Effects of Relationship Type on Quality of Life in Older Adults with Cognitive Impairment and the Informal Caregivers

Abstract Purpose The purpose of this study was to assess whether there was an association between care-recipient relationship type and the QoL of older adults and their informal caregivers, and whether this association pertained to older adults’ cognitive function. Methods This was a secondary data analysis. Older adults (n=1230) and their informal caregivers (n=1871) were identified from participants in the National Health and Aging Trends Study (NHATS) Round 5 and the National Study of Caregiving (NSOC) II. A series of bivariate and multivariable regression models examined the associations among the care-recipient relationship type and QoL in older adults and their informal caregivers, adjusted for socio-demographic variables as well as cognitive functioning. Results Both older adults and caregivers’ QoL outcomes varied by the type of relationship. Recipients cared for by adult-child caregivers or multiple caregivers experienced higher functional limitation than those cared by spousal caregivers (β=.79, CI [.39, 1.19]; β=.50, CI [.17, .82], respectively). “Other” caregivers, such as siblings, friends, etc., had lower odds of experiencing negative emotional burden than spousal caregivers (OR=.26, CI [.13, .52]; OR=.53, CI [.35, .81], respectively). "Other" caregivers were also 51% less likely to experience social strain than spousal caregivers. Lower odds of experiencing negative emotional burdens were also found with multiple caregivers. The association between adult-child caregivers and social strain was explained by the recipients’ cognitive function. Conclusions Care-recipient relationship type impacts the QoL in both recipients and their informal caregivers. This association appears to be affected by care recipients' cognitive function level.

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Longitudinal Effects of Cultural and Psychosocial Factors on Biomarkers of Cardiovascular Risk in Caregivers

Innovation in Aging ◽

10.1093/geroni/igab046.008 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 3-3

Author(s):

Rosa Romero-Moreno ◽

Carlos Vara-García ◽

Samara Barrera-Caballero ◽

María del Sequeros Chaparro ◽

Javier Olazarán ◽

...

Keyword(s):

Behavioral Problems ◽

Cardiovascular Health ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Adult Child ◽

Spousal Caregivers ◽

Care Recipient ◽

Cardiovascular Health Study ◽

Child Caregivers ◽

Over Time

Abstract Dysfunctional thoughts about caregiving (DTAC) and familism (i.e. familistic obligation) were associated with worse caregiver emotional and cardiovascular health in cross-sectional studies. The aim of this study was to longitudinally examine the effects of familism and DTAC on cardiovascular health, considering caregiver kinship adjusting for well-established predictors of cardiovascular health. Study participants were 80 family dementia caregivers. Individual interviews and collection of blood samples were conducted in three yearly assessments. Linear mixed (random effects) regression analysis was performed to examine longitudinal associations of familism, DTAC, and circulating levels of cytokine interleukin (IL)-6, a cytokine and biomarker of cardiovascular disease risk (CVD). Caregiver age, gender, alcohol consumption, body mass index (BMI), hours caring, frequency and reaction of behavioral problems and caregivers’ transitions were used as covariates. Results showed that increases in DTAC, in familism and higher caregiver age were independently and significantly associated with higher levels of IL-6 over time in the group of spousal caregivers. No significant effects were found for any of the other covariates in spousal caregivers. In contrast, increases in BMI and in frequency of behavioral problems were significantly associated with increases in IL-6 over time in adult child caregivers. No significant effects were found for any of the rest of predictors in adult child caregivers. Findings suggest that high level of obligation familism and DTAC may a profile of increased vulnerability for CVD in spousal caregivers. In contrast, problem behaviors of the care recipient may characterize adult child caregivers in terms of an increased CVD risk.

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Depressive symptoms among informal caregivers of older adults: insights from the Singapore Survey on Informal Caregiving

International Psychogeriatrics ◽

10.1017/s1041610212000324 ◽

2012 ◽

Vol 24 (8) ◽

pp. 1335-1346 ◽

Cited By ~ 29

Author(s):

