1
|
Wu-Chung EL, Medina LD, Paoletti-Hatcher J, Lai V, Stinson JM, Mahant I, Schulz PE, Heijnen CJ, Fagundes CP. Mitochondrial Health, Physical Functioning, and Daily Affect: Bioenergetic Mechanisms of Dementia Caregiver Well-Being. Psychosom Med 2024; 86:512-522. [PMID: 38666654 PMCID: PMC11230842 DOI: 10.1097/psy.0000000000001312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
OBJECTIVE Chronic stress adversely affects mental and physical well-being. However, health outcomes vary among people experiencing the same stressor. Individual differences in physical and emotional well-being may depend on mitochondrial biology, as energy production is crucial for stress regulation. This study investigated whether mitochondrial respiratory capacity corresponds to individual differences in dementia spousal caregivers' mental and physical health. METHODS Spousal caregivers of individuals with Alzheimer's disease and related dementias ( N = 102, mean age = 71, 78% female, 83% White) provided peripheral blood samples and completed self-report questionnaires on quality of life, caregiver burden, and a 7-day affect scale. Multiple and mixed linear regressions were used to test the relationship between mitochondrial biology and well-being. RESULTS Spare respiratory capacity ( b = 12.76, confidence interval [CI] = 5.23-20.28, p = .001), maximum respiratory capacity ( b = 8.45, CI = 4.54-12.35, p < .0001), and ATP-linked respiration ( b = 10.11, CI = 5.05-15.18, p = .0001) were positively associated with physical functioning. At average ( b = -2.23, CI = -3.64 to -0.82, p = .002) and below average ( b = -4.96, CI = -7.22 to 2.70, p < .0001) levels of spare respiratory capacity, caregiver burden was negatively associated with daily positive affect. At above average levels of spare respiratory capacity, caregiver burden was not associated with positive affect ( p = .65). CONCLUSIONS Findings suggest that higher mitochondrial respiratory capacity is associated with better psychological and physical health-a pattern consistent with related research. These findings provide some of the earliest evidence that cellular bioenergetics are related to well-being.
Collapse
Affiliation(s)
- E Lydia Wu-Chung
- From the Department of Psychological Sciences (Wu-Chung, Paoletti-Hatcher, Lai, Mahant, Heijnen, Fagundes), Rice University; Department of Psychology (Medina, Fagundes), University of Houston; Department of Neurology (Stinson), Baylor College of Medicine; Neurocognitive Disorders Center (Schulz), University of Texas Health Science Center at Houston; Department of Behavioral Science (Fagundes), The University of Texas MD Anderson Cancer Center; and Department of Psychiatry (Fagundes), Baylor College of Medicine, Houston, Texas
| | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Zhu Y, Yin MXC. The impact of care-recipient relationship type on mental health burden of caregivers for schizophrenia patients: evidence from Beijing, China. Front Psychol 2024; 15:1402159. [PMID: 38947902 PMCID: PMC11211629 DOI: 10.3389/fpsyg.2024.1402159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/05/2024] [Indexed: 07/02/2024] Open
Abstract
Objective To examine the impact of care-recipient relationship type on mental health burden of caregivers for schizophrenia patients in China, elucidating the underlying mechanisms. Methods A cross-sectional study was conducted using face-to-face surveys administered to caregivers of patients with schizophrenia in selected communities in Beijing, China. 1,853 samples' data was used. Descriptive statistics, logistic regression models and Sheaf coefficient method were employed to analyze the data. Results The mental health burden experienced by caregivers of schizophrenia patients has reached a high level, with 66.9% reporting a moderate or severe impact from their caregiving responsibilities. Parents and spouses were the primary providers of care for schizophrenia patients in China. Parent caregivers experienced greater suffering in their caregiving role compared to spouse caregivers, whereas the difference between child caregivers and spouse caregivers was not significant. The factors influencing caregiver's mental health burden vary according to the type of relationship with the care-recipient. For parent caregivers, the mental health burden primarily stems from personal conditions of schizophrenia patients, while for spouse or child caregivers, it mainly arises from family economic conditions. Conclusion This study reveals that caregivers having different types of care-recipient relationship with schizophrenia patients experience significantly different mental health burdens in Beijing, China, and major influencing factors are distinct according to different care-recipient relationship types.
Collapse
Affiliation(s)
- Yi Zhu
- School of Public Administration, Northwest University, Xi’an, China
| | | |
Collapse
|
3
|
Wang J, Wang Z, Niu B. Empirical Analysis of Preferences of Older Adults for Care Facilities in Japan: Focusing on Household Structure and Economic Status. Healthcare (Basel) 2023; 11:1843. [PMID: 37444677 DOI: 10.3390/healthcare11131843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/16/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Japan is advancing into a super-aged society at an unprecedented speed, and the proportion of the elderly population will continue to rise. The number of older adults needing nursing care will also increase with the aging population. We used a cross-sectional dataset of older Japanese adults to examine their future preferences for care facilities and their relationship with individual characteristics, household structure, and economic status. We further focused on a subgroup of those who lived alone and were experiencing poverty and examined their care needs through their choice of care facilities. We found the following results from multinomial logit and probit regressions. First, compared with living alone, older adults who live with their spouses or other members prefer to live in their own houses. Second, older adults experiencing poverty preferred to choose facilities geared towards low-income groups, while wealthy older adults preferred to choose fee-based nursing homes/nursing homes with diverse services and high costs. Third, single older adults in poverty were less likely to choose to live in facilities. Covariates such as sex, age, and health status also mattered in their choices. Therefore, tailoring the formal care services to the preferences and actual needs of older adults is imperative.
Collapse
Affiliation(s)
- Jinhan Wang
- Graduate School of Economics, Osaka Metropolitan University, Osaka 599-8531, Japan
| | - Ziyan Wang
- Graduate School of Economics, Osaka Metropolitan University, Osaka 599-8531, Japan
| | - Bing Niu
- Graduate School of Economics, Osaka Metropolitan University, Osaka 599-8531, Japan
| |
Collapse
|
4
|
Contreras M, Khondoker M, Mioshi E, Kishita N. Factors affecting the quality of life of family carers of people with dementia: the role of carer anxiety. PSYCHOL HEALTH MED 2023; 28:843-853. [PMID: 35769020 DOI: 10.1080/13548506.2022.2093926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The role of anxiety on the quality of life of family carers of people with dementia is somewhat neglected in the carer literature. The current study aimed to investigate the impact of common risk factors (i.e., care recipient's neuropsychiatric symptoms, carer depression, and burden) and anxiety on QoL. This cross-sectional study recruited 89 family carers. Most of the participants were looking after a spouse with Alzheimer's or mixed dementia. A multiple regression analysis was conducted with carer QoL as a dependent variable. All risk factors (i.e., people with dementia's neuropsychiatric symptoms, carer depression, anxiety, and burden) were entered into the model simultaneously as independent variables. The model's R2 was 33%. The results demonstrated that anxiety was the only significant independent variable predicting carer QoL (β = - 0.34, p = 0.03, 95% CI: - 0.64 to - 0.04). These results indicated that having more symptoms of anxiety was associated with worse QoL as measured by the ICEpop CAPability measure for Older people (ICECAP-O). These findings suggested that improving carer's anxiety may be particularly important in promoting QoL among family carers of people with dementia. Future interventions should target this variable to achieve the desired result of improving carer QoL.
Collapse
Affiliation(s)
- Milena Contreras
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Mizanur Khondoker
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Eneida Mioshi
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Naoko Kishita
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| |
Collapse
|
5
|
Kawaguchi K, Ide K, Kondo K. Family social support and stability of preferences regarding place of death among older people: a 3-year longitudinal study from the Japan Gerontological Evaluation Study. Age Ageing 2022; 51:6730557. [PMID: 36173990 PMCID: PMC9521793 DOI: 10.1093/ageing/afac210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND it remains unclear how family relationships could affect stability of end-of-life care preferences. OBJECTIVE to describe change patterns of preferred place of death (POD) among older people and to examine associations between family social support and stability of preferences regarding POD. METHODS this longitudinal study of 1,200 noninstitutionalized independent Japanese older people aged over 65 years used panel data between 2016 and 2019 from the Japan Gerontological Evaluation Study (JAGES). Preference stability was defined as the congruence of preferred POD based on questionnaires between baseline and follow-up. We performed multiple logistic regression analysis and gender-stratified analysis to examine associations between social support (spouse, children living together and children living apart) and preference stability. RESULTS only 40.9% of participants had stable preferences. For a spouse, both receiving and providing social support was associated with less stable preferences (OR: 0.63, 95% CI: 0.43-0.93; OR: 0.55, 95% CI: 0.38-0.80, respectively), and providing social support to children living apart was associated with more stable preferences (OR: 1.35, 95% CI: 1.03-1.76). In gender-stratified analysis, significant associations between preference stability and providing social support to a spouse among women (OR: 0.53, 95% CI: 0.34-0.82) and providing social support to children living apart among men (OR: 1.72, 95% CI: 1.16-2.55) were observed. CONCLUSIONS family social support was associated with the stability of preferences, and the associations differed by support resources and gender. Incorporating family members in the process of end-of-life care discussion may be necessary for establishing stable preferences.
