The Role of Secondary Care Networks, Gender, and Race on Primary Caregiver Burden

Abstract In addition to primary caregivers, many older adults receive care from secondary care networks (SCN), which include family members and friends. Literature rarely considers support that SCN provided to primary caregivers. This study examines: (a) the association between SCN support and primary caregiver burden, and (b) the intersectional effects of gender (male/female)-race (White/Black) identities of primary caregivers on the association. A cross-sectional study using data from 2015 National Health and Aging Trend Study (NHATS) and National Study of Caregiving (NSOC) was conducted. A total of 967 older adults, 967 primary caregivers, and 2253 secondary caregivers were selected. SCN support was measured by (a) care domain overlap, and (b) proportion of caregiving by SCN. Negative binomial regressions on overall and split samples estimated main effects of SCN support and the intersectional effects of gender and race. Both SCN-related variables were associated with primary caregiver burden, but significant three-way interaction was only found between gender, race, and proportion of caregiving by SCN. Black female caregivers reported heaviest burden and having SCN support was associated with lower risk of being burdened. Whereas Black male caregivers reported lightest burden and SCN support was not associated with their perceived burden. Our findings support the positive role of SCN in reducing stress of primary caregivers, and demonstrate that positive impacts of SCN support vary across gender-race groups. The results indicate a strong need for support programs aimed at promoting cooperation among family caregivers for burden reduction, especially families with female and Black primary caregivers.

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Leisure Activity and Caregiver Involvement in Middle-Aged and Older Adults With Down Syndrome

Intellectual and Developmental Disabilities ◽

10.1352/1934-9556-55.2.97 ◽

2017 ◽

Vol 55 (2) ◽

pp. 97-109 ◽

Cited By ~ 5

Author(s):

Iulia Mihaila ◽

Sigan L. Hartley ◽

Benjamin L. Handen ◽

Peter D. Bulova ◽

Rameshwari V. Tumuluru ◽

...

Keyword(s):

Older Adults ◽

Down Syndrome ◽

Support Services ◽

Leisure Activities ◽

Primary Caregivers ◽

Leisure Activity ◽

Primary Caregiver ◽

Middle Aged ◽

Need For Support ◽

Caregiver Involvement

Abstract The present study examined leisure activity and its association with caregiver involvement (i.e., residence and time spent with primary caregiver) in 62 middle-aged and older adults with Down syndrome (aged 30–53 years). Findings indicated that middle-aged and older adults with Down syndrome frequently participated in social and passive leisure activities, with low participation in physical and mentally stimulating leisure activities. Residence and time spent with primary caregiver were associated with participation in physical leisure activity. The findings suggest a need for support services aimed at increasing opportunities for participating in physical and mentally stimulating leisure activity by middle-aged and older adults with Down syndrome. These support services should partner with primary caregivers in order to best foster participation in physical leisure activity.

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Do Income Supplemental Programs for Older Adults’ Help Reduce Primary Caregiver Burden? Evidence from Mexico

Journal of Cross-Cultural Gerontology ◽

10.1007/s10823-019-09374-8 ◽

2019 ◽

Vol 34 (4) ◽

pp. 385-402 ◽

Cited By ~ 1

Author(s):

Emma Aguila ◽

Mariana López-Ortega ◽

Sean Angst

Keyword(s):

Older Adults ◽

Caregiver Burden ◽

Primary Caregiver

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Cross-cultural ageism: ageism and attitudes toward aging among Jews and Arabs in Israel

International Psychogeriatrics ◽

10.1017/s1041610212001548 ◽

2012 ◽

Vol 25 (1) ◽

pp. 6-15 ◽

Cited By ~ 23

Author(s):

Yoav S. Bergman ◽

Ehud Bodner ◽

Sara Cohen-Fridel

Keyword(s):

Older Adults ◽

Primary Caregivers ◽

Cross Cultural ◽

Arab Women ◽

Cultural Comparison ◽

The Family ◽

Traditional Societies ◽

Research Findings ◽

Arab Men

ABSTRACTBackground: While it is generally agreed that traditional societies are more favorable toward their elders, research findings have been inconsistent. Accordingly, this study presents a cultural comparison between Jews and Arabs in Israel in attitudes toward older adults and personal views regarding one's own aging. It was assumed that Arabs would rate their culture as more tolerant toward older adults, would report spending more time with them, and express lower ageism and aging anxieties.Method: We examined 154 native Israeli citizens, 86 Jewish and 68 Muslim Arabs, who completed measures of ageism, aging anxieties, and cultural views of older adults.Results: Arabs rated their culture as more tolerant toward their elders, perceived older adults as significantly more contributing to society, and reported engaging in less avoiding behaviors toward them. Arabs also exhibited less general fears of growing old and concerns over one's physical appearance in old age. But it was interesting to note that Arab women reported higher scores of aging anxieties and ageist attitudes in comparison to Arab men, whereas no such differences were found among Jews.Conclusions: Our findings point that the cultural importance of elders for the Arab cohort transcends beyond Westernization processes which affect the Arab society in Israel, and reflect the demanding role of Arab women as primary caregivers for the elders in the family. Limitations and implications of the study are discussed.

