Caregivers Of Elderly Patients Research Articles

The knowledge of memory aging questionnaire (KMAQ) in a Brazilian sample: a questionnaire for informants to recognize early signs of dementia.

The aim of this study was to assess the knowledge about cognition, aging, and dementia as evaluated by the KMAQ in people who are in contact with elderly people, with and without cognitive impairment. A total of 78 relatives and caregivers of elderly patients were classified into two groups: group 1: relatives of patients with dementia (n1=48), and group 2: relatives of patients without cognitive impairment (n2=30). They were asked to answer some questionnaires about dementia, including the KMAQ. Comparing the questionnaire's scores for normal cognitive changes items (g1: 0.53 vs. g2: 0.53, p-value: 0.99) did not show differences between the knowledge in both groups, nor shows the scores for pathological cognitive changes items (g1: 0.55 vs. g2: 0.55, p-value: 0.969). It seems that being in contact with dementia does not improve knowledge about it. Knowledge of normal changes in cognition could make it possible to recognize "red flags" suggestive of neurodegenerative processes, allowing for earlier diagnosis and more options for treatment.

Assessment of Anxiety and Burden on caregivers for haemodialysis patients in southern Punjab, Pakistan

The aim of present study is to assess anxiety and depression experienced by unpaid caregivers of chronic haemodialysis patients suffering from end-stage renal failure (ESRF). The evaluation of factors influencing anxiety and depression and care-giving burden was performed. In the present study, non-paid primary caregivers (218 study participants) of patients with ESRF receiving haemodialysis, who were providing care (minimum 6 months and up to 5 years) were interviewed by using Aga Khan University Anxiety and Depression Scale (AKUADS) and the carer’s burden of peritoneal dialysis patients (CSCDP) questionnaire. According to the scoring of AKUADS, 90.4% caregivers were found to be experiencing significant anxiety and depression. From assessment of demographic factors collected using the AKUAD scale, it was found that female gender was more in number (44%), wedded (72.01%), with a mean life span of 38.5 ± 2 (SE) years, and having monthly income below average. The main relationships of caregivers with patients, was life partners (38%) and parents (18.2%). The highest depression levels were found in mothers as attendants (67%), caregivers of age less than 30 years (22 %) and caregivers of elderly patients (87%). The outcome of this study has revealed a need to plan policies to support unpaid caregivers as well as the patients

The Effects of Stigma on the Caregivers of Elderly Patients With Psychiatric Issues in a Chinese Community

World Health Organization in 2017 indicates the proportion of persons over the age of 60 years will exponentially grow from 12% in 2015 to 22% in 2050. Advanced age is a common risk factor for multiple conditions, including psychosis, depression, and other mental illnesses linked to cognitive and neurologic disorders. The majority of the studies identify ethnicity and socioeconomic status as primary determinants of mental health care access. Recent studies show that up to 12% of elderly Chinese have had a history of mental problems. However, over 50% of Chinese with mental disorders have failed to obtain professional help. Lack of access to health care for mental disorders has been linked to multiple underlying socioeconomic and cultural factors. These Chinese Americans lack an in-depth understanding of their psychosis, and psychiatric conditions are often a minority in nature. This study will systematically review the existing situations relating the factors to the stigma on caregivers. The result shows that the leading cause of psychiatric disorders, physical and emotional components of the elderly population, needs to be incorporated in the care plan in nursing homes and hospitals. In North America, the constant perception of discrimination and the inherent feeling of isolation and stigma among families with elderly members remains challenging. This review could contribute to the policy reform, which can help design effective control strategies to manage gaps of most mental disorders that continue to disproportionately affect different ethnic groups across the U. S. and Canada.

Factors Associated with the Caregiving Burden of the Primary Caregivers of Elderly Patients Undergoing Peritoneal Dialysis

Factors Associated with the Caregiving Burden of the Primary Caregivers of Elderly Patients Undergoing Peritoneal Dialysis

Factors associated with the burden of family caregivers of elderly patients with femoral neck fracture: a cross-sectional study