Collapse
Affiliation(s)
| | - Kazushige Ide
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 260-8670, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 260-8670, Japan,Department of Geriatric Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| |
Collapse
|
6
|
Birkenhäger‐Gillesse EG, Achterberg WP, Janus SI, Zuidema SU, van den Hout WB. Cost-effectiveness of dementia training for caregivers in caregiver-patient dyads: A randomized controlled study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12281. [PMID: 35774593 PMCID: PMC9216199 DOI: 10.1002/trc2.12281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
Abstract
Introduction We evaluated the cost-effectiveness of the "More at Home with Dementia" intervention, a multicomponent training program for co-residing caregivers of people with dementia (PwDs). Methods We performed a two-armed randomized controlled trial with an intervention and a control group. Participants were community-dwelling caregivers living with a person with dementia (59 randomized to intervention and 50 to control arm). The training program lasted 5 days and took place in a holiday accommodation. Quality-adjusted life-years (QALYs) were calculated using the EuroQol-5 Dimensions 3 Levels (EQ-5D-3L) for caregivers and PwDs. Costs for informal and formal social care, as well as health care, were collected at four times over a 6-month period from baseline. Information on nursing home admission or death was collected for 2 years after baseline. Results QALYs for caregivers and PwDs added together were 0.12 higher in the intervention group compared with the control group (P = .11). After 1 year, there tended to be fewer nursing home admissions in the intervention group, but this difference was lost by 2 years (P = .19). The cost of the intervention was estimated at €1000 (USD 1090) per dyad. Compared with the control group, the intervention group used other health care and formal social care significantly less for a year after baseline (P = .02 and .001, respectively). The estimated decrease in total costs was €10,437 (P = .07), with an estimated 96% probability that the intervention was cost-effective vs usual care. Discussion The multicomponent "More at Home with Dementia" training program is effective and appears to save costs compared with usual care. Savings appear to be achieved by delaying nursing home admissions and by reducing the use of other care resources. Further research is also needed to clarify if this intervention is effective for caregivers who do not live with a PwD, such as adult children, and for the caregivers of patients with other debilitating chronic diseases. At the same time, effort is advised to implement caregiver training in standard care programs.
Collapse
Affiliation(s)
- Elizabeth G. Birkenhäger‐Gillesse
- Department of General Practice and Elderly Care MedicineUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
- Laurens Care CentersRotterdamthe Netherlands
| | - Wilco P. Achterberg
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenthe Netherlands
| | - Sarah I.M. Janus
- Department of General Practice and Elderly Care MedicineUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care MedicineUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Wilbert B. van den Hout
- Department of Medical Decision Making & Quality of CareLeiden University Medical CenterLeidenthe Netherlands
| |
Collapse
|
7
|
Phetsitong R, Vapattanawong P. Reducing the Physical Burden of Older Persons’ Household Caregivers: The Effect of Household Handrail Provision. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042272. [PMID: 35206460 PMCID: PMC8872235 DOI: 10.3390/ijerph19042272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022]
Abstract
The household handrail is necessary for dependent older people to perform their daily living activities, improve caregiving competency, and reduce caregiver burden. This study aimed to explore physical burden levels and examine their association with handrail provision among caregivers in older people’s households in Phuttamonthon District, Thailand, in 2017. This study used the physical dimension of the Caregiver Burden Inventory to quantify the levels of physical burden among 254 caregivers in households with a dependent older person. It classified the studied households into three categories: no handrail, one handrail, and more than one handrail. The analysis employed the ordinal logistic model approach. The findings showed that the mean physical burden score was 5 ± 3.85, indicating a high burden. After adjusting for potential factors, the caregivers in older people’s households with one handrail were less likely to experience a high physical burden than those without a handrail (OR = 0.30, 95% CI = 0.14–0.67). Nonetheless, the analysis found no significant differences in physical burden between caregivers of households with more than one handrail and those of households with no handrails. Having handrails in housing might enhance older people’s ability to adjust to disability and illness, ultimately reducing the physical care burden of caregivers. However, having the appropriate number of handrails in older people’s households should be considered.
Collapse
Affiliation(s)
- Ruttana Phetsitong
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom 73170, Thailand;
| | - Patama Vapattanawong
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand
- Correspondence:
| |
Collapse
|
8
|
Contreras M, Mioshi E, Kishita N. Factors predicting quality of life in family carers of people with dementia: The role of psychological inflexibility. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
9
|
Birkenhäger‐Gillesse EG, Achterberg WP, Janus SI, Kollen BJ, Zuidema SU. Effects of caregiver dementia training in caregiver-patient dyads: A randomized controlled study. Int J Geriatr Psychiatry 2020; 35:1376-1384. [PMID: 32662184 PMCID: PMC7689696 DOI: 10.1002/gps.5378] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/21/2020] [Accepted: 07/06/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Caregivers for people with dementia (PWD) have reported needing emotional and social support, improved coping strategies, and better information about the illness and available support services. In this study, we aimed to determine the effectiveness of an Australian multicomponent community-based training program that we adapted and implemented in a non-medical Dutch health care setting. METHODS AND DESIGN A randomized controlled trial was performed: 142 dyads of cohabiting caregivers and PwD were randomized to control (care as usual) or intervention (training program) groups and outcomes were compared. Programs lasted 1 week, comprised 14 sessions, and were delivered by specialist staff. We included 16 groups of two to six caregivers. The primary outcome was care-related quality of life (CarerQol-7D) at 3 months. The main secondary outcomes for caregivers were self-rated burden, health and mood symptoms, and for PwD were neuropsychiatric symptoms, quality of life, and agitation. RESULTS No significant difference was observed for the primary outcome. However, caregivers experienced fewer role limitations due to physical function (adjusted mean difference, 13.04; 95% confidence interval [95%CI], 3.15-22.93), emotional function (13.52; 95%CI, 3.76-23.28), and pain reduction (9.43; 95%CI, 1.00-17.86). Positive outcomes identified by qualitative analysis included better acceptance and coping and improved knowledge of dementia and available community services and facilities. CONCLUSION Quantitative analysis showed that the multicomponent course did not affect care-related quality of life but did have a positive effect on experienced role limitations and pain. Qualitative analysis showed that the course met the needs of participating dyads.
Collapse
Affiliation(s)
- Elizabeth G. Birkenhäger‐Gillesse
- Department of General Practice and Elderly Care MedicineUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands,Laurens Care Centers, Division Long StayRotterdamThe Netherlands
| | - Wilco P. Achterberg
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenThe Netherlands
| | - Sarah I.M. Janus
- Department of General Practice and Elderly Care MedicineUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Boudewijn J. Kollen
- Department of General Practice and Elderly Care MedicineUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care MedicineUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| |
Collapse
|
10
|
Karakis I, Morton ML, Janocko NJ, Groover O, Teagarden DL, Villarreal HK, Loring DW, Drane DL. Caregiver burden in psychogenic non-epileptic seizures. Seizure 2020; 81:13-17. [PMID: 32683267 DOI: 10.1016/j.seizure.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Caregiver burden in psychogenic non-epileptic seizures (PNES) is an important but understudied reality. The objective of this exploratory study was to quantify caregiver burden in PNES and to identify the patient and caregiver characteristics associated with it. METHODS PNES patients and their identified caregivers completed surveys about demographic, disease related and psychosocial characteristics during their Epilepsy Monitoring Unit (EMU) admission. Associations were evaluated using the Zarit Caregiver Burden Inventory (ZCBI) score as an independent variable and the patient and caregiver related characteristics as dependent variables. RESULTS 43 patients and 28 caregivers were recruited. The patients were on average 36 years old, single women, unemployed, with some college education. They suffered from PNES on average for 8 years, having approximately 20 seizures per month, and were previously maintained on ≥ 2 antiseizure medications. Most caregivers were first degree relatives with a mean age of 43 years, married employed women of higher educational attainment, typically cohabitating with the patients. Caregiver burden was within the mild-moderate range (ZCBI mean score 28). The burden appeared higher in caregivers of male patients. Patient quality of life, depression and medication side effects were associated with that burden. Additionally, caregiver stigma, depression and anxiety emerged as potential contributors. In the multivariate analysis, patient quality of life and caregiver depression stood out as the most robust factors. CONCLUSION There is substantial caregiver burden in PNES. It is associated with both the patient and the caregiver psychosocial well-being in a reciprocal relationship.
