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Samuel PS, Marsack-Topolewski CN, Janks E, Raoufi G, Milberger S. Family Support of Older Caregivers: Factors Influencing Change in Quality of Life. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:308-325. [PMID: 38917996 DOI: 10.1352/1944-7558-129.4.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/30/2024] [Indexed: 06/27/2024]
Abstract
Understanding factors that can improve the quality of life (QOL) of older caregivers of people with intellectual and developmental disabilities (IDD) is important in broadening participation in family empowerment interventions. The purpose of this study was to identify the factors influencing the QOL of older caregivers (50+) of adults with IDD who participated in a peer-mediated state-wide family support project. The research study used a quasi-experimental research design grounded in the family quality of life (FQOL) framework, with pretest and posttest data gathered from 82 caregivers. Correlation and regression analyses were conducted to identify factors influencing changes in the QOL of study participants. Findings indicated that improvements in caregiver QOL after participating in the project could be explained by caregiver's employment status, increased global FQOL, and decreased caregiver stress and depression.
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Affiliation(s)
| | | | - Elizabeth Janks
- Elizabeth Janks, Gelareh Raoufi, and Sharon Milberger, Wayne State University
| | - Gelareh Raoufi
- Elizabeth Janks, Gelareh Raoufi, and Sharon Milberger, Wayne State University
| | - Sharon Milberger
- Elizabeth Janks, Gelareh Raoufi, and Sharon Milberger, Wayne State University
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Woldring JM, Paans W, Gans R, Dorland L, Luttik ML. Families' importance in nursing care-families' opinions: a cross-sectional survey study in the homecare setting. Arch Public Health 2024; 82:87. [PMID: 38886839 PMCID: PMC11181553 DOI: 10.1186/s13690-024-01314-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Informal care is an essential part of support provided in the homecare setting. To ensure effective healthcare provision, good communication and collaboration between informal and formal care providers are crucial. To achieve this aim, it is necessary to have a clear understanding of the perspectives of all stakeholders. In the scientific literature, limited knowledge is available regarding family members' opinions about their involvement in care. To date, no instruments have been developed that accurately measure these opinions. This study aims to elucidate the opinions of family members about their involvement in nursing care. METHODS A cross-sectional survey approach was employed. The methodological steps in this study were (1) convert the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) from a nurses' perspective to a family perspective and thus develop the Families' Importance in Nursing Care-Families' Opinions (FINC-FO) and (2) measure families' opinions regarding their involvement in home nursing care. The questionnaire was sent to 3,800 patients with activated patient portals, which accounts for about 17% of the total patient base. Responses were received from 1,339 family members, a response rate of 35%. RESULTS The developed FINC-FO questionnaire showed homogeneity and internal consistency. The results of the questionnaire indicate that family members consider it important to be involved in care and that they wish to be acknowledged as participants in discussions about care (planning) but are less inclined to actively participate in the provision of care by nurses. Family members expressed less explicit opinions about their own support needs. Factors such as level of education, type of partnership, and amount of care provided are seemingly associated with these opinions. CONCLUSIONS Family members in the homecare setting wish to be involved in discussions about care (planning). The transition in care from primarily formal to more informal care necessitates an awareness and clear definition-on part of both healthcare professionals and families-of their respective roles in the provision of care. Communication about wishes, expectations, and the need for support in care is essential to ensure quality of care and that the family can sustain caregiving.
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Affiliation(s)
- Josien M Woldring
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands.
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
| | - Wolter Paans
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands
- Department of Critical Care, University Medical Centre Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Reinold Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Laura Dorland
- Merkbaar Beter, PO Box 102, Espria, Beilen, 9410 AC, the Netherlands
| | - Marie Louise Luttik
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands
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Turner SG, Robinson JRM, Pillemer KA, Reid MC. Prevalence Estimates of Arthritis and Activity-Limiting Pain Among Family Caregivers to Older Adults. THE GERONTOLOGIST 2024; 64:gnad124. [PMID: 37656675 PMCID: PMC11020308 DOI: 10.1093/geront/gnad124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about the prevalence of physical pain among family caregivers to older adults. We used national survey data to assess the relative prevalence of caregivers' arthritis and activity-limiting bothersome pain by caregiver and care-recipient characteristics to identify which caregivers may be at a higher risk for physical pain. RESEARCH DESIGN AND METHODS We analyzed data collected from 1,930 caregivers who participated in the National Study on Caregiving (2017). We utilized modified Poisson models to estimate adjusted associations of caregiver and care-recipient characteristics with the relative prevalence of arthritis and bothersome pain. RESULTS Forty percent of caregivers had a lifetime diagnosis of arthritis. Seventy-five percent of caregivers with arthritis reported bothersome pain, nearly 30% of whom endorsed bothersome pain that limited their activities on most or every day of the previous month (i.e., activity-limiting bothersome pain). Regardless of whether they had arthritis, 51% of the sample reported bothersome pain in the previous month, 24% of whom indicated activity-limiting bothersome pain. Caregivers who were older or more highly educated had a higher prevalence of arthritis. Black caregivers had a lower prevalence of arthritis and activity-limiting bothersome pain compared to White caregivers. Caregivers with physical difficulty providing care had a higher prevalence of arthritis and activity-limiting bothersome pain than caregivers without physical difficulty providing care. DISCUSSION AND IMPLICATIONS Arthritis and activity-limiting bothersome pain are highly prevalent among caregivers. Given increased prevalence of pain among certain caregivers, it may be efficient to target these groups for pain management interventions.
