Due to the increase in the number of people with dementia, relatives often provide in-home care. This care constitutes a cornerstone of the healthcare system, and maintaining these caregivers’ well-being is therefore of paramount importance. Although respite interventions are generally considered an effective support system, they tend to be underutilized. The aim of this integrative literature review is to highlight the factors that promote and impede the use of respite interventions. Searches were conducted on the PubMed and CINAHL databases for studies of respite interventions from 1980 to 2016, and they yielded 51 articles of relevance. Analysis of these articles revealed modifiable and immutable factors that influence the use of respite. The most cited topic categories in the literature were attributes of respite services and workload managed by caregivers, which is characterized by the onset of burden. The factors promoting or impeding the use of respite interventions identified by our analysis highlight the need to adapt respite service attributes and use caregivers’ skills to foster the partnership between healthcare teams and caregivers and to ensure the accompanying dyad’s quality and safety.

Background: Annual immunization with influenza vaccine is effective in preventing influenza-associated mortality and morbidity in the elderly. Pneumococcal vaccination is also considered as an effective strategy to decrease pneumococcal-associated diseases and mortality, particularly in the geriatric health care setting. However, in France, influenza and pneumococcal vaccination coverage in senior citizens living in long-term care facilities has not been comprehensively evaluated. Objectives: A prospective multicenter study was conducted to measure influenza and pneumococcal vaccine coverage and to assess the existence of local recommendations and the reasons for reluctance to immunize patients in geriatric health care settings in France. Two questionnaires were developed: the initial questionnaire to record the demographic characteristics of patients in health care facilities and to note influenza and pneumococcal vaccine coverage, and a second questionnaire, sent to all responders in June 2003, to record the number and causes of death (December 2002 to April 2003). Questions about the reasons for non-vaccination were added to all settings which had pneumococcal or influenza vaccination coverages below the median levels in the first query. Results: 105 health care facilities measuring vaccine coverage in 7,882 elderly patients participated in the study. Of 105 units, 9 were acute care units (n = 203 patients), 22 rehabilitation care units (n = 923), 68 long-term care facilities (n = 6,458), and 6 nursing homes (n = 315). The median and mean age of patients was 83 (SD 3.5) years. Influenza and pneumococcal vaccine rates were 87.7% (median 90%, range 0–100%) and 21.9% (median 2.8%, range 0–100%), respectively. There were significant differences between the type of setting and wide variability. There was no correlation between vaccine coverage and local recommendations. Mortality was 15.2% and was negatively correlated with influenza vaccine. The reasons for non-vaccination evaluated in 20 units differed for influenza and pneumococcal vaccine. Conclusion: Influenza vaccine coverage is high in long-term care settings but not in other settings. Pneumococcal vaccine coverage is very low in most settings, in part because of the lack of positive recommendations in France. Annual vaccination records are needed and should be a goal for the National Health Care Department. In addition, reasons for failure to administer both vaccines should be precisely evaluated on large populations to improve vaccination coverage.