Household Need and Unmet Need for Caregivers of Older Persons in Thailand.

The need for caregivers is a crucial issue in Thailand. This research examined levels and trends of household needs and unmet needs for caregivers of older persons and explored potential factors associated with these needs. The analysis utilized data from the Survey of Older Persons in Thailand 2007, 2011, 2014, and 2017. The household need for a caregiver of older persons was defined as a household with one or more older people who needed a caregiver to help them perform basic activities of daily living. The unmet need for a caregiver referred to households where at least one older person in the household needed care but did not receive it. Findings illustrated the increasing levels and trends of household needs as well as unmet needs over time. In terms of potential determinants, older person households in Bangkok and households with higher socioeconomic status were more likely to be the household need for caregivers. In contrast, those households in the Northeastern, the poorest region, were more likely to be the unmet need household. These findings are indicative of the rising demand for long-term care services in Thailand. However, it is vital to consider unmet household needs, especially in the worse-off area, when designing national policies.

In Caring for Older People in Low- and Middle-Income Countries, Do Older Caregivers Have a High Level of Care Burden and Psychological Morbidity Compared to Younger Caregivers?

Caregivers have become older as longevity increases. Caregiving for older people can cause burdens and psychological morbidity, which are the chronic stresses perceived by informal caregivers. This study aimed to compare the levels of care burden and psychological morbidity between older and younger caregivers in low- and middle-income countries. A cross-sectional survey was conducted in Cuba, the Dominican Republic, Peru, Venezuela, Mexico, Puerto Rico, and China. Data were collected by the 10/66 Dementia Research Group. The Zarit Burden Inventory was used to measure the levels of burden on caregivers. Psychological morbidity was assessed through the Self-Reporting Questionnaire. Data from 1348 households in which informal caregivers provided home care for one older person were included in the analysis. Multivariable logistic regression was used to investigate the effects of caregiver age upon care burden and psychological morbidity. A fixed-effect meta-analysis model was used to obtain a pooled estimate of the overall odds ratios of each country. The unadjusted and the adjusted model for potential covariates revealed no significant difference in care burden and psychological morbidity between older caregivers and younger caregivers. The adjusted pooled estimates, however, indicated a lower psychological morbidity among older caregivers (OR = 0.61, 95% CI: 0.41-0.93, I2 = 0.0%). The demographic implications of caregiver age may suggest different policy responses across low- and middle-income countries.

Reducing the Physical Burden of Older Persons' Household Caregivers: The Effect of Household Handrail Provision.

The household handrail is necessary for dependent older people to perform their daily living activities, improve caregiving competency, and reduce caregiver burden. This study aimed to explore physical burden levels and examine their association with handrail provision among caregivers in older people's households in Phuttamonthon District, Thailand, in 2017. This study used the physical dimension of the Caregiver Burden Inventory to quantify the levels of physical burden among 254 caregivers in households with a dependent older person. It classified the studied households into three categories: no handrail, one handrail, and more than one handrail. The analysis employed the ordinal logistic model approach. The findings showed that the mean physical burden score was 5 ± 3.85, indicating a high burden. After adjusting for potential factors, the caregivers in older people's households with one handrail were less likely to experience a high physical burden than those without a handrail (OR = 0.30, 95% CI = 0.14-0.67). Nonetheless, the analysis found no significant differences in physical burden between caregivers of households with more than one handrail and those of households with no handrails. Having handrails in housing might enhance older people's ability to adjust to disability and illness, ultimately reducing the physical care burden of caregivers. However, having the appropriate number of handrails in older people's households should be considered.

State of household need for caregivers and determinants of psychological burden among caregivers of older people in Thailand: An analysis from national surveys on older persons.

OBJECTIVES: To explore the levels and trends of household need for caregivers of older people and to explore the impact of potential determinants of psychological burden among caregivers of older people in Thailand. METHODS: The secondary data analysis was performed using the Survey of Older Persons in Thailand 2007, 2011, and 2014 datasets which conducted by the National Statistical Office of Thailand. The household need for caregivers of older persons refers to having at least one older person in the household who needs a caregiver for assistance with activities of daily living. Caregiver mental health, which is confined to the available 2011 data, is defined as a state of psychological burden. Ordinal logistic regression models were used to explore the impact of potential determinants of psychological caregiver burden. RESULTS: The household need for caregivers in Thailand tends to be increasing, from 5.0% in 2007 to 6.6% in 2014. The levels of the household need for caregivers were significantly higher in urban areas, Bangkok, and high socioeconomic households. In terms of psychological caregiver burden, the Thai Mental Health Indicators in 2011 produced, on average, a fair level of mental health, but one-fourth of caregivers had poor mental health. Duration of care for older people, household wealth, and functional dependency significantly predict total caregiver burden. Household characteristics are vital in predicting psychological caregiver burden, and the adjusted effect of the fifth quintile of household wealth was high (odds ratio = 2.34; 95% confidence interval = 1.47-3.73). CONCLUSION: The increasing need for caregiving in households with an older person can lead to a higher caregiver burden, particularly among those caregivers who care for dependent older people in poor households. Longer duration of caregiving is a factor that mitigates this burden.