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Unmet care needs, care provision and patient satisfaction in patients with a late life depression: a cross-sectional study
- Authors:
- CLIGNET Frans, et al
- Journal article citation:
- Aging and Mental Health, 23(4), 2019, pp.491-497.
- Publisher:
- Taylor and Francis
Background: Research has shown that some 30% of total care needs in people with late-life depression (LLD) are unmet. It is not known to what extent patients actually don't receive any care for these needs or consider the care to be insufficient and their satisfaction with the provided care. Aim: The aim of this study is to obtain insight into the care provided in relation to the reported unmet care needs and satisfaction with the total care provided is examined. Method: A cross-sectional study of 99 people with LLD in an ambulatory setting. Results: In 67% of patients, at least one unmet need was ascertained. In most cases (80%) care was actually provided for those needs by professionals and/or informal caregivers. Patients were satisfied with the care delivered for 81% of the reported care needs. Satisfaction was lowest for social care needs (67%). For six specific care needs it was demonstrated that dissatisfied patients were significantly more depressed than satisfied patients. Conclusion: Even though patients might receive care for certain needs, this does not mean that their needs are met. A substantial proportion of patients with LDD feel that they need additional help for unmet needs. (Edited publisher abstract)
Factors associated with depression in older carers
- Authors:
- LOI Samantha M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(3), 2016, p.294–301.
- Publisher:
- Wiley
Objective: Depression is an adverse outcome frequently seen in carers. With the increasing ageing population and reliance on informal carers, this study aims to identify factors associated with depression in carers in the older age group, using factors that have not been previously investigated. Methods: The authors conducted a cross-sectional analysis of 202 older carers using the Geriatric Depression scale, demographics, personality traits, attitudes to ageing and other carer characteristics. Results: Increased hours spent caring and higher levels of neuroticism were all factors associated with depression. The care-recipient diagnosis, other personality traits, attitudes to ageing, leisure-physical activity (PA) and domestic-PA were not significantly associated with depression. Conclusions: These findings have important implications for interventions to target at-risk carers. (Publisher abstract)
Stressors and caregivers’ depression: multiple mediators of self-efficacy, social support, and problem-solving skill
- Authors:
- TANG Fengyan, et al
- Journal article citation:
- Social Work in Health Care, 54(7), 2015, pp.651-668.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Caring for an older adult with memory loss is stressful. Caregiver stress could produce negative outcomes such as depression. Previous research is limited in examining multiple intermediate pathways from caregiver stress to depressive symptoms. This study addresses this limitation by examining the role of self-efficacy, social support, and problem solving in mediating the relationships between caregiver stressors and depressive symptoms. Using a sample of 91 family caregivers, the authors tested simultaneously multiple mediators between caregiver stressors and depression. Results indicate that self-efficacy mediated the pathway from daily hassles to depression. Findings point to the importance of improving self-efficacy in psychosocial interventions for caregivers of older adults with memory loss. (Edited publisher abstract)
Caregiver physical and mental health predicts reactions to caregiving
- Authors:
- DE FRIAS C. M., TUOKKO H., ROSENBERG T.
- Journal article citation:
- Aging and Mental Health, 9(4), July 2005, pp.331-336.
- Publisher:
- Taylor and Francis
Self-reported health and reactions to providing care to older adults with cognitive or physical impairments were examined. Health status was examined on a single occasion in 177 persons (aged 63–94 years) referred to programs within a comprehensive set of geriatric care services and the 133 family members involved in their care (ages 31–96 years). The five-scale Caregiver Reaction Assessment (CRA) was administered to the family members. Reliability analyses revealed that the CRA had good internal consistency. Being older was related to experiencing greater health problems in the caregiver role. Greater health problems from providing care were reported by caregivers in worse physical health and also when the care recipient had more physical pain. Caregivers who reported fewer health problems attributed to caregiving reported better mental health and less depressive symptomatology. Caregivers with health problems may be at increased risk of suffering from stress from caregiving.
Survival of persons with Alzheimer's disease: caregiver coping matters
- Authors:
- McCLENDON McKee J., SMYTH Kathleen A., NEUDORFER Marcia M.
- Journal article citation:
- Gerontologist, 44(4), August 2004, pp.508-519.
- Publisher:
- Oxford University Press
Although persons with Alzheimer's disease (AD) require increasingly more assistance with activities of daily living as their disease progresses, the caregiving environment has received little attention as a source of predictors of their survival time. We report here on a study to determine whether variation in survival time of persons with AD can be better explained by including caregiver variables such as coping style and depressive symptoms as predictors. A sample of 193 persons with AD residing in the community and their family caregivers was used to estimate the parameters of a Cox regression model of survival time that included both caregiver characteristics and care-recipient impairments as covariates. Caregiver wishfulness–intrapsychic coping was related to shorter care-recipient survival time, but instrumental and acceptance coping and caregiver depressive symptoms were not associated with survival time. Care-recipient impairments (dependency in activities of daily living, low score on the Mini-Mental State Examination, and problematic behaviors) were associated with shorter survival time. Because this study is the first to report the link between caregiver coping and care-recipient survival, further study to understand the dynamics is required. We discuss several possible mechanisms, including the possibility that caregivers engaging in wishfulness–intrapsychic coping are less psychologically available to the person with dementia. These caregivers may therefore provide less person-centered care that is responsive to the true capacities of the person with dementia, and thus they may inadvertently contribute to excess disability and consequent accelerated decline. Because wishfulness–intrapsychic coping was uncorrelated with instrumental or acceptance coping, our findings suggest that interventions to enhance coping skills among caregivers, which have focused primarily on increasing problem solving and acceptance coping, also may have to include specific attempts to reduce wishfulness–intrapsychic approaches to benefit not only the caregiver but the care recipient as well.
