scholarly journals Multiple Chronic Conditions in Spousal Caregivers of Older Adults With Functional Disability: Associations With Caregiving Difficulties and Gains

2017 ◽  
Vol 75 (1) ◽  
pp. 160-172 ◽  
Author(s):  
Courtney A Polenick ◽  
Amanda N Leggett ◽  
Noah J Webster ◽  
Benjamin H Han ◽  
Steven H Zarit ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Functional Disability ◽  
Management Strategies ◽  
Later Life ◽  
Spousal Caregivers ◽  
National Study ◽  
Multiple Chronic Conditions ◽  
Spousal Caregiving ◽  
Care Recipients ◽  
Aging Adults

Abstract Objectives Multiple chronic conditions (MCCs) are common and have harmful consequences in later life. Along with managing their own health, many aging adults care for an impaired partner. Spousal caregiving may be more stressful when caregivers have MCCs, particularly those involving complex management. Yet, little is known about combinations of conditions that are most consequential for caregiving outcomes. Method Using a U.S. sample of 359 spousal caregivers and care recipients from the 2011 National Aging Trends Study and National Study of Caregiving, we examined three categories of MCCs based on similarity of management strategies (concordant only, discordant only, and both concordant and discordant) and their associations with caregiving difficulties and gains. We also considered gender differences. Results Relative to caregivers without MCCs, caregivers with discordant MCCs reported fewer gains, whereas caregivers with both concordant and discordant MCCs reported greater emotional and physical difficulties. Wives with discordant MCCs only reported a trend for greater physical difficulties. Caregivers with concordant MCCs did not report more difficulties or gains. Discussion Spousal caregivers with MCCs involving discordant management strategies appear to be at risk for adverse care-related outcomes and may benefit from support in maintaining their own health as well as their caregiving responsibilities.

scholarly journals Association Between Speed of Multimorbidity Accumulation in Old Age and Life Experiences: A Cohort Study

2019 ◽  
Vol 188 (9) ◽  
pp. 1627-1636 ◽  
Author(s):  
Serhiy Dekhtyar ◽  
Davide Liborio Vetrano ◽  
Alessandra Marengoni ◽  
Hui-Xin Wang ◽  
Kuan-Yu Pan ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Elementary Education ◽  
Chronic Conditions ◽  
Life Experiences ◽  
Laboratory Data ◽  
Later Life ◽  
Adverse Outcomes ◽  
National Study ◽  
Multiple Chronic Conditions ◽  
Medical Histories

Abstract Rapidly accumulating multiple chronic conditions (multimorbidity) during aging are associated with many adverse outcomes. We explored the association between 4 experiences throughout life—childhood socioeconomic circumstances, early-adulthood education, midlife occupational stress, and late-life social network—and the speed of chronic disease accumulation. We followed 2,589 individuals aged ≥60 years from the Swedish National Study on Aging and Care in Kungsholmen for 9 years (2001–2013). Information on life experiences was collected from detailed life-history interviews. Speed of disease accumulation was operationalized as the change in the count of chronic conditions obtained from clinical examinations, medical histories, laboratory data, drug use, and register linkages over 9 years. Linear mixed models were used to analyze the data. Speed of disease accumulation was lower in individuals with more than elementary education (for secondary, β × time = −0.065, 95% CI: −0.126, −0.004; for university, β × time = −0.118, 95% CI: −0.185, −0.050); for active occupations compared with high-strain jobs (β × time = −0.078, 95% CI: −0.138, −0.017); and for richer social networks (for moderate tertile, β × time = −0.102, 95% CI: −0.149, −0.055; for highest tertile, β × time = −0.135, 95% CI: −0.182, −0.088). The association between childhood circumstances and speed of disease accumulation was attenuated by later-life experiences. Diverse experiences throughout life might decelerate chronic disease accumulation during aging.

scholarly journals Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability

2019 ◽  
Vol 54 (7) ◽  
pp. 455-469
Author(s):  
Courtney A Polenick ◽  
Kira S Birditt ◽  
Angela Turkelson ◽  
Helen C Kales
Keyword(s):  
Depressive Symptoms ◽  
Chronic Conditions ◽  
Functional Disability ◽  
Well Being ◽  
Multiple Chronic Conditions ◽  
Individual Level ◽  
Growth Curve Models ◽  
Rate Of Increase ◽  
The Individual ◽  
Retirement Study

