Exploring aging-related stress among older spousal caregivers

Care provided by older adults in active cancer treatment to a spouse: A scoping review

OBJECTIVES

Older adults with cancer may be spousal caregivers for partners with one or more chronic conditions, and there has not been an overview of the needs of this population. Therefore, we conducted a scoping review to assess what is known about the type and amount of spousal care provided by older adults (≥65 years) with any type of cancer, in the active treatment phase.

MATERIALS AND METHODS

A search strategy was designed with a Health Sciences Librarian and performed using the following electronic databases from inception to January 2021: Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (Embase), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo. Two independent reviewers screened all abstracts and full-text studies for inclusion.

RESULTS

Searches were run February 26, 2020, and re-run January 8, 2021. A total of 8887 titles and abstracts were screened and 32 selected for full text review, but only two case reports were included in this review. The two case reports discussed the experience of an older adult with cancer, in active treatment, as the caregiver to a spouse. However, the type and amount of care provided by the caregiver to the spouse was not specified in either report. In both reports, caregivers declined cancer therapy to focus on the needs of the care recipients.

CONCLUSION

Only two case reports were identified that examined the experiences of older adults with cancer acting as caregivers to a spouse. It is important for future studies to address this gap to better understand the needs of this population and develop future supportive interventions.

Factors Associated With Mental Health Status Among Older Primary Caregivers in Japan

This study aimed to elucidate factors affecting the mental health status of older primary caregivers. Participants comprised 81 pairs of home care recipients aged ≥65 years and primary caregivers aged ≥65 years who were caring for the recipients. We used an individual interview method, which covered basic attributes, activities of daily living by Barthel Index, mental health status by Center for Epidemiologic Studies Depression Scale (CES-D), sense of coherence (SOC), and sense of care burden by Japanese version of the Zarit Burden Interview (J-ZBI). The score for the comprehensibility subscale of the SOC was significantly higher for the old-old caregivers compared with the young-old caregivers (P < .01). A significant positive correlation between the number of years of caregiving and the score for the SOC meaningfulness subscale was seen for the young-old caregivers (P < .05). For the old-old caregivers alone, negative correlations were seen between the CES-D score and the scores for all the SOC items. Multiple linear regression analysis using CES-D as the dependent variable showed a significant positive relationship to J-ZBI in all caregivers (P < .01). In contrast, a significant negative relationship was seen with meaningfulness, an SOC subscale only for the old-old caregivers. Meaningfulness as well as J-ZBI was extracted as a factor affecting the mental health status of the old-old caregivers, suggesting that higher SOC relates to lower stress levels with a remarkable decline in physical condition. Meaningfulness, an SOC subscale, is an important factor for improving the mental health of old-old caregivers.

The experiences of older caregivers of cancer patients following hospital discharge

PURPOSE

This study addressed the experiences of older caregivers of cancer patients in the 2 weeks following a hospital discharge. It sought to understand the challenges they face in providing supportive care to patients at home.

METHODS

Qualitative descriptive interviews with a narrative approach were conducted with each caregiver at 1 and 2 weeks following the patient's discharge from the hospital. A thematic analysis approach was used to identify the themes that emerged from the caregiver interviews.

RESULTS

Caregivers were primarily Caucasian (77%), were mostly 68 years of age or older (62%), and were primarily caring for a spouse (69%). Three key themes emerged from the qualitative analysis: caregiver and patient wellness are connected, caregivers' struggle with control issues, and challenges in communication with health professionals.

CONCLUSIONS

These findings highlight psychosocial changes that caregivers experience over the 2-week time period following hospital discharge. Implications include the need to identify interventions to better prepare caregivers for the post-discharge period.

The Social Convoy for Family Caregivers Over the Course of Hospice

CONTEXT

Family caregivers play a central role in the care of those in hospice care. Little is known about the social support networks for those providing this day-to-day care without training.

OBJECTIVES

The purpose of this study was to explore changes in family and friend social networks among hospice caregivers over the course of the hospice stay.

METHODS

Data on social support networks were collected as part of a multisite randomized controlled trial and analyzed using structural equation modeling.

RESULTS

A statistically significant decline in the caregivers' family network subscale score was found over the four week period during which they received hospice services, reflecting a possible weakening of their family networks.

CONCLUSION

This result illustrates the potential importance of ongoing comprehensive assessment of caregiver networks and attention to interventions that may assist in capitalizing on both the quantity of support (numbers of individuals asked to help) and the quality of social support (attending to issues of support burden).