State of household need for caregivers and determinants of psychological burden among caregivers of older people in Thailand: An analysis from national surveys on older persons.

William Joe,Malee Sunpuwan,Patama Vapattanawong,Marc Völker,Ruttana Phetsitong

doi:10.1371/journal.pone.0226330

Abstract

ObjectivesTo explore the levels and trends of household need for caregivers of older people and to explore the impact of potential determinants of psychological burden among caregivers of older people in Thailand.MethodsThe secondary data analysis was performed using the Survey of Older Persons in Thailand 2007, 2011, and 2014 datasets which conducted by the National Statistical Office of Thailand. The household need for caregivers of older persons refers to having at least one older person in the household who needs a caregiver for assistance with activities of daily living. Caregiver mental health, which is confined to the available 2011 data, is defined as a state of psychological burden. Ordinal logistic regression models were used to explore the impact of potential determinants of psychological caregiver burden.ResultsThe household need for caregivers in Thailand tends to be increasing, from 5.0% in 2007 to 6.6% in 2014. The levels of the household need for caregivers were significantly higher in urban areas, Bangkok, and high socioeconomic households. In terms of psychological caregiver burden, the Thai Mental Health Indicators in 2011 produced, on average, a fair level of mental health, but one-fourth of caregivers had poor mental health. Duration of care for older people, household wealth, and functional dependency significantly predict total caregiver burden. Household characteristics are vital in predicting psychological caregiver burden, and the adjusted effect of the fifth quintile of household wealth was high (odds ratio = 2.34; 95% confidence interval = 1.47–3.73).ConclusionThe increasing need for caregiving in households with an older person can lead to a higher caregiver burden, particularly among those caregivers who care for dependent older people in poor households. Longer duration of caregiving is a factor that mitigates this burden.

Highlights

Since the late 1980s, Thailand has been undergoing an epidemiological transition from communicable to non-communicable diseases
The levels of the household need for caregivers were significantly higher in urban areas, Bangkok, and high socioeconomic households
Household characteristics are vital in predicting psychological caregiver burden, and the adjusted effect of the fifth quintile of household wealth was high

Summary

Introduction

Since the late 1980s, Thailand has been undergoing an epidemiological transition from communicable to non-communicable diseases During this transition, which has been accompanied by demographic aging, more than 70% of Thai older people have had chronic illnesses, and 9.8% have been disabled [1]. Due to these impairments, older persons have had an increasing need for care services. Individual Thai caregivers often need to take care of more than one older family member, a burden that can negatively affect their physical and psychological health, social life, as well as finances of the caregivers. The psychological caregiver burden has been identified as a serious health risk and mortality factor for both caregivers themselves and the older people they care for [3,4]

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