scholarly journals Social Isolation, Caregiving Alone, and Caregiving Stress in Family Caregivers of Older Adults in Korea

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 990-990
Author(s):  
Sol Baik ◽  
Jiweon Jun
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Social Isolation ◽  
Negative Impact ◽  
Reference Group ◽  
Term Care ◽  
Social Time ◽  
Caregiving Stress ◽  
Ordinal Logistic Regression Analysis ◽  
Socially Isolated

Abstract The tendency of caregiving alone is increasing, and these solo caregivers often perceive caregiving responsibilities as a burden. Still, literature on positive aspects of caregiving shows that not all caregivers experience severe distress. Little is known on which factors make a difference in experiencing caregiving distress among solo caregivers. We focused on the empirical findings on the negative impact of social isolation on caregiver’s mental health, examining if and how the intersection of solo caregiving and social isolation is related to severe caregiving stress among caregivers of older adults in Korea. We analyzed 501 family caregivers of older adults in Korea using survey data from the Care Work and the Economy research project (2018). We conducted ordinal logistic regression analysis. The findings show that solo caregivers with a lack of social time fall under the most at-risk group of caregivers in terms of experiencing severe stress (OR=3.72, SE=0.93) whereas solo caregivers with enough social time did not show significantly higher stress compared to the reference group (OR=1.50, SE=0.43). Being socially isolated caregivers still had high levels of stress despite the division of care (OR=2.16, SE=0.55), implying the need to provide caregivers more time for social interaction with others. The current public long-term care insurance in Korea provides limited hours of in-home care aide services to enable aging in place of older adults. To reduce the social isolation of caregivers, it is necessary to extend the service hours and provide support, such as creating online caregiver networks.

scholarly journals A Pandemic Paradox: Innovations in Psychological Resiliency and Suicide Prevention in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 417-418
Author(s):  
Marnin Heisel
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Suicide Prevention ◽  
Negative Impact ◽  
Well Being ◽  
Social Advocacy ◽  
Term Care ◽  
Research Education ◽  
Health And Well Being

Abstract The COVID-19 pandemic has had a substantial negative impact on the health and well-being of older adults, a demographic with the highest proportion of fatalities in North America. Long-term care and retirement homes have been especially hard hit. Sheltering in place can increase social isolation among older adults and contribute to feelings of stigmatization, burden, stress, anxiety, anger, and despair. As older adults also account for high rates of suicide, fear of infection, reduced access to professional and social supports, and growing apathy, hopelessness, and social isolation could amplify suicide risk (see Zortea et al., 2020). The speaker will discuss how his program of research on psychological resiliency and suicide prevention in older adults has pivoted online over the past year, and how the pandemic has paradoxically inspired innovative approaches to research, education, clinical practice, and social advocacy for older adults that will likely continue well beyond the present time.

scholarly journals 40-Year Projections of Disability and Social Isolation of Older Adults for Long-Range Policy Planning in Singapore

2020 ◽  
Vol 17 (14) ◽  
pp. 4950 ◽  
Author(s):  
Reuben Ng ◽  
Si Qi Lim ◽  
Su Ying Saw ◽  
Kelvin Bryan Tan
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Long Range ◽  
Living Arrangements ◽  
Living Alone ◽  
Population Projections ◽  
Policy Planning ◽  
Housing Type ◽  
Term Care ◽  
Socially Isolated

Against a rapidly aging population, projections are done to size up the demand for long-term care (LTC) services for long-range policy planning. These projections are typically focused on functional factors such as disability. Recent studies indicate the importance of social factors, for example, socially isolated seniors living alone are more likely to be institutionalized, resulting in higher demand for LTC services. This is one the first known studies to complete a 40-year projection of LTC demand based on disability and social isolation. The primary micro dataset was the Retirement and Health Survey, Singapore’s first nationally representative longitudinal study of noninstitutionalized older adults aged 45 to 85 with over 15,000 respondents. Disability prevalence across the mild to severe spectrum is projected to increase five-fold over the next 40 years, and the number of socially isolated elders living alone is projected to grow four-fold. Regression models of living arrangements revealed interesting ethnic differences: Malay elders are 2.6 times less likely to live alone than their Chinese counterparts, controlling for marital status, age, and housing type. These projections provide a glimpse of the growing demand for LTC services for a rapidly aging Singapore and underscore the need to shore up community-based resources to enable seniors to age-in-place.

scholarly journals SOCIAL ISOLATION, LONELINESS, AND CAREGIVER BURDEN AMONG PAID AND UNPAID CAREGIVERS OF HOMEBOUND OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S967-S967
Author(s):  
Amy Y Sun ◽  
Emily Finkelstein ◽  
Karin Ouchida
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Social Isolation ◽  
Support Groups ◽  
Caregiver Burden ◽  
Chronically Ill ◽  
Structured Interviews ◽  
Socially Isolated ◽  
Homebound Older Adults ◽  
Paid Caregivers

