Age Differences and Similarities in Associated Stressors and Outcomes Among Young, Midlife, and Older Adult Family Caregivers

Author(s):  
Athena Koumoutzis ◽  
Kelly E. Cichy ◽  
Mary Dellmann-Jenkins ◽  
Maureen Blankemeyer

Background and Objectives Few studies have simultaneously compared caregivers in all stages of the adult life course. This study examined age differences in associations among primary stressors (caregiver burden which includes hours of provided care and number of activities of daily living and instrumental activities of daily living performed), secondary stressors (financial and employment strains), and caregiver outcomes (emotional strain and physical strain). Research Design Using Pearlin’s Stress Process Model (1990) and the Caregiving in the United States 2015 dataset, 1,156 caregivers were identified (including 278 young adults aged 18–39 years, 464 midlife adults aged 40–59 years, and 414 older adults aged 60–80 years). Results Post hoc analyses revealed that compared to older adults, young adults reported less caregiver burden, less physical strain, and greater financial strain. Linear regression analyses revealed associations between caregiver burden and financial strain with emotional and physical strain for all respondents. Discussion and Implications Findings emphasize the need for age-specific interventions.

Author(s):  
Jing Huang ◽  
Pui Hing Chau ◽  
Edmond Pui Hang Choi ◽  
Bei Wu ◽  
Vivian W Q Lou

Abstract Objectives This study identified the classes (i.e., patterns) of caregivers’ activities, based on their engagements in caregiving activities, and explored the characteristics and the caregiver burden of these classes. Methods This study was a secondary analysis of a cross-sectional survey on the profiles of family caregivers of older adults in Hong Kong. A latent class analysis approach was adopted to classify family caregivers (N = 932) according to their routine involvements in 17 daily caregiving activities: 6 activities of daily living (ADLs) and 8 instrumental activities of daily living activities (IADLs) in addition to emotional support, decision making, and financial support. Multinomial logistic regression and multiple linear regression illuminated the characteristics of the classes and compared their levels of caregiver burden. Results The family caregivers fell into 5 classes: All-Round Care (High Demand, 19.5%), All-Round Care (Moderate Demand, 8.2%), Predominant IADLs Care (High Demand, 23.8%), Predominant IADLs Care (Moderate Demand, 32.5%), and Minimal ADLs and IADLs Care (Low Demand, 16.0%). These classes exhibited different characteristics in terms of care recipients’ cognitive statuses and caregiver backgrounds. The levels of caregiver burden differed across classes; the All-Round Care (High Demand) class experienced the highest levels of caregiver burden. Discussion This study contributes to existing scholarship by turning away from a predefined category of care tasks to explore the patterns of caregiving activities. By identifying caregiving activity patterns and understanding their associated characteristics and caregiver burden, prioritizing and targeting caregiver support interventions better is possible.


2019 ◽  
Vol 15 (3) ◽  
pp. e1-e10 ◽  
Author(s):  
Seonho Kim ◽  
Dallong Han ◽  
Jongeun Lee

Background and ObjectiveSocietal aging and increasing average life expectancy have led to a significant increase in the population of individuals aged 75 years or above. Hence, it is becoming more meaningful and appropriate for researchers to divide those above the age of 65 years into various subgroups, such as young-old and old-old. Based on this division, we investigated the prevalence and correlates of impairments in activities of daily living (ADLs) among community-dwelling older adults (young-old vs. old-old) in South Korea. Material and MethodsThis was a cross-sectional study. We used the data of 4,368 older adults (≥65 years old) from the 2012 Korean Longitudinal Study of Aging. ADL impairment was assessed using a modified version of the Katz Index of Independence in Activities of Daily Living. ResultsThe prevalence of ADL impairment was greater in old-old participants (12.7%) than in young-old ones (3.0%). ADL impairment was significantly associated with gender, perceived health status, regular exercise, cognitive function, and depressive symptoms in young-old individuals. By contrast, in old-old individuals, the significant predictors were residential area, socioeconomic status, perceived health status, regular exercise, cognitive function, and depressive symptoms. Among both age subgroups, cognitive function was the strongest predictive factor of ADL impairment. Conclusion We found clear age differences in the prevalence and correlates of ADL impairment in older Koreans. Such age differences should be considered when studying and developing interventions for ADL impairment in older adults.


