Characterizing Supportive Services Use by Caregiving Relationship Status

Abstract Informal caregivers of aging older adults experience a high degree of burden and strain. These emotional experiences often stem from stressful tasks associated with caregiving. Caregiving supportive services that target the provision of support for stressful tasks are instrumental in alleviating caregiving burden and strain. Research is limited on what types of caregiving supportive services caregivers are accessing by relationship status and their source of information. We sought to characterize caregiving supportive services use by caregiving relationship status. We analyzed cross-sectional data from the 2015 National Study of Caregiving limited to caregivers of older adults □65 years. Caregiver relationship status (i.e., spouse, child, other relative/non-relative) was the independent variable. Bivariate analyses were performed to examine the association with caregiver relationship status and 1) any use of supportive services, 2) type of supportive service used among users, and 3) source of information about supportive services. Our sample consisted of 1,871 informal caregivers, 30.7% reported using supportive services. By caregiver relationship status, children had the greatest use of supportive services compared to spouses and other relatives/non-relatives (33.3% vs. 22.5% vs. 22.1%, p=.02, respectively). Among users of services, there were no differences in type of services used. Spouses primarily received their information about services from a medical provider or social worker (73.8%, p=.004). Our findings highlight the need to ensure that other caregiving groups such as spouses have access to important supportive services such as financial support. Medical providers and/or social workers should be better leveraged and equipped to provide this information.

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IDENTIFYING UNMET NEED IN INFORMAL CAREGIVING: DISPARITIES BY GENDER, EMPLOYMENT STATUS, AND RACE-ETHNICITY

Innovation in Aging ◽

10.1093/geroni/igz038.803 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S219-S220

Author(s):

Steven A Cohen ◽

Furong Xu ◽

Marissa R Meucci ◽

Symone Woodham ◽

Mary L Greaney

Keyword(s):

Older Adults ◽

Employment Status ◽

Informal Caregivers ◽

Unmet Need ◽

Informal Caregiving ◽

Care Recipient ◽

National Study ◽

Caregiver Health ◽

White Caregivers ◽

Race Ethnicity

Abstract Older adults, including those with dementia and other types of cognitive decline, often report a desire to remain in their homes. Over 50 million informal caregivers in the US provide needed in-home assistance to those in need, and there are well-documented disparities in informal caregiving responsibilities by sociodemographic factors , yet little is known about “unmet need” in informal caregiving. Therefore, the study’s objective is to examine discrepancies in unmet caregiving-related need by race/ethnicity, gender, and employment status. We abstracted data about caregivers from the 2017 National Study of Caregiving and linked these data to participants in the National Health and Aging Trends Study on caregivers of older adults (n=993). Generalized linear models were used to model the discrepancies between the number of activities of daily living for which the care recipient required assistance and the number of tasks caregivers provide, by race/ethnicity, gender, and employment status, accounting for confounders and complex sampling. Care recipients whose primary informal caregivers were employed were 69% more likely than those whose informal caregivers were not employed to experience unmet caregiving need (OR 1.69, 95%CI 1.19-2.41). A similar association between employment and unmet caregiving was observed among White caregivers (OR=1.79, 95% CI 1.16-2.69), while the association was not significant among Black caregivers (p=0.228). These findings suggest potentially addressable disparities in informal caregiving duties between Black and White caregivers, and can be used to inform and develop of policies and programs designed to improve caregiver health and reduce undue strain on caregiver health and wellbeing.

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RACIAL DIFFERENCES IN CHARACTERISTICS AND PERCEPTIONS OF CAREGIVERS TO BLACK AND WHITE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.747 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S206-S206

Author(s):

Chanee D Fabius ◽

Chanee Fabius ◽

Jennifer Wolff ◽

Judith Kasper

Keyword(s):

Older Adults ◽

Racial Differences ◽

Social Engagement ◽

National Study ◽

Medicare Beneficiaries ◽

Supportive Services ◽

Black And White ◽

Nationally Representative ◽

Using Data ◽

Negative Feelings

Abstract Persistent racial differences in health, socioeconomic characteristics, and service utilization of older adults likely result in differential effects for the circumstances and experiences of family and unpaid caregivers. Utilization of community-based services has been found to alleviate caregiver burden, but the extent to which supports and informal help affect race differences in caregiver perceptions (e.g. positive/negative feelings associated with caregiving) and engagement in activities such as religious services, volunteering, or visiting family and friends, is less understood. Using data from the 2015 National Health and Aging Trends Study (NHATS; Round 5) and the National Study of Caregiving (NSOC; Round 2), nationally representative studies of Medicare beneficiaries aged 65 and older and their caregivers, this presentation will discuss the association between sociodemographic characteristics, use of assistance from others or supportive services, and perceived gains, difficulties, and social engagement among caregivers to older black and white adults.