The sense of coherence, burden, and depressive symptoms in informal caregivers during the first month after stroke
- Authors:
- CHUMBER Neale R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(10), October 2004, pp.944-953.
- Publisher:
- Wiley
Individuals with a strong sense of coherence (SOC), which considers one's ability to respond to stressors by the appropriate use of adaptive coping resources, can avoid breakdown when confronted with stress. This study examined the associations between SOC, perceived burden (caregiver's perception of the effect of caregiving-related stress) and depressive symptoms of informal caregivers (family members and involved friends) of stroke survivors one-month after the stroke. One-hundred and four ethnically diverse veterans who were hospitalized after experiencing an acute stroke and their informal caregivers were enrolled in the study prior to discharge. One-month after being discharged from one of five Veterans Affairs Medical Centers in Florida and Puerto Rico, comprehensive data was collected and analyzed. Multiple regression analyses showed that greater SOC was associated with both lower burden (p < 0.0001) and fewer depressive symptoms (p < 0.0001). Higher caregiver burden, in turn, was significantly associated with more depressive symptoms (p = 0.003). However, when depressive symptoms was regressed on both SOC and burden jointly, the previously significant association between burden and depressive symptoms was no longer significant (p = 0.80) and SOC was still strongly associated with fewer depressive symptoms (p < 0.0001). Determining factors that may lessen burden and depressive symptoms for caregivers of stroke survivors during the transition period after discharge to their residence are imperative for developing successful interventions. SOC appears to be an important response in alleviating the levels of perceived burden and especially in depressive symptoms.
Neuroticism and longitudinal change in caregiver depression: impact of a spouse-caregiver intervention programme
- Authors:
- JANG Yuri, et al
- Journal article citation:
- Gerontologist, 44(3), June 2004, pp.311-317.
- Publisher:
- Oxford University Press
The authors examined the impact of caregiver neuroticism on longitudinal change in depression among spouse-caregivers of individuals with Alzheimer's disease receiving either enhanced psychosocial treatment or usual care. We were interested in whether high levels of caregiver neuroticism would lead to a diminished response to the enhanced treatment and whether neuroticism affected the longitudinal course of caregiver depression regardless of intervention. They analyzed data from the NYU Spouse-Caregiver Intervention Study, which randomly assigned caregivers either to an enhanced treatment group that received a comprehensive intervention with counseling, support, and consultation, or to a usual-care control group. The present study analyzed data from 320 caregivers, 160 in each group, who completed the NEO questionnaire. They used random-effects growth curve modeling to examine changes in depression in the first year after intake, examining possible effects of neuroticism on the course of caregiver depression and on response to intervention. Caregivers high in neuroticism showed a worse longitudinal course of depression compared with those low in neuroticism in both the enhanced treatment and usual-care groups after we adjusted for baseline depression as a covariate. Caregivers showed benefits from the enhanced treatment compared with usual care, regardless of neuroticism score. However, caregivers low in neuroticism responded to treatment with declining levels of depression, whereas caregivers high in neuroticism maintained their baseline level of depression. Caregiver neuroticism is a risk factor for increased caregiver depression over time. High neuroticism does not preclude successful caregiver intervention with a highly individualized intervention, but expectations of outcome should be different than for caregivers low in neuroticism. Future studies should investigate the relationship between neuroticism and response to less individualized interventions and the impact of other personality characteristics on response to treatment.
Reciprocal relationship between social support and depressive symptoms among Chinese elderly
- Authors:
- CHOU K.-L., CHI I.
- Journal article citation:
- Aging and Mental Health, 7(3), May 2003, pp.224-231.
- Publisher:
- Taylor and Francis
For many Hong Kong Chinese elderly, Depression is a quite common occurrence. This study examines the reciprocal relationship between social support and depressive symptoms. The data came from a longitudinal study of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, the authors found that elderly persons who reported depressive symptoms more frequently were likely to receive higher levels of social support from family members living with elders, but lower levels of social support from friends three years later, even after controlling for socio- demographic and physical health status variables. In addition, elderly people who received more social support from family members not living with elders reported fewer depressive symptoms three years later.
Informal caregiving to older adults hospitalized for depression
- Authors:
- MORROW-HOWELL N.L., PROCTOR E.K.
- Journal article citation:
- Aging and Mental Health, 2(3), August 1998, pp.222-231.
- Publisher:
- Taylor and Francis
This study addresses the following questions: what are the caregiving needs stemming from functional dependency of older adults hospitalised for depression and discharged at home; who are the informal caregivers, and what assistance do they provide; and how adequate is this informal care? On a sample of depressed older adults, in-hospital information was collected from medical records and discharge planners; and one-month post-discharge, a telephone interview was completed. Finds that despite high levels of involvement, concerns remain about the adequacy of the care informal caregivers are able to provide in the face of such need. Increased attention should be paid to the topic of informal caregiving to older adults with depression.
A pilot study comparing psychological and physical morbidity in carers of elderly people with dementia and those with depression
- Authors:
- WIJERATNE Chanka, LOVESTONE Simon
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(8), August 1996, pp.741-744.
- Publisher:
- Wiley
The pilot study compared the difficulties faced by co-resident relatives caring for elderly patients with dementia and those with depression, referred to a psychogeriatric service in London. Reports on the research results.