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The Role of Psychological and Social Well-being on Physical Function Trajectories in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa114 ◽

2020 ◽

Vol 75 (8) ◽

pp. 1579-1585

Author(s):

Marguerita Saadeh ◽

Anna-Karin Welmer ◽

Serhiy Dekhtyar ◽

Laura Fratiglioni ◽

Amaia Calderón-Larrañaga

Keyword(s):

Older Adults ◽

Physical Function ◽

Well Being ◽

Community Dwelling ◽

National Study ◽

Age Related ◽

Combining Data ◽

Study Population ◽

Rate Of Decline

Abstract Background Psychological and social well-being are emerging as major determinants in preserving health in old age. We aimed to explore the association between these factors and the rate of decline in physical function over time in older adults. Methods Data were gathered from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). The study population consisted of 1,153 non-demented, community-dwelling men and women free from multimorbidity or impairments in basic or instrumental activities of daily living at baseline. They were followed over 12 years to capture the rate of decline in physical function, which was measured by combining data on walking speed, balance, and chair stands. The association between baseline psychological and social well-being and decline in physical function was estimated through linear mixed models, after multiple adjustments including personality and depressive symptoms. Results Higher levels of psychological (β = .007; p = .037) and social (β = .008; p = .043) well-being were significantly associated with a decreased rate of decline in physical function over the follow-up. There was a significant three-way interaction between psychological well-being*time*sex (female vs male) (β = .015; p = .047), showing that a slower decline in physical function was observed only among women and not in men. The association was strongest for individuals with high levels of both psychological and social well-being (β = .012; p = .019). Conclusion High levels of psychological and social well-being may slow down the age-related decline in physical function, which confirms the complexity of older adults’ health, but also points towards new preventative strategies.

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Caring for Older Adults With Vision Impairment and Dementia

Innovation in Aging ◽

10.1093/geroni/igaa043 ◽

2020 ◽

Vol 4 (6) ◽

Author(s):

Varshini Varadaraj ◽

Shang-En Chung ◽

Kayla S Swiatek ◽

Orla C Sheehan ◽

Ashley Deemer ◽

...

Keyword(s):

Older Adults ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Vision Impairment ◽

National Study ◽

Medicare Beneficiaries ◽

Similar Time ◽

Survey Report ◽

Nationally Representative ◽

Design And Methods

Abstract Background and Objectives Dementia and vision impairment (VI) are common among older adults but little is known about caregiving in this context. Research Design and Methods We used data from the 2011 National Health and Aging Trends Study, a nationally representative survey of Medicare beneficiaries, linked to their family/unpaid helpers from the National Study of Caregiving. Vision impairment was defined as self-reported blindness or difficulty with distance/near vision. Probable dementia was based on survey report, interviews, and cognitive tests. Our outcomes included hours of care provided, and number of valued activities (scored 0–4) affected by caregiving, per month. Results Among 1,776 caregivers, 898 (55.1%, weighted) assisted older adults without dementia or VI, 450 (21.9%) with dementia only, 224 (13.0%) with VI only, and 204 (10.0%) with dementia and VI. In fully adjusted negative binomial regression analyses, caregivers of individuals with dementia and VI spent 1.7 times as many hours (95% confidence interval [CI] = 1.4–2.2) providing care than caregivers of those without either impairment; however, caregivers of individuals with dementia only (95% CI = 1.1–1.6) and VI only (95% CI = 1.1–1.6) spent 1.3 times more hours. Additionally, caregivers of individuals with dementia and VI had 3.2 times as many valued activities affected (95% CI = 2.2–4.6), while caregivers of dementia only and VI only reported 1.9 times (95% CI = 1.4–2.6) and 1.3 times (95% CI = 0.9–1.8) more activities affected, respectively. Discussion and Implications Our results suggest that caring for older adults with VI involves similar time demands as caring for older adults with dementia, but that participation impacts are greater when caring for older adults with both dementia and VI.

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Alzheimer's Alphabet Soup: ADRD research in NHATS and NSOC

Innovation in Aging ◽

10.1093/geroni/igab046.1685 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 435-435

Author(s):