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Affiliation(s)
- Shelbie G Turner
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
| | | | - Karl A Pillemer
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - M Carrington Reid
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
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Brantner CL, Bentley JP, Roth DL. Subtypes of Transitions into a Family Caregiving Role: A Latent Class Analysis. J Appl Gerontol 2024; 43:374-385. [PMID: 37990505 PMCID: PMC10923009 DOI: 10.1177/07334648231210680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
This paper groups persons who have transitioned into family caregiving using a latent class analysis and examines class differences on measures of well-being. Latent classes were identified for a sample of 251 participants who became family caregivers while participating in a longitudinal national study, and linear regression analyses compared average well-being change scores across classes. Fit indices supported a four-class solution dispersed along two conceptual dimensions: caregiving intensity and caregiving stain. The largest class (35.5%) was characterized as low intensity, low strain. The smallest class (12.7%) was characterized as high intensity, high strain, and these caregivers had significantly worse well-being change scores compared to the other caregiving classes. Categorizing caregivers by differing levels of care intensity and caregiving strain helps identify caregivers who are at most risk for poor psychosocial outcomes, determines which caregivers might benefit from specific caregiver support programs, and informs investigators on possible refinements to interventions.
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Affiliation(s)
- Carly L. Brantner
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John P. Bentley
- Department of Pharmacy Administration and Center for Pharmaceutical Marketing and Management, School of Pharmacy, University of Mississippi, University, MS, USA
| | - David L. Roth
- Center on Aging and Health, Division of Geriatrics and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Methi F, Nes RB, Skirbekk V, Hansen T. The double-edged sword of becoming a caregiver: dynamic impact on four dimensions of well-being in Norway. BMC Psychol 2024; 12:120. [PMID: 38439109 PMCID: PMC10913458 DOI: 10.1186/s40359-024-01623-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/25/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Becoming a caregiver can be a transformative journey with profound, multifaceted implications for well-being. However, existing research predominantly emphasizes the negative aspects of caregiving, paying less attention to the positive sides. This study aims to explore the impact of transitioning into a caregiving role on various well-being indicators, such as negative hedonic, positive hedonic, eudaimonic, and social well-being. METHODS We use Norwegian panel data (2019-2021) and employ a combination of nearest-neighbour matching and a difference-in-differences approach to analyse well-being trajectories among new caregivers (n = 304) and non-caregivers (n = 7822). We assess ten items capturing the dimensions of negative hedonic (anxiousness, sadness, and worriedness), positive hedonic (happiness and life satisfaction), eudaimonic (contributing to others' happiness, engagement, and meaning), and social (strong social relations and loneliness) well-being. RESULTS Our results show a general increase in negative hedonic well-being and a decline in positive hedonic well-being for new caregivers. These impacts are larger for caregivers providing daily care, compared to those providing weekly and monthly care, and for those providing care inside rather than outside their own household. We observe only minor differences regarding gender and age. Interestingly, we also notice neutral or beneficial changes for eudaimonic aspects of well-being; of note, caregivers generally experience an increased sense of contributing to others' happiness. CONCLUSION Our study reveals that adopting a caregiving role often leads to significant psychosocial challenges, especially in intensive caregiving situations. However, it also uncovers potential positive influences on eudaimonic aspects of well-being. Future research should explore underlying explanatory mechanisms, to inform strategies that enhance caregivers' well-being.
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Affiliation(s)
- Fredrik Methi
- Department of Health Services, Norwegian Institute of Public Health, Postboks 222, Skøyen, N-0213, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Department of Philosophy, Classics, and History of Arts and Ideas, University of Oslo, Oslo, Norway
| | - Vegard Skirbekk
- Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Oslo Metropolitan University, Oslo, Norway
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Berghout M, Waller A, Lachapelle N, Noble N, Nair BK, Sanson-Fisher R. Preferred type, timing and format of dementia information: A cross-sectional survey of carers of people living with dementia. Australas J Ageing 2024; 43:131-139. [PMID: 37877350 DOI: 10.1111/ajag.13251] [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: 02/13/2023] [Revised: 08/15/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES To clarify the unmet information needs of carers of people living with dementia, including the stage of their care journey at which topics become relevant, and the preferred format and mode of delivery of information. METHODS A cross-sectional survey of carers of people living with dementia was conducted between April 2022 and October 2022. Carers were recruited through public and private geriatric hospital and community clinics, aged care providers, an online research register and community dementia services. Consenting carers completed a survey assessing sociodemographic characteristics, preferred type and timing of information about dementia, accessing services, changes in behaviour/personality, changes in physical/emotional health, managing own health/well-being and preferred information format and mode of delivery. RESULTS A total of 163 carers returned a survey (20% response rate). Most carers (75-98%) reported wanting information across a range of topics. Carers preferred general dementia information at diagnosis, information about accessing services at or within the first year of diagnosis, and information on managing symptoms as they emerged. Carers were most interested in receiving information in-person face-to-face (60% very interested), written information (51% very interested) or via face-to-face group information sessions (42% very interested). CONCLUSIONS Carers of people living with dementia expressed a desire for information on a wide range of topics, which changed as the dementia of the person they cared for progressed. Information needs to be made available in a variety of formats to cater for differing ways in which it is consumed.
