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American Family Physician Jun 2019Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers...
Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase during the next few decades. Caring for loved ones is associated with several benefits, including personal fulfillment; however, caregiving is also associated with physical, psychological, and financial burdens. Family physicians can aid in the identification, support, and treatment of caregivers by offering caregiver assessments-interviews directed at identifying high levels of burden-as soon as caregivers are identified. Repeat assessments may be considered when there is a change in the status of the caregiver or the care recipient. Caregivers should be directed to appropriate resources for support, including national caregiving organizations, local elder care agencies, websites, and respite care. Psychoeducation, skills training, and therapeutic counseling interventions for caregivers have shown small to moderate success by decreasing caregiver burden and increasing caregiver quality of life. Additional research is needed to further identify strategies to offset caregiver stress, depression, and poor health outcomes. Support and anticipatory guidance for the caregiver is especially helpful during care transitions and at the care recipient's end of life.
Topics: Adult; Aged; Caregivers; Cost of Illness; Family; Female; Humans; Long-Term Care; Male; Middle Aged; Social Support; Stress, Psychological
PubMed: 31150177
DOI: No ID Found -
Multifactorial Examination of Caregiver Burden in a National Sample of Family and Unpaid Caregivers.Journal of the American Geriatrics... Feb 2019To examine factors associated with caregiver burden from a multifactorial perspective by examining caregiver and care recipient characteristics and a full range of...
OBJECTIVES
To examine factors associated with caregiver burden from a multifactorial perspective by examining caregiver and care recipient characteristics and a full range of caregiving tasks.
DESIGN
Nationally representative surveys of community-dwelling older adults and their family caregivers residing in the United States.
SETTING
2011 National Health and Aging Trends Study and National Study of Caregiving.
PARTICIPANTS
Community-dwelling older adults and their family caregivers.
MEASUREMENTS
Caregiver burden, comprising emotional, physical, and financial difficulties associated with caregiving.
RESULTS
An estimated 14.9 million caregivers assisted 7.6 million care recipients. More than half of caregivers reported burden related to caregiving. In a multivariable regression model, caregivers who assisted with more activities of daily living and instrumental activities of daily living, health management tasks, and health system logistics were more likely to experience burden, as were female caregivers, adult child caregivers, caregivers in poor health, caregivers with anxiety symptoms, and those using respite care. Dementia was the only care recipient characteristic associated with burden.
CONCLUSION
Caregiver characteristics and provision of caregiving tasks determine caregiver burden more than care recipient characteristics. Absence of an association between type of a care recipient's chronic conditions and burden, except for dementia, suggests that the tasks that caregivers who assist older adults with a variety of health conditions undertake shape the experience of caregiving. J Am Geriatr Soc 67:277-283, 2019.
Topics: Activities of Daily Living; Adult Children; Aged; Aged, 80 and over; Caregivers; Chronic Disease; Compensation and Redress; Cost of Illness; Dementia; Female; Humans; Independent Living; Male; Regression Analysis; United States
PubMed: 30452088
DOI: 10.1111/jgs.15664 -
BMJ (Clinical Research Ed.) Jan 1993
Topics: Community Health Services; Humans; Respite Care; United Kingdom
PubMed: 8443477
DOI: 10.1136/bmj.306.6871.160 -
The Cochrane Database of Systematic... Jan 2014Caring for someone with dementia can be emotionally and physically demanding. Respite care is any intervention designed to give rest or relief to caregivers. It is not... (Review)
Review
BACKGROUND
Caring for someone with dementia can be emotionally and physically demanding. Respite care is any intervention designed to give rest or relief to caregivers. It is not clear what positive and negative effects such care may have on them, or on people with dementia.
OBJECTIVES
To assess the benefits and harms of respite care for people with dementia and their caregivers, in particular the effect of respite care on rates of institutionalisation.
SEARCH METHODS
The trials were identified from a search of ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group, using the terms respite* OR daycare OR caregiver* relief. ALOIS contains up-to-date records from all major healthcare databases and many ongoing trial databases.
SELECTION CRITERIA
Randomised controlled trials comparing respite care with a control intervention for people with dementia.
