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Anderson JG, Summers AJ, Ahn S, Harris RF, Smith JL, Jabson Tree JM, Neal AM, Misawa M, Rauer AJ. Digital Health and Caregiving Resources Used by Family Caregivers of Older Adults During the COVID-19 Pandemic. JOURNAL OF FAMILY NURSING 2024:10748407241275897. [PMID: 39206750 DOI: 10.1177/10748407241275897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Caregiving is often associated with negative physical and mental health outcomes, and as the COVID-19 pandemic escalated, caregivers experienced more burden and provided more care with substantially less support. Digital resources may have been one way caregivers managed demands for care and needs for information. This mixed-methods study included surveys and semi-structured interviews with caregivers (n = 11) to describe experiences and use of digital health resources during the COVID-19 pandemic. Caregivers most often provided significant physical care and experienced reduced or no social support during the pandemic. Caregivers reported the need for improving the quality of telehealth services and digital health resources. COVID-19 will not likely be the last pandemic faced by contemporary society. Measures should be taken to reduce the anticipated negative impacts on caregivers and those receiving care during future pandemics.
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Affiliation(s)
| | | | - Sangwoo Ahn
- Pennsylvania State University, University Park, USA
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2024 Alzheimer's disease facts and figures. Alzheimers Dement 2024; 20:3708-3821. [PMID: 38689398 PMCID: PMC11095490 DOI: 10.1002/alz.13809] [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: 05/02/2024]
Abstract
This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non-physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community-based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community-based workers to provide dementia care. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non-physician health care professionals play in facilitating clinical care and access to community-based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.
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Saravanan A, Shade M, Liu Y, Olayeni B, Sanders S, Johnson R, Booker S, Starkweather A. Training to use smart tablets to access reliable online health information in older adults' post-pandemic: A focused pilot intervention study. Geriatr Nurs 2024; 56:204-211. [PMID: 38359740 PMCID: PMC10990773 DOI: 10.1016/j.gerinurse.2024.02.010] [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: 12/02/2023] [Revised: 01/13/2024] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Older adults are becoming more accepting and interested in using digital technologies, but difficulties and barriers remain for accessing reliable health-related information. The purpose of this focused pilot intervention study was to: (1) understand older adults' firsthand experiences and challenges while using smart tablets post-COVID-19 pandemic, and (2) gather suggestions for age-appropriate training materials, preference of training materials, and resources to access reliable online health information. METHODS A focused pilot intervention study that involved training older adults to use smart tablets followed by focus group of a convenience sample of 13 older adults (65-85 years old; 91.6% female) on their experiences of using smart tablets. RESULTS Thematic analysis revealed three themes: tablets are convenient to access online information and older adults reported technical, security concerns, emotional and cognitive challenges regarding use of smart tablets. Older adults also requested one-on-one support, assistance, and topic specific learning for future training sessions. CONCLUSIONS Future studies should focus on providing detailed, clear instructions at an acceptable pace for older adults.
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Affiliation(s)
- Anitha Saravanan
- School of Nursing, Northern Illinois University, 3100, Sycamore Rd. DeKalb, IL 60115, USA.
| | - Marcia Shade
- College of Nursing, 985330 University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Yujun Liu
- School of Family and Consumer Science, Northern Illinois University, DeKalb, IL 60115, USA
| | - Bolanle Olayeni
- Northern Illinois University School of Nursing, 3100, Sycamore Rd. DeKalb, IL 60115, USA
| | - Sameera Sanders
- Northern Illinois University School of Nursing, 3100, Sycamore Rd. DeKalb, IL 60115, USA
| | - Rhea Johnson
- Northern Illinois University School of Nursing, 3100, Sycamore Rd. DeKalb, IL 60115, USA
| | - Staja Booker
- College of Nursing, University of Florida, PO Box 100197, Gainesville, FL 32610, USA
| | - Angela Starkweather
- Research Development, College of Nursing, University of Florida, Gainesville, FL 32610, USA
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Cho TC, Park B, Choi H. Measuring spatial availability of children for older adults with disability. Soc Sci Med 2023; 335:116201. [PMID: 37729819 PMCID: PMC10980977 DOI: 10.1016/j.socscimed.2023.116201] [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: 06/01/2023] [Revised: 08/14/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Having an adult child living with or nearby may prevent parents with disability from moving to nursing homes and reduce the use of paid care services. Despite the profound implications for care resources and utilization among older adults, there is no measure summarizing the spatial availability of all adult children for an older adult. Our study aims to develop a holistic measure of adult children's spatial availability to assess potential family care resources for older adults with disability. METHODS Data were obtained from the population-based, longitudinal study in the U.S., the Health and Retirement Study (HRS). We selected a nationally representative sample of older adults 55+ years with disability. Using multivariable two-part regression models, we developed a care-weighted child spatial availability for caregiving (CSAC) index, which summarizes the spatial dispersion of all adult children accounting for potential caregiving associated with distance. We also constructed a reference index of child spatial proximity (CSP) focusing only on spatial distance by employing Gaussian kernel weighting functions. RESULTS CSAC index highlights the great importance of having an adult child in the same household (vs. nearby or far) for receiving care among older adults with disability, compared to the CSP index, showing relatively a gradual decline over the spatial distance. Both indices vary substantially by older adults' sociodemographic attributes. CONCLUSIONS The holistic indices of adult child spatial availability will contribute to assessing care resources for older adults, albeit future development is needed to extend the utility of the indices tailored for specific care needs.