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Affiliation(s)
- Mani Berghout
- John Hunter Hospital, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Amy Waller
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Nicole Lachapelle
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Natasha Noble
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
| | - Balakrishnan Kichu Nair
- John Hunter Hospital, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New South Wales, Newcastle, Australia
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Lacey RE, Xue B, Di Gessa G, Lu W, McMunn A. Mental and physical health changes around transitions into unpaid caregiving in the UK: a longitudinal, propensity score analysis. Lancet Public Health 2024; 9:e16-e25. [PMID: 37977176 DOI: 10.1016/s2468-2667(23)00206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 08/25/2023] [Accepted: 09/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The health of unpaid caregivers is poorer, on average, than in non-caregivers. There has been little focus on how health changes when becoming a caregiver and whether this varies by age, gender, and caregiving intensity. We aimed to investigate the mental and physical health changes involved with becoming a caregiver and whether these associations varied by gender, caregiving intensity, or age. METHODS This study used data from the UK Household Longitudinal Study (2009-20) to examine mental and physical health changes around the transition to becoming a caregiver in adults aged 16 years and older. We included adults with information on care, complete covariates needed for matching, and at least one measure of health before or after becoming a caregiver (or matched non-caregiver). Health was measured via General Health Questionnaire-12 (GHQ-12, psychological distress) and 12-item Short Form Survey (SF-12, physical and mental functioning). We applied piecewise growth curve modelling with propensity score matching to model trajectories of mental and physical health for caregivers and matched non-caregivers. Analyses were stratified by age group, gender, and caregiving intensity. FINDINGS Sample sizes varied from 3025 (GHQ-12 analyses in early adulthood) to 5785 (SF-12 analyses in early mid-adulthood). Psychological distress increased during transition to caregiving for all ages, particularly in those younger than 64 years, those providing care for 20 h or more per week, and for someone living within the household. Mental health functioning worsened during caregiving transition for those aged 30-64 years, those providing 20 h or more per week, and for those caring for someone within the household. Physical health functioning did not change but there was evidence of lower levels of functioning before caregiving. Changes in mental and physical health upon transition to caregiving did not differ by gender. INTERPRETATION Our findings highlight the importance of early identification of and support for caregivers, including younger caregivers. This is important to break the cycle of caregiving and future care need. Health services staff, including general practitioners and hospital discharge teams, are well positioned for early identification of caregivers. We also encourage particular support for the mental health of caregivers and particularly those who become caregivers at a younger age. FUNDING The UK Economic and Social Research Council.
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Affiliation(s)
- Rebecca E Lacey
- Research Department of Epidemiology and Public Health, University College London, London, UK; Population Health Research Institute, St George's, University of London, London, UK.
| | - Baowen Xue
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Giorgio Di Gessa
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Wentian Lu
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Anne McMunn
- Research Department of Epidemiology and Public Health, University College London, London, UK
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8
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Haley WE, Elayoubi J. Family caregiving as a global and lifespan public health issue. Lancet Public Health 2024; 9:e2-e3. [PMID: 37977175 DOI: 10.1016/s2468-2667(23)00227-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 11/19/2023]
Affiliation(s)
- William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL 33620, USA.
| | - Joanne Elayoubi
- School of Aging Studies, University of South Florida, Tampa, FL 33620, USA
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Irani E, Wang F, Meyer K, Moore SE, Ding K. Social Activity Restriction and Psychological Health Among Caregivers of Older Adults With and Without Dementia. J Aging Health 2023:8982643231209089. [PMID: 37937398 DOI: 10.1177/08982643231209089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
OBJECTIVES We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups. METHODS Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with (N = 541) and without (N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers' age, gender, race, education, relationship to care recipient, and self-rated health. RESULTS Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting friends and family was associated with higher distress and lower well-being in non-dementia caregivers. Any activity restriction had stronger association with distress for caregivers of older adults with versus without dementia. DISCUSSION Findings highlight the need for tailored interventions based on caregivers' perceptions of meaningful social activities and dementia-friendly communities to promote social participation.
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Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Fei Wang
- College of Social Work, University of Tennessee, Knoxville, TN, USA
| | - Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Scott Emory Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Kedong Ding
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Elayoubi J, Nelson ME, Mu CX, Haley WE, Wadley VG, Clay OJ, Crowe M, Cushman M, Grant JS, Roth DL, Andel R. The role of caregiving in cognitive function and change: The REGARDS study. Psychol Aging 2023; 38:712-724. [PMID: 37428734 PMCID: PMC10776801 DOI: 10.1037/pag0000766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Chronic stress is associated with negative health outcomes, including poorer cognition. Some studies found stress from caregiving associated with worse cognitive functioning; however, findings are mixed. The present study examined the relationship between caregiving, caregiving strain, and cognitive functioning. We identified participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who were family caregivers at baseline assessment and used propensity matching on 14 sociodemographic and health variables to identify matched noncaregivers for comparison. Data included up to 14 years of repeated assessments of global cognitive functioning, learning and memory, and executive functioning. Our results showed that when compared to noncaregivers, caregivers had better baseline scores on global cognitive functioning and word list learning (WLL). Among caregivers, a lot of strain was associated with better WLL and delayed word recall in the unadjusted model only. Caregivers with a lot of strain had higher depressive symptoms but not significantly higher high-sensitivity c-reactive protein (hsCRP) at baseline compared to caregivers with no or some strain after covariate adjustment. Although caregiving can be highly stressful, we found caregiving status and caregiving strain were not associated with cognitive decline. More methodologically rigorous studies are needed, and conclusions that caregiving has negative effects on cognition should be viewed with caution. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Joanne Elayoubi
- School of Aging Studies, University of South Florida, Tampa, FL
| | | | - Christina X. Mu
- School of Aging Studies, University of South Florida, Tampa, FL
| | | | | | - Olivio J. Clay
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Joan S. Grant
- School of Nursing, University of Alabama at Birmingham, Birmingham
| | - David L. Roth
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University
| | - Ross Andel
- Center for Innovation in Healthy and Resilient Aging, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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Templeman ME, Lee S, Haley WE. Factors Associated With Working Caregivers' Well-Being: Comparisons Between Black and White Working Caregivers in the United States. Int J Aging Hum Dev 2023:914150231208680. [PMID: 37899571 DOI: 10.1177/00914150231208680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
This study investigated stressors and strains, resources, and well-being among Black working caregivers (BWC) and White working caregivers (WWC) who participated in the Midlife in the United States study (Black: n = 49, White: n = 250). Comparisons were made between BWC and WWC for primary caregiving stressors, secondary strains, resources, and well-being, and hierarchical regression models tested associations among these factors. BWC reported less negative work-to-family spillover, more perceived control and religious/spiritual coping, and higher positive affect than WWC, complementing existing evidence of greater resilience among BWC. Secondary strains stemming from the workplace had stronger associations with well-being than primary caregiving stressors, confirming that the workplace deserves greater attention in stress research and interventions for working caregivers. Finally, perceived control, optimism, and family support were important resources for well-being for both BWC and WWC, substantiating their valuable role in interventions for working caregivers.