Collapse
Affiliation(s)
- Ioannis Karakis
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Matthew L Morton
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nicholas J Janocko
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Olivia Groover
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Diane L Teagarden
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Hannah K Villarreal
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - David W Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington, Seattle, WA, USA
| |
Collapse
|
11
|
Pothiban L, Srirat C, Wongpakaran N, Pankong O. Quality of life and the associated factors among family caregivers of older people with dementia in Thailand. Nurs Health Sci 2020; 22:913-920. [PMID: 32483932 DOI: 10.1111/nhs.12746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
Long-term care for older people with dementia can adversely impact a family caregiver's life. A decrease in their quality of life may compromise the quality of care they provide to older people and their own quality of life. The samples include 76 family caregivers of older people with dementia in Thailand. Six questionnaires and the EuroQoL Five Dimensions Questionnaire were used in data collection. Descriptive and inferential statistics were used in data analysis. The findings revealed that quality of life of family caregivers was at a high level. Experiences of close relationships between care dyads and perceived social support were positively related to family caregiver's quality of life, whereas perceived stress and burden were negatively related. Perceived social support and experiences of close relationships might be predictors of family caregiver's quality of life. High quality of life levels among Thai family caregivers of older people with dementia were influenced by high perceived social support and high experiences of close relationships. An intervention focusing on modifying such predicting factors may effectively help maintain quality of life of these family caregivers.
Collapse
Affiliation(s)
- Linchong Pothiban
- Medical Nursing Department, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Chomphoonut Srirat
- Medical Nursing Department, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Orawan Pankong
- Adult and Gerontological Nursing Unit, Boromarajonani Nursing College, Praputhabat, Saraburi, Thailand
| |
Collapse
|
12
|
Xiong C, Ye B, Mihailidis A, Cameron JI, Astell A, Nalder E, Colantonio A. Sex and gender differences in technology needs and preferences among informal caregivers of persons with dementia. BMC Geriatr 2020; 20:176. [PMID: 32423406 PMCID: PMC7236350 DOI: 10.1186/s12877-020-01548-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/02/2020] [Indexed: 11/23/2022] Open
Abstract
Background Dementia is a major public health concern associated with significant caregiver demands and there are technologies available to assist with caregiving. However, there is a paucity of information on caregiver needs and preferences for these technologies, particularly from a sex and gender perspective. To address this gap in research, the objectives of this study are to examine (1) the knowledge of technology, (2) perceived usefulness of technology, (3) feature preferences when installing and using technology and (4) sex and gender influences on technology needs and preferences among family caregivers of persons with dementia (PWD) across North America. Methods A secondary analysis was conducted on an existing cross-sectional survey with family caregivers of PWDs. Respondents were recruited through the Alzheimer Society of Canada, the Victorian Order of Nurses and Adult Day Programs and other Canadian health care provision institutes. Descriptive statistics, bivariate and multivariate analyses were used to describe the study sample, uncover differences between male and female caregivers and examine sex and gender influences on caregivers’ technology needs and preferences. Results A total of 381 eligible responses were received over a nine month data collection period. The majority of respondents did not know much about and never used any technologies to assist with caregiving. “Being easy to install”, “easy to learn how to use” and “cost” were identified as the most important features when purchasing and setting up technology, while “reliability” was identified as the most important feature when using technology. Most respondents were willing to pay up to $500 to acquire individual technologies. Controlling for other socio-demographic variables, female respondents were more likely to have some or more knowledge about technology for caregiving while male respondents were more willing to pay higher amounts for these technologies compared to their female counterparts. Conclusions As one of the first studies of its kind, our findings represent a step towards the incorporation of sex and gender considerations such as cost and reliability in technology design and promotion for caregivers. Future efforts are warranted to establish an in-depth understanding of sex and gender influences in relation to other social and environmental factors.
Collapse
Affiliation(s)
- Chen Xiong
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada. .,Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada. .,Acquired Brain Injury Research Lab, University of Toronto, 500 University Ave, Room 260, Toronto, M5G 1V7, Ontario, Canada.
| | - Bing Ye
- Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Alex Mihailidis
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Jill I Cameron
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Arlene Astell
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, M5G 2A2, Ontario, Canada.,Acquired Brain Injury Research Lab, University of Toronto, 500 University Ave, Room 260, Toronto, M5G 1V7, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, M5T 3M7, Ontario, Canada
| |
Collapse
|
13
|
Clarke R, Farina N, Chen HL, Rusted JM. Quality of Life and Well-being of Carers of People With Dementia: Are There Differences Between Working and Nonworking Carers? Results From the IDEAL Program. J Appl Gerontol 2020; 40:752-762. [PMID: 32396415 DOI: 10.1177/0733464820917861] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to identify the differences in quality of life (QoL) and well-being between working and nonworking dementia carers and the relative contribution of psychological characteristics, caregiving experience, and social support. Multiple regressions modeled the contribution of working status, caregiver experiences, and psychological and social resources to carer QoL (EQ-5D) and well-being (WHO-5). After controlling for age, gender, carer-dyad relationship, and severity of dementia, working status contributed significant variance to EQ-5D (2%) but not to WHO-5 scores. Independent of working status, higher self-esteem and reduced stress contributed to variance in both models. Self-efficacy, social support, and positive perceptions of caregiving additionally contributed to higher WHO-5 scores. Working status associated with higher EQ-5D QoL; this may reflect the sustained sense of independence associated with supported work opportunities for carers. Outside of working status, the findings support the importance of psychological and social factors as targets to improved mental health for dementia carers.
Collapse
|
14
|
Sex and gender differences in caregiving burden experienced by family caregivers of persons with dementia: A systematic review. PLoS One 2020; 15:e0231848. [PMID: 32310969 PMCID: PMC7170244 DOI: 10.1371/journal.pone.0231848] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/01/2020] [Indexed: 01/29/2023] Open
Abstract
Objectives Much is known about the demands of caregiving for persons with dementia (PWD) and its effects on family caregivers, however sex and gender aspects have received less attention. We synthesized the evidence on sex and gender distinctions in: (1) the caregiving burden and (2) the impact of caregiving on the physical and mental health of family caregivers of PWD. Design Systematic review. Data sources Medline, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature between January 2007 and October 2019 were searched. Eligibility criteria for selecting studies Included studies met the following criteria: (1) examine experiences and/or impacts of caregiving among family caregivers of individuals with any form of dementia; (2) report sex and/or gender distribution of study population and/or report results stratified by sex and/or gender, and (3) include both male and female family caregivers. Data extraction and synthesis Two independent reviewers extracted the data and assessed risk of bias using the Critical Appraisal Skills Program checklist and National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Data were synthesized using a narrative synthesis approach. Results A total of 22 studies were included. Caregiving burden was measured using various methods. A majority of studies reported higher burden among females. All studies that did not report a sex and gender difference in caregiving burden accounted for confounders. Findings on sex and gender differences on physical and mental health conditions were inconsistent with most studies failing to account for confounders in their analyses. Conclusions Current evidence on sex and gender differences in caregiving burden, mental and physical health is limited. Findings suggest presence of sex and gender differences in caregiving burden. Given the variety of mental and physical health constructs that were examined, further research is required to substantiate the evidence. PROPSERO Registration Number: CRD 42018070032.
