Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults
- First Online:
- 316 Downloads
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.
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.
This is a cross-sectional study.
Baseline sample of caregivers to older (aged 65+ years) multimorbid adults enrolled in an ongoing cluster-randomized controlled trial (N = 308).
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.
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).
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.
KEY WORDScaregiver chronic disease self efficacy psychology
- 5.Bookman A, Harrington M. Family caregivers: a shadow workforce in the geriatric health care system? Journal of Health Politics, Policy and Law. 2007;23(6):1005–41.Google Scholar
- 13.Albert SM. Beyond ADL-IALD: recognizing the full scope of family caregiving. In: Levine C, ed. Family caregivers on the job: moving beyond ADLs and IADLs. New York: United Hospital Fund; 2004.Google Scholar
- 22.Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.Google Scholar
- 26.Boyd C, Wolff JL, Giovannetti ER, Reider L, Weiss CO, Xue Q, et al. Difficulty with health care management tasks among multimorbid older adults. JAGS. 2010. 58(s1). Presented at the annual research meeting in Orlando, FL.Google Scholar
- 27.Lorig K, Stewart A, Ritter P, Gonzalez V, Laurent D, Lynch J. Outcome measures for health education and other health care interventions. Thousand Oaks: Sage; 1996.Google Scholar
- 30.Ware J, Kosinski M. SF-36 Physical and Mental Health summary scales: a manual for users of version I. 2nd ed. Lincoln: Quality Metric Inc.; 2001.Google Scholar
- 41.Council on Scientific Affairs, American Medical Association. Physicians and family caregivers: a model for partnership. JAMA. 1993;269(10):1282–4.Google Scholar