Abstract Background Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability. Purpose We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability. Methods The U.S. sample included 3,991 couples drawn from nine waves (1998–2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner’s baseline depressive symptoms, and each partner’s number of chronic conditions across waves. Results Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels. Conclusions Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges.

scholarly journals Prioritizing Illness: Lessons in Self-Managing Multiple Chronic Diseases

2009 ◽  
Vol 34 (4) ◽  
pp. 983-1002 ◽  
Author(s):  
Sally Lindsay
Keyword(s):  
Chronic Illness ◽  
Chronic Conditions ◽  
Chronic Disease Management ◽  
Management Strategies ◽  
Chronic Illnesses ◽  
Multiple Chronic Conditions ◽  
Illness Trajectory ◽  
Biographical Disruption ◽  
Multiple Chronic Diseases ◽  
Multiple Conditions

Chronic disease management strategies are largely based on single disease models, yet patients often need to manage multiple conditions. This study uses the concepts of ‘chronic illness trajectory’ and ‘biographical disruption’ to examine how patients self-manage multiple chronic conditions and especially how they prioritize which condition(s) will receive the greatest attention. Fifty-three people with multiple chronic illnesses participated in one of 6 focus groups. The results suggest that people who were disrupted tended to be younger than 60, lived on their own, cared for other family members, or other barriers. Many participants anticipated subsequent illnesses given their age and prior experience with illness. In order to cope with their multiple illnesses most felt it was necessary to prioritize their ‘main’ illness. Their reasons for prioritizing a particular illness included: (1) the unpredictable nature of the disease; (2) the condition could not be controlled by tablets; and (3) the condition tended to set off the rest of their health problems. Social context played a key role in shaping patients’ biography and chronic illness trajectory.

scholarly journals Predictors of Secondary Role Strains Among Spousal Caregivers of Older Adults With Functional Disability

2018 ◽  
Vol 59 (3) ◽  
pp. 486-498 ◽  
Author(s):  
Courtney A Polenick ◽  
Nicole DePasquale
Keyword(s):  
Relationship Quality ◽  
Functional Disability ◽  
Spousal Caregivers ◽  
Care Recipient ◽  
Health Conditions ◽  
Role Overload ◽  
National Study ◽  
Cross Sectional ◽  
Activity Restriction ◽  
Secondary Role

Abstract Background and Objectives Aging spouses commonly care for a partner with functional disability, but little is known about how spousal caregiving may impact different life domains. This study evaluated how caregiving characteristics are associated with secondary role strains among spousal caregivers. Research Design and Methods This cross-sectional study examined 367 spousal caregivers and their partners from the 2011 National Health and Aging Trends Study and National Study of Caregiving. Hierarchical regressions were estimated to determine how caregiver background factors (sociodemographics, health conditions) along with primary objective (care activities, care recipient health conditions, and dementia status) and subjective (emotional caregiving difficulties, role overload) stressors are linked to care-related valued activity restriction, negative caregiving relationship quality, and care-related family disagreements. Gender differences were considered. Results After accounting for all predictors, older caregivers and caregivers providing more help with activities of daily living and health system interactions (e.g., scheduling appointments) were more likely to report activity restriction, whereas caregivers with more emotional difficulties reported higher negative caregiving relationship quality. Role overload was positively associated with all three secondary strains. For husbands only, caring for a partner with more chronic conditions was linked to higher negative caregiving relationship quality and caring for a partner with dementia was associated with a greater likelihood of family disagreements. Discussion and Implications Secondary role strains may develop through similar and unique pathways for caregiving wives and husbands. Further research is needed to identify those who could benefit from support in managing their care responsibilities alongside other life areas.

Failing Bodies: Body Image and Multiple Chronic Conditions in Later Life

2008 ◽  
Vol 18 (8) ◽  
pp. 1084-1095 ◽  
Author(s):  
Laura Hurd Clarke ◽  
Meridith Griffin ◽  
Keyword(s):  
Body Image ◽  
Chronic Conditions ◽  
Later Life ◽  
Multiple Chronic Conditions

scholarly journals Impact of Multiple Chronic Conditions on Activity Limitations Among Older Mexican-American Care Recipients

2018 ◽  
Vol 15 ◽  
Author(s):  
Diane M. Collins ◽  
Brian Downer ◽  
Amit Kumar ◽  
Shilpa Krishnan ◽  
Chih-ying Li ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Mexican American ◽  
Multiple Chronic Conditions ◽  
Activity Limitations ◽  
Care Recipients

scholarly journals Prevalence and patterns of multi-morbidity in the productive age group of 30-69 years: A cross-sectional study in Pathanamthitta District, Kerala.

