Entitlement of carer's allowance to support home care of persons with Alzheimer's disease: evaluation of current decision criteria.

Abstract

Several countries support family caregivers (FCs) by means of an informal carer's allowance (CA). In this study, we aimed to examine CA entitlement in association with clinical factors related to persons with Alzheimer's disease (AD) and their FCs, provided psychosocial rehabilitation, and the Morbidity index designed to measure regional variations in morbidity and burden. A total of 236 FCs and 236 care recipients (CRs) with AD participated in this prospective longitudinal 5-year follow-up study (ALSOVA). We used generalized estimating equation models to investigate the associations between granting CA and repeated measurements of socioeconomic and clinical characteristics. Over 5years of caregiving, CAs were granted to only 18% of the FCs. CA receipt was significantly associated with the CR having decreased activities of daily living (lower ADCS-ADL, p ≤ 0.001, OR 0.93, 95% CI 0.92-0.94) and increased disease severity (lower Clinical Dementia Rating-Sum of Boxes, p ≤ 0.001, OR 1.40, 95% CI 1.30-1.50). In addition, CAs were more commonly granted in municipalities with higher morbidity rates (p = 0.010, OR 1.03, 95% CI 1.01-1.05), and a 1-year increase in FC age was associated with a 4% increase in the odds of CA receipt (OR 1.04, 95% CI 1.01-1.07). CA receipt was influenced by increased dependency (measured by ADCS-ADL) and disease severity of persons with AD. FCs more commonly received CAs in municipalities with older and less-healthy populations. These findings verified that informal care is supported in accordance with international recommendations.