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Affiliation(s)
- Tsai-Chin Cho
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Bona Park
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - HwaJung Choi
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
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Abstract
This article describes the public health impact of Alzheimer's disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer's. An estimated 6.7 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer's or other dementias in 2022. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $339.5 billion in 2022. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the paid health care workforce are involved in diagnosing, treating and caring for people with dementia. In recent years, however, a shortage of such workers has developed in the United States. This shortage - brought about, in part, by COVID-19 - has occurred at a time when more members of the dementia care workforce are needed. Therefore, programs will be needed to attract workers and better train health care teams. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2023 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $345 billion. The Special Report examines whether there will be sufficient numbers of physician specialists to provide Alzheimer's care and treatment now that two drugs are available that change the underlying biology of Alzheimer's disease.
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Hicks B, Gridley K, Dixon J, Baxter K, Birks Y, Colclough C, Karim A, Perach R, Moseley E, Russell A, Sondh HK, Storey B, Tipping E, Ardle RM, Donaghy P, Dangoor M, Miles E, Robinson L, Rusted J, Waine H, Wheatley K, Banerjee S. Using digital technologies to facilitate social inclusion during the COVID-19 pandemic: Experiences of co-resident and non-co-resident family carers of people with dementia from DETERMIND-C19. Int J Geriatr Psychiatry 2023; 38:e5886. [PMID: 36734147 PMCID: PMC10947510 DOI: 10.1002/gps.5886] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND The COVID-19 pandemic triggered rapid and unprecedented changes in the use of digital technologies to support people's social inclusion. We examined whether and how co-resident and non-co-resident family carers of people with dementia engaged with digital technologies during this period. METHODS Throughout November 2020-February 2021, we interviewed 42 family carers of people with dementia from our DETERMIND-C19 cohort. Preliminary analysis was conducted through Framework analysis, followed by an inductive thematic analysis. FINDINGS Digital technologies served as a Facilitator for social inclusion by enabling carers to counter the effects of the differing restrictions imposed on them so they could remain socially connected and form a sense of solidarity, access resources and information, engage in social and cultural activities and provide support and independence in their caring role. However, these experiences were not universal as carers discussed some Challenges for tech inclusion, which included preferences for face-to-face contact, lack of technological literacy and issues associated with the accessibility of the technology. CONCLUSION Many of the carers engaged with Information and Communication Technologies, and to a lesser extent Assistive Technologies, during the pandemic. Whilst carers experienced different challenges due to where they lived, broadly the use of these devices helped them realise important facets of social inclusion as well as facilitated the support they provided to the person with dementia. However, to reduce the 'digital divide' and support the social inclusion of all dementia carers, our findings suggest it is essential that services are attuned to their preferences, needs and technological abilities.
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Affiliation(s)
- Ben Hicks
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | - Kate Gridley
- Social Policy Research UnitUniversity of YorkYorkUK
| | - Josie Dixon
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Kate Baxter
- Social Policy Research UnitUniversity of YorkYorkUK
| | - Yvonne Birks
- Social Policy Research UnitUniversity of YorkYorkUK
| | | | - Anomita Karim
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | | | - Elen Moseley
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Alice Russell
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | | | | | - Eva Tipping
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | | | | | - Margaret Dangoor
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | | | | | | | - Harriet Waine
- South London and Maudsley NHS Foundation TrustLondonUK
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Murciano-Hueso A, Martín-García AV, Cardoso AP. Technology and Quality of Life of Older People in Times of COVID: A Qualitative Study on Their Changed Digital Profile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10459. [PMID: 36012093 PMCID: PMC9408618 DOI: 10.3390/ijerph191610459] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
The situation caused by the COVID-19 pandemic brought negative consequences such as social isolation, limited access to routine health and social care services, and lack of self-esteem, especially for older people. In this context, technology took on an important role as the main means of communication and service delivery. The main objective of this study is to analyze the situation of the elderly and their access to technological resources in the time of COVID-19. Based on a qualitative methodology, 58 semi-structured interviews were conducted with people between 65 and 90 years old in Portugal. The results reveal specific difficulties in the use of this type of digital devices and a change in the digital use profile of this age group, characterized by more frequent use of digital devices such as smartphones, the incorporation of certain services such as video calls, and uses associated with communication and entertainment. This study shows that attitudes toward technology among the elderly should be studied further, and these results should be considered to develop and implement training programs specially designed for this age group in order to contribute to their well-being and quality of life.
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