2020 ◽  
Vol 5 ◽  
pp. 233
Author(s):  
Rohini C ◽  
Panniyammakal Jeemon
Keyword(s):  
Chronic Conditions ◽  
Integrated Management ◽  
Management Strategies ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Multiple Chronic Conditions ◽  
Behavioral Risk ◽  
Age Group ◽  
Cross Sectional

Background: Multi-morbidity is the coexistence of multiple chronic conditions in individuals. With advancing epidemiological and demographic transitions, the burden of multi-morbidity is expected to increase India. Methods: A cross-sectional representative survey was conducted among 410 participants aged 30-69 years in Pathanamthitta District, Kerala to assess the prevalence of multi-morbidity. A multi-stage cluster sampling method was employed to identify households for the survey. We interviewed all eligible participants in the selected households. A structured interview schedule was used to assess socio-demographic variables, behavioral risk factors and prevailing clinical conditions. We used the PHQ-9 questionnaire for depression screening. Further, we conducted active measurements of both blood sugar and blood pressure. Multiple logistic regression was used to identify variables associated with multi-morbidity. Results: Overall, the prevalence of multi-morbidity was 45.4% (95% CI: 40.5-50.3%). Nearly a quarter of the study participants (25.4%) reported only one chronic condition (21.3-29.9%). Further, 30.7% (26.3-35.5), 10.7% (7.9-14.2), 3.7% (2.1-6.0) and 0.2% reported two, three, four and five chronic conditions, respectively. At least one person with multi-morbidity was present in around seven out of ten households (72%, 95% CI: 65-78%). Further, one in five households (22%, 95% CI: 16.7-28.9%) reported more than one person with multi-morbidity. Diabetes and hypertension was the most frequent dyad (30.9%, 95% CI: 26.5-35.7%), followed by hypertension and depression (7.8%, 95% CI: 5.5-10.9%). Diabetes, hypertension and ischemic heart disease was the common triad in males (8.5%, 95% CI: 4.8-14.1%), while it was diabetes, hypertension and depression (6.9%, 95% CI: 4.2-11.1%) in females. Age, sex, and employment status were associated with multi-morbidity. Conclusion: Multi-morbidity is prevalent in one of two participants in the productive age group of 30-69 years. Further, seven of ten households have at least one person with multi-morbidity. The high burden of multi-morbidity calls for integrated management strategies for multiple chronic conditions.

scholarly journals Living with multimorbidity? The lived experience of multiple chronic conditions in later life

2019 ◽  
Vol 24 (6) ◽  
pp. 701-718 ◽  
Author(s):  
Tom Porter ◽  
Bie Nio Ong ◽  
Tom Sanders
Keyword(s):  
Older People ◽  
Lived Experience ◽  
Chronic Conditions ◽  
Later Life ◽  
Constructivist Grounded Theory ◽  
Multiple Chronic Conditions ◽  
Long Term Conditions ◽  
Depth Interviews ◽  
Multiple Conditions

Multimorbidity is defined biomedically as the co-existence of two or more long-term conditions in an individual. Globally, the number of people living with multiple conditions is increasing, posing stark challenges both to the clinical management of patients and the organisation of health systems. Qualitative literature has begun to address how concurrency affects the self-management of chronic conditions, and the concept of illness prioritisation predominates. In this article, we adopt a phenomenological lens to show how older people with multiple conditions experience illness. This UK study was qualitative and longitudinal in design. Sampling was purposive and drew upon an existing cohort study. In total, 15 older people living with multiple conditions took part in 27 in-depth interviews. The practical stages of analysis were guided by Constructivist Grounded Theory. We argue that the concept of multimorbidity as biomedically imagined has limited relevance to lived experience, while concurrency may also be erroneous. In response, we outline a lived experience of multiple chronic conditions in later life, which highlights differences between clinical and lay assumptions and makes the latter visible.

Sign in / Sign up

Export Citation Format

Share Document