scholarly journals LONG-DISTANCE CAREGIVING: MENTAL HEALTH CONSEQUENCES AND USE OF RESOURCES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S556-S557
Author(s):  
Verena R Cimarolli ◽  
Amy Horowitz ◽  
Rachel Pruchno

Abstract Long-distance caregiving (LDC) is a growing phenomenon and common experience for caregivers of frail older adults. In fact, 11% of family caregivers in the US live more than two hours distance from the care recipient (CR). Unfortunately, there is a paucity of research on unique experiences of LDCs and the impact of LDC on the mental health of LDCs. This symposium presents findings from the NIA funded Fordham Long-Distance Caregiving Study (R21AG050018) analyzing data of 304 long-distance caregivers (LDCs). The overall study goal was to better understand how LDCs deal with the structural constraint of distance, and to examine LDC consequences and resources. First, Horowitz presents the study background, characteristics of the sample, and provides a description of the unique experiences of LDCs. Next, Cimarolli concentrates on the Sociocultural Stress Process Model applied to LDC. Her study tested the impact of LDC on mental health and investigated resources (e.g., coping skills) which could mediate the association between caregiving stressors and mental health outcomes. The third paper (Falzarano) presents data related to satisfaction with formal service providers for four subgroups of LDCs based on CR residence and dementia status. Finally, Jimenez focuses on the characteristics of LDCs’ network of other informal caregivers (IC) providing assistance to the CR and factors are associated with more help received from other ICs. Dr. Pruchno, an expert in caregiving research, will discuss study findings. The symposium provides insights into unique experiences of LDCs, the impact of LDC on mental health, and resource use among LDCs.

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S337-S337
Author(s):  
Katherine Kricorian

Abstract Background The COVID-19 pandemic was associated with an array of social and economic events, influencing how the pandemic affected people of all genders. In particular, job losses surged during the COVID-19 pandemic, especially among women. We analyzed how the pandemic and rising job losses affected the mental health of unmarried women with and without children in order to identify possible health disparities, potential causal factors and opportunities for interventions. Methods Data were collected from Wave 3 (January 6-February 15, 2021) of the US Census COVID-19 Household Pulse online survey designed to measure the impact of COVID-19. Microdata files were downloaded from the Census website and included N=13,940 never-married female respondents aged 25-54 years old. Data were analyzed using χ2 tests, with z-tests for more granular between-group comparisons. Results When asked if they had felt anxiety in the past week, 31% of respondents without children in the household and 28% of those with children reported feeling anxiety nearly every day (p< .05). Among those who did not lose work during the pandemic, 24% of those without children felt anxiety nearly every day vs. 20% of those with children (p< .05). Among those who did experience pandemic-related job loss, 33% of those with children and 42% of those without children reported daily anxiety (p< .05). Conclusion Overall, COVID-19 job loss was associated with higher levels of anxiety for never-married adult women. Notably, respondents without children expressed significantly higher levels of anxiety than respondents with children, and this difference was even greater when comparing those who had lost jobs during the pandemic. Reasons are being further researched but may be related to mothers’ greater opportunities for social and community support, particularly when encountering difficult circumstances. These results have implications for the development of mental health programs serving women experiencing environmental stressors such as job loss, especially women without children who may not have the same mental health and community support. Disclosures All Authors: No reported disclosures


2018 ◽  
Vol 28 (6) ◽  
pp. 670-681 ◽  
Author(s):  
S. Diminic ◽  
E. Hielscher ◽  
M. G. Harris ◽  
Y. Y. Lee ◽  
J. Kealton ◽  
...  

AbstractAimsPlanning mental health carer services requires information about the number of carers, their characteristics, service use and unmet support needs. Available Australian estimates vary widely due to different definitions of mental illness and the types of carers included. This study aimed to provide a detailed profile of Australian mental health carers using a nationally representative household survey.MethodsThe number of mental health carers, characteristics of carers and their care recipients, caring hours and tasks provided, service use and unmet service needs were derived from the national 2012 Survey of Disability, Ageing and Carers. Co-resident carers of adults with a mental illness were compared with those caring for people with physical health and other cognitive/behavioural conditions (e.g., autism, intellectual disability, dementia) on measures of service use, service needs and aspects of their caring role.ResultsIn 2012, there were 225 421 co-resident carers of adults with mental illness in Australia, representing 1.0% of the population, and an estimated further 103 813 mental health carers not living with their care recipient. The majority of co-resident carers supported one person with mental illness, usually their partner or adult child. Mental health carers were more likely than physical health carers to provide emotional support (68.1%v.19.7% of carers) and less likely to assist with practical tasks (64.1%v.86.6%) and activities of daily living (31.9%v.48.9%). Of co-resident mental health carers, 22.5% or 50 828 people were confirmed primary carers – the person providing the most support to their care recipient. Many primary mental health carers (37.8%) provided more than 40 h of care per week. Only 23.8% of primary mental health carers received government income support for carers and only 34.4% received formal service assistance in their caring role, while 49.0% wanted more support. Significantly more primary mental health than primary physical health carers were dissatisfied with received services (20.0%v.3.2%), and 35.0% did not know what services were available to them.ConclusionsResults reveal a sizable number of mental health carers with unmet needs in the Australian community, particularly with respect to financial assistance and respite care, and that these carers are poorly informed about available supports. The prominence of emotional support and their greater dissatisfaction with services indicate a need to better tailor carer services. If implemented carefully, recent Australian reforms including the Carer Gateway and National Disability Insurance Scheme hold promise for improving mental health carer supports.


