The National Family Caregiver Support Program: A Multivariate Examination of State-Level Implementation

Perceived Training Needs of the Informal Caregivers of Older Adults: A Cross-Sectional Study

BACKGROUND

Due to the enormous caregiving burden faced by informal caregivers, providing appropriate skills training has become an important supporting strategy in many countries/regions. Understanding caregivers' training needs is instrumental in designing effective training intervention programs, which are expected to reduce the caregiving burden of informal caregivers and avoid the health deterioration associated with caregiving. This paper aims to explore the potential training needs of informal caregivers in Shanghai, and to identify the factors associated with these perceived training needs.

METHODS

A total of 196 eligible informal caregivers participated in this survey. A multivariate analysis was conducted to explore the factors associated with informal caregivers' perceived training needs.

RESULTS

86.7% (N = 170) of the caregivers reported at least one need for targeted training activity, and 62.7% (N = 123) of them identified two or more training needs. The top three activities requiring training included the following: self-care skills; safety supervision; and functional rehabilitation. The factors associated with various training needs included the health status of the care recipient, complementary caregiving support, caregiving stress, and the personal attributes of the informal caregiver. The technical skills training needs were more related to the care recipients' health status (e.g., dependency level, disease progression) and formal care support resources. Conversely, the intangible skills training needs were more sensitive to caregiver attributes (e.g., gender, age, and education level).

CONCLUSIONS

A personalized training strategy and early-stage intervention program are critical to providing effective support to informal caregivers. The potential implications are to raise awareness of the importance of skills training for informal caregivers, and to inform the implementation of effective training strategies for improving the quality of informal care and the well-being of informal caregivers in China.

Caregiver policies in the United States: a systematic review

In the United States, there are nearly 53 million informal or unpaid caregivers, many of whom experience mental and physical stress related to their caregiving duties and increased financial responsibility. We identified federal and state informal caregiver support policies authorized by specific legislation along with their key provisions and conducted a systematic review of the academic literature related to quantitative evaluations of these policies. Twenty policies, eight academic studies, and four gray literature reports were included in the study, with half of the policies introduced since 2000. Our study criteria yielded few academic valuations tied to caregiver policies and few policies including research provisions. Of the provision areas identified in policies, respite services, caregiver training, and workplace protections appeared the most. Future policies and the studies examining them should incorporate cost outcomes and equity as focus areas and disaggregate data by vulnerable groups to ensure value and equity in caregiver support legislation. KEY MESSAGES: Increased legislation to support informal caregivers may be warranted. The limited academic research examining existing caregiver policies identifies mixed outcomes for caregivers. Prioritizing vulnerable populations in such policy research examining outcomes could help improve caregiver support efforts. The included studies investigated the outcomes of three policies and identified more negative than positive outcomes for caregivers.

Progress and Policy Opportunities in Family Caregiver Assessment: Results From a National Survey

Family caregivers play an essential role in long-term services and supports (LTSS). Despite numerous calls for robust caregiver assessment policies to determine needs and treat them as partners in care planning, there has been limited information about whether or how states assess caregiver needs and strengths, or use caregiver information. Using cross-sectional survey data from the 2015 Process Evaluation of the Older Americans Act National Family Caregiver Support Program (NFCSP), this study analyzes caregiver assessment policies and practices in 54 State Units on Aging, 619 Area Agencies on Aging, and 642 local service providers. It examines whether and for what purposes caregiver assessments are used, what domains are included, and how well current policies conform to recommended practice. It also recommends that policy makers who influence NFCSP and other LTSS programs develop caregiver assessment practices using a multidimensional framework including more caregiver-focused domains and utilizing assessment data to measure program outcomes.

Psychometric properties of the Hebrew version of the Zarit Caregiver Burden Scale short version

OBJECTIVES

The purpose of this study was to evaluate the reliability and validity of the Hebrew version of the Zarit Burden Interview (H-ZBI) short version.

METHOD

Cross-sectional research methodology was used to measure the caregiver burden felt by informal family caregivers of cognitively intact but physically frail older family members. Data of this study were drawn from two convenience samples that included altogether 456 dyads of family caregivers and care recipients in Israel. Caregivers included adult children, spouses, and other relatives of the care recipients.

RESULTS

The H-ZBI short version demonstrated good psychometric properties similar to those of the English version. Internal consistency of Cronbach's alpha was high (α = 0.85) and the measure showed good convergent and exploratory validity due to significant correlations with Caregiving Burden Scale, caregivers' quality of life (World Health Organization Quality of Life, WHOQOL-Brief), perceived health and economic statuses, as well as with health and functional statuses of care recipients. Factor analysis showed two loading factors.

CONCLUSIONS

The scale can be a useful screening instrument for professionals working with family caregivers to assess the degree of burden felt by family caregivers who provide long-term care for physically frail older adults. The scale also provides indications of the need for professional intervention when burden is great and negatively affects the caregivers' quality of life.