Chetna Malhotra ◽

Rahul Malhotra ◽

Truls Østbye ◽

David Matchar ◽

Angelique Chan

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Emotional Support ◽

Adult Child ◽

Self Esteem ◽

Negative Reaction ◽

Care Recipient ◽

Domestic Worker ◽

Caregiver Health ◽

Child Caregivers

ABSTRACTBackground: This paper determines care recipient and caregiver characteristics and caregiving dimensions – associated with depression among caregivers of older adults, using path analysis and assesses whether the identified path model differs between spousal and adult child caregivers.Methods: Data from 1,190 dyads comprising care recipients (community-dwelling adults aged ≥75 years with at least one activity of daily living (ADL) limitation) and caregivers (family member/friend most involved in providing care/ensuring provision of care to care recipient), who were interviewed through the Singapore Survey on Informal Caregiving (2010–2011), were used. Using path analysis, we assessed the direct and indirect associations between primary stressors (care recipient's ADL and instrumental ADL status, and memory and behavior problems), caregiver health status, receipt of assistance from a foreign domestic worker/maid, amount of caregiving, negative reaction to caregiving, caregiver's self-esteem, perceived emotional support, and caregiver depressive symptoms.Results: Our analysis showed that primary stressors, receipt of assistance from a foreign domestic worker/maid, perceived emotional support, and caregiver health status were directly or indirectly associated with caregiver depressive symptoms, and this association was mediated by negative reaction to caregiving. Caregiver self-esteem mediated the relationship between perceived emotional support and negative reaction to caregiving only among adult child caregivers.Conclusions: The results provide insights into factors associated with depressive symptoms among spousal and adult child caregivers, and help identify targeted interventions for improving caregiver mood.

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Differential response to a multicomponent telehealth intervention by spouses and adult child caregivers of older adults

PsycEXTRA Dataset ◽

10.1037/e713962011-001 ◽

2011 ◽

Author(s):

Kathleen Chwalisz ◽

Stephanie M. Clancy Dollinger ◽

Eiei Hlaing

Keyword(s):

Older Adults ◽

Adult Child ◽

Differential Response ◽

Child Caregivers ◽

Telehealth Intervention

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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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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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NEEDS AND EXPERIENCES OF CAREGIVERS TO PERSONS WITH DEMENTIA WHO HAVE LOST THEIR DRIVING PRIVILEGES

Innovation in Aging ◽

10.1093/geroni/igz038.414 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S111-S112

Author(s):

Stephanie Yamin ◽

Cassandre Gratton

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Motor Vehicle ◽

Informal Caregivers ◽

Well Being ◽

Care Recipient ◽

Theory Approach ◽

Negative Consequences ◽

Driving Cessation

Abstract The ability to drive a motor vehicle for most older adults is associated with a sense of independence, well-being, quality of life and identity. For many older adults, driving cessation eventually becomes inevitable. This is especially the case for older adults with a diagnosis of dementia. Driving cessation has been shown to negatively impact individuals’ mobility and, consequently, quality of life. Informal caregivers (i.e., family caregivers) can mitigate the negative consequences associated with driving cessation in persons with dementia (PWD) by meeting their mobility needs and by offering emotional support. The purpose of this study was to examine the experience and needs of informal caregivers of PWD who had recently lost their driving privileges. Ten informal caregivers of PWD were recruited from a tertiary memory disorders clinic. Semi-structured interviews were conducted and transcribed. Transcripts of interviews were thematically analyzed using a grounded theory approach. The major themes emerging from the experience of caregivers included being overwhelmed by responsibility, overwhelmed by the emotional response of their care recipient and feeling resentment towards their care recipient. Similarly, the major themes emerging from the needs of caregivers included having the need for mobility training, psychoeducation on how to best attend to the emotional needs of their care recipient and the need for coping strategies. These experiences and needs expressed by caregivers indicate that driving cessation of the care recipient is a difficult experience for caregivers and that a therapeutic intervention based on the reported needs may be beneficial.

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AN OLDER CARER, BUT STILL A CHILD: UNEXPECTED IDENTITIES OF OLDER ADULTS CARING FOR A NEAR-CENTENARIAN PARENT

Innovation in Aging ◽

10.1093/geroni/igz038.2277 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S612-S612

Author(s):

Oscar Riberio ◽

Typhanie Macedo ◽

Liliana Sousa

Keyword(s):