2018 ◽  
Vol 115 (28) ◽  
pp. 7290-7295 ◽  
Author(s):  
Noreen Goldman ◽  
Dana A. Glei ◽  
Maxine Weinstein

Although there is little dispute about the impact of the US opioid epidemic on recent mortality, there is less consensus about whether trends reflect increasing despair among American adults. The issue is complicated by the absence of established scales or definitions of despair as well as a paucity of studies examining changes in psychological health, especially well-being, since the 1990s. We contribute evidence using two cross-sectional waves of the Midlife in the United States (MIDUS) study to assess changes in measures of psychological distress and well-being. These measures capture negative emotions such as sadness, hopelessness, and worthlessness, and positive emotions such as happiness, fulfillment, and life satisfaction. Most of the measures reveal increasing distress and decreasing well-being across the age span for those of low relative socioeconomic position, in contrast to little decline or modest improvement for persons of high relative position.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S557-S557
Author(s):  
Verena R Cimarolli ◽  
Amy Horowitz ◽  
Danielle Jimenez ◽  
Xiaomei Shi ◽  
Francesca Falzarano ◽  
...  

Abstract This study investigated the impact of LDC on mental health utilizing the Sociocultural Stress Process Model as a conceptual framework. A path analytic model tested the impact of caregiving stressors (i.e. distance, frequencies of visits, hours spent helping, burden) and sociocultural values (i.e. familialism) on LDCs’ mental health outcomes (i.e. depression, anxiety), and resources (i.e. coping strategies, social support) which can mediate the association between stressors and mental health outcomes while controlling for socio-demographics. Results show that resources did not mediate the effects of stressors on the mental health outcomes. However, both higher depression and anxiety were associated with living closer to the care recipient (CR), less frequent visits, higher burden, being younger, being female, and less optimal income adequacy. In addition, higher depression was associated with lower use of coping strategies and higher education. Higher anxiety was also associated with lower levels of social support and higher familialism.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017296 ◽  
Author(s):  
Naeemah Abrahams ◽  
Soraya Seedat ◽  
Carl Lombard ◽  
Andre P Kengne ◽  
Bronwyn Myers ◽  
...  

IntroductionSouth Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.Methods and analysisThis longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.Ethics and disseminationThe South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.


Author(s):  
Joshua Kreimeyer ◽  
Olya Zaporozhets ◽  
Jacqueline Smith ◽  
Olga Lozova

Ukraine is a country that has lacked access to adequately trained mental health professionals. As in other countries the development of the field of Counseling in Ukraine has some parallels to that of the US. One of the most notable parallels is the push for a better and more effective approach to mental health, driven by the impact of war, with WWII being the catalyst for refinement in the US and current war in Ukraine as the drive there. As the American Psychology Association and American Counseling Association have highlighted, the effects of trauma and unresolved problems do not need to last a lifetime. A developing initiative in Ukraine was brought by U.S.-based teams that established a postgraduate Counselor Education Program. Professional American Counselor Educators, trained in the trenches of wars abroad and representing vast ranges of experience, have volunteered their time as visiting faculty and distance supervisors. This study measures the initial progression of treatment symptomology of clients seen by Postgraduate Program in Psychological Counseling and Trauma Therapy trained Counselors. This study utilized an analysis of repeated measures over the first five sessions of counseling with the program-trained Counselor. The following measurement methods were utilized: Outcome Rating Scale (ORS), Impact Event Scale (IES-R), Beck Depression Inventory (BDI II), PTSD Checklist (PCL-5), Symptom Checklist (SCL-9). The resulting data obtained from the clients was compared to the outcomes of treatment with similarly trained therapists in the United States, United Kingdom, Australia and Denmark. Results indicated overall significance as measured on 3 out of 5 instruments (ORS, BDI-II, IES-R). The data from this sample revealed similarities to the outcomes of comparable early treatment research, conducted outside of Ukraine. These results provide a preliminary overview of how effective mental health counselors (educated by the American standards) are in mitigating client mental health symptomology. This study is a logical and necessary step in the continued development of the field of Counseling in Ukraine.


