Journal of General Internal Medicine

, Volume 26, Issue 5, pp 474–479 | Cite as

Inadequate Health Literacy Among Paid Caregivers of Seniors

  • Lee A. LindquistEmail author
  • Nelia Jain
  • Karen Tam
  • Gary J. Martin
  • David W. Baker
Original Research



Many seniors rely on paid non-familial caregivers to maintain their independence at home. Caregivers often assist with medication reminding and activities of daily living. No prior studies have examined the health literacy levels among paid non-familial caregivers.


To determine health literacy levels and the health-related responsibilities of paid non-familial caregivers of seniors.


One-on-one face-to-face surveys. The Test for Functional Health Literacy (TOFHLA) was administered to identify health literacy levels. Caregivers were asked to demonstrate their skill in medication use by following directions on pill bottles and sorting medications into pill boxes.


Ninety-eight paid unrelated caregivers of seniors recruited at physician offices, caregiver agencies, senior shopping areas, and independent living facilities.


Average age of caregivers was 49.5 years, and 86.7% were female. Inadequate health literacy was found in 35.7% of caregivers; 60.2% of all caregivers made errors with the pillbox test medications, showing difficulty in following label directions. Health-related tasks (i.e., medication reminding, sorting, dispensing, and accompanying seniors to physician appointments) were performed by 85.7% of caregivers. The mean age of their seniors was 83.9 years (range 65–99 years), and 82.1% were female.


Paid non-familial caregivers are essential for many seniors to remain independent and maintain their health. Many caregivers perform health-related duties, but over 1/3 have inadequate health literacy and have difficulties following medication-related instructions. Educating caregivers and ascertaining their health literacy levels prior to assigning health-related tasks may be an important process in providing optimal care to seniors.


caregivers older patients health literacy 



We would like to thank the Barney Family Foundation for their support and funding of this study.

Conflict of Interest

None disclosed.


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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Lee A. Lindquist
    • 1
    • 2
    Email author
  • Nelia Jain
    • 2
  • Karen Tam
    • 2
  • Gary J. Martin
    • 2
  • David W. Baker
    • 2
  1. 1.Division of GeriatricsNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Division of General Internal MedicineNorthwestern University Feinberg School of MedicineChicagoUSA

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