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Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults

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Abstract

BACKGROUND

Family caregivers provide assistance with health care tasks for many older adults with chronic illnesses. The difficulty they experience in providing this assistance, and related implications for their well-being, have not been well described.

OBJECTIVE

The objectives of this study are: (1) to describe caregiver’s health care task difficulty (HCTD), (2) determine the characteristics associated with HCTD, and (3) explore the association between HCTD and caregiver well-being.

DESIGN

This is a cross-sectional study.

PARTICIPANTS

Baseline sample of caregivers to older (aged 65+ years) multimorbid adults enrolled in an ongoing cluster-randomized controlled trial (N = 308).

MAIN MEASURES

The HCTD scale (0–16) is comprised of questions measuring self-reported difficulty in assisting older adults with eight health care tasks, including taking medication, visiting health care providers, and managing medical bills. Caregivers were categorized using this scale into no, low, medium, and high HCTD groups. We used ordinal logistic regression and multivariate linear regression analyses to examine the relationships between HCTD, caregiver self-efficacy, caregiver strain (Caregiver Strain Index), and depression (Center for Epidemiological Studies Depression Scale), controlling for patient and caregiver socio-demographic and health factors.

KEY RESULTS

Caregiver age and number of health care tasks performed were positively associated with increased HCTD. The quality of the caregiver’s relationship with the patient, and self-efficacy were inversely associated with increased HCTD. A one-point increase in self-efficacy was associated with a significant lower odds of reporting high HCTD (OR, 0.64; 95% CI, 0.54, 0.77).Adjusted linear regression models indicated that high HCTD was independently associated with significantly greater caregiver strain (B, 2.7; 95% CI, 1.12, 4.29) and depression (B, 3.01; 95% CI, 1.06, 4.96).

CONCLUSIONS

This study demonstrates that greater HCTD is associated with increased strain and depression among caregivers of multimorbid older adults. That caregiver self-efficacy was strongly associated with HCTD suggests health-system-based educational and empowering interventions might improve caregiver well-being.

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Acknowledgments

The authors acknowledge the invaluable contributions to this study made by Johns Hopkins Community Physicians, MedStar, Battelle Centers for Public Health Research, the Centers for Medicare & Medicaid Services, and all of the participating patients, caregivers, physicians, and Guided Care Nurses. An earlier version of the manuscript was presented as a poster at the American Geriatric Society Annual Meeting in Orlando, FL, in 2010

Financial Support

This study was supported by AHRQ 1R21 HS017601-01, NIH T32 A600021 052507, NIMH 5K01MH82885-2, the Robert Wood Johnson Physician Faculty Scholars Program, the Jacob and Valeria Langeloth Foundation, The John A Hartford Foundation, the Agency for Healthcare Research and Quality, the National Institute on Aging, Kaiser-Permanente Mid-Atlantic, Johns Hopkins HealthCare, and the Roger C. Lipitz Center for Integrated Health Care.

Conflict of interest

None disclosed.

Author information

Authors and Affiliations

  1. Division of Geriatrics, Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA

    Erin R. Giovannetti PhD, Jennifer L. Wolff PhD, Qian-Li Xue PhD, Carlos O. Weiss MD, MHS, Bruce Leff MD, Chad Boult MD, MBA, MPH, Travonia Hughes PhD & Cynthia M. Boyd MD, MPH

  2. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21224, USA

    Jennifer L. Wolff PhD, Qian-Li Xue PhD, Bruce Leff MD, Chad Boult MD, MBA, MPH & Cynthia M. Boyd MD, MPH

  3. Johns Hopkins University School of Medicine, Mason F. Lord Buliding, Center Tower, Rm. 710, 5200 Eastern Ave., Baltimore, MD, 21224, USA

    Erin R. Giovannetti PhD

Authors
  1. Erin R. Giovannetti PhD
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  2. Jennifer L. Wolff PhD
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  3. Qian-Li Xue PhD
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  4. Carlos O. Weiss MD, MHS
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  8. Cynthia M. Boyd MD, MPH
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Correspondence to Erin R. Giovannetti PhD.

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Giovannetti, E.R., Wolff, J.L., Xue, QL. et al. Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults. J GEN INTERN MED 27, 37–44 (2012). https://doi.org/10.1007/s11606-011-1831-5

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  • DOI: https://doi.org/10.1007/s11606-011-1831-5

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