BackgroundThis study aimed to study the factors associated with caregiver burden among caregivers of elderly patients with femoral neck fracture.MethodsThis cross-sectional study was based on a non-probabilistic sampling of 183 elderly postoperative patients (aged 65 years or older) with femoral neck fracture who were hospitalized in the orthopedic center in our hospital and their family caregivers. Data were collected from January 2016 to June 2019. Patients and family caregivers completed the sociodemographic questionnaire. The Social Support Rating Scale (SSRS), the General Self-Efficacy Scale (GSE), and the Chinese version of the Zarit Burden Interview (ZBI) were used to evaluate social support, self-efficacy, and caregiver burden, respectively. By analyzing the clinical data of patients and family caregivers and combining the factors that affect the caregiver burden in parallel studies, we selected the factors that affected the caregiver burden in this study and conducted a multivariate analysis of these factors. P < 0.05 was considered statistically significant.ResultsWe observed 176 caregivers aged 69.28 ± 7.19 years old, among whom 52.3% were male, 58.0% lived in the city, 84.0% were spouses of the patients, and 67.0% had a primary school educational background. The ZBI score of the family caregivers was 37.8 ± 8.9, and 82.7% of the caregivers were under a moderate to severe burden. The patient’s functional status, Harris score, and pain score and the caregiver’s SSRS scores, GSE scores, and the ratio of medical expenses to monthly income per capita were factors that affected the caregiver burden.ConclusionsMost family caregivers of elderly patients with femoral neck fracture are subject to a considerable care burden, and social support and self-efficacy intervention are conducive to reducing the caregiver burden.

Quantifying Burden among Caregivers of Elderly Patients with Heart Failure

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.

A qualitative research on the nutritional care experience of primary caregivers in elderly patients with pressure injury in outpatients

Objective To explore the experience of nutritional care provided by the main caregivers of elderly patients with pressure injury in outpatients. Methods Semi-structured, in-depth interviews were conducted on 15 main caregivers of elderly patients with pressure injury in outpatient by the purposive sampling method. Data was analyzed by Colaizzi content analysis. Results Seven themes were identified, including multiple troubles in nutritional care, lack of awareness of the relationship between nutrition and pressure injury, poor knowledge of nutritional care, unreliable ways to obtain the knowledge, poor attitude towards nutritional care, poor nutritional care behaviors, and differences in nutritional care needs. Conclusion Health care providers should value the evaluation of patients' eating ability and behavior, provide more learning approaches, change their attitude, improve the nutritional care behavior, and, if necessary, cooperate with nutritionists to provide targeted nutrition education, and establish effective family and social support systems. Key words: Pressure injury/pressure ulcer; Primary caregivers; Nutritional care; Aged; Qualitative research

A pilot study assessing the burden of caregivers of elderly patients at University College Hospital UCH.

12 Background: Caregiver burden is defined as “the perception of stress and fatigue caused by the sustained effort required in caring for persons with chronic illness or other conditions with special needs for care”. It is a type of stress or strain experienced by caregivers, which is directly/ indirectly related to the challenges/problems they face as a result of the health status of the person cared for. Stucki et al. 2000, described the carers burden as “strain or load borne by a person who cares for a chronically ill, disabled, or elderly family member”. Caregiver burden is response to physical, psychological, emotional, social, and financial stressors associated with the caregiving in a multidimensional way. It is the psychosocial and physical reaction to the imbalance of demands placed on the caregiver by various factors, including personal time, multiple roles, physical and emotional states, financial resources, and formal care resources. The caregiver's perception of the burden, rather than the perception of other family members or healthcare providers, determines the impact of this burden on his or her life. Methods: Caregivers of elderly patients attending the geriatric and medical outpatient’s clinics at UCH completed a caregiver strain index scale, over a 2 month period. Demographic information regarding gender, age, were obtained and scaled questions were ticked. Data was analysed using IBM SPSS statistics 21. Results: Eighty-five participants completed the caregiver strain index scale. The socio-demographic data described age and gender. Most participants fell in the 31 - 40 and 41 - 50 age groups (41.2% for each group). Fifty-eight (68.2%) were females while 27 (31.8%) were males. Most common strain variable was demand on time with percentage 54.1% (46). Twenty-nine (34.1%) had moderate level of stress (4 - 6) , while 32 (37.6%) had mild level of stress, and 17 (20.0%) had high level of stress. One participant had the highest score index was 11 while 13 (15.3%) had scores of 3 and 13 (15.3%) had scores of 5. Conclusions: The study showed that caregivers of elderly patients have high burden in the demand on their time and need supportive/collaborative systems which includes palliative care to help with the task of caring for these elderly ones.

Caregiver Out-of-Pocket Costs for Octogenarian Intensive Care Unit Patients in Canada.

