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Caregivers of frail elders: updating a national profile
- Authors:
- WOLFF Jennifer L., KASPER Judith D.
- Journal article citation:
- Gerontologist, 46(3), June 2006, pp.344-=356.
- Publisher:
- Oxford University Press
In this American study data are drawn from the 1989 and 1999 National Long-Term Care Survey and Informal Caregiver Survey to develop nationally representative profiles of disabled older adults and their primary informal caregivers at two points in time. The proportion of chronically disabled community-dwelling older adults who were receiving informal assistance from family or friends declined over the period of interest, whereas the proportion receiving no human help increased. On average, recipients of informal care were older and more disabled in 1999 than in 1989. Primary caregivers were children (41.3%), spouses (38.4%), and other family or friends (20.4%); children were more likely and others less likely to serve as primary caregivers in 1999 relative to 1989. Primary caregivers provided frequent and high levels of help at both points in time. A striking increase was found (from 34.9% to 52.8%) in the proportion of primary caregivers working alone, without secondary caregiver involvement. In the context of projected demographic trends and budgetary constraints to public health insurance programs, these data underscore the importance of identifying viable strategies to monitor and support family caregivers in the coming years.
Cognition of caregiving tasks: multidimensional scaling of the caregiver task domain
- Author:
- ALBERT Steven M.
- Journal article citation:
- Gerontologist, 31(6), 1991, pp.726-734.
- Publisher:
- Oxford University Press
Reports on a study of the tasks performed by carers to distinguish the distinctions they make between different types of caring.
The value of caregiver inclusive practices in geriatric transitions of care: a systematic review
- Authors:
- MEULENBROEKS Isabelle, EPP Joanne, SCHROEDER Liz
- Journal article citation:
- Health Policy, 125(7), 2021, pp.888-898.
- Publisher:
- Elsevier
Globally, hospital length of stay is decreasing, yet the number of aged patients requiring complex care is increasing. This causes more patients, and their informal caregivers, to self-manage in the community following acute care discharge. This study aims to assess whether transitional care programs that integrate caregivers provide better value care than routine care. In this systematic review, Medline Ovid, EMBASE Ovid, CINAHL EbscoHOST, Scopus, and Proquest were searched for any study design that investigated a caregiver inclusive transitional care intervention in a population of people with geriatric syndrome, enroled a comparator group, and assessed population health, experience, and/or cost related outcomes. Risk of bias was assessed by two reviewers using ROBINS I and RoB 2. The review included 23 studies and results were mixed. Consistently positive results occurred for patient and caregiver satisfaction. Cost tended to increase with caregiver inclusive practices. Most studies found no difference in population health outcomes. There was insufficient evidence on healthcare professional experience. Currently, there is insufficient evidence to determine whether caregiver inclusive transitions of care provide better value care than routine care. Studies that rigorously implement and evaluate caregiver inclusive care models are urgently required to inform future policy. (Edited publisher abstract)
The mobilities of care in later life: exploring the relationship between caring and mobility in the lives of older people
- Authors:
- CROUCHER Karen, et al
- Journal article citation:
- Ageing and Society, 41(8), 2021, pp.1788-1809.
- Publisher:
- Cambridge University Press
There has been a renewed call for a revaluing of informal caring in order to counter the way that caring is undervalued, taken for granted and invisible. Travel is one area where a detailed critique of this issue has emerged with the concept of ‘mobility of care’, however, this concept has only been applied in relation to younger age groups, and our understanding of mobilities of care in later life remains underdeveloped. By ‘mobilities of care’ we mean journeys made for the purpose of giving and receiving informal care and support. This paper draws on the mobility narratives of 99 older people (aged 55 and above) living in three locations in the North of England who participated in a two-year qualitative longitudinal study that explored the inter-play between mobility, wellbeing and life transitions. We focused on the experience of managing life transitions rather than assume that chronology per se determines wellbeing. Narratives of ageing emphasise the importance of getting out and about, and being socially connected active citizens. Our study demonstrates that for many older people getting out and about is not for leisure or utility purposes but to give support and care. As such, these journeys have a particular significance in the lives of older people and in the construction of roles, meaning and identity in later life. (Edited publisher abstract)
Stress, burden, and well-being in dementia and nondementia caregivers: insights from the caregiving transitions study
- Authors:
- SHEEHAN Orla C., et al
- Journal article citation:
- Gerontologist, 61(5), 2021, pp.670-679.