Abstract Caregivers of homebound older adults may have high levels of burden and more vulnerability to social isolation and loneliness, given that their care recipients are more physically frail and isolated. Existing literature has not fully investigated differences between paid and unpaid caregiver burden or their experiences of social isolation. We interviewed paid (n=21) and unpaid family caregivers (n=22) of homebound older adults in a hospital-affiliated geriatric house call program. We used validated survey instruments to measure social isolation, loneliness, and caregiver burden, and semi-structured interviews to solicit qualitative data. In our sample, 42% of caregivers helped with 5+ ADLs and 58% with 5+ iADLs. Using the Caregiver Burden Inventory, burden types between caregivers were compared with chi-squared tests. Compared to paid caregivers, unpaid family caregivers experienced more “developmental” burden such as “missing out on life” (p<0.01). Paid caregivers exhibited more “time” burden, such as “not having a minute’s break from caregiving responsibilities” (p<0.01). 44% of caregivers were considered socially isolated according to the Berkman-Syme Social Index. However, using the UCLA 3-item Loneliness Scale, few caregivers felt lonely (14%). Thematic analysis revealed that family caregivers desired support groups but time pressures limited their participation (23%). Interestingly, smart phones were regularly cited as a tool for alleviating loneliness for paid caregivers when alone on the job (19%), a novel finding. Findings suggest that caregivers of the chronically ill and physically isolated may be at particular risk of social isolation. Network based social support interventions may mitigate some of these vulnerabilities.

Addressing COVID-19 Worry and Social Isolation in Home-Based Primary Care

2020 ◽  
Author(s):  
Rachel Elizabeth Weiskittle ◽  
Michelle Mlinac ◽  
LICSW Nicole Downing
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Social Workers ◽  
Social Isolation ◽  
Mental Health Providers ◽  
Health Providers ◽  
Home Based Primary Care ◽  
Home Based ◽  
Socially Isolated

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

scholarly journals Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults

2021 ◽  
pp. 084456212110443
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Caregivers ◽  
Older Adult ◽  
Long Term Care ◽  
Home Care Services ◽  
Term Care ◽  
Care Services ◽  
Hospital To Home

Background An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Older adults often lack adequate support to transition from hospital to home, without access to appropriate health services when they are needed in the community and resources to live safely at home. Purpose This study collaborated with an existing enhanced home care program called Home Again in Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of multiple stakeholders, from December 2019 to February 2020, through analysis of nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results Findings indicate home care services for older adults are being sought too late, after hospital readmission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services led to barriers preventing family caregivers from continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional care services, highlighting the importance of investing in additional home care services for rehabilitation and prevention of rapidly deteriorating health.

scholarly journals Management of bio-psycho-social frailty to reduce hospital use and improve survival of older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Liotta ◽  
N Accarino ◽  
S Orlando ◽  
S Gentili ◽  
E Terracciano ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Health Outcomes ◽  
Social Isolation ◽  
Hospital Care ◽  
Admission Rate ◽  
Term Care ◽  
Hospital Admission Rate ◽  
Starting Point ◽  
The Impact

Abstract Background Ageing of population is associated to the increase of care demand. Many health systems are still centered on hospital care, that sometime is not appropriate. The shift from hospital to community care requires a new model of service delivery. Aim of this paper is to assess the impact of a community service based on the assessment of frailty, on mortality and use of hospital care by older adults. Methods A cohort made up by 8,592 over-75 subjects (67.1% female, mean age 84.5; SD ± 5.29) has been assessed once a year for bio-psycho-social frailty by the administration of the Short Functional Geriatric Evaluation questionnaire. The enrolled subjects were involved in a Community-based pro-Active Monitoring Program which provides interventions aimed at reducing social isolation. Mortality, use of hospital care and use of residential long-term care have been recorded during the follow up and separate and cumulative incidence rate was measured. Results The sample was stratified in Robust (37.5%), Pre-frail (24.0%), Frail, (29.5%) and Very Frail (9.1%) individuals. Mortality, Hospital admission rate and Residential LTC admission rate were higher in the very frails than among the other groups. However, according to social isolation, the integrated subjects at the baseline assessment, showed the highest incidence of negative events: 29.5%, 20.8%, 21.0%, .and 20.8% for integrated, mild isolated, moderate isolated and severely isolated individuals respectively (p < 0.001). The logistic regression analysis, adjusted for age, gender and level of frailty, confirmed the protective role of reducing social isolation among isolated individuals compared with integrated ones (OR: 0.729; CL95% 0.673-0.720). Conclusions The assessment of bio-psycho-social frailty could be the starting point for effective intervention at community level, like the program mentioned above. Management of frailty may lead to an improvement of public health outcomes. Key messages Intervention dealing with social isolation are able to revert the increase of mortality related to the lack of social resources. Management of frailty may lead to an improvement of public health outcomes.

scholarly journals 2400 How have characteristics of end-of-life family caregiving changed from 1999 to 2015? Preliminary results from two waves of nationally representative data

2018 ◽  
Vol 2 (S1) ◽  
pp. 82-82
Author(s):  
Judith Vick ◽  
Jennifer Wolff
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Family Caregivers ◽  
Family Caregiving ◽  
Physical Strain ◽  
Term Care ◽  
Care Survey ◽  
Nationally Representative ◽  
Over Time