ABSTRACTMedical issues facing the aging population are of growing concern with consequences for patients and their caregivers. This study determined the indirect and out-of-pocket costs incurred by the caregivers of elderly patients in Canadian Intensive Care Units (ICUs). Primary family caregivers were surveyed capturing out-of-pocket costs, hours of work, and hours of leisure forgone in providing patient care while the patient was in the ICU. Total costs of care per month were reported across caregiver sex, age, and geographic region. Average out-of-pocket costs were $791 (2016 Canadian dollars) in the first month of ICU care. The mean total cost to family caregivers per patient was $162 per day. Male primary caregivers had higher mean out-of-pocket costs than female caregivers. Subsidization programs covering expenses such as travel, meals, accommodation, and parking are needed to support family caregivers of elderly ICU patients who are incurring considerable out-of-pocket costs.

Caring ability of family caregivers of patients on cancer treatment: associated factors.

ABSTRACTObjective:To analyze the association between the caring ability of family caregivers of patients on cancer treatment with the demographic and clinical characteristics of the patients, as well as the sociodemographic characteristics of the caregivers and of the care provided. Methods:A cross-sectional study was conducted with 132 family caregivers of patients on cancer treatment whose data were collected through the Brazilian version of the Caring Ability Inventory and questionnaires characterizing patients, caregivers and the care provided. Student’s t, Mann-Whitney or Kruskal-Wallis tests were used at the significance level ≤5%. Results:Patients’ age was significantly associated with overall caring ability (p = 0.002) and the caregiver’s dimensions courage (p = 0.006) and patience (p = 0.009). Caregivers’ education was associated with overall caring ability (p = 0.028) and the dimensions courage (p = 0.008) and patience (p = 0.045). Marital status was associated with the overall caring ability (p = 0.020); and the patience dimension (p = 0.045) and the time providing care with the patience dimension (p = 0.027). Conclusion:Caregivers of elderly patients who have higher schooling and do not have a partner demonstrate greater caring ability.

Between State, society and family: the care of female caregivers.

to investigate the care provided by family female caregivers of elderly dependents who have been monitored by public home care and its social repercussions, discussing the facets between State, society and families. descriptive cross-sectional study, with 45 caregivers of elderly patients accompanied by Home Care Services. Data were collected by means of a structured script. The discussion was elaborated in light of the works "Cuidado e cuidadoras: as várias faces do trabalho do 'care'" (Care and female caregivers: the several faces of the care work) and "Gênero e trabalho na França e no Brasil" (Gender and work in France and Brazil). Most caregivers were women (95%) who performed home care at several places and incorporated hospital equipment into everyday life. They have been caregivers for four and a half years, working 18 hours a day on average; they presented average age of 55 years; 82% were ill, and 43% had no income. the study demonstrated the relevance of the care of female caregivers to society as well as their invisibility to public health and social policies.

Quality of life and depression in caregivers of patients with cancer

BackgroundMost elderly patients, with cancer are cared for, by a family member who may be affected by various stressors that can influence their health and quality of life (QOL).ObjectivesTo explore depression, quality of life and its related factors among caregivers of elderly patients with cancer.MethodologyThis is a descriptive and analytical cross-sectional study including 40 primary caregivers of old patients aged 65 or older, with cancer in oncologic radiotherapy service in university hospital Habib Bourguibain Sfax, Tunisia. The short form health survey (SF-36) and Beck inventory (13 items) were used to assess respectively QOL and depression.ResultsThe average age of caregivers was 44.62 years. The sex ratio (M/F) was 0.9. Most of caregivers (75%) had impaired QOL (score ˂ 66.7). The two main components of SF-36 were altered with a standard score of 45 for the physical component and 41.1 for mental component. According to Beck inventory, Depression was present in 67.6% of cases. Impaired QOL of life was significantly correlated with somatic illnesses in the caregiver (P = 0.016), advanced stage of cancer (P = 0.01), financial difficulties (P = 0.04), the non-cohabitation with the patient before the disease (P = 0.031) and depression (P = 0.00).ConclusionAccording to our study, caregiving can have a negative effect on the caregiver's mental and physical health. Assistance and information from healthcare professionals are the key to improving the ability of caregivers to cope with caring for older patients with cancer.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Investigation of the factors affecting the burden on caregivers of elderly patients with urinary incontinence: a cross-sectional study in Greece