2019 ◽  
Vol 39 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Claire K. Ankuda ◽  
Deborah A. Levine ◽  
Kenneth M. Langa ◽  
Katherine A. Ornstein ◽  
Amy S. Kelley

This study assesses patterns of caregiving, death, and recovery after incident disability in older adults. We used the Health and Retirement Study to follow of a cohort of adults age ≥65 years in the United States with incident disability in activities of daily living (ADLs) or instrumental activities of daily living (IADLs; n = 8,713). Rates of care and function state were assessed biennially: deceased, nursing home dwelling, at home with paid help, at home with both paid and unpaid help, at home with unpaid help, at home with no assistance and recovered. In the 2 years after incident disability, 22.1% recovered and 46.8% died. Transitions between care and function states occurred frequently, with more than 20% of the cohort living at home with no assistance despite disability at least once. This study demonstrates the high levels of care and function state fluctuation and unmet needs after functional disability.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 202-202
Author(s):  
Rachel Logue ◽  
Elana Goldenkoff ◽  
Michael Vesia ◽  
Susan Brown

Abstract Aging is associated with a decline in hand muscle strength, dexterity, and tactile perception, leading to difficulties in activities of daily living and reduced independence (Millan-Calenti et al., 2010). However, current assessments do not adequately capture sensorimotor skills that underlie everyday activities such as dressing and food preparation. This study examined the ability of two novel assessment devices to detect age-related changes in hand force control and tactile pattern discrimination. Sensorimotor function was assessed in 13 healthy older adults (mean age 72.2 +/- 5.5y) and 13 young adults (mean age 20 +/- 1.4y). Maximum grip force (MVC), tactile sensation, and hand dexterity were measured using standard clinical techniques. Novel assessments consisted of submaximal (5-20% MVC) grip force tracking and computer-controlled tactile pattern recognition. Monofilament testing of tactile sensation was normal in the older group. In contrast, both the accuracy and speed associated with identifying tactile patterns was significantly worse in older (p<0.001) compared to young adults for both hands. While maximum grip force was similar in both groups, the ability to smoothly produce (p<0.05) and maintain (p<0.02) low grip force levels was compromised in older adults. Manual dexterity (Grooved Pegboard test) was significantly reduced in the older group (p<0.001) regardless of hand. These results indicate that the ability to extract meaningful information from tactile feedback and control low levels of force - aspects of fine hand control associated with activities of daily living – are impaired in older adults and underscore the need for more sensitive measures of hand function.


2020 ◽  
Vol 35 (6) ◽  
pp. 795-795
Author(s):  
Conniff K ◽  
Gomez R

Abstract Objective Two people who are significantly linked, such as in a husband and wife relationship, are known as a dyad. Dyadic units are helpful to look at as members influence the function of one another. This study looks at families where one member is the caregiver and the other has Alzheimer’s disease and receives care (labeled here as Alzheimer’s disease care recipient or CR). Symptoms of Alzheimer’s include cognitive and functional impairment, social withdrawal, impaired judgment, and mood changes. Notably, there is little research examining how Alzheimer’s dyads influence one another’s level of depression. This study examines how the influence of cognitive and psychosocial variables from the dyad impact depression severity in CRs. Method Archival data of 670 Alzheimer’s disease community-dwelling care recipients from several major cities throughout the United States from the Resources for Enhancing Alzheimer’s Caregivers Health II (REACH II) study was analyzed. The measures included: Mini Mental State Examination (MMSE), Revised Memory and Behavior Problems Checklist (RMBPL), Activities of Daily Living/Instrumental Activities of Daily Living (IADL), Caregiver Burden, Social Support, and Positive Aspects of Caregiving. Results A multiple regression found that caregiver burden (β = 0.34, p < .001), IADL (β = 0.14, p < .001), and positive aspects of caregiving (β = 0.10, p = .02) significantly predicted CR depression ratings. Conclusion Increased positive aspects of caregiving, caregiver burden, and higher levels of CR functional decline were associated with significantly increased levels of depression in CRs. Increased CR depression could correspond with higher levels of awareness during earlier stages of the disease process regarding their impairment and impact on their caregiver.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 355-355
Author(s):  
Jing Huang ◽  
Pui Hing Chau ◽  
Edmond Pui Hang Choi ◽  
Bei Wu ◽  
Vivian Lou

