Assessing and Supporting Caregivers of the Elderly:

[Development of the French Canadian version of the Montgomery Borgatta caregiver burden scale]

Assessing the burden linked to caring for the frail elderly is becoming an important issue in rehabilitation. The purpose of this study was to translate/validate the Montgomery Borgatta Caregiver Burden Scale into French for use in Canada. This easy-to-use questionnaire evaluates aspects of burden such as objective, subjective stress and subjective demand burden. The instrument underwent: 1) parallel translation/back-translation; 2) expert's committee review leading to an experimental version; 3) pre-test to ensure wording clarity; and 4) study of psychometric properties with bilingual subjects (n = 27) and French-speaking subjects (n = 18). Results suggest that convergence between the original and the French versions is satisfactory for two of the three sub-scales of the MBCBS (ICC 0.83 & 0.96). The test-retest stability coefficients are also very good (ICC of 0.92 & 0.91), as is internal consistency (0.90, 0.66). The objective burden sub-scale correlates moderately with a measure of functional autonomy (SMAF). Results for the subjective burden scale linked to demand are, however, inadequate. All in all, two of the three sub-scales of the French-Canadian version of the Montgomery Borgatta Caregiver Burden Scale demonstrate adequate psychometric properties, thereby favouring its use in geriatric rehabilitation.

Caregivers' Aspirations, Realities, and Expectations: The CARE Tool

Caregivers to family and friends are increasingly recognized as essential players in the continued shift of care of dependent populations to the community. Currently, Canadian provincial home care programs have neither a comprehensive policy nor an assessment regarding caregivers' needs. This article describes an assessment tool that takes into account caregivers' reality and conditions and that situates them as essential partners with the formal system and reports on the validation and reliability testing of this tool. Seven sites in Quebec and Nova Scotia involving 40 assessors tested the tool with 168 caregivers. Results suggest that this comprehensive tool enables practitioners to understand caregivers' needs and situations. Focus groups with assessors and interviews with home care administrators revealed that the tool increased worker understanding and awareness of what it means to be a caregiver, ascertained the key caregiver concerns, and identified these needs in rapid succession.

Development of a conceptual framework for the assessment of geriatric rehabilitation outcomes

The objective of the study was to develop a conceptual framework of key assessment areas for the evaluation of rehabilitation outcomes in older persons. The study was designed in four stages. First, a review of the literature generated a list of 84 potential outcome variables. Second, semi-structured interviews were conducted with older adults informants (n = 19) to record their thoughts about important rehabilitation outcomes. From the analyses of the transcripts, 20 recurrent themes became apparent. Third, relevant assessment areas were determined based on the merged data from the literature and the interviews. Fourth, a focus group was held with a panel of eight interdisciplinary experts with strong involvement in geriatric rehabilitation to evaluate, improve, and validate the preliminary work. As a result of the study, the conceptual framework for the assessment of geriatric rehabilitation outcomes (FAGRO) is composed of four primary outcome domains related to important activities for community-living older persons: mobility activities, basic activities of daily living, activities of independent living, and leisure activities. The models also allows for four brief evaluations of underlying functioning components, including: physical functioning, psychological functioning, social functioning, and factors related to the caregiver status and available resources. The model has the potential to become a valuable additional tool for outcome assessment, researched and developed specifically for geriatric rehabilitation.