The impact of caregiving on the health status of regional carers in Australia: Findings from a mixed-method study.

While it is known that informal carers provide the majority of caregiving in Australia, there remains limited understanding of the challenges that regional carers face in their caring role and the impact of the caregiving role on carer well-being. OBJECTIVE: The aim of this study was to better understand the health status of caregivers as the person they care for was entering the National Disability Support Scheme. DESIGN: This is a mixed-methods study. SETTING: The study was undertaken in regional New South Wales, Australia. PARTICIPANTS: Seventy-five carers were enrolled into the study. All lived in regional New South Wales. MAIN OUTCOME MEASURE: The World Health Organization Well-being Index was used for quantitative data collection, and semi-structured interviews were undertaken for the collection of qualitative data. RESULT: Quantitative data indicated that carers from Aboriginal or Torres Strait Islander backgrounds and those from low socio-economic status had significantly lower scores on the well-being index. Two key qualitative categories were evident describing carer's journey to resilience by (a) adjusting to reality predominantly through cognitive reframing strategies and (b) carers accessing external supports. CONCLUSION: The health status of regional carers who are predominantly women is experiencing low levels of well-being. While many of these carers have initiated successful coping responses to the challenges of caring, there is an urgent need to increase the supports available to this population. As the recent National Disability Support Scheme is embedded, it is of importance to monitor if there are improvements in the health status of carers over time.

The effects on carer well-being of carer involvement in cognition-based interventions for people with dementia: a systematic review and meta-analysis.

OBJECTIVES: To investigate the effects on carer well-being of carer involvement in cognition-based interventions (CBIs) for people with dementia. METHODS: A review and meta-analysis were performed. We searched electronic databases for randomised controlled trials (RCTs). Two reviewers worked independently to select trials, extract data and assess the risk of bias. RESULTS: A total of 4737 studies was identified. Eight RCTs met the inclusion criteria. Only seven studies with 803 dyads of people with dementia and carers were included in the meta-analysis. Evidence indicated that carer involvement in CBIs for people with dementia had a beneficial effect on carers' quality of life with effect size Hedges' g = 0.22; 95% confidence interval of 0.02 to 0.42, z = 2.19 and p = 0.03. Carers' depression levels were reduced in the intervention group with effect size Hedges' g = 0.17; 95% confidence interval of 0.02 to 0.32, z = 2.19 and p = 0.03. No significant differences were observed in levels of anxiety symptoms, caregiving relationship and carer burden in the intervention group compared to those in the control group. CONCLUSION: Because CBIs are designed to deliver benefit for people with dementia, the collateral benefits for carers have potential implications for the importance of CBIs in service delivery and may contribute to cost effectiveness. However, there remains a lack of quality of research in this area. Particularly, in some outcomes, there was a lack of consistency of results, so the findings should be interpreted with caution. Future studies of the impact of CBIs on carers with larger samples and high-quality RCTs are warranted. Copyright © 2017 John Wiley & Sons, Ltd.