OBJECTIVES/SPECIFIC AIMS: Family members are often critical in the delivery of hands-on care and decisions about care for persons approaching end-of-life (EOL). Prompted by concerns about the poor quality and high costs of care at the EOL, recent delivery reform efforts—such as the growth of hospice and palliative care—have been directed at improving EOL care for both patients and family. Trends of the characteristics of EOL family caregivers and care recipients over time have not been well described. The goal of this study is to evaluate changes in EOL family caregiving from 1999 to 2015. METHODS/STUDY POPULATION: This study uses reconciled data from two nationally representative surveys and their linked caregiver surveys: the 1999 wave of the National Long-Term Care Survey (NLTCS) and the Informal Care Survey (ICS), and the 2015 wave of the National Health and Aging Trends Study (NHATS) and the National Survey of Caregiving (NSOC). RESULTS/ANTICIPATED RESULTS: Crude analysis shows that older adults living in the community and receiving help from family caregivers in the last year of life were significantly better educated (72% with greater than 12 years of education vs. 46%), and more diverse (78% White vs. 89%) in 2015 compared with 1999. Family caregivers in the last year of life were less likely to be female in 2015 compared with 1999 (74% vs. 68%, NS) and significantly less likely to be spouses (45% vs. 38%) in 2015. In 2015, a significantly greater proportion of older adults received help with five or more activities of daily living (47% vs. 34%), but family caregivers reported significantly lower levels of caregiving-associated distress: financial strain (80% reporting none in 2015 vs. 53%), emotional (51% vs. 39%), and physical strain (70% vs. 45%). In addition, a significantly greater proportion of EOL family caregivers used respite care in 2015 compared to 1999 (15% vs. 4%). DISCUSSION/SIGNIFICANCE OF IMPACT: Changes in the experience of EOL family caregiving may be impossible to capture in studies of single interventions, but tracking nationally representative trends can be used as an indicator of broader changes that take place cumulatively over time. Although studies of this nature cannot identify causal mechanisms of change, they are important to monitor long-term impact of program implementation and to guide future research, policy, and resource allocation.

scholarly journals Disaster Preparedness Among Older Japanese Adults With Long-Term Care Needs and Their Family Caregivers

2016 ◽  
Vol 11 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Tomoko Wakui ◽  
Emily M. Agree ◽  
Tami Saito ◽  
Ichiro Kai
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Community Support ◽  
The United States ◽  
Great East Japan Earthquake ◽  
Care Needs ◽  
Term Care

AbstractObjectiveIn the 2011 Great East Japan Earthquake, as in Hurricanes Katrina and Rita in the United States, older individuals were at the greatest risk of mortality. Much concern has been raised about developing plans to reduce these risks, but little information has been provided about preparedness, and the key role played by caregivers has been largely unexplored. The aims of this study were thus to examine the preparedness of family caregivers of older adults with long-term care needs and to identify the characteristics of older adults and their caregivers that are associated with poor preparedness and greater concern about disasters.MethodsShortly after the Great East Japan Earthquake, the second wave of the Fukui Longitudinal Caregiver Study was administered to the family caregivers of older Japanese individuals with long-term care needs. The sample included 952 caregivers from 17 municipalities in Fukui prefecture. Logistic regression analyses were used to identify the factors associated with self-assessed preparedness, evacuation planning, and caregivers’ concerns about preparedness.ResultsThe majority (75%) of the caregivers had no concrete plans for evacuation in an emergency, and those caring for persons with dementia were 36% less likely to have any plan. In multivariate models, caregivers who were more experienced and wealthier and who reported more family and community support were more likely to feel well prepared. Caregivers with poor health or limited financial resources or who were responsible for older persons with mobility difficulties reported higher levels of anxiety about their disaster preparedness.ConclusionsThis study indicates that most caregivers are ill prepared to respond in emergencies and that caregiver resources, community support, and the needs of older care recipients influence both preparedness and concern about disasters. Education for caregivers and the development of community support programs could provide important sources of assistance to this vulnerable group. (Disaster Med Public Health Preparedness. 2017;11:31–38)

Neighborhood Deterioration and Social Isolation in Later Life

1993 ◽  
Vol 36 (1) ◽  
pp. 9-38 ◽  
Author(s):  
Neal Krause
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Social Isolation ◽  
Strong Support ◽  
Nationwide Survey ◽  
Later Life ◽  
Neighborhood Characteristics ◽  
Financial Difficulties ◽  
Low Levels ◽  
Socially Isolated

The purpose of this study is to test a conceptual model that attempts to show how selected neighborhood characteristics are related to social isolation in later life. This model specifies that older adults with low levels of educational attainment are more likely to experience financial problems and that elderly people who are confronted by financial difficulties are more likely to reside in dilapidated neighborhoods. The model further predicts that deteriorated neighborhoods in turn tend to promote distrust of others and older adults who are more distrustful of others tend to be more socially isolated. Based on data provided by a nationwide survey of elderly people, subsequent analyses revealed strong support for the theoretical sequence described above.

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