Purpose: Population ageing is directly associated with the occurrence of diseases related to old age, such as urinary incontinence. This does not only aggravate the quality of life of elderly patients, but is also an important element that affects the mental health and quality of life of their caregivers. The purpose of the study is to assess the degree of burden experienced by caregivers of elderly patients with incontinence in a Greek community of the prefecture of Magnesia. Methodology: During the period 02/2013-04/2014, we selected 300 caregivers, who were divided into three groups. Group I consisted of 100 caregivers of elderly patients with various diseases besides urinary incontinence, Group II of 100 caregivers of elderly patients who had urinary incontinence effectively treated with medication, and group III of 100 caregivers of elderly patients with severe untreated incontinence. The survey used the Zarit questionnaire. Results: In groups I and II, about half of the sample experienced a “moderate to severe burden”. In group III, the majority of caregivers experienced a severe burden (37%). The mean values of the total degree of burden differ significantly among the three groups ( p = 0.024). Conclusion: The study highlighted the need for psychosocial and financial support for caregivers of patients with incontinence, to reduce the burden they experience. Σκοπός: Η πληθυσμιακή γήρανση συνδέeται άμeσα μe την eμφάνιση ασθeνeιών που συνδέονται μe την τρίτη ηλικία, όπως η ακράτeια ούρων. Αυτή δeν eπιβαρύνeι μόνο την ποιότητα ζωής των ηλικιωμένων ασθeνών, αλλά ταυτόχρονα αποτeλeί σημαντικό στοιχeίο που eπιδρά στην ψυχική υγeία και την ποιότητα ζωής των φροντιστών των ασθeνών αυτών. Σκοπός της μeλέτης eίναι η eκτίμηση του βαθμού eπιβάρυνσης που βιώνουν οι φροντιστές ηλικιωμένων ασθeνών μe ακράτeια σe μία eλληνική κοινότητα του νομού Μαγνησίας. Μeθοδολογία: Κατά το χρονικό διάστημα 02/2013 - 04/2014 eπιλέχθηκαν 300 φροντιστές οι οποίοι χωρίσθηκαν σe τρeις ομάδeς. Η ομάδα Ι πeριeλάμβανe 100 φροντιστές ηλικιωμένων μe διάφορeς παθήσeις eκτός ακράτeιας ούρων, η ομάδα ΙΙ 100 φροντιστές ηλικιωμένων που παρουσίαζαν ακράτeια ούρων η οποία αντιμeτωπιζόταν αποτeλeσματικά μe φαρμακeυτική θeραπeία, και στην ομάδα ΙΙΙ φροντιστές 100 ηλικιωμένων μe σοβαρού βαθμού ακράτeια που δeν αντιμeτωπιζόταν. Στην έρeυνα χρησιμοποιήθηκe το eρωτηματολόγιο Zarit. Αποτeλέσματα: Στις ομάδeς Ι και ΙΙ πeρίπου οι μισοί βίωσαν «μέτρια έως σοβαρή eπιβάρυνση». Στην ομάδα ΙΙΙ το μeγαλύτeρο ποσοστό των φροντιστών παρουσίασe υψηλού βαθμού eπιβάρυνση (37%). Οι μέσeς τιμές ως προς το συνολικό βαθμό eπιβάρυνσης στις τρeις ομάδeς διαφέρουν στατιστικά σημαντικά μeταξύ τους ( p = 0,024). Συμπέρασμα: Η μeλέτη ανέδeιξe την ανάγκη ψυχοκοινωνικής και οικονομικής στήριξης των φροντιστών ασθeνών μe ακράτeια, ώστe να μeιωθeί η eπιβάρυνση που υφίστανται.

CARE OF THE ELDERLY WITH ALZHEIMER'S FAMILY CAREGIVER: A UNIVERSITY EXTENSION ACTIVITY

ABSTRACT An academic experience report of the university extension project: Mutual Help Group for Relatives of Elderly Living with Alzheimer's or Related Diseases. Alzheimer's is a progressive neurodegenerative disease, which is part of the group of dementias, being characterized by the deterioration of the mental functions resulting in cognitive impairment. Therefore, the family caregivers of elderly patients with Alzheimer's needs care and guidance to promote management and care for themselves and for the patients. It is important to involve health professionals in this scenario, especially nurses, acting directly in the health education process. Thus, the academic involvement in the extension project enriches the college education based on the contact with a certain community and, in this context, provides for further interaction with the complexity involving families and elderly people with Alzheimer's.

Effectiveness of coping strategies intervention on caregiver burden among caregivers of elderly patients with dementia.