Loretta Anderson ◽

Alexandra Wennberg ◽

Frank Lin

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Caregiver Burden ◽

Functional Decline ◽

Cognitive Outcomes ◽

National Study ◽

Dementia Patients ◽

Nationally Representative ◽

And Function

Abstract There are 5.8 million Americans living with Alzheimer’s disease, but currently there is no cure or effective treatment. Alzheimer’s disease and related dementias (ADRD) are characterized by cognitive decline, but patients also have behavioral symptoms and functional decline. Understanding the gamut of risk and prognostic factors for ADRD and those associated with the task of caring for these patients is layered. The National Health and Aging Trends Study (NHATS) and the sister National Study of Caregiving (NSOC) are excellent resources to investigate layers of ADRD incidence, progression, and caregiving in the population. NHATS is a nationally representative sample of Medicare beneficiaries aged 65 and older. Since 2011, annual in-person interviews have collected data in many areas, including health, environment, wellbeing, cognition, and function. NSOC has been conducted at three timepoints corresponding with NHATS rounds and collects detailed data on caregivers, including information on care activities, caregiver burden, and caregiver wellbeing. This symposium illustrates the broad range of ADRD research questions that can be probed using NHATS/NSOC data. The session begins with a presentation the association between caregiver burden and ADRD patient cognitive outcomes. The second presentation examines the role of physical performance as a predictor of developing ADRD. The third presentation investigates the role of dual sensory impairment – both hearing and vision impairment – on dementia incidence. The session concludes with an examination of whether hearing impairment among dementia patients is associated with different caregiving needs.

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P096: Risk for early unplanned rehospitalization of older adults after an ED visit: role of the caregiver burden

European Geriatric Medicine ◽

10.1016/s1878-7649(14)70271-2 ◽

2014 ◽

Vol 5 ◽

pp. S112

Author(s):

S. Bonin-Guillaume ◽

A.C. Durand ◽

F. Yahi ◽

M. Curiel Berruyer ◽

O. Lacroix ◽

...

Keyword(s):

Older Adults ◽

Caregiver Burden

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Multimorbidity Patterns and Unplanned Hospitalisation in a Cohort of Older Adults

Journal of Clinical Medicine ◽

10.3390/jcm9124001 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4001

Author(s):

Roselyne Akugizibwe ◽

Amaia Calderón-Larrañaga ◽

Albert Roso-Llorach ◽

Graziano Onder ◽

Alessandra Marengoni ◽

...

Keyword(s):

Older Adults ◽

Negative Binomial ◽

Community Dwelling ◽

National Study ◽

Multiple Chronic Conditions ◽

Cox Models ◽

Care Utilisation ◽

Hospital Days ◽

Binomial Models

The presence of multiple chronic conditions (i.e., multimorbidity) increases the risk of hospitalisation in older adults. We aimed to examine the association between different multimorbidity patterns and unplanned hospitalisations over 5 years. To that end, 2,250 community-dwelling individuals aged 60 years and older from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were studied. Participants were grouped into six multimorbidity patterns using a fuzzy c-means cluster analysis. The associations between patterns and outcomes were tested using Cox models and negative binomial models. After 5 years, 937 (41.6%) participants experienced at least one unplanned hospitalisation. Compared to participants in the unspecific multimorbidity pattern, those in the cardiovascular diseases, anaemia and dementia pattern, the psychiatric disorders pattern and the metabolic and sleep disorders pattern presented with a higher hazard of first unplanned hospitalisation (hazard ratio range: 1.49–2.05; p < 0.05 for all), number of unplanned hospitalisations (incidence rate ratio (IRR) range: 1.89–2.44; p < 0.05 for all), in-hospital days (IRR range: 1.91–3.61; p < 0.05 for all), and 30-day unplanned readmissions (IRR range: 2.94–3.65; p < 0.05 for all). Different multimorbidity patterns displayed a differential association with unplanned hospital care utilisation. These findings call for a careful primary care follow-up of older adults with complex multimorbidity patterns.

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Older adults' spirituality and life satisfaction: a longitudinal test of social support and sense of coherence as mediating mechanisms

Ageing and Society ◽

10.1017/s0144686x12000633 ◽

2012 ◽

Vol 33 (7) ◽

pp. 1243-1262 ◽

Cited By ~ 30

Author(s):

SEAN COWLISHAW ◽

SYLVIA NIELE ◽

KAREN TESHUVA ◽

COLETTE BROWNING ◽

HAL KENDIG

Keyword(s):

Social Support ◽

Older Adults ◽

Life Satisfaction ◽

Sense Of Coherence ◽

Psychological Functioning ◽

Community Sample ◽

Successful Ageing ◽

Positive Role ◽

Over Time

ABSTRACTSpirituality is proposed to be a component of successful ageing and has been shown to predict wellbeing in old age. There has been conceptual discussion of possible mechanisms that link spirituality with positive psychological functioning in older adults, but few empirical examinations of these linking mechanisms over time. The current study examined the role of Antonovsky's Sense of Coherence (SOC) and social support in mediating the effects of spirituality on life satisfaction in older participants over a four-year period. The study used a cross-lagged panel analysis to evaluate longitudinal mediation within a path analysis framework. Results showed that the meaningfulness dimension of SOC mediated the influence of spirituality on life satisfaction over time, suggesting that spirituality may influence older adults' experience and perception of life events, leading to a more positive appraisal of these events as meaningful. Social support was not found to mediate the pathway between spirituality and life satisfaction. This study may be the first to examine the link between spirituality, sense of coherence, social support and wellbeing, as measured by life satisfaction, using longitudinal data from a community sample of older adults. The study provides evidence for the positive role of spirituality in the lives of older people. This is an area that requires further examination in models of successful ageing.

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