Collapse
|
15
|
Eisenmann Y, Golla H, Schmidt H, Voltz R, Perrar KM. Palliative Care in Advanced Dementia. Front Psychiatry 2020; 11:699. [PMID: 32792997 PMCID: PMC7394698 DOI: 10.3389/fpsyt.2020.00699] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/02/2020] [Indexed: 12/20/2022] Open
Abstract
Dementia syndrome is common and expected to increase significantly among older people and characterized by the loss of cognitive, psychological and physical functions. Palliative care is applicable for people with dementia, however they are less likely to have access to palliative care. This narrative review summarizes specifics of palliative care in advanced dementia. Most people with advanced dementia live and die in institutional care and they suffer a range of burdensome symptoms and complications. Shortly before dying people with advanced dementia suffer symptoms as pain, eating problems, breathlessness, neuropsychiatric symptoms, and complications as respiratory or urinary infections and frequently experience burdensome transitions. Pharmacological and nonpharmacological interventions may reduce symptom burden. Sensitive observation and appropriate assessment tools enable health professionals to assess symptoms and needs and to evaluate interventions. Due to lack of decisional capacity, proxy decision making is often necessary. Advanced care planning is an opportunity establishing values and preferences and is associated with comfort and decrease of burdensome interventions. Family carers are important for people with advanced dementia they also experience distress and are in need for support. Recommendations refer to early integration of palliative care, recognizing signs of approaching death, symptom assessment and management, advanced care planning, person-centered care, continuity of care, and collaboration of health care providers.
Collapse
Affiliation(s)
- Yvonne Eisenmann
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Heidrun Golla
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Holger Schmidt
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.,Clinical Trials Center (ZKS), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.,Center for Health Services Research, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Klaus Maria Perrar
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| |
Collapse
|
16
|
Conrad I, Alltag S, Matschinger H, Kilian R, Riedel-Heller SG. [Quality of life among older informal caregivers of people with dementia]. DER NERVENARZT 2019; 89:500-508. [PMID: 29637233 DOI: 10.1007/s00115-018-0510-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Germany, informal caregiving becomes an increasingly important issue especially for people with dementia. Spouses often provide nursing care due to the limited daily living skills of people with dementia. This leads to a wide range of caregiver burden and decreased quality of life (QoL). Analyses on the relation between QoL and caregiver burden of older informal caregivers in Germany are rare. OBJECTIVE The following research questions were assessed: (1) Does caregivers' QoL differ from that of the older general population?; (2) Which sociodemographic, health- and care-related characteristics affect caregivers' QoL? MATERIAL AND METHODS For this study, two samples (aged 60 years and older) were recruited: informal caregivers (n = 119) and a representative sample of older non-caregivers in the general population (n = 1133). Linear regression analyses were applied to examine the effects of sociodemographic, health and care-related variables on the QoL of older informal caregivers of people with dementia. RESULTS Older informal caregivers reported a significantly lower QoL compared to older non-caregivers in the general population. Especially the domains autonomy, activities in the past, the present and the future as well as intimacy were negatively associated with caregivers' QoL. CONCLUSION The results of the study highlighted caregivers' need for assistance. Due to demographic changes, tailored support services should be based on older caregivers' needs.
Collapse
Affiliation(s)
- I Conrad
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
| | - S Alltag
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
| | - H Matschinger
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
| | - R Kilian
- Abt. Psychiatrie II, Bezirkskrankenhaus Günzburg, Universität Ulm, Ulm, Deutschland
| | - S G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
| |
Collapse
|
17
|
Gok Ugur H, Orak OS, Yaman Aktas Y, Enginyurt O, Saglambilen O. [Effects of Music Therapy on the Care Burden of In-Home Caregivers and Physiological Parameters of Their In-Home Dementia Patients: A Randomized Controlled Trial]. Complement Med Res 2018; 26:22-30. [PMID: 30497077 DOI: 10.1159/000490348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study was conducted to explore the effects of classical Turkish music therapy on both the caregiver burden and physiological parameters of patients with dementia. METHODS The study was a randomized controlled trial. It was conducted with dementia patients (n = 75) and their caregivers who were registered at in-home care services of the General Secretariat of the Association of Public Hospitals in Ordu. The study sample consisted of 30 control and 30 music group patients and their caregivers who satisfied the inclusion criteria for the study conducted between April 2015 and April 2016. The primary outcome of the study was to measure the care burden of in-home caregivers, and the secondary outcome was to measure physiological parameters, including systolic and diastolic blood pressure, heart rate, and respiration rate in patients with dementia. RESULTS The mean scores of the post-test caregiver burden in the music group were found to be significantly lower than those of the control group (t = -4.478, p = 0.001). The differences in the post-test systolic and diastolic blood pressures between the patient groups were found to be statistically significant (t = -4.603, p = 0.001; t = -2.656, p = 0.010). CONCLUSIONS Classical Turkish music intervention in in-home dementia patients decreased the care burden of caregivers and the patients' blood pressures were brought under control. In parallel with these results, it is recommended that more studies to reveal the effects of classical Turkish music on care burden should be conducted.
Collapse
|
18
|
Gerritsen DL, Koopmans RTCM, Walravens V, van Vliet D. Using Video Feedback at Home in Dementia Care: A Feasibility Study. Am J Alzheimers Dis Other Demen 2018; 34:153-162. [PMID: 30352521 PMCID: PMC6463273 DOI: 10.1177/1533317518808021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Video feedback at home (VFH) aims to improve the well-being of informal caregivers and persons with dementia by training the caregiver to communicate successfully. This feasibility study had 2 aims: (1) to investigate possible effects regarding VFH, caregiver self-efficacy and the burden experienced, and the frequency of challenging behavior in persons with dementia, and (2) to perform a process evaluation of barriers and facilitators regarding the use of VFH. The respondents were caregivers of home-dwelling persons with dementia participating in VHF (N = 10), a group of caregivers who declined participating in VFH (N = 18), stakeholders (N = 6), and field experts (N = 55). The assessments performed were Positive and Negative Affect Scales, Cohen-Mansfield Agitation Inventory, Sense of Competence Scale, semistructured interviews, and questionnaires. Results demonstrated that caregivers were satisfied with VFH and that various (sub)scores on questionnaires improved. Caregivers mentioned a reluctance toward being filmed and both caregivers and referrers were unfamiliar with VFH. Recommendations have been made for health-care professionals and researchers to overcome these barriers.
Collapse
Affiliation(s)
- Debby L Gerritsen
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands.,3 Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Raymond T C M Koopmans
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands.,4 Joachim en Anna, Centre for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Veerle Walravens
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands
| | - Deliane van Vliet
- 1 Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.,2 Radboud Alzheimer Centre, Nijmegen, the Netherlands
| |
Collapse
|
19
|
[Caregiver burden among older informal caregivers of patients with dementia and its influence on quality of life : A systematic literature review]. Z Gerontol Geriatr 2018; 52:477-486. [PMID: 29992357 DOI: 10.1007/s00391-018-1424-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 03/12/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Projections revealed that the age group of 60+ years will increase to 1.4 billion people worldwide by 2030. Germany is affected by the demographic change with an increase in people suffering from dementia and a substantial proportion will be cared for by informal caregivers. Quality of life (QOL) is of utmost importance for the stability of domestic care arrangements. OBJECTIVES This review aimed at collecting and analyzing articles on the association between burden of care and QOL in older informal caregivers of people with dementia. MATERIAL AND METHODS A systematic literature search was conducted in the databases Web of Science and PubMed. German and English papers were considered. RESULTS Caregiver burden, health-related characteristics of the informal caregiver, dementia-related characteristics, sociodemographics and contextual factors were significantly negatively associated with informal caregivers' QOL. Support arrangements in order to relieve caregivers were rarely utilized. CONCLUSION Despite different methods of analysis and instruments used, consistent results regarding the association between caregiver burden and QOL in older informal caregivers were found. The existence of a care situation already negatively influenced the caregivers' QOL. Especially older informal caregivers require special support.
Collapse
|
20
|
Gorniak SL, Johnson CA. The Need for Innovative Methods to Increase Adherence in Individuals Experiencing Cognitive Decline. Am J Lifestyle Med 2018; 12:291-294. [PMID: 32063812 PMCID: PMC6993094 DOI: 10.1177/1559827618769551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cognitive impairment, particularly coupled with advanced age, is becoming an increasing concern for both clinicians and caregivers. Nonadherence is a common problem in individuals with cognitive impairment, leading to concerns regarding patient autonomy. The development and use of innovative strategies to overcome nonadherence is important to increase the likelihood of engagement in healthy lifestyle behaviors.