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Affiliation(s)
- Maureen E Templeman
- Department of Sociology, Anthropology, and Gerontology, Missouri State University, Springfield, MO, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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12
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Kling SMR, Lessios AS, Holdsworth LM, Yefimova M, Wu S, Martin M, Sheffrin M, Winget M. Caregiver Experiences Participating in a Home-Based Primary Care Program: A Pragmatic Evaluation Including Qualitative Interviews and Quantitative Surveys. J Appl Gerontol 2023; 42:2066-2077. [PMID: 37269325 DOI: 10.1177/07334648231176380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
The aim of this evaluation was to assess caregiver experience and burden during their first year in a geriatric home-based primary care (HBPC) program with qualitative interviews and surveys. HBPC included in-home visits for homebound, older adult patients. Seventeen caregivers, with varied amount of experience with HBPC, participated in semi-structured interviews. Change in caregiver burden from baseline was captured for 44 caregivers at 3 months post-enrollment, 27 caregivers at 6 months, and 22 caregivers at 12 months. Satisfaction survey was administered at these timepoints, but the last response of 48 caregivers was analyzed. Caregiver interviews revealed three themes: caregiving stressors, reliance on HBPC in relation to other medical care, and healthcare in the home. Surveyed caregivers were highly satisfied, but burden did not change substantially over the 1 year intervention. Caregivers appreciated HBPC reduced patient transportation and provided satisfactory primary care, but additional research is needed to tailor this care to reduce caregiver burden.
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Affiliation(s)
- Samantha M R Kling
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Anna Sophia Lessios
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Laura M Holdsworth
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Maria Yefimova
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Office of Research Patient Care Services, Stanford Healthcare, Stanford, CA, USA
| | - Siqi Wu
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marina Martin
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Meera Sheffrin
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marcy Winget
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Milberger S, Marsack-Topolewski C, Janks E, Anderson N, Bray M, Samuel PS. Evaluating the Benefits of a Family Support Program on the Health and Well-Being of Aging Family Caregivers of Adults with Intellectual and Developmental Disabilities. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:413-432. [PMID: 35950328 DOI: 10.1080/01634372.2022.2110347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Providing care to a family member with intellectual and developmental disabilities (I/DD) takes a toll on the health of the caregiver and the family, especially as they age. Research shows that peer mediated family support programs can improve caregiver health and well-being. To date, most family support programs have focused on family caregivers of children and youth with I/DD. The purpose of this study was to examine the benefits of participating in the Michigan Older Caregivers of Emerging Adults with Autism and Neurodevelopmental Disabilities (MI-OCEAN) family support program grounded in the Family Quality of Life (FQOL) framework. Specifically, we examined the effect of participation on health care utilization, caregiver well-being, and perceptions of global FQOL for older caregivers of adults with I/DD. Quantitative analysis of data gathered from 82 caregivers (age 50 and older) indicated that study participation was associated with increased use of Medicaid and improved caregiver well-being (reduced burden, stress, depression; increased health satisfaction and FQOL). Future research is needed to examine the long-term impact of the family support programs in improving the health and well-being of older caregivers of adults with I/DD.
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Affiliation(s)
- Sharon Milberger
- Michigan Developmental Disabilities Institute & Department of Helath Care Sciences, Wayne State University, Detroit, Michigan, USA
| | | | - Elizabeth Janks
- Michigan Developmental Disabilities Institute & Department of Helath Care Sciences, Wayne State University, Detroit, Michigan, USA
| | - Nia Anderson
- Michigan Developmental Disabilities Institute & Department of Helath Care Sciences, Wayne State University, Detroit, Michigan, USA
| | - Michael Bray
- Michigan Developmental Disabilities Institute & Department of Helath Care Sciences, Wayne State University, Detroit, Michigan, USA
| | - Preethy S Samuel
- Michigan Developmental Disabilities Institute & Department of Helath Care Sciences, Wayne State University, Detroit, Michigan, USA
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14
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Humber MB, Yefimova M, Lessios AS, Trivedi RB, Sheffrin M, Martin M. "It Isn't the Same": Experiences of Informal Caregivers of Older Adults Enrolled in a Home-Based Senior Care Program During COVID-19. J Gerontol Nurs 2023; 49:19-26. [PMID: 36852991 DOI: 10.3928/00989134-20230209-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic placed new strains on informal caregivers, who are already vulnerable to negative psychosocial effects due to demands of the caregiving role. The current study aimed to explore the early impact of COVID-19 on caregivers living with and apart from care recipients. Semi-structured qualitative interviews with seven cohabitating and 10 distanced caregivers of patients in a home-based primary care program were conducted from April to November 2020. A framework matrix was used to identify patterns in caregiver experiences. Cohabitating and distanced caregivers reported shared concerns about COVID-19 and unique concerns dependent on cohabitation status. Cohabitating caregivers reported financial worries, care recipients with dementia being unable to understand restrictions, and concerns about community business changes. Distanced caregivers reported communication challenges with cognitively impaired care recipients and challenges with visitation policies. During pandemics, caregivers' clinical and policy support needs may differ depending on their place of residence relative to care recipients. [Journal of Gerontological Nursing, 49(3), 19-26.].
