Evaluation of Carer Strain and Carer Coping with Medications for People with Dementia after Discharge: Results from the SMS Dementia Study.

Remia Bruce,Andrew Searles,Christopher Oldmeadow,Anne Fullerton,Ashley Kable,Carolyn Hullick,Dimity Pond,John Attia,Samantha Fraser,Rod Ling,Kerrin Palazzi,Wendy Murdoch

doi:10.3390/healthcare8030248

Remia Bruce, Andrew Searles + Show 10 more

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https://doi.org/10.3390/healthcare8030248

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Abstract

This study reports carer strain and coping with medications for people with dementia with an unplanned admission to hospital, and it evaluates the impact of a safe medication intervention on carer coping and carer strain. This was a quasi-experimental pre/post-controlled trial that included a survey of carers about managing medications for people with dementia after discharge. For 88 carers who completed surveys, 33% were concerned about managing medications, and 40% reported difficulties with medication management, including resistive behaviours by people with dementia. Dose administration aids were used by 72% of carers; however, only 15% reported receiving a recent home medicines review by a community pharmacist. High carer strain was reported by 74% of carers. Carer comments described many issues that contributed to high carer stress, as well as their engagement in vigilant activities to maintain medication safety. Strategies that can contribute to carers managing medications and reducing their strain include an increased use of dose administration aids, increased provision of home medicines reviews, and increased education of health professionals to provide adequate support and education about managing medications.

Highlights

In 2017, it was estimated that there were 196,491 carers of people with dementia in the community in Australia, and most of them were informal carers [1]
There were 156 carers who consented to participate in the carer post-discharge telephone survey, which is a consent rate of 29.8% from 523 people with dementia who were admitted from home
Carers in this study reported having a good understanding of the indications for medications for people with dementia, using dose administration aids (DAAs) to manage medications and receiving good support from primary health care clinicians

Summary

Introduction

In 2017, it was estimated that there were 196,491 carers of people with dementia in the community in Australia, and most of them were informal carers [1]. The burden of this disease is associated with significant disability and premature mortality [1], and carers/caregivers adopt a substantial role in managing the health needs of their loved ones and coordinating their care [2]. Wales (NSW) Carers (Recognition) Act amended in 2017 defines a carer as a person who provides ongoing and unpaid support to people with disability, terminal illness, chronic illness, mental illness, dementia, or ageing [3], which identifies them as informal carers. In Australia, one in four people with dementia are reported to be admitted to hospital each year [10]

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