Collapse
Affiliation(s)
- Stacey L. Gorniak
- Department of Health and Human Performance,
University of Houston, Houston, Texas
| | - Craig A. Johnson
- Department of Health and Human Performance,
University of Houston, Houston, Texas
| |
Collapse
|
21
|
Lai C, Cipriani M, Renzi A, Luciani M, Lombardo L, Aceto P. The Effects of the Perception of Being Recognized by Patients With Alzheimer Disease on a Caregiver's Burden and Psychophysical Health. Am J Hosp Palliat Care 2018; 35:1188-1194. [PMID: 29580073 DOI: 10.1177/1049909118766316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Caring for a patient with Alzheimer disease (AD) represents a real challenge that can have considerable long-term psychological and physical consequences. The aim of this study was to evaluate the impact of the perception of being recognized on both the psychophysical health and the level of burden reported in caregivers of patients with AD. The secondary aim was to evaluate the association between the use of a home care assistance service and the burden and psychophysical health in caregivers. The Caregiver Burden Inventory (CBI), the 36-item Short-Form Health Survey (SF-36), and a visual analog scale (VAS) to evaluate the level of perception of being recognized were administered to 31 caregivers of patients with AD. Data were also collected from patients with AD using the Mini-Mental State Examination (MMSE). The level of perception of being recognized was significantly and negatively correlated with total burden ( r = -0.36; P = .045) and objective burden ( r = -0.53; P = .002). It was also significantly and positively correlated with the MMSE score ( r = 41; P = .02). Regression models showed that only the perception of being recognized, and not MMSE, significantly predicted lower caregiver objective burden scores. Furthermore, the use of a home care assistance service significantly predicted higher caregiver physical functioning. The perception of being recognized by an AD relative significantly predicted the caregiver's objective burden associated with a shortage of time. The use of a home care assistance service also resulted in a promotion in the caregiver's social functioning. Further studies are needed to confirm these results.
Collapse
Affiliation(s)
- Carlo Lai
- 1 Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| | - Marta Cipriani
- 1 Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| | - Alessia Renzi
- 1 Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| | - Massimiliano Luciani
- 2 Psychiatry and Psychology Institute, Catholic University of Sacred Heart, Rome, Italy
| | | | - Paola Aceto
- 4 Department of Anaesthesiology and Intensive Care, Catholic University of Sacred Heart, Rome, Italy
| |
Collapse
|
22
|
Gehrman P, Gooneratne NS, Brewster GS, Richards KC, Karlawish J. Impact of Alzheimer disease patients' sleep disturbances on their caregivers. Geriatr Nurs 2018; 39:60-65. [PMID: 28684102 PMCID: PMC5752633 DOI: 10.1016/j.gerinurse.2017.06.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/02/2017] [Accepted: 06/09/2017] [Indexed: 11/28/2022]
Abstract
Sleep disturbance symptoms are common in persons living with Alzheimer disease (AD). However little is known about the impact of sleep disturbance symptoms in patients living with AD on caregiver burden and quality of life (QOL). The aims of this study were to determine the prevalence of symptoms of disturbed sleep in patients with AD, identify the care-recipient sleep disturbance symptoms that predict caregiver burden and QoL, and determine how care-recipient sleep disturbance symptoms compare to other caregiver and patient characteristics when predicting caregiver QoL. Caregiver burden was assessed using the Screen for Caregiver Burden. Sixty percent of the care-recipients had at least one sleep symptom. In 130 caregiver/patient dyads, nocturnal awakenings, nocturnal wandering, and snoring predicted caregiver burden. Multivariate modeling demonstrated that caregiver burden, caregiver physical and mental health, and caregiver depression were predictors of overall caregiver QoL. Treating disturbed sleep in care-recipients and caregiver mental health symptoms could have important public health impact by improving the lives of the caregiving dyad.
Collapse
Affiliation(s)
- Philip Gehrman
- Department of Psychiatry, University of Pennsylvania School of Medicine, USA; Center for Sleep and Respiratory Neurobiology, University of Pennsylvania School of Medicine, USA
| | - Nalaka S Gooneratne
- Center for Sleep and Respiratory Neurobiology, University of Pennsylvania School of Medicine, USA; Division of Geriatric Medicine, University of Pennsylvania School of Medicine, USA
| | - Glenna S Brewster
- Center for Sleep and Respiratory Neurobiology, University of Pennsylvania School of Medicine, USA; New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
| | | | - Jason Karlawish
- Division of Geriatric Medicine, University of Pennsylvania School of Medicine, USA
| |
Collapse
|
23
|
Costs and quality of life in community-dwelling patients with Alzheimer's disease in Spain: results from the GERAS II observational study. Int Psychogeriatr 2017; 29:2081-2093. [PMID: 28720158 DOI: 10.1017/s1041610217001211] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Country-specific data on resource use and costs associated with Alzheimer's disease (AD) help inform governments about the increasing need for medical and financial support as the disease increases in prevalence. METHODS GERAS II, a prospective observational study, assessed resource use, costs, and health-related quality of life (HRQoL) among patients with AD and their caregivers in Spain. Community-dwelling patients aged ≥55 years with probable AD, and their primary caregivers, were recruited by study investigators during routine clinical practice and assessed as having mild, moderate, or moderately severe/severe (MS/S) AD dementia based on patient Mini-Mental State Examination scores. Costs of AD were calculated by applying costs to resource-use data obtained in caregiver interviews using the Resource Utilization in Dementia instrument. Total societal costs included patients' health and social care costs and caregiver informal care costs. Baseline results are presented. RESULTS Total mean monthly societal costs/patient (2013 values) were €1514 for mild (n = 116), €2082 for moderate (n = 118), and €2818 for MS/S AD dementia (n = 146) (p value <0.001 between groups). Caregiver informal care costs comprised most of the total societal costs and differed significantly between groups (€1050, €1239, €1580, respectively; p value = 0.013), whereas patient healthcare costs did not. Across AD dementia severity groups, patient HRQoL (measured by proxy) decreased significantly (p value <0.001), caregiver subjective burden significantly increased (p value <0.001) and caregiver HRQoL was similar. CONCLUSIONS Societal costs associated with AD in Spain were largely attributable to caregiver informal care costs and increased with increasing AD dementia severity.
Collapse
|
24
|
Hamidou Z, Baumstarck K, Chinot O, Barlesi F, Salas S, Leroy T, Auquier P. Domains of quality of life freely expressed by cancer patients and their caregivers: contribution of the SEIQoL. Health Qual Life Outcomes 2017; 15:99. [PMID: 28494773 PMCID: PMC5427569 DOI: 10.1186/s12955-017-0672-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 04/28/2017] [Indexed: 12/13/2022] Open
Abstract
Background The purposes of this study, performed on a large sample of cancer patient-caregiver dyads, were: i) to simultaneously investigate, using an individualized quality of life (QoL) measure (Schedule for the Evaluation of Individual QoL, SEIQoL), the QoL domains freely expressed by cancer patients and their caregivers, and ii) to explore overlapping between the SEIQoL assessment and QoL assessment using traditional instruments. Methods The study employed a cross-sectional design including cancer patients who were going to receive chemotherapy treatment and their caregivers. Quality of life was assessed using condition-specific questionnaires (EORTC QLQ-C30 and CarGOQoL), generic health-related questionnaire (SF-36), and open individualized measure (SEIQoL). Results The final sample included 205 patient-caregiver dyads. From the SEIQoL, Family, Health, and Leisures were the most freely expressed QoL domains by patients and caregivers, but reported with different weights. Love life and financial issues were less spontaneously mentioned. The SEIQoL index was moderately correlated to the condition-specific QoL questionnaires (R lower than |0.40|) and to SF-36 (correlation coefficients: R ranging from 0.17 to 0.31). Conclusion Individualized QoL measures allow individuals to spontaneously express important, non-predefined domains. This study highlights the need to explore QoL using a combination of individualized questionnaires and standardized questionnaires, capturing complementary facets that patients consider important in their life.