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Uitbraak COVID-19 in de verpleeghuiszorg

Tijdschrift voor Gerontologie en Geriatrie ◽

10.36613/tgg.1875-6832/2020.03.01 ◽

2020 ◽

Keyword(s):

Older Adults ◽

Nursing Home ◽

Nursing Homes ◽

Long Term Care ◽

Informal Caregivers ◽

Rapid Review ◽

Daily Routine ◽

Term Care ◽

Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

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ASIAN OLDER ADULTS’ ONLINE AND OFFLINE HEALTH INFORMATION PREFERENCES AND BEHAVIORS

Innovation in Aging ◽

10.1093/geroni/igz038.1535 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S412-S412

Author(s):

Bo Xie ◽

Kristina Shiroma

Keyword(s):

Older Adults ◽

Decision Making ◽

Ethnic Minority ◽

Health Information ◽

Survey Data ◽

National Study ◽

Information Preferences ◽

Internet Users ◽

And Behaviors ◽

Older Chinese

Abstract Older adults living in Asia or of Asian origin have unique preferences for information that require special attention. This symposium focuses on the health information preferences and behaviors of Asian older adults. Song et al. investigated the relationship between Internet use and perceived loneliness among Older Chinese using from survey data collected in the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS), a national study involving 12,400 households in Mainland China. Multiple regression results suggest that older Chinese Internet users perceived significantly less loneliness compared with their age peers who were non-Internet users. Zhang et al. investigated the role of information and communication technologies in supporting antiretroviral therapy (ART)-related knowledge seeking among older Chinese with HIV. Their cross-sectional survey data were collected from 2012 to 2013 in Guangxi, China. The results suggest that less than 5% of the participants sought HIV-related information via computers. Patients less knowledgeable about ART were more likely than those more knowledgeable to consult medical professionals about the disease via cell phones. Shiroma et al. report findings of a systematic literature review conducted in spring 2019 that examined Asian ethnic minority older adults’ preferences for end-of-Life (EOL) information seeking and decision making. The results suggest Asian ethnic minority older adults are understudied in the literature on EOL information and decision making, especially in terms of their unique cultural contexts. Du et al. examined how health information obtained from different types of social networks affect osteoporosis self-management behaviors among older White and Asian women.

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Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

Palliative & Supportive Care ◽

10.1017/s1478951520001200 ◽

2020 ◽

pp. 1-9

Author(s):

Hyunjin Noh ◽

Lewis H. Lee ◽

Chorong Won

Keyword(s):

Older Adults ◽

Palliative Care ◽

Cognitive Impairment ◽

Educational Intervention ◽

Test Scores ◽

Informal Caregivers ◽

Cognitively Impaired ◽

Significant Difference ◽

Post Test ◽

Seriously Ill

Abstract Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

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Role of social integration in the protection against depression in the Chilean elderly population

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1053 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L de Albuquerque Araújo ◽

N Bello Escamilla ◽

V Sabando Franulic

Keyword(s):

Mental Health ◽

Older Adults ◽

Social Integration ◽

Old Age ◽

Protective Factor ◽

Depression Scale ◽

Mental Illnesses ◽

National Study ◽

Close Relatives ◽

Negative Gradient

Abstract Chile has improved survival however this process occurs under a framework of socioeconomic and gender inequalities, which results in an impact of mental health, especially in vulnerable groups. The objective was to determine the association between depression and social integration in Chilean older adults. Cross-sectional study from the National Study of Dependence in Old Person 2010. The risk of depression was amount with Geriatric Depression Scale (>5). The social integration were quantity as frequency of meeting with close relatives (child, partner, daughter/ son-in-law, grandchildren); with other relatives (brother, brothers-in-law, nephews or other relatives) and with friends and neighbors in the last 12 months in 5 categories (never visit; less frequently; 1-2 times a month; 1-2 times a week; every day or almost). Logistic regression models considered the sampling design of the survey to identify association with odd ratio (OR) (never as reference category), adjustment for sex, age, ethnicity, household income, education, housing arrangement and chronic diseases (p ≤ 0,5). Total of 4179 older adults 25,3% reported risk of depression, the significative association with close relatives was in daily or almost frequency OR:0.42 (95%CI 0.27-0.67), 1-2 times a week OR: 0,57 (95%CI 0,33-0,99), 1-2 times/month OR: 0,56 (95%CI 0,99); other relatives were lower frequency OR: 0.54 (95%CI 0.38-0.78); 1-2 times/month OR; 0.50 (95%CI 0.31-0.81); 1-2 times/week OR:0.35 (95%CI 0.22-0.55); daily or almost OR:0.27 (95%CI 0.18-0.42). And meeting with friends and neighbors in the same frequency order were OR: 0.66 (95%CI 0.44-0.99); OR:0.43 (95%CI 0.26-0.73); OR:0.4 (95%CI 0.25-0.62); OR: 0.32 (95%CI 0.21-0.47). There is a negative gradient between depression and the frequency of meeting with friends, neighbors and family, independent of sociodemographic and health characteristics. Social integration must be promoted as a protective factor of mental health in elderly. Key messages Depression is one of the most common mental illnesses in old age and we found a negative gradient between the frequency of meeting friends, neighbors and family and the possibility of depression. It seems essential for public health to have strategies that address social life in old age to strengthen quality of live and mental health.