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15
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Elayoubi J, Haley WE, Roth DL, Cushman M, Sheehan OC, Howard VJ, Hladek MD, Hueluer G. Associations of perceived stress, depressive symptoms, and caregiving with inflammation: a longitudinal study. Int Psychogeriatr 2023; 35:95-105. [PMID: 35543307 DOI: 10.1017/s1041610222000370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Higher inflammation has been linked to poor physical and mental health outcomes, and mortality, but few studies have rigorously examined whether changes in perceived stress and depressive symptoms are associated with increased inflammation within family caregivers and non-caregivers in a longitudinal design. DESIGN Longitudinal Study. SETTING REasons for Geographic And Racial Differences in Stroke cohort study. PARTICIPANTS Participants included 239 individuals who were not caregivers at baseline but transitioned to providing substantial and sustained caregiving over time. They were initially matched to 241 non-caregiver comparisons on age, sex, race, education, marital status, self-rated health, and history of cardiovascular disease. Blood was drawn at baseline and approximately 9.3 years at follow-up for both groups. MEASUREMENTS Perceived Stress Scale, Center for Epidemiological Studies-Depression, inflammatory biomarkers, including high-sensitivity C-reactive protein, D dimer, tumor necrosis factor alpha receptor 1, interleukin (IL)-2, IL-6, and IL-10 taken at baseline and follow-up. RESULTS Although at follow-up, caregivers showed significantly greater worsening in perceived stress and depressive symptoms compared to non-caregivers, there were few significant associations between depressive symptoms or perceived stress on inflammation for either group. Inflammation, however, was associated with multiple demographic and health variables, including age, race, obesity, and use of medications for hypertension and diabetes for caregivers and non-caregivers. CONCLUSIONS These findings illustrate the complexity of studying the associations between stress, depressive symptoms, and inflammation in older adults, where these associations may depend on demographic, disease, and medication effects. Future studies should examine whether resilience factors may prevent increased inflammation in older caregivers.
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Affiliation(s)
- Joanne Elayoubi
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - David L Roth
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, USA
| | - Mary Cushman
- Department of Medicine & Pathology, University of Vermont, Burlington, VT, USA
| | - Orla C Sheehan
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Gizem Hueluer
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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16
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Roth DL, Bentley JP, Mukaz DK, Haley WE, Walston JD, Bandeen-Roche K. Transitions to Family Caregiving and Latent Variables of Systemic Inflammation Over Time. Res Aging 2023; 45:173-184. [PMID: 35422166 DOI: 10.1177/01640275221084729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Circulating levels of inflammatory biomarkers may be influenced by chronic psychological stressors such as those experienced by family caregivers. However, previous studies have found mostly small and inconsistent differences between caregivers and control samples on individual measures of systemic inflammation. Latent variables of inflammation were extracted from six biomarkers collected from two blood samples over 9 years apart for 502 participants in a national cohort study. One-half of these participants transitioned into a sustained family caregiving role between the blood samples. Two latent factors, termed "up-regulation" and "inhibitory feedback," were identified, and the transition to family caregiving was associated with a lower increase over time on the inhibitory feedback factor indexed by interleukin (IL)-2 and IL-10. No caregiving effect was found on the up-regulation factor indexed primarily by IL-6 and C-reactive protein. These findings illustrate the advantages of using latent variable models to study inflammation in response to caregiving stress.
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Affiliation(s)
- David L Roth
- Center on Aging and Health, 1466Johns Hopkins University, Baltimore, MD, USA
| | - John P Bentley
- School of Pharmacy, 8083University of Mississippi, Oxford, MS, USA
| | - Debora Kamin Mukaz
- Larner College of Medicine, 12352University of Vermont, Colchester, VT, USA
| | - William E Haley
- School of Aging Studies, 7831University of South Florida, Tampa, FL, USA
| | - Jeremy D Walston
- Division of Geriatric Medicine and Gerontology, School of Medicine, 1500Johns Hopkins University, Baltimore, MD, USA
| | - Karen Bandeen-Roche
- Department of Biostatistics, Bloomberg School of Public Health, 25802Johns Hopkins University, Baltimore, MD, USA
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17
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Downer B, Li CY, Snih SA. Hospitalizations and Emergency Room Admissions by Mexican American Older Adults with and without Dementia and Caregiver Mental Health. J Alzheimers Dis 2023; 91:1185-1195. [PMID: 36565125 PMCID: PMC9946698 DOI: 10.3233/jad-220997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Evidence from predominately non-Hispanic White populations indicates that emergency room (ER) admissions and hospitalizations by older adults with and without dementia are associated with caregiver stress and depressive symptoms. These results may not generalize to Hispanic populations because of cultural differences in caregiving roles, responsibilities, and perspectives about care burden. OBJECTIVE Investigate the association between ER admissions and hospitalizations by Mexican American older adults with and without dementia and symptoms of depression and stress among family caregivers. METHODS Data came from the 2010/11 wave of the Hispanic Established Populations for the Epidemiologic Study of the Elderly and Medicare claims files. The final sample included 326 older adults and their caregivers. Negative binomial regression was used to model the association between hospitalizations and ER admissions by older adults in the previous two years and caregivers' depressive symptoms and stress in 2010/11. RESULTS The number of older adult ER admissions and hospitalizations was not associated with caregiver depressive symptoms. Two or more ER admissions (incident rate ratio [IRR] = 1.26, 95% CI = 1.05-1.51) and two or more hospitalizations (IRR = 1.32, 95% CI = 1.07-1.61) were associated with significantly higher caregiver stress. Additionally, ER admissions and hospitalizations for a circulatory disease or injury and poisoning were associated with significantly higher caregiver stress. These associations were not modified by the care recipient's dementia status. CONCLUSION Hospitalizations and ER admissions by older Mexican Americans were associated with greater caregiver stress but not depressive symptoms. These associations were similar for caregivers to older adults with and without dementia.
