Quantifying Burden among Caregivers of Elderly Patients with Heart Failure

Abstract

Background Heart failure (HF) patients (Pts) rely on caregivers (CGs) for assistance in many aspects of their care. While CG burden has been studied in Pts with other chronic diseases, that among CGs of HF Pts is largely unexplored. We sought to quantify CG stress to explore whether CG burden correlates with physical and emotional disability of the HF Pt. Methods Pairs of Pts and their CGs were surveyed. CG stress was assessed using the Zarit Burden Interview (ZBI) questionnaire. HF Pts disability was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Demographic data was also collected. Surveys were coded to assure that a given Pt was matched to their CG. A total of 24 paired Pts and CGs participated. Results We observed no correlation between the CG ZBI score (higher score associated with greater burden) and the MLHFQ scores. Moreover, no correlations were observed between CG burden and CG age, income, hours spent per week, or number of CGs available. Interestingly, we identified a significant inverse correlation (r=-0.449, p=0.032) between CG burden and the CG's number of children. In addition, a significant correlation existed between CG burden and Pt age (r=0.5, p=0.025), with a non-significant correlation between CG burden and the HF duration (r=0.39, p=0.08). These variables were additive: the sum of Pt age and HF duration correlated well with CG burden (r=0.61, p Conclusions These data support that causes of CG burden are complex and not driven solely by severity of Pt symptoms assessed by the MLHFQ. The significant correlation between CG burden and Pt age + HF duration, perhaps reflecting overall Pt disability, supports that these contribute importantly to CG burden. The inverse correlation between CG stress and number of children may reflect greater emotional and/or logistical support for the CG. A better understanding of factors contributing to CG burden will improve the ability of HF providers to ameliorate CG stress leading to improved quality of life among HF Pts and their families.