Collapse
Affiliation(s)
- Zeinab Hamidou
- EA3279, Self-perceived Health Assessment Research Unit, Aix Marseille Université, 27 bd Jean Moulin, Marseille, cedex 05, F-13385, France.,National Clinical research Quality of Life in Oncology Platform, Nancy, France
| | - Karine Baumstarck
- EA3279, Self-perceived Health Assessment Research Unit, Aix Marseille Université, 27 bd Jean Moulin, Marseille, cedex 05, F-13385, France.
| | - Olivier Chinot
- Department of Neuro-Oncology, Assistance Publique Hôpitaux de Marseille, Timone Hospital, 13005, Marseille, France
| | - Fabrice Barlesi
- Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Centre d'Investigation Clinique, 13385, Marseille, France
| | - Sébastien Salas
- Department of adult oncology, Assistance Publique Hôpitaux de Marseille, Timone Hospital, 13005 Marseille, and CRO2, Aix Marseille Université, 13284, Marseille, France
| | - Tanguy Leroy
- Université Lumière Lyon 2, Social Psychology Research Group (GRePS EA 4163), Bron, France
| | - Pascal Auquier
- EA3279, Self-perceived Health Assessment Research Unit, Aix Marseille Université, 27 bd Jean Moulin, Marseille, cedex 05, F-13385, France
| |
Collapse
|
25
|
Farina N, Page TE, Daley S, Brown A, Bowling A, Basset T, Livingston G, Knapp M, Murray J, Banerjee S. Factors associated with the quality of life of family carers of people with dementia: A systematic review. Alzheimers Dement 2017; 13:572-581. [DOI: 10.1016/j.jalz.2016.12.010] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 12/03/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies Brighton and Sussex Medical School Brighton UK
| | | | - Stephanie Daley
- Centre for Dementia Studies Brighton and Sussex Medical School Brighton UK
| | - Anna Brown
- School of Psychology University of Kent Canterbury UK
| | - Ann Bowling
- Health Sciences University of Southampton Southampton UK
| | - Thurstine Basset
- Lived Experience Advisory Panel Sussex Partnership NHS Foundation Trust Hove UK
| | | | - Martin Knapp
- Department of Social Policy London School of Economics London UK
| | - Joanna Murray
- Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Sube Banerjee
- Centre for Dementia Studies Brighton and Sussex Medical School Brighton UK
| |
Collapse
|
26
|
Emotional Burden, Quality of Life, and Coping Styles in Care Givers of Patients with Disorders of Consciousness Living in Italy: Preliminary Data. BRAIN IMPAIR 2016. [DOI: 10.1017/brimp.2016.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The literature about the care givers of patients with Disorders of Consciousness (DOCs) has highlighted the impact on both mental and physical dimensions of quality of life. This study aimed to: (1) describe emotional burden, quality of life, and coping styles in care givers of hospitalized patients with DOCs, compared to Italian normative data; (2) explore the relationships between these variables and their associations with socio-demographic features; and (3) describe their changes over time.Fifteen care givers of patients with DOCs, mostly middle-aged women, were assessed using the Family Strain Questionnaire, the SF-36 Health Survey, and the Coping Orientation to Problems Experienced – Nuova Versione Italiana. Eleven subjects were also assessed after 6 and 12 months. Data were analysed through descriptive statistics, correlations, and nonparametric tests of group differences.Compared to the Italian normative data, our sample showed a worse outcome in mental health, social functioning, global mental component, and emotional role functioning. Furthermore, subjects with high emotional burden had more thoughts of death compared to subjects with low emotional burden. Follow-up analyses revealed no variables changed over time.These results highlight the need for psychological interventions and support, since care givers represent an important part of an all-embracing support and care network for patients with DOCs.
Collapse
|
27
|
Anand KS, Dhikav V, Sachdeva A, Mishra P. Perceived caregiver stress in Alzheimer's disease and mild cognitive impairment: A case control study. Ann Indian Acad Neurol 2016; 19:58-62. [PMID: 27011630 PMCID: PMC4782554 DOI: 10.4103/0972-2327.167695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objectives: Cross sectional studies have reported a tremendous amount of stress in caregivers of patients with Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). The present study aimed at evaluating the perceived stress in caregivers of patients with AD and MCI compared to controls. Materials and Methods: Caregivers of patients diagnosed with Alzheimer's disease/Mild Cognitive Impairment were recruited at the Memory Clinic of Neurology Department of a Tertiary Care Hospital in Northern India. The controls included caregivers of patients with chronic medical and psychiatric disorders. Caregivers were interviewed using Perceived Stress Scale (PSS) and the patients were assessed using The Blessed Activity of Daily Living (ADL), Mini Mental State Examination (MMSE) and Clinical Dementia Rating scale. The perceived stress of caregivers was compared amongst both groups and correlated with the severity of illness and activities of daily living of the patients. Results: Caregivers of a total of 31 patients of AD/MCI (Males = 24, Females = 7), and 30 controls (Males = 18, Females = 12) were interviewed. PSS Score was 23.29 ± 7.17 in cases and 7.5 ± 3.12 in controls. ADL Score was 7.97±5.53 in cases and 0.00 in controls. There was a significant difference between the PSS and ADL scores between those with AD and controls (P < 0.0001). Caregivers of patients with MCI had lower PSS scores compared to AD caregivers but significantly higher scores compared to caregivers of other chronic disorders. Similarly, correlation between Perceived Stress and ADL was significant (P < 0.001). Conclusions: Present study shows that caregivers of patients with AD/MCI have a high perceived stress compared to caregivers of patients with other chronic illness.
Collapse
Affiliation(s)
- Kuljeet Singh Anand
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vikas Dhikav
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ankur Sachdeva
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pinki Mishra
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| |
Collapse
|
28
|
Peeters JM, Pot AM, de Lange J, Spreeuwenberg PM, Francke AL. Does the organisational model of dementia case management make a difference in satisfaction with case management and caregiver burden? An evaluation study. BMC Geriatr 2016; 16:65. [PMID: 26956725 PMCID: PMC4784401 DOI: 10.1186/s12877-016-0237-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 03/01/2016] [Indexed: 11/30/2022] Open
Abstract
Background In the Netherlands, various organisational models of dementia case management exist. In this study the following four models are distinguished, based on differences in the availability of the service and in the case management function: Model 1: the case management service is available from first dementia symptoms + is always a separate specialist function; Model 2: the case management service is only available after a formal dementia diagnosis + is always a separate specialist function; Model 3: the case management service is available from first dementia symptoms + is often a combined function; Model 4: the case management service is only available after a formal dementia diagnosis + is often a combined function. The objectives of this study are to give insight into whether satisfaction with dementia case management and the development of caregiver burden depend on the organisational model. Methods A survey was carried out in regional dementia care networks in the Netherlands among 554 informal carers for people with dementia at the start of case management (response of 85 %), and one year later. Descriptive statistics and multilevel models were used to analyse the data. Results The satisfaction with the case manager was high in general (an average of 8.0 within a possible range of 1 to 10), although the caregiver burden did not decrease in the first year after starting with case management. No differences were found between the four organisational models regarding the development of caregiver burden. However, statistically significant differences (p < 0.05) were found regarding satisfaction: informal carers in the organisational model where case management is only available after formal diagnosis of dementia and is often a combined function had on average the lowest satisfaction scores. Nevertheless, the satisfaction of informal carers within all organisational models was high (ranging from 7.51 to 8.40 within a range of 1 to 10). Conclusions Organisational features of case management seem to make little or no difference to the development in caregiver burden and the satisfaction of informal carers. Future research is needed to explore whether the individual characteristics of the case managers themselves are associated with case management outcomes.