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Affiliation(s)
- Brian Downer
- Department of Population Health & Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Chih-Ying Li
- Department of Occupational Therapy, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Population Health & Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
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18
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Liu C, Marino VR, Howard VJ, Haley WE, Roth DL. Positive aspects of caregiving in incident and long-term caregivers: Role of social engagement and distress. Aging Ment Health 2023; 27:87-93. [PMID: 34749554 PMCID: PMC9126189 DOI: 10.1080/13607863.2021.2000935] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/17/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Positive caregiver adaptation over time may be associated with reports of positive aspects of caregiving (PAC). We examined differences in PAC by caregiving duration and social engagement, controlling for measures of distress. METHODS Participants included 283 African American or White caregivers from the Caregiving Transitions Study with a wide range of caregiving durations. PAC are defined as positive appraisals that caregivers report about their role, such as feeling appreciated or confident. We fit multivariable linear models with the total PAC score as the outcome to assess its association with years of caregiving and social engagement (social network, monthly social contact). Models were adjusted for age, sex, race, marital status, relationship to care recipient, care recipient's dementia status, perceived stress and caregiving strain. RESULTS Caregivers with higher social engagement reported significantly higher PAC. A non-significant trend was found in most analytic models for caregivers with longer duration of care to report higher PAC. African American caregivers reported higher PAC compared to White caregivers. Dementia caregivers reported lower PAC than non-dementia caregivers in models adjusting for demographics and social network size, but the association was attenuated with the addition of caregiving strain. DISCUSSION Higher social engagement and longer duration of care tend to be associated with higher PAC after adjusting for demographics and measures of distress. Future studies should aim to leverage longitudinal data to understand whether caregivers shift appraisal to positive aspects of their role and explore implementation of caregiving interventions targeting PAC in order to improve the caregiving experience.
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Affiliation(s)
- Chelsea Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Victoria R Marino
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - David L Roth
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, USA
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19
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Ramirez-Gomez L, Johnson JK, Ritchie C, Meyer AK, Tan E, Madarasmi S, Gutierrez-Ramirez P, Aldarondo-Hernández C, Mischoulon D, Banerjee S, Jain FA. Virtual mentalizing imagery therapy for Spanish language Latino family dementia caregivers: A feasibility and acceptability study. Front Psychol 2023; 14:961835. [PMID: 36874854 PMCID: PMC9979537 DOI: 10.3389/fpsyg.2023.961835] [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: 07/12/2022] [Accepted: 01/11/2023] [Indexed: 02/18/2023] Open
Abstract
Spanish speaking family caregivers of people living with dementia have limited supportive resources in Spanish. There are few validated, culturally acceptable virtual interventions for reducing these caregivers' psychological distress. We investigated the feasibility of a Spanish language adaptation of a virtual Mentalizing Imagery Therapy (MIT) program, which provides guided imagery and mindfulness training to reduce depression, increase mentalizing, and promote well-being. 12 Spanish-speaking family dementia caregivers received a 4-week virtual MIT program. Follow-up was obtained post group and at 4 months post baseline assessment. Feasibility, acceptability, and satisfaction with MIT were assessed. The primary psychological outcome was depressive symptoms; secondary outcomes included caregiver burden, dispositional mindfulness, perceived stress, well-being, interpersonal support, and neurological quality of life. Statistical analysis was performed with mixed linear models. Caregivers were 52 ± 8 (mean ± SD) years of age. 60% had a high school education or less. Participation in weekly group meetings was 100%. Home practice was performed on average 4 ± 1 times per week [range 2-5]. Satisfaction with MIT reached 19 ± 2 of a possible 20 points. Reduction in depression from baseline was observed by week three (p = 0.01) and maintained at 4 month follow-up (p = 0.05). There were significant improvements in mindfulness post-group, and in caregiver burden and well-being at 4 months. MIT was successfully adapted for Latino Spanish language family dementia caregivers within a virtual group environment. MIT is feasible and acceptable and may help reduce depressive symptoms and improve subjective well-being. Larger, randomized controlled trials of MIT should determine durability of effects and validate efficacy in this population.
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Affiliation(s)
- Liliana Ramirez-Gomez
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.,Department of Neurology, Harvard Medical School, Boston, MA, United States.,Mongan Institute Center for Aging and Serious Illness, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Julene K Johnson
- Center for Aging in Diverse Communities, University of California, San Francisco, CA, United States
| | - Christine Ritchie
- Mongan Institute Center for Aging and Serious Illness, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Ashley K Meyer
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Emily Tan
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Saira Madarasmi
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Paulina Gutierrez-Ramirez
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Cecilianna Aldarondo-Hernández
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - David Mischoulon
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Sreya Banerjee
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Felipe A Jain
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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20
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Blinka MD, Spira AP, Sheehan OC, Cidav T, Rhodes JD, Howard VJ, Roth DL. Sleep Quality Reports From Family Caregivers and Matched Non-caregiving Controls in a Population-Based Study. J Appl Gerontol 2022; 41:1568-1575. [PMID: 35343285 DOI: 10.1177/07334648221079110] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The stress of family caregiving may affect many health-related variables, including sleep. We evaluated differences in self-reported sleep quality between incident caregivers and matched non-caregiving controls from a national population-based study. Caregivers and controls were identified in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and matched on seven different demographic and health history factors. Caregivers reported significantly longer sleep onset latency than controls, before and after adjusting for covariates (ps < .05). No differences were found on measures of total sleep time or sleep efficiency. Among caregivers only, employed persons reported less total sleep time and number of care hours was a significant predictor of total sleep time. Dementia caregivers did not differ from other caregivers. This is one of the few population-based studies of sleep quality in family caregivers. Additional research is needed to examine whether sleep disturbance contributes to greater health problems among caregivers.
