with 95% completing all stages. Initially, panelists scored and provided feedback on 60 items, with improvements in 18 out of 20 revised items in the second round. The final item pool emphasizes strategies like accessing support services, managing stress, providing personalized care, and fostering self-improvement. This process finalized 21 items, encouraging caregivers to use resources effectively, maintain well-being, and adapt to caregiving challenges.

Conclusion: The construct of successful caregiving provides a comprehensive framework to support family caregivers of people with dementia, highlighting caregiving’s dynamic and multifaceted nature. It serves as a reference for future research and interventions, helping assess caregiver needs and guide policy. By integrating various caregiving experiences, it empowers caregivers and improves care quality. Future research should validate this construct across diverse populations to ensure reliability and cultural relevance, ultimately enhancing the well-being of caregivers and care recipients globally.

Acknowledgement: This work was supported by the Hong Kong University Grants Committee General Research Fund [grant number 17603923]; and the Natural Science Foundation of China [grant number 72174118].

Howard Haochu Li, PhD, is a Research Assistant Professor at Sau Po Centre on Ageing, Department of Social Work and Social Administration, The University of Hong Kong. His research focuses on innovative and interdisciplinary healthcare studies, encompassing both infectious diseases and chronic conditions, such as HIV/AIDS, STIs/STDs, and dementia. Currently, his research emphasizes family caregivers of people with dementia.

 

Yuting Huang is a Ph.D. candidate in the Department of Social Work and Social Administration at The University of Hong Kong. Her research focuses on family caregiving for older adults, community-based care, and long-term care systems. She is passionate about improving the well-being of both family caregivers and older adults through theoretical and practical research.

 

Vivian Lou is a Professor at the University of Hong Kong and Director of Sau Po Centre on Ageing. Her research interests include long-term care, family caregiving for people with dementia, chronic conditions, stroke, and end-stage of life. Vivian is also passionate about developing evidence-based interventions.

 

Fan Yang is an Associate Professor in the School of International and Public Affairs of Shanghai Jiao Tong University. His research focuses on social welfare policies, especially on long-term care and caregivers empowerment through smart devices.

 

Xiaobo Ke is currently an Assistant Professor at Hong Kong Shue Yan University. His research focuses on esports, IT applications in geriatric caregiving, gamification for social good, and playable media.