- Publisher:
- Oxford University Press
Background and Objectives: Few population-based studies have directly compared caregivers of persons with dementia to caregivers of persons with other disabilities (nondementia caregivers). We enrolled dementia and nondementia caregivers who were providing substantial and sustained care and compared these groups on measures of caregiver stressors, appraisals of burden, and well-being. Research Design and Methods: Caregivers (N = 251) who provided continuous care for at least 1 year and at least 5 h per week were recruited from the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Caregivers reported on dementia caregiving status, stressors, burden, and well-being. Results: Forty-seven percent (n = 117) reported caring for a person with dementia. Dementia caregivers reported more stressors, providing more care for self-care and behavioral problems than nondementia caregivers. Dementia caregivers also reported higher appraisals of stress and burden, and more depressive symptoms, but did not differ from nondementia caregivers on mental and physical health quality of life. In multivariable-adjusted models, adjustment for the total number of care recipient problems attenuated differences between dementia and nondementia caregivers on burden and depression measures. Discussion and Implications: Dementia and nondementia caregivers showed relatively few differences in indicators of overall well-being in this population-based sample, perhaps because both groups of caregivers in this study were providing substantial care. Dementia caregivers may require special assistance with dementia-specific problems such as behavioral problems. Clinical interventions and policy changes targeting highly burdened caregivers are needed to support them in allowing their care recipients to age in place at home. (Edited publisher abstract)
The impact of caregiver's depressive symptoms on trajectories of cognitive function in older adults with functional limitations
- Authors:
- JIANG Nan, SUN Qian, LOU Vivian W.Q.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(8), 2021, pp.1284-1294.
- Publisher:
- Wiley
Objectives: Family caregivers are important to older adults' health, but few studies have examined how caregivers' mental health is associated with older adults' cognitive function. This study examined the trajectories of cognitive function of older adults and whether caregivers' depressive symptoms shape the pattern of cognitive function trajectories. Methods: This 6-year longitudinal sample consisted 1188 older adults aged ≥75 years with deficits in activities of daily living (ADL) and their family caregivers in Shanghai, China (Rounds 1–3). Cognitive function trajectories were identified based on an enhanced group-based trajectory modeling that accounted for nonrandom attrition. Multinomial logistic regression tested the association between caregivers' depressive symptoms and older adults' cognitive function trajectory. Results: Three trajectory groups were identified: a “newly onset” group (50.4%) had an increased risk of being cognitive impaired during the 6-year period; a “never” group (46.2%) remained cognitive active; and a “chronic” group was largely persistently cognitive impaired (3.4%). Caregivers' depressive symptoms increased the relative risk of having the “onset” or “chronic” versus “never” trajectory. Among the four dimensions of depressive symptoms, only somatic complaints were associated with a higher risk of the “newly onset” trajectory in 6 years. Conclusion: The progression of cognitive function among older adults with deficits in ADL followed three distinct trajectories during a 6-year period. Addressing the mental health of caregivers may prevent or delay progression of cognitive impairment among older adults. (Edited publisher abstract)
Double child and elder care responsibilities and emotional exhaustion of an older sandwiched generation: the mediating effect of self-care
- Authors:
- JANG Soo Jung, et al
- Journal article citation:
- International Social Work, 64(4), 2021, pp.611-624.