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Affiliation(s)
- Marcela D Blinka
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Adam P Spira
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, 1466Johns Hopkins University, Baltimore, MD, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Orla C Sheehan
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Tom Cidav
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, 1466Johns Hopkins University, Baltimore, MD, USA
| | - J David Rhodes
- Department of Biostatistics, School of Public Health, 48653University of Alabama at Birmingham, Birmingham, AL, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, 48653University of Alabama at Birmingham, Birmingham, AL, USA
| | - David L Roth
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, 1466Johns Hopkins University, Baltimore, MD, USA.,Department of Epidemiology, 1466School of Public Health (joint Appointment) Johns Hopkins University, Baltimore, MD, USA.,Department of Biostatistics, 1466School of Public Health (joint Appointment) Johns Hopkins University, Baltimore, MD, USA
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21
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Camicia M, Lutz BJ, Theodore BR. The preparedness assessment for the transition home after stroke predicts key domains of caregiver health. Top Stroke Rehabil 2022; 30:384-392. [PMID: 35156562 DOI: 10.1080/10749357.2022.2038835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Caregivers of stroke survivors often experience adverse health effects due to poor preparation. OBJECTIVES We evaluate the concurrent and predictive validity of the Preparedness Assessment for the Transition Home after Stroke (PATH-s) family caregiver assessment tool relative to important domains of caregiver health and stroke survivor outcomes. METHODS A convenience sample of caregivers (N = 183) was assessed on several health-related quality of life instruments prior to stroke survivor discharge (T1), and at 30-days (T2) and 90-days (T3) post-discharge. RESULTS Caregivers completed assessments at T1 (N = 183), T2 (N = 116, 63%), and T3 (N = 97, 53%). At T1, the PATH-s demonstrated concurrent validity with depressive symptoms (r = -0.26, p < .001), global health (r = 0.45 p < .001) and activation (r = 0.34, p < .001). The PATH-s also has predicted improvements in T2 outcomes including depressive symptoms (radj = -0.21, p < .05), global health (radj = 0.30, p < .01), perceived stress (radj = -0.30, p < .01), activation (radj = 0.21, p < .05), caregiving-specific health-related quality of life (r = 0.23, p < .05), and caregiver strain (r = -0.36, p < .001). At T3, higher scores on the PATH-s were a significant predictor for improvements in activation (radj = 0.24, p < .05). CONCLUSION The PATH-s demonstrates good concurrent and predictive validity and predicts important domains relevant to caregiver well-being. This can be used to identify gaps in caregiver preparedness so interventions can be tailored to optimize the transition home and mitigate adverse effects of caregiving.
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Affiliation(s)
- Michelle Camicia
- Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo, Vallejo, USA
| | - Barbara J. Lutz
- School of Nursing,University of North Carolina-Wilmington, Wilmington, USA
| | - Brian R. Theodore
- Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo, Vallejo, USA
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22
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Blinka MD, Liu C, Sheehan OC, Rhodes JD, Roth DL. Family caregivers emphasise patience and personal growth: a qualitative analysis from the Caregiving Transitions Study. Age Ageing 2022. [DOI: 10.1093/ageing/afab266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
informal caregiving for family and friends is becoming increasingly common due to the rising prevalence of chronic conditions and a shortage of affordable care options. While the impact of caregiving on caregivers’ health is well-documented, nuances in caregivers’ experiences may not be captured in quantitative studies. We aimed to better understand caregivers’ perception of their experiences through qualitative analysis.
Methods
participants were from the Caregiving Transitions Study (CTS), which is ancillary to the REasons for Geographic and Racial Differences in Stroke Study. We analysed responses from 150 caregivers to an open-ended question at the end of the CTS telephone interview concerning additional information about their caregiving experiences. We identified main themes and examined differences by sex, condition and relationship to the care recipient.
Results
four major themes were identified: cultural/family expectations; growth opportunities; and reciprocity; stressors and challenges and recommendations. Male caregivers more often indicated that their motivation for taking on this role was their sense of duty towards family, while female caregivers focused on the challenges and burden of caregiving that they experienced. Overall, caregivers highlighted the importance of patience and the positive impact of caregiving, such as opportunities for personal growth, acquiring new skills, and finding fulfillment and gratitude.
Conclusions
family caregivers shared both positive and challenging experiences as well as the impact that these experiences had on their lives. Understanding the full spectrum of the caregiving experience will help inform how the community and the health care system can best support caregivers in their roles.