Collapse
Affiliation(s)
- José M Peeters
- Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands.
| | - Anne Margriet Pot
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands. .,Department of Clinical Psychology and EMGO Institute for Health and Care Research, Faculty of Psychology and Education, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
| | - Jacomine de Lange
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, The Netherlands.
| | - Peter M Spreeuwenberg
- Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands.
| | - Anneke L Francke
- Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands. .,Department of Public and Occupational Health and EMGO institute for Health and Care Research, VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
| |
Collapse
|
29
|
Droogsma E, van Asselt D, van Steijn J, Diekhuis M, Veeger N, De Deyn PP. Long-term Course of Alzheimer Disease in Patients Treated According to the Dutch Dementia Guideline at a Memory Clinic. Alzheimer Dis Assoc Disord 2016; 30:53-9. [DOI: 10.1097/wad.0000000000000090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
30
|
Välimäki TH, Martikainen JA, Hongisto K, Väätäinen S, Sintonen H, Koivisto AM. Impact of Alzheimer’s disease on the family caregiver’s long-term quality of life: results from an ALSOVA follow-up study. Qual Life Res 2015; 25:687-97. [DOI: 10.1007/s11136-015-1100-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2015] [Indexed: 10/23/2022]
|
31
|
Initial cognitive response to cholinesterase inhibitors and subsequent long-term course in patients with mild Alzheimer's disease. Int Psychogeriatr 2015; 27:1323-33. [PMID: 25779465 DOI: 10.1017/s1041610215000289] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Some guidelines recommend to discontinue treatment with cholinesterase inhibitors (ChEIs) in patients with Alzheimer's disease (AD) without an initial response to ChEI treatment. Evidence supporting this recommendation, however, is limited. This study aimed to investigate the relation between the initial cognitive response to ChEI treatment and the subsequent long-term course of cognition of AD patients. METHODS The Frisian Alzheimer's Disease Cohort study is a retrospective longitudinal study of 576 community-dwelling AD patients treated with ChEIs in a "real-life" setting at a large memory clinic. A repeated measures analysis using a marginal model (population based averaged model) was applied to investigate whether there is a difference in the subsequent long-term course of cognition (Mini-Mental State Examination (MMSE)) between initial non-responders and responders. Absence of an initial response was defined as a lower MMSE score after the first six months of treatment compared to baseline, a positive response as the same or a higher MMSE score. RESULTS At baseline, median age was 80 years and the median MMSE score 23. Non-responders showed a slower rate of cognitive decline in the three subsequent years than responders, with a mean annual MMSE decline of 0.9 points versus 1.2 points, respectively (p < 0.0001). CONCLUSIONS Our results suggest that it is not appropriate to discontinue ChEI treatment solely based on the absence of an initial cognitive response.
Collapse
|
32
|
Bakker C, de Vugt ME, van Vliet D, Verhey F, Pijnenburg YA, Vernooij-Dassen MJFJ, Koopmans RTCM. Unmet needs and health-related quality of life in young-onset dementia. Am J Geriatr Psychiatry 2014; 22:1121-30. [PMID: 23871115 DOI: 10.1016/j.jagp.2013.02.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 01/03/2013] [Accepted: 02/04/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Young-onset dementia (YOD) causes specific challenges and issues that are likely to affect health-related quality of life (HRQOL). This study explored patient and caregiver HRQOL and its association with unmet needs in YOD. METHODS A cross-sectional design was used to study 215 community-dwelling YOD patients and their primary caregivers. Multiple linear regression analyses were performed to determine the relationship between unmet needs assessed with the Camberwell Assessment of Need for the Elderly scale and patient and caregiver HRQOL, controlling for other variables such as demographic characteristics, patient functional status, neuropsychiatric symptoms, and caregiver sense of competence. RESULTS Patient HRQOL was not associated with unmet needs. However, we found that the unmet needs of both patient and caregiver were related to several domains of caregiver HRQOL. CONCLUSIONS This study shows that patient and caregiver unmet needs are related to caregiver HRQOL in YOD. However, the relationship between HRQOL and unmet needs is complex. The assessment of unmet needs within the context of HRQOL seems to be an important prerequisite for personalizing care in YOD. Adjusting supportive services to match the individual needs and preferences of these young patients and their caregivers is likely to enhance their quality of life.
Collapse
Affiliation(s)
- Christian Bakker
- Florence, Mariahoeve, Centre for Specialised Care in Early Onset Dementia, The Hague, the Netherlands; Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands.
| | - Marjolein E de Vugt
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Deliane van Vliet
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Frans Verhey
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | | | - Myrra J F J Vernooij-Dassen
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands; Alzheimer Centre Nijmegen, Centre for Quality of Care Research, Nijmegen, the Netherlands; IQ Healthcare, Kalorama Foundation, Nijmegen, the Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands
| |
Collapse
|
33
|
Ishii S, Kojima T, Yamaguchi K, Akishita M. Guidance statement on appropriate medical services for the elderly. Geriatr Gerontol Int 2014. [DOI: 10.1111/ggi.12310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Shinya Ishii
- Department of Geriatric Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Taro Kojima
- Department of Geriatric Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Kiyoshi Yamaguchi
- Department of Geriatric Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | | |
Collapse
|
34
|
Abstract
ABSTRACTThe purpose of this study is to develop and extend our understanding of dementia care-giving by introducing a typology of informal care-giving across four different diseases. Care-giving factors were examined with respect to specific dementia presentation in mild cognitive impairment, Alzheimer's disease, dementia with Lewy bodies and Parkinson's disease-associated dementia. Informal care-giving literature in the four diseases was systematically searched to identify specific disease symptoms and resultant care-giving strains and outcomes. Key concepts were extracted and grouped thematically. The first classification, ‘role-shift’, reflects care-giving where cognitive deterioration results in changing roles, uncertainty and relational deprivation among married partners. The second classification, ‘consumed by care-giving’, refers to those caring for persons with dementia-motor decline that greatly increases worry and isolation. Finally, in the ‘service use’ classification, formal support is needed to help care-givers cope with daily responsibilities and behaviour changes. In each case, the dementia presentation uniquely impacts care-giver strains. A major conclusion is that the same support to all care-givers under the umbrella term ‘dementia’ is unwarranted; the development of targeted support is required.
Collapse
|
35
|
Guidance statement on appropriate medical services for the elderly by the study group of the Ministry of Health, Labour and Welfare. Nihon Ronen Igakkai Zasshi 2014; 51:89-96. [PMID: 24747506 DOI: 10.3143/geriatrics.51.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
36
|
Caregiver burden in epilepsy: determinants and impact. EPILEPSY RESEARCH AND TREATMENT 2014; 2014:808421. [PMID: 24808956 PMCID: PMC3997889 DOI: 10.1155/2014/808421] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/02/2014] [Accepted: 03/03/2014] [Indexed: 12/13/2022]
Abstract
Aim. Caregiver burden (CB) in epilepsy constitutes an understudied area. Here we attempt to identify the magnitude of this burden, the factors associated with it, and its impact to caregiver quality of life (QOL). Methods. 48 persons with epilepsy (PWE) underwent video-EEG monitoring and their caregivers completed questionnaires providing demographic, disease-related, psychiatric, cognitive, sleep, QOL, and burden information. Results. On regression analysis, higher number of antiepileptic drugs, poorer patient neuropsychological performance, lower patient QOL score, and lower caregiver education level were associated with higher CB. Time allocated to patient care approximated but did not attain statistical significance. A moderate inverse correlation between CB and caregiver QOL physical component summary score and a stronger inverse correlation between CB and caregiver QOL mental component summary score were seen. Conclusion. In a selected cohort of PWE undergoing video-EEG monitoring, we identified modest degree of CB, comparable to that reported in the literature for other chronic neurological conditions. It is associated with specific patient and caregiver characteristics and has a negative effect on caregiver QOL.
Collapse
|
37
|
Abstract
BACKGROUND Numerous studies have reported that caring for a person with dementia is a stressful experience. Nevertheless, quality of life (QoL) measures have commonly focused on patients, while factors that influence caregivers' QoL have not been clearly identified. In order to contribute to the understanding of caregivers' QoL, we explored how QoL among caregivers is related to their perceived level of burden, their reported number of depressive symptoms, and the level of care recipients' dependency. METHODS Seventy-six caregivers referred by the two main referral centers of patients with dementia in Cyprus participated in a cross-sectional survey with a descriptive correlational design. Caregivers completed four instruments, measuring burden (ZBI), depression (CES-D), quality of life-Alzheimer's disease (QoL-AD), and activities of daily living (ADL) of the care recipients and provided socio-demographic information. RESULTS The majority of the participants scored high levels of burden (M = 43.32/SD = 15.23) and depression (59.2% scored over the cut-off point of 16). QoL was only moderate (M = 30.89/SD = 8.21) and negatively correlated with burden (r = -32, p = 0.01) and depression (r = -0.296, p < 0.05). Only a weak correlation was observed between QoL and ADL (r = 0.167, p = 0.15). Hierarchical multiple regression analyses revealed that overall burden scores and income were associated with QoL, explaining 20% of the overall variance of the caregiver's QoL. CONCLUSION Further research is necessary to investigate which additional domains determine QoL and further our understanding of the factors that may reduce the burden imposed on dementia caregivers.