2020 ◽  
Author(s):  
cother hajat ◽  
yakir siegal ◽  
amalia adler-waxman

Objective To investigate healthcare costs and contributors to costs for multiple chronic conditions (MCCs), common clusters of conditions and their impact on cost and utilisation. Methods This was a cross-sectional analysis of US financial claims data representative of the US population, including Medicare, Medicaid and Commercial insurance claims in 2015. Outcome measures included healthcare costs and contributors; ranking of clusters of conditions according to frequency, strength of association and unsupervised (k-means) analysis; the impact of clustering on costs and contributors to costs. Results Of 1,878,951 patients, 931,045(49.6%) had MCCs, 56.5% weighted to the US population. Mean age was 53.0 years(SD16.7); 393,121(42.20%) were male. Mean annual healthcare spending was $12,601, ranging from $4,385 (2 conditions) to $33,874 (11 conditions), with spending increasing by 22-fold for inpatient services, 6-fold for outpatient services, 4.5-fold for generic drugs and 4.2-fold for branded drugs. Cluster ranking using the 3 methodologies yielded similar results: highest ranked clusters included metabolic syndrome(12.2% of US insured patients), age related diseases(7.7%), renal failure(5.6%), respiratory disorders(4.5%), cardiovascular disease(CVD)(4.3%), cancers(4.1-4.3%), mental health-related clusters(1.0-1.5%) and HIV/AIDS(0.2%). Highest spending was in HIV/AIDS clusters ($48,293), mental health-related clusters ($38,952-$40,637), renal disease ($38,551) and CVD ($37,155); with 89.9% of spending on outpatient and inpatient care combined, and 10.1% on medication. Conclusion and Relevance Over 57% of insured patients in the US may have MCCs. MCC Clustering is frequent and is associated with healthcare utilisation. The findings favour health system redesign towards a multiple condition approach for clusters of chronic conditions, alongside other cost-containment measures for MCCs.


2003 ◽  
Vol 13 (1) ◽  
pp. 99-105
Author(s):  
Elizabeth Fudge

When adults experience mental health problems, the effect on their family members can be immense. The impact on the person's children, both of the parent's behaviour and of their treatment, can be profound but is frequently overlooked by service providers for a range of reasons. The current national COPMI project has been initiated to promote better mental health outcomes for children of parents with a mental illness, especially by providing information and good practice guidance for services and people in the community who work with these families and their children.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S260-S260
Author(s):  
Aaron M Ogletree ◽  
Rosemary Blieszner ◽  
Rachel Pruchno ◽  
Jyoti Savla ◽  
Laura P Sands

Abstract More than 62% of adults aged 65+ have more than one chronic condition; this number increases to more than 82% for those 85+. Older adults simultaneously experience changes in their relationships due to negative relational life events, including illness, injury, or death of a loved one. Stressors occurring in tandem can overload psychological resources and increase risk for poor mental health. Informed by the stress process model, we assessed the influence of relational life events on depressive symptoms over time and evaluated the moderating effects of chronic condition onset. Self-reports of four stressful life events, five chronic conditions, and depressive symptoms as measured by the CES-D came from 2,948 older adults participating in the ORANJ BOWL panel. Using longitudinal multilevel mixed effect modeling, we examined trajectories of depressive symptoms across three waves. While depressive symptoms increased over time, they were greater for people who experienced more relational life events and the onset of more chronic conditions. Participants who reported experiencing all four relational life events but no chronic conditions had an average CES-D score of 5.28 (p<.0001); average CES-D score increased to 12.72 (p<.0001) for those who reported four life events and the onset of four or more new chronic conditions during the study period. In summary, chronic condition onset moderated the relationship between life events and depressive symptoms. Findings highlight the need for practitioner awareness of increased mental health risks for people experiencing stressors in multiple domains of life.


2014 ◽  
Vol 19 (3) ◽  
pp. 194-206 ◽  
Author(s):  
Lisa O’Farrell ◽  
Michael Byrne ◽  
Linda Moore

Purpose – Regulation is increasingly being used in healthcare to influence the behaviour of healthcare organisations. Since 2006, a key change in Ireland has been the introduction of national regulatory standards in mental health services under new legislation. Little empirical evidence, however, exists on the effects of regulation. The purpose of this paper is to examine the perceived impact of standards at patient level as well as on professional and organisational practice in services. Design/methodology/approach – An anonymous online survey methodology using a self-devised questionnaire instrument was employed. A national cohort of service managers and multi-disciplinary mental health professionals were asked their views on the introduction of standards. Findings – A total of 185 individuals responded to the survey, yielding a response rate of 38 per cent. Substantial improvements were reported to have taken place across services with the most notable changes being improved safeguarding of patients’ rights and increased safety of care. Additionally, major changes were reported in professional working with new topics being discussed at management meetings and new functions being incorporated into certain professionals’ roles. Practical implications – Standards can change behaviour at several levels across healthcare organisations, although professional groups differ in their views on the degree of this impact. Originality value – To the authors’ knowledge, this is the first evaluation of the impact of national regulatory standards in healthcare in Ireland. This study lends support to the use of standards to enhance patient rights and the safety of services. The results provide useful direction for policy makers, regulators, and service providers.


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