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Evaluating the provision of Further Enabling Care at Home (FECH+) for informal caregivers of older adults discharged home from hospital: protocol for a multicentre randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-046600 ◽

2021 ◽

Vol 11 (6) ◽

pp. e046600

Author(s):

Anne-Marie Hill ◽

Rachael Moorin ◽

Susan Slatyer ◽

Christina Bryant ◽

Keith Hill ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Randomised Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Informal Caregivers ◽

Care Recipient ◽

Care At Home ◽

Randomised Controlled

IntroductionThere are personal and societal benefits from caregiving; however, caregiving can jeopardise caregivers’ health. The Further Enabling Care at Home (FECH+) programme provides structured nurse support, through telephone outreach, to informal caregivers of older adults following discharge from acute hospital care to home. The trial aims to evaluate the efficacy of the FECH+ programme on caregivers’ health-related quality of life (HRQOL) after care recipients’ hospital discharge.Methods and analysisA multisite, parallel-group, randomised controlled trial with blinded baseline and outcome assessment and intention-to-treat analysis, adhering to Consolidated Standards of Reporting Trials guidelines will be conducted. Participants (N=925 dyads) comprising informal home caregiver (18 years or older) and care recipient (70 years or older) will be recruited when the care recipient is discharged from hospital. Caregivers of patients discharged from wards in three hospitals in Australia (one in Western Australia and two in Queensland) are eligible for inclusion. Participants will be randomly assigned to one of the two groups. The intervention group receive the FECH+ programme, which provides structured support and problem-solving for the caregiver after the care recipient’s discharge, in addition to usual care. The control group receives usual care. The programme is delivered by a registered nurse and comprises six 30–45 min telephone support sessions over 6 months. The primary outcome is caregivers’ HRQOL measured using the Assessment of Quality of Life—eight dimensions. Secondary outcomes include caregiver preparedness, strain and distress and use of healthcare services. Changes in HRQOL between groups will be compared using a mixed regression model that accounts for the correlation between repeated measurements.Ethics and disseminationParticipants will provide written informed consent. Ethics approvals have been obtained from Sir Charles Gairdner and Osborne Park Health Care Group, Curtin University, Griffith University, Gold Coast Health Service and government health data linkage services. Findings will be disseminated through presentations, peer-reviewed journals and conferences.Trial registration numberACTRN12620000060943.

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Positive Emodiversity Buffers the Association Between Stress and Depressive Symptoms

Innovation in Aging ◽

10.1093/geroni/igaa057.2250 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 653-653

Author(s):

Lizbeth Benson ◽

Anthony Ong

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Life Span ◽

Daily Diary ◽

National Study ◽

Younger Adults ◽

Shannon's Entropy ◽

Daily Experiences ◽

Age Related ◽

Optimal Functioning

Abstract Intensive measurements of individuals’ experiences allow for identifying patterns of functioning that may be markers of resilience, and whether such patterns differ across the life span. Using 8 daily diary reports collected in the second burst of the National Study of Daily Experiences (NSDE, n=848, age 34-84; 55%female), we examined whether positive emodiversity (Shannon’s entropy) attenuated the association between cumulative stressor exposure and depressive symptoms, and age-related differences therein. Results indicated age moderated the extent to which positive emodiversity attenuated the association between stress and depressive symptoms (b=0.11, p < .05). The attenuated association was strongest for younger adults with higher positive emodiversity, compared to those with lower positive emodiversity. For older adults, the association between stress and depressive symptoms was relatively similar regardless of their positive emodiversity. Implications pertain to for whom and in what contexts specific types of dynamic emotion experiences may promote optimal functioning and resilience.

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