Older Adults ◽

Adult Child ◽

Care Recipient ◽

White Female ◽

Close Relative ◽

Care Providers ◽

Cross Sectional ◽

Family Identity ◽

Children’S Views ◽

Definition Of

Abstract According to the National Alliance for Caregiving (2015), the typical definition of an older adult caregiver points to a 79-year-old white female who cares for a close relative due to a long-term physical condition; in such cases the care-recipient is often a spouse, an adult child or a sibling, but not a parent. This cross-sectional qualitative study explores the experience of a group of fifteen children in their 70s who are main care-providers of their parents (mean age 98; range 95-105); it focuses on their overall caregiving experience with a particular emphasis on how they feel being still a child at such an advanced age. In-depth interviews were conducted and analyzed for recurrent themes using thematic analysis. Main findings revealed that although being in an overall positive experience, often socially exalted (proudness of having a parent alive/being in an unique situation), none had expected to be holding the identity of a child at their current age. These children’s views of their ageing self were strongly embedded in their caregiving role, and some reported losing awareness of their own age and a mixture of feelings of being simultaneously a child, a parent and a grandparent. Role captivity (late life prison) and disregarding self-care shaped their current situation in terms of caregiving burden and altered life plans as older adults. This study adds to the limited available knowledge on very old caregiving dyads, and raises awareness on how personal and family identity may be shaped in older age by unforeseen family dynamics.

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Informal Caregivers Assisting People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073-13.4.177 ◽

2011 ◽

Vol 13 (4) ◽

pp. 177-187 ◽

Cited By ~ 6

Author(s):

Robert J. Buchanan ◽

Chunfeng Huang

Keyword(s):

Multiple Sclerosis ◽

Negative Impact ◽

Informal Caregivers ◽

Spousal Caregivers ◽

Care Recipient ◽

Spousal Relationship ◽

Factors Associated ◽

Ordered Logistic Regression ◽

The Impact ◽

The Relationship

The objective of this study was to identify characteristics of informal caregivers, caregiving, and people with multiple sclerosis (MS) receiving this assistance that are associated with the strength of the care-giver/care recipient relationship. Data were collected in a national survey of informal caregivers and analyzed using an ordered logistic regression model to identify factors associated with caregiver perceptions of the strength of the relationship with the person with MS. The overall health of the person with MS was significantly associated with caregiver perceptions that providing assistance strengthened the caregiver/care recipient relationship, with poor health having a negative impact on the relationship. A spousal relationship between the caregiver and the person with MS was associated with significantly lower perceptions of a strengthened relationship. Conversely, caregiver perceptions that MS symptoms interfered with the independence of the person with MS in daily life were associated with caregiver perceptions of a strengthened relationship. Longer duration of caregiving and more hours per week spent providing assistance also were associated with a stronger relationship. In contrast, we found a significant negative association between caregiver perceptions that assisting the person with MS was burdensome and the strength of the relationship. Similarly, higher levels of education among caregivers tended to have a significantly negative impact on the caregiver/care recipient relationship. Our findings highlight the importance of addressing the needs and concerns of spousal caregivers. Health professionals who treat informal caregivers, as well as those treating people with MS, should be sensitive to the impact caregiving has on caregivers, especially spouses providing assistance.

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Caregiver Stigma and Burden in Memory Disorders: An Evaluation of the Effects of Caregiver Type and Gender

Current Gerontology and Geriatrics Research ◽

10.1155/2016/8316045 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 23

Author(s):

Phoebe V. Kahn ◽

Heather A. Wishart ◽

Jennifer S. Randolph ◽

Robert B. Santulli

Keyword(s):

Short Form ◽

Public Awareness ◽

Adult Child ◽

The United States ◽

Spousal Caregivers ◽

Similar Data ◽

Dementia Patients ◽

Child Caregivers ◽

Male Caregivers ◽

And Gender

Despite considerable gains in public awareness of dementia, dementia patients and their caregivers continue to be stigmatized. Previous work has explored stigma and burden among adult children of persons with dementia in Israel, but no similar data exist for spousal caregivers or caregivers in general in the United States. This study examines the differences in stigma and burden experienced by spousal and adult child caregivers and male and female caregivers of persons with dementia. Eighty-two caregivers were given the Zarit Burden Inventory Short Form (ZBI) and the Caregiver Section of the Family Stigma in Alzheimer’s Disease Scale (FS-ADS-C). Scores on the FS-ADS-C and ZBI were positively correlated (rs=.51,p<.001). Female caregivers reported experiencing more stigma on the FS-ADS-C (t(80)= −4.37,p<.001) and more burden on the ZBI (t(80)= −2.68,p=.009) compared to male caregivers, and adult child caregivers reported experiencing more stigma on the FS-ADS-C (t(30.8)= −2.22,p=.034) and more burden on the ZBI (t(80)= −2.65,p=.010) than spousal caregivers. These results reinforce the importance of support for caregivers, particularly adult child and female caregivers who may experience higher levels of stigma and burden.

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