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Caregiver, Caregiver Support, Caregiver Burden

  • See Also
  1. Caregiver Resources
  2. Caregiver Burden Scale
  3. Health Concerns in the Elderly
  4. Advance Care Planning
  5. Activities of Daily Living
  6. Instrumental Activities of Daily Living
  • Definitions
  1. Caregiver
    1. Family or friend who offers unpaid assistance to a person with chronic or disabling condition
  • Epidemiology
  1. Of those adults requiring Longterm Care, 80% live in the community
    1. Unpaid Caregivers provide 90% of the care for these patients (nearly 25 hours/week on average)
    2. Nearly all require assistance in Instrumental Activities of Daily Living
    3. Nearly 60% require assistance in Activities of Daily Living
    4. More than half were hospitalized in the last 12 months
    5. https://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-united-states-2015-report-revised.pdf
  • Mechanism
  • Caregiver Burden
  1. Caregiving has benefits of personal satisfaction, feeling useful and needed, and finding purpose and meaning in life
  2. However, caregiving also is associated with significant persistent, uncontrollable and unpredictable stressors
    1. Comprises physical, psychological and financial burdens (one third of Caregivers rate the burden as high)
    2. Caregivers are more likely to miss work and have reduced work hours with loss of salary and benefits
    3. Caregivers have higher rates of Major Depression, emotional stress, Insomnia and serious illness
    4. Caregivers report neglecting health habits and self-care, and less time for other family and friends
  • Evaluation
  • Caregiver
  1. See Caregiver Burden Scale
  2. Caregiver Assessment via Guided Care Model
    1. https://www.caregiver.org/caregivers-count-too-section-3-what-should-family-caregiver-assessments-include
  3. Modified Caregiver Strain Index
    1. https://consultgeri.org/try-this/general-assessment/issue-14.pdf
  4. Adapted Zaret Burden Interview
    1. Bedard (2001) Gerontologist 41(5): 652–7 +PMID:11574710 [PubMed]
  • Management
  • General
  1. Caregiver well-being
    1. Take a break from caregiving
    2. Support group
    3. Pursue own interests (e.g. hobbies)
    4. Maintain own health including healthy lifestyle
    5. Family and Medical Leave Act (FMLA)
  2. Caregiver education
    1. Caregiver training for medical tasks
    2. AARP Prepare to Care: A Caregiving Planning Guide for Families
      1. https://www.aarp.org/caregiving/prepare-to-care-planning-guide/
  3. Referrals
    1. Elder agencies in local area
    2. Home health services
    3. Adult day programs
    4. Meal delivery services
  4. General patient management
    1. Early Palliative Care
    2. Advance Care Planning
    3. Improve quality of life with symptom management
    4. Address ways to unburden the Caregiver in specific conditions (e.g. Dementia, cancer, stroke)
  • Resources
  1. See Caregiver Reources
  • References
  1. Swartz (2019) Am Fam Physician 99(11): 699-706 [PubMed]