- Publisher:
- Sage
The number of informal caregivers over the age of 50 who care for multiple family members including children and elderly relatives – a practice termed ‘double care’ – has steadily increased in Asian countries. Despite the rise in depression and stress among such caregivers, few studies have examined factors that may mitigate their emotional exhaustion. This research examines relationships between care responsibilities and emotional exhaustion, and the mediation effects of self-care on people in their 50s through 70s who provide care to multiple family members including children and elderly parents or relatives. The participants of this study were 183 people who were providing double care. The authors used care responsibilities as the independent variable, self-care as a mediator, and emotional exhaustion as the dependent variable. Results indicate that care responsibilities significantly affect emotional exhaustion, and that emotional exhaustion is mediated by self-care. The findings suggest that attention to self-care may reduce emotional exhaustion among caregivers in this older age group. (Edited publisher abstract)
Supporting older co-resident carers of older people – the impact of Care Act implementation in four Local Authorities in England
- Authors:
- O'ROURKE Gareth, et al
- Journal article citation:
- Social Policy and Society, 20(3), 2021, pp.371-384.
- Publisher:
- Cambridge University Press
The Care Act 2014 provides for ‘parity of esteem’ between people with social care needs and carers. This is achieved by extending the principles of prevention and wellbeing to carers; reinforcing carers’ right to an assessment; and setting national eligibility criteria for access to carer support services. This article reports on research that examined the impact of these changes on older co-resident carers of older people in four English local authorities. Findings are described in relation to four key themes: organisational arrangements and rationale; the aims of carer support and preventative services; design and delivery of carer assessment; and barriers to assessment and support. The findings of the research suggest that, despite the new statutory requirements, underlying contradictions and tensions in local authorities’ relationship with carers, and efforts to support them, remain unresolved. (Edited publisher abstract)
Multiple engagement: the relationship between informal care-giving and formal volunteering among Europe's 50+ population
- Author:
- STRAUSS Susanne
- Journal article citation:
- Ageing and Society, 41(7), 2021, pp.1562-1586.
- Publisher:
- Cambridge University Press
The article investigates the conditions of multiple engagement in the private and public realm in the second half of life. More specifically, I look at the relationship between informal care-giving and formal volunteering in a country-comparative way. Based on longitudinal data from the Survey of Health, Ageing and Retirement, 2004–2015, I investigate the 50+ population in 13 European countries. Controlling for unobserved heterogeneity by using conditional fixed-effect logistic regression models, I confirm earlier findings that care-givers are more likely to volunteer than non-care-givers; this effect is independent of care-giving intensity but only true for those who care outside their own household. As to macro-level influences, I find that both care-in-kind and cash-for-care expenditures increase the likelihood of volunteering among the 50+ population. The effect of cash-for-care expenditure is even stronger for the group of those who give intensive care outside their own households than for non-care-givers. Moreover, I find effects related to family's and women's role in society. First, I show a negative effect of a country's societal norm of family orientation on volunteering participation for those giving sporadic care outside their household but also among non-care-givers. Second, in countries with higher female labour market participation among the middle-aged, the volunteering likelihood is higher for sporadic female care-givers outside their own household but also among female non-care-givers. (Edited publisher abstract)
Commentary on “The experiences of older carers of people with learning disabilities: ‘I just carry on with it’”
- Author:
- SUNMAN Jan
- Journal article citation:
- Tizard Learning Disability Review, 26(1), 2021, pp.58-62.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide a commentary on the article by Rachel Forrester-Jones on the experiences of older carers of people with learning disabilities. Design/methodology/approach: The commentary reflects on the themes identified in the original article, comparing its findings to the lived experiences of those taking part in older carers’ projects in Oxfordshire, England. Findings: Similar broad themes were identified in both samples. Given these findings, the extent to which matters have changed, since the Valuing People work on older carers is considered. Originality/value: The paper discusses policy and practice implications to improve the quality of life of older carers and their families and explores how the voice of older carers can be strengthened to enable them to shape practice and policy. (Edited publisher abstract)