Collapse
|
38
|
Wang WF, Chiu PY, Lin YT, Hu CJ, Fuh JL, Yang YH. Registration of Alzheimer's disease in Taiwan: patient and informant. Am J Alzheimers Dis Other Demen 2014; 29:18-22. [PMID: 24085249 PMCID: PMC11007955 DOI: 10.1177/1533317513504818] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
BACKGROUND To obtain updated data of patients with Alzheimer's disease (AD) and their informants in Taiwan with the aim of fostering and supporting collaborative research. METHODS In total, 691 patients with the diagnosis of AD were recruited at 6 sites in Taiwan. The Uniform Data Set (UDS; form A) was administrated. RESULTS The mean age of the patients with AD was 79.3 ± 7.7 years and the mean age of informants was 57.5 ± 13.7 years. In all, 69% of the informants lived with patients and 77% of patients lived with spouse, partner, or children; 11% had 1 sibling with dementia, 1.8% had 2 siblings with dementia, and 0.5% had 3 or more siblings with dementia. CONCLUSION We have reported the updated status of AD in Taiwan through a UDS that will foster future collaboration among countries using UDS. The updated information of patients with AD and their informants will direct the future care of AD in Taiwan.
Collapse
Affiliation(s)
- Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
- Center for General Education, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Lin Shin Hospital, Taichung, Taiwan
| | - Yu-Te Lin
- Section of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of and Master’s Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Mentality Protection Center, Fo Guang Shan Compassion Foundation, Taiwan
| |
Collapse
|
39
|
Beinart N, Weinman J, Wade D, Brady R. Caregiver burden and psychoeducational interventions in Alzheimer's disease: a review. Dement Geriatr Cogn Dis Extra 2012; 2:638-48. [PMID: 23341829 PMCID: PMC3551411 DOI: 10.1159/000345777] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Caring for a patient with Alzheimer's disease (AD) is associated with poor quality of life and deteriorating health for the caregiver. METHODS This comprehensive review was performed to investigate the current literature on caregiver burden, factors affecting caregiver burden and the effectiveness of different types of intervention. RESULTS Successful psychoeducational interventions for caregivers have included provision of information about AD, care planning, advice about patient management and the importance of self-care, skills training to aid patient management, stress management training, and problem-solving and decision-making guidance. CONCLUSION Interventions that are individually tailored to the caregiver are particularly effective at reducing caregiver burden and should be further investigated. The use of effective pharmacological treatment for the improvement and/or stabilisation of AD symptoms in the patient is also likely to improve caregiver burden.
Collapse
Affiliation(s)
- N Beinart
- Institute of Psychiatry, Kings College London, UK
| | | | | | | |
Collapse
|
40
|
Erder MH, Wilcox TK, Chen WH, O'Quinn S, Setyawan J, Saxton J. A new measure of caregiver burden in Alzheimer's disease: the caregiver-perceived burden questionnaire. Am J Alzheimers Dis Other Demen 2012; 27:474-82. [PMID: 22904030 PMCID: PMC10697400 DOI: 10.1177/1533317512456449] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
OBJECTIVE To validate the Caregiver-Perceived Burden Questionnaire (CPBQ) and report its psychometric properties. METHODS The CPBQ was administered to caregivers of patients with moderate-to-severe AD in a double-blind randomized trial comparing extended-release memantine to placebo (n = 676). Measurement properties were analyzed using factor analysis, classical test theory, and Rasch analysis. RESULTS Two subscales were identified: the Caregivers' Assessment of the Patient (CAP) and the Caregivers' Assessment of Themselves (CAT). The reliability was .89 (CAP) and .83 (CAT). The CAP scores were significantly correlated (r > .3) with scores from the Severe Impairment Battery (SIB) and the Neuropsychiatric Inventory (NPI). The CAT scores were significantly correlated with NPI scores. The CAT discriminated among patients by clinician-rated severity and significantly differentiated between responders and nonresponders. CONCLUSION The CPBQ appears to be a reliable, valid, and responsive measure that enables linking caregiver's perceptions about burden and patient function in patients with moderate-to-severe AD.
Collapse
|
41
|
Imes CC, Dougherty CM, Pyper G, Sullivan MD. Descriptive study of partners' experiences of living with severe heart failure. Heart Lung 2011; 40:208-16. [PMID: 21411148 PMCID: PMC3089716 DOI: 10.1016/j.hrtlng.2010.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 12/17/2010] [Accepted: 12/21/2010] [Indexed: 02/07/2023]
Abstract
PURPOSE This qualitative study sought to describe the experiences of living with severe heart failure (HF) from the perspective of the partner. METHODS In-depth, semistructured interviews were conducted with 14 partners of individuals diagnosed with severe HF. Content analysis was performed to derive the main themes and subthemes of responses. RESULTS Three main themes were derived from the data: (1) My Experience of HF in My Loved One, (2) Experience With Healthcare Providers, and the (3) Patient's Experience of HF as Perceived by the Partner. CONCLUSION The severity of the patient's disease limited the partner's lifestyle, resulting in social isolation and difficulties in planning for the future for both the patient and the partner. The partners were unprepared to manage the disease burden at home without consistent information and assistance by healthcare providers. Moreover, end-of-life planning was neither encouraged by healthcare providers nor embraced by patients or partners.
Collapse
Affiliation(s)
- Christopher C Imes
- School of Nursing, University of Washington, Seattle, Washington 98195, USA
| | | | | | | |
Collapse
|
42
|
Rapp T, Grand A, Cantet C, Andrieu S, Coley N, Portet F, Vellas B. Public financial support receipt and non-medical resource utilization in Alzheimer's disease results from the PLASA study. Soc Sci Med 2011; 72:1310-6. [PMID: 21463914 DOI: 10.1016/j.socscimed.2011.02.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Revised: 02/16/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022]
Abstract
A major health policy objective is to encourage and sustain informal caregiving networks for people with Alzheimer's disease (AD). This goal can be reached by providing financial assistance to patients facing difficulties in the accomplishment of activities of daily living, in order to encourage utilization of professional service and therefore alleviate informal caregiver burden. The main issue is to understand if and how financial assistance is correlated with the distribution between informal and professional care. We used a cross-sectional sample of 1131 French elderly patients (≥65) with mild to moderate AD. Informal and professional service resource use was measured in hours per month using a validated instrument, the Resource Use in Dementia questionnaire. Our results confirmed the utter dominance of informal care, which represented more than 80% of total care even among patients receiving public financial support. However financial support receipt was associated with differences in care utilization: higher use of total non-medical care (formal and informal) and lower proportion of informal care in total non-medical care. Our results suggested the presence of a threshold effect that would influence non-medical care demand decisions. Even if on average the use of informal care in total was 13.3% lower among patients receiving public financial support, informal care use represented more than 80% of total non-medical care use. Providing robust evidence of these associations is crucial to further identify the right dosage between professional service demand and informal care utilization that could be associated with a lower burden and therefore a lower probability of institutionalization.
Collapse
Affiliation(s)
- Thomas Rapp
- LIRAES, University of Paris Descartes, France; Gerontopôle of Toulouse, France.
| | | | | | | | | | | | | |
Collapse
|
43
|
Kim MS, Shin HI, Min Y, Kim JY, Kim JS. Correlation between Severe ALS Patient-Caregiver Couples' Characteristics and Caregivers' Health Related Quality of Life. J Korean Acad Nurs 2011; 41:354-63. [DOI: 10.4040/jkan.2011.41.3.354] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Myoung Soo Kim
- Assistant Professor, Department of Nursing, Pukyong National University, Busan, Korea
| | - Hyung-Ik Shin
- Assistant Professor, Department of Rehabilitation Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - Yusun Min
- Clinical Instructor, Department of Rehabilitation Medicine, Seoul National University, Bundang Hospital, Seongnam, Korea
| | - Jung Yoon Kim
- Clinical Instructor, Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jung Soon Kim
- Professor, College of Nursing, Pusan National University College of Nursing, Yangsan, Korea
| |
Collapse
|