Abstract
Few studies have estimated care burden in large, representative, multi-ethnic Asian population-based informal caregivers of older adults with care needs. This study describes informal caregivers' care participation for a population-based sample of older adults with care needs in Singapore, investigates differences by dementia status, and examines correlates of caregivers' burden. Data collected from 693 pairs of older adults, aged 60 to 100 years, having any care needs, and their informal caregivers, who were aged 21 to 88 years, closely involved in their care and "knew the older resident best," and were interviewed during a cross-sectional national survey, were used. Clinical characteristics of older adults, including behavioral and psychological symptoms of dementia (BPSD) and dementia diagnosis, care needs, and socio-demographic characteristics of participants were obtained. Care burden was assessed with the Zarit Burden Interview. Informal caregivers' participation was highest in activities related to communication (35.1%), feeding (32%), and bathing (21.1%). Among the older adults with any care need, 356 (51.4%) had dementia. Care burden was significantly associated with married caregivers (odds ratio (OR) 2.4 vs. never married), when their relative belonged to a younger cohort (OR 2.5 vs. >84 years), needed care much of the time (OR 2.5 vs. no care needed), exhibited BPSD (OR 3.5 vs. no BPSD), and had dementia (OR 2.52 vs. no dementia). Factors related to older adults--more care needs, presence of BPSD, and dementia--were significant contributors to informal caregivers' burden, and these should be considered while planning interventions to alleviate care burden.
Highlights
Older populations typically have multiple medical problems, huge healthcare utilization, require multiple service approaches, and need caregivers to take care of their health and care requirements (Bähler et al, 2015; Huang et al, 2015), all of which impose significant challenges in their management
Informal caregivers’ role varies by the care need of older adults, which often precedes a formal diagnosis of common geriatric illnesses such as stroke or dementia (Prince et al, 2004), and these influence the care burden experienced by caregivers
Consistent with previous studies (Beeri et al, 2002; Sink et al, 2005; Tew et al, 2010; Prince et al, 2012), our study found that the presence of behavioral and psychological symptoms of dementia (BPSD), care need, and dementia in older adults are significant factors contributing to care burden
Summary
Older populations typically have multiple medical problems, huge healthcare utilization, require multiple service approaches, and need caregivers to take care of their health and care requirements (Bähler et al, 2015; Huang et al, 2015), all of which impose significant challenges in their management. With the focus on rehabilitation and managing care in the right setting, such as the community, the role and process of caring for older adults often emerges naturally among families. Informal caregivers of older adults often experience significant long-term burden of care (Prince et al, 2012; Ikeda et al, 2015). Informal caregivers’ role varies by the care need of older adults, which often precedes a formal diagnosis of common geriatric illnesses such as stroke or dementia (Prince et al, 2004), and these influence the care burden experienced by caregivers. Few studies have estimated care burden in large, representative, multi-ethnic Asian populationbased informal caregivers of older adults with care needs. This study describes informal caregivers’ care participation for a population-based sample of older adults with care needs in Singapore, investigates differences by dementia status, and examines correlates of caregivers’ burden
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