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Affiliation(s)
- Marcela D Blinka
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Chelsa Liu
- Department of Epidemiology, School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Orla C Sheehan
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD 21205, USA
| | - J David Rhodes
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - David L Roth
- Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD 21205, USA
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23
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McGarrigle C, Ward M, De Looze C, O'Halloran A, Kenny R. Caring in the time of COVID-19, longitudinal trends in well-being and mental health in carers in Ireland: Evidence from the Irish Longitudinal Study on Ageing (TILDA). Arch Gerontol Geriatr 2022; 102:104719. [PMID: 35588613 PMCID: PMC9085370 DOI: 10.1016/j.archger.2022.104719] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/20/2022] [Accepted: 05/07/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic in 2020 resulted in the older population being asked to remain at home and avoid other people outside their household. This could have implications for both receipt and provision of informal caring. OBJECTIVE To determine if informal care provision by older carers changed during the first wave of the COVID-19 pandemic from pre-pandemic care and if this was associated with a change in mental health and well-being of carers. DESIGN AND SETTING Longitudinal nationally representative study of community dwelling adults from The Irish Longitudinal Study on Ageing (TILDA) (Waves 3-COVID-Wave 6). METHODS We studied a cohort of 3670 adults aged ≥60 in Ireland during the COVID-19 pandemic (July-November 2020) and compared with previous data collections from the same cohort between 2014-2018. Independent variables were caregiving status and caregiving intensity, outcome measures included depressive symptoms (CES-D8), Perceived Stress (PSS4) and Quality of life (CASP12). Mixed models adjusting for socio-demographics and physical health were estimated. RESULTS Caregiving increased from 8.2% (2014) to 15.4% (2020). Depression, and stress scores increased while quality of life decreased for all participants. Carers reported poorer mental health, and higher caring hours were associated with increased depression and stress and decreased quality of life scores on average, and increased depression was higher for women. CONCLUSIONS Informal caregiving increased during the pandemic and family caregivers reported increased adverse mental health and well-being and this continued throughout the early months of the pandemic. The disproportionate burden of depression was highest in women providing higher caring hours.
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Affiliation(s)
- C.A. McGarrigle
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland,Corresponding author
| | - M. Ward
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - C. De Looze
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - A. O'Halloran
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - R.A. Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland,Mercer's Institute for Successful Ageing, St James’ Hospital, Dublin, Ireland
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24
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Thieken F, van Munster M. Deriving Implications for Care Delivery in Parkinson's Disease by Co-Diagnosing Caregivers as Invisible Patients. Brain Sci 2021; 11:brainsci11121629. [PMID: 34942931 PMCID: PMC8699371 DOI: 10.3390/brainsci11121629] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022] Open
Abstract
For persons with Parkinson’s disease, the loss of autonomy in daily life leads to a high level of dependency on relatives’ support. Such dependency strongly correlates with high levels of perceived stress and psychosocial burden in informal caregivers. Global developments, such as demographic change and the associated thinning infrastructure in rural areas cause a continuously growing need for medical and nursing care. However, this need is not being adequately met. The resulting care gap is being made up by unpaid or underpaid work of informal caregivers. The double burden of care work and gainful employment creates enormous health-related impairments of the informal caregivers, so that they eventually become invisible patients themselves. Expectedly, those invisible patients do not receive the best care, leading to a decrease in quality of life and, in the end, to worse care for PD patients. Suggested solutions to relieve relatives, such as moving the person affected by Parkinson’s to a nursing home, often do not meet the wishes of patients and informal caregivers, nor does it appear as a structural solution in the light of demographic change against an economic background. Rather, it requires the development, implementation and evaluation of new, holistic approaches to care that make invisible patients visible.
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Affiliation(s)
- Franziska Thieken
- Department of Neurology, University Hospital of Marburg, Baldingerstraße, 35043 Marburg, Germany;
- Correspondence: ; Tel.: +49-6421-58-64855
| | - Marlena van Munster
- Faculty of Medicine, Philipps-Universität Marburg, Biegenstraße 10, 35037 Marburg, Germany
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25
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Irani E, Niyomyart A, Zauszniewski JA. Caregiving Stress and Self-Rated Health during the COVID-19 Pandemic: The Mediating Role of Resourcefulness. Issues Ment Health Nurs 2021; 42:982-988. [PMID: 34080954 PMCID: PMC8714403 DOI: 10.1080/01612840.2021.1924324] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Family caregivers faced unprecedented circumstances and experienced increased levels of stress during the COVID-19 pandemic. Resourcefulness can minimize the effect of stress on health outcomes. The purpose of this study was to examine the associations between caregiving stress during the pandemic, resourcefulness, and self-rated health and assess the mediating effect of resourcefulness. A convenience sample of 70 family caregivers of adults with chronic and/or disabling conditions was recruited using social media groups and professional networking platforms. Data were collected using an online survey and analyzed using linear regression. Mediation analysis was conducted using the PROCESS macro. Higher levels of caregiving stress during the pandemic and lower levels of resourcefulness were associated with worse self-rated health, while controlling for age, employment status, and weekly caregiving hours. Resourcefulness mediated the relationship between caregiving stress and self-rated health. Our findings highlight the importance of assessing the psychological impact of the pandemic on family caregivers' outcomes. Resourcefulness skills can be targeted to improve the health and well-being of family caregivers during and beyond the pandemic.
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Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Atsadaporn Niyomyart
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jaclene A Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Altan Sarikaya N, Oz S, Ozturk S. Perceptions of loneliness and well-being of psychiatric patients' families. Perspect Psychiatr Care 2021; 57:1806-1811. [PMID: 33651413 DOI: 10.1111/ppc.12753] [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] [Received: 11/14/2019] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study was conducted to determine and explain the relationship between the loneliness perceptions and well-being of family caregivers of psychiatric patients. DESIGN AND METHODS This cross-sectional and descriptive study was conducted with the families of 141 individuals with mental illness, who were outpatients psychiatry clinic of a university hospital. FINDINGS There was a statistically significant moderate relationship between loneliness levels and well-being subscales of the psychiatric patients' caregivers (p < 0.001). PRACTICAL IMPLICATIONS Mental health nurses should carefully evaluate the perception of loneliness of family caregivers when diagnosing the family and determining needs.
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Affiliation(s)
- Nihan Altan Sarikaya
- Department of Mental Health and Psychiatric Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Sevcan Oz
- Department of Mental Health and Psychiatric Nursing, Nursing Faculty, Ege University, Izmir, Turkey
| | - Selda Ozturk
- Department of Mental Health and Psychiatric Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey
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