Abstract The purposes of this study were to identify the patterns of caregiving activities among family caregivers in Hong Kong and to examine their associations with characteristic factors and caregiver burden. The data was from the cross-sectional survey on the profiles of family caregivers of older adults in Hong Kong. 932 family caregivers were classified into different classes by using the Latent class analysis (LCA) according to their engagements in the 17 daily caregiving activities: 6 activities of daily living (ADLs), 8 instrumental activities of daily living activities (IADLs), emotional support, decision-making, and financial support. Five classes were revealed and labeled “Total All-round Caregiving” (Class I: 19.5%), “Partial All-round Caregiving” (Class II: 8.2%), “ADLs Free Caregiving” (Class III: 23.8%), “ADLs & Partial IADLs Free Caregiving” (Class IV: 32.5%), “Financial Caregiving” (Class V: 16.0%), respectively. Results from multinomial logistic regression found that the following factors were associated with the class membership: care recipients’ age, medical diagnoses, and caregivers’ gender, job status, marital status, self-rated economic status, living with care recipients, and caring for ≥40 hours per week. Findings from multiple linear regression showed caregivers with different patterns of caregiving activities reported different levels of caregiver burden. Caregivers in Class I have been found with the highest caregiver burden. This is the first study that has applied LCA to capture the patterns of caregiving activities among family caregivers. Identification of caregiving activity patterns and examination of their characteristics and caregiver burden can help healthcare providers to shift to prioritized and targeted caregiver support.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 355-355
Author(s):  
Lei Chen ◽  
Kathryn Kietzman ◽  
Rebecca Allen

Abstract This study examines disparities in the experience of financial strain among older adults and people with disabilities by age, gender, race/ethnicity, poverty, and disability type. People with disabilities refer to those who report cognitive impairment, difficulties performing activities of daily living (ADLs) and/or instrumental activities of daily living (IADLs). Financial strain includes challenges that participants incurred during the last 12 months in acquiring food, housing, health care, or income. This study uses the data from the 2019 California Long-Term Services and Supports (LTSS) survey that was merged with data from the omnibus California Health Interview Survey (CHIS) (N=1097). This is the most comprehensive population-level dataset to examine LTSS needs, unmet needs, and uses of LTSS in California. Initial findings show that 50% of participants report spending less on food, while 40% report cutting down on saving for retirement, receiving and borrowing money from others, and experiencing a decline in household income. More than 20% note that they could not make rent or mortgage payments, had debt due to medical bills, and had to spend less on prescription medications or medical care. We also find significant disparities in financial strain by age, gender, poverty, and disability type; however, no significant disparities by race/ethnicity. This study is among the first to examine disparities in various financial strain types for people who need LTSS in California. The findings have policy implications for the Master Plan for Aging (MPA), which serves as a blueprint to build environments that promote an age-friendly California.


Author(s):  
Nicola Camp ◽  
Martin Lewis ◽  
Kirsty Hunter ◽  
Julie Johnston ◽  
Massimiliano Zecca ◽  
...  

The use of technology has been suggested as a means of allowing continued autonomous living for older adults, while reducing the burden on caregivers and aiding decision-making relating to healthcare. However, more clarity is needed relating to the Activities of Daily Living (ADL) recognised, and the types of technology included within current monitoring approaches. This review aims to identify these differences and highlight the current gaps in these systems. A scoping review was conducted in accordance with PRISMA-ScR, drawing on PubMed, Scopus, and Google Scholar. Articles and commercially available systems were selected if they focused on ADL recognition of older adults within their home environment. Thirty-nine ADL recognition systems were identified, nine of which were commercially available. One system incorporated environmental and wearable technology, two used only wearable technology, and 34 used only environmental technologies. Overall, 14 ADL were identified but there was variation in the specific ADL recognised by each system. Although the use of technology to monitor ADL of older adults is becoming more prevalent, there is a large variation in the ADL recognised, how ADL are defined, and the types of technology used within monitoring systems. Key stakeholders, such as older adults and healthcare workers, should be consulted in future work to ensure that future developments are functional and useable.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.


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