DATA COLLECTION AND ANALYSIS
Two review authors carried out study selection independently and reached a consensus through discussion. Data were extracted by a single review author. The review authors contacted all investigators for methodological details not reported in the text and for additional data for three studies included in the previous version of the review.
MAIN RESULTS
Four trials are now included in the review, with 753 participants. They were different in many ways including the intervention, duration, outcomes and control group so pooling of data was not possible. Overall, the quality of the evidence was rated as very low. Re-analysis of outcomes using data from the published studies found no significant effects of respite care compared to no respite care on any caregiver variable. When respite care was compared to polarity therapy a significant effect was found in favour of polarity therapy for caregiver perceived stress (n = 38, MD 5.80, 95% CI 1.43 to 10.17), but not for other measures of psychological health and other caregiver outcomes. No studies reported evaluable data on outcomes related to the people with dementia.
AUTHORS' CONCLUSIONS
Current evidence does not demonstrate any benefits or adverse effects from the use of respite care for people with dementia or their caregivers. These results should be treated with caution, however, as they may reflect the lack of high quality research in this area rather than an actual lack of benefit. Given the frequency with which respite care is advocated and provided, well-designed trials are needed in this area.
Topics: Aged; Caregivers; Dementia; Humans; Randomized Controlled Trials as Topic; Respite Care; Stress, Psychological; Therapeutic Touch
PubMed: 24435941
DOI: 10.1002/14651858.CD004396.pub3 -
American Family Physician Jun 2011In 2009, nearly 66 million Americans (three in 10 U.S. households) reported at least one person providing unpaid care as a family caregiver. More adults with chronic...
In 2009, nearly 66 million Americans (three in 10 U.S. households) reported at least one person providing unpaid care as a family caregiver. More adults with chronic conditions and disabilities are living at home than ever before, and family caregivers have an even higher level of responsibility. Caring for loved ones is associated with several benefits, including personal fulfillment. However, caregiving is also associated with physical, psychological, and financial burdens. Primary care physicians can aid in the identification, support, and treatment of caregivers by offering caregiver assessments-interviews directed at identifying high levels of burden-as soon as caregivers are identified. Repeat assessments may be considered when there is a change in the status of caregiver or care recipient. Caregivers should be directed to appropriate resources for support, including national caregiving organizations, local area agencies on aging, Web sites, and respite care. Psychoeducational, skills-training, and therapeutic counseling interventions for caregivers of patients with chronic conditions such as dementia, cancer, stroke, and heart failure have shown small to moderate success in decreasing caregiver burden and increasing caregiver quality of life. Further research is needed to further identify strategies to offset caregiver stress, depression, and poor health outcomes. Additional support and anticipatory guidance for the care recipient and caregiver are particularly helpful during care transitions and at the care recipient's end of life.
Topics: Adaptation, Psychological; Adult; Caregivers; Chronic Disease; Cost of Illness; Disabled Persons; Family Relations; Home Nursing; Humans; Needs Assessment; Physicians, Primary Care; Quality of Life; Respite Care; Social Support; Stress, Psychological; Surveys and Questionnaires
PubMed: 21661713
DOI: No ID Found -
Annual Review of Psychology Jan 2020Family members are the primary source of support for older adults with chronic illness and disability. Thousands of published empirical studies and dozens of reviews... (Review)
Review
Family members are the primary source of support for older adults with chronic illness and disability. Thousands of published empirical studies and dozens of reviews have documented the psychological and physical health effects of caregiving, identified caregivers at risk for adverse outcomes, and evaluated a wide range of intervention strategies to support caregivers. Caregiving as chronic stress exposure is the conceptual driver for much of this research. We review and synthesize the literature on the impact of caregiving and intervention strategies for supporting caregivers. The impact of caregiving is highly variable, driven largely by the intensity of care provided and the suffering of the care recipient. The intervention literature is littered with many failures and some successes. Successful interventions address both the pragmatics of care and the emotional toll of caregiving. We conclude with both research and policy recommendations that address a national agenda for caregiving.
Topics: Aging; Caregivers; Exercise Therapy; Family; Humans; Psychotherapy; Respite Care; Stress, Psychological
PubMed: 31905111
DOI: 10.1146/annurev-psych-010419-050754