Examination of the Healthy Caregiver Effect among Older Adults: Findings from the Canadian Longitudinal Study on Aging.

INTRODUCTION: The Healthy Caregiver Hypothesis (HCH) suggests that caregiving is associated with beneficial health impacts for family caregivers. However, mixed results have been reported, particularly when different levels of caregiving intensity were examined. This study analyzes the relationship between caregiving intensity and three health indicators (functional health, chronic illness, and self-rated general health) among Canadian older adults over 3 years. METHODS: We drew upon a subsample of 11,344 participants aged 65 years and older from the Baseline and Follow-up 1 data of the Canadian Longitudinal Study on Aging and used linear mixed models to test the hypothesis based on different levels of caregiving intensity. RESULTS: Older adults who provided low-intensity care recently or continuously reported better functional health and self-rated health than noncaregivers. In contrast, older adults with low-intensity caregiving responsibility reported more chronic conditions over time compared to noncaregivers, but this association was not found for high-intensity caregivers. DISCUSSION/CONCLUSION: This study elucidates the HCH by incorporating caregiving intensity to understand patterns of better functional health and perceived health but more chronic conditions. The findings yielded from different health indicators suggest the impact of caregiving on health may be domain specific.

Understanding the experiences of older caregivers of patients with lung cancer during palliative chemotherapy in China: a qualitative study.

PURPOSE: Although there has been an increase in research on caregivers of patients with cancer, there has been little focus on the specific experiences of older caregivers of patients with lung cancer and the effect of their cultural backgrounds on their experiences. This study explored the caregiver experience among the ageing population in China. METHODS: Older caregivers of patients with lung cancer undergoing palliative chemotherapy were recruited. Data were collected using a qualitative descriptive design involving semi-structured interviews, which were recorded, transcribed verbatim and analysed qualitatively using inductive content analysis. RESULTS: Eighteen caregivers aged 61-81 years completed the interviews. The following four themes were identified: physical difficulty, living with ambivalence, perception of role and role-related behaviour changes. These themes enabled a greater understanding of role-related behaviours in older caregivers and their challenges in addressing biological and psychosocial challenges related to older age. CONCLUSION: The present study highlighted the vulnerability and perceived challenges of the role of older caregivers. These findings help lay the foundation for interventions to improve the care provided to caregivers and their health outcomes, especially caregivers with chronic conditions.

Becoming an older caregiver: A study of gender differences in family caregiving at the end of life.

OBJECTIVES: Older people are not traditionally expected to become caregivers. For this reason, the experience of caregiving in older persons has not been explored adequately in the research on gender differences. The objective of this study was to assess the caregiver burden among older family members who care for cancer patients facing the end of their lives, in order to compare their differences according to gender (male vs. female). METHODS: This is a cross-sectional study. A total of 102 older caregivers (aged ≥65 years) of hospice patients were interviewed through the Caregiver Burden Inventory (CBI). The sample group was divided into two gender subgroups. RESULTS: Compared with male caregivers, the older female group reported significantly higher scores in the CBI-physical subscale (P = 0.028), and in the CBI, the overall score (P = 0.0399) confirmed by the generalized linear model (multivariate) evaluation that included possible predictors in the model. There were no significant differences in the other CBI subscale scores (time-dependent, developmental, social, and emotional). SIGNIFICANCE OF RESULTS: Older female caregivers are at higher risk of experiencing burden and worse physical health compared with men. Further research is needed in modern palliative care to assess the role of gender differences in the experience of caregiving when the caregiver is an older person.

Predictors of caregiver burden in aged caregivers of demented older patients.

BACKGROUND: Dementia in the oldest-old is projected to increase exponentially as is the burden of their caregivers who may experience unique challenges and suffering. Thus, we aim to investigate which factors are associated with older caregivers' burden in caring demented outpatients in a multicenter cohort. METHODS: Patients and their caregivers, both aged ≧65 years, in the National Dementia Registry Study in Taiwan (T-NDRS) were included in this study. Caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The correlations between the ZBI scores and characteristics of caregivers and patients, including severity of dementia, physical comorbidities, instrumental activities of daily living (IADL), neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI), and family monthly income, were analyzed. RESULTS: We recruited 328 aged informal caregiver-patient dyads. The mean age of caregivers was 73.7 ± 7.0 years, with female predominance (66.8%), and the mean age of patients was 78.8 ± 6.9 years, with male predominance (61.0%). Multivariable linear regression showed that IADLs (ß = 0.83, p < 0.001) and NPI subscores of apathy (ß = 3.83, p < 0.001)and irritability (ß = 4.25, p < 0.001) were positively associated with ZBI scores. The highest family monthly income (ß = - 10.92, p = 0.001) and caregiver age (ß = - 0.41, p = 0.001) were negatively correlated with ZBI scores. CONCLUSIONS: Older caregivers of older demented patients experience a higher care burden when patients had greater impaired functional autonomy and the presence of NPI symptoms of apathy and irritability. Our findings provide the direction to identify risky older caregivers, and we should pay more attention to and provide support for these exhausted caregivers.

Caregiver burden, health status, and learned resourcefulness of older caregivers.

As caregivers undertake caregiving responsibilities over a long period of time, the burdens placed on them could lead to undue stress and affect their health. This correlation study examined the current situations and relationships among caregiver burden, health status, and learned resourcefulness (LR) of older caregivers who care for disabled older adults, and predicted the important factors that affect their caregiver burden. In all, 108 older caregivers were recruited from home care services of two hospitals. Structured questionnaire interviews were applied to collect data: the Caregiver Burden Scale, the SF-36 Health Survey (SF-36), and the Rosenbaum's Self-Control Schedule. Results indicated that the caregiver burden was negatively correlated with physical health, mental health, and LR. Physical and mental health were positively correlated with LR. The predictors of caregiver burden included LR, health status, economic status, and activities of daily living, which accounted for 58.60% of the total caregiver burden variance.