Coping strategies are a potential way to improve interventions designed to manage the caregiver burden of dementia. The purpose of this study was to develop an intervention targeted towards improving coping strategies and to examine its effectiveness on reducing caregiver burden. A controlled study design was used. Fifty-seven caregivers of dementia patients were enrolled. Coping strategies were assessed with the Revised Ways of Coping Checklist (WCCL-R) and caregiver burden was assessed with the Chinese version of the Caregiver Burden Inventory. The participants were randomly divided into two groups. The intervention group was offered a series of five interventions in which problem-solving skills, knowledge of dementia, social resources, and emotional support were taught every 2 weeks, and the control group was telephoned every 2 weeks for the usual clinical management. Two weeks after the end of the intervention, we again administered the WCCL-R and the Caregiver Burden Inventory. Two-way repeated-measure anova was used to evaluate the changes in coping strategies and caregiver burden. Forty-six participants completed the study. No statistically significant differences were noted in the demographic data between the two groups. On the problem-focused coping subscale on the WCCL-R, the intervention group's mean score increased by 3.8 points, and the control group's decreased by 5.1 points (F = 7.988, P = 0.007). On the seeking social support coping subscale on the WCCL-R, the intervention group's mean score increased by 3.8 points, and the control group's decreased by 3.1 points (F = 4.462, P = 0.04). On the Caregiver Burden Inventory, the intervention group's mean score decreased by 7.2 points, and the control group's increased by 2.2 points (F = 6.155, P = 0.017). Psychosocial intervention can help caregivers to adopt more problem-focused and social support coping strategies, which are beneficial in terms of reducing the caregiver burden.

Effect of specific training on the nursing ability of caregivers for elderly living at home with nasal feeding

Objective To explore the effect of specific training on the nursing ability of caregivers for elderly living at home with nasal feeding .Methods Sixty-three caregivers for elderly patients with nasal feeding in the hospital were chosen and were divided into the control group （ n=32 ） and the intervention group （ n=31） according to the hospital stays .The control group received the routine health education of nursing of nasal feeding, and the intervention group received the special training of nursing of nasal feeding .The score of the nursing ability of caregivers , and the incidence of tube taking off and complication within three months after the discharge were compared between two groups .Results No difference was found in the score of nursing ability of caregivers between two groups before the intervention （P〉0.05）.The score of nursing ability of caregivers in the intervention group at the time of discharge was （71.45 ±10.99）, and was higher than （56.79 ±7.31） in the control group, and the difference was statistically significant （t =5.288, P 〈0.01）.The cases of the occurrence of tube taking off and complication within three months after the discharge in the intervention group were respectively 2, 10 cases, and were lower than 9, 20 in the control group, and the differences were statistically significant （χ2 =5.132, 5.773, respectively;P〈0.05）.Conclusions The specific training can improve the nursing ability of caregivers for elderly living at home with nasal feeding . Key words: Elderly; Health education; Nursing of nasal feeding; Nursing ability; Special training

EPA-0740 – Delirium screening using the family confusion assessment method (fam-cam): preliminary results of portuguese validation study

Introduction The Family Confusion Assessment Method (FAM-CAM), derived from the original Confusion Assessment Method (CAM), was recently developed to screen for delirium by interviewing family caregivers. Aim to present the preliminary results of the Portuguese version of FAM-CAM. Methods The translation process of FAM-CAM was carried out, according to ISPOR guidelines, with trained researchers. After that, a pilot-study was carried out with a sample of families and/or caregivers of elderly patients hospitalized (≥48 hours), in an intermediate care unit of Critical Care Service/CHSJ. Inclusion criteria were: patient knowledge to enable reporting on his/her mental and physical abilities and staying at patient's bedside daily during hospitalization. Families/caregivers aged less than 18 years and who did not speak Portuguese were excluded. All patients were assessed by DSM-IV-TR (reference standard) and by CAM. The FAM-CAM was administered to the families and/or caregivers, by a trained researcher. Results The sample included 40 families/caregivers (59% adult children). According to the DSM-IV-TR, 20.5% of patients had delirium. FAMCAM had a moderate sensitivity (75%) and a good specificity (87%) when were assessed against to DSM-IV-TR. Compared with CAM, this instrument presented a better sensitivity (86%) and specificity (90%). Conclusion These preliminary results suggested that FAM-CAM appears as a sensitive screening tool for detection of delirium in elderly hospitalized patients, using observations of family caregivers. However, future studies with larger samples will be needed to further validate these results and to analyze other psychometric proprieties. The present work was supported by Foundation for Science and Technology/FCT ( SFRH/BD/63154/2009 ).

Social Representation of Dementia and Its Influence on the Search for Early Care by Family Member Caregivers.

Social representations (SRs) contain 3 dimensions: information, attitude, and field. These affect the recognition of the first symptoms of dementia by the patient's caregiver. This study focused on the period from the first signs of cognitive difficulties to the diagnosis of dementia. Eight caregivers of elderly patients with dementia were interviewed to construct their SRs regarding dementia and how this influences seeking medical treatment during the first stages of the disease. Social representations were analyzed through a structural focus, based on the content analysis. Decision making is related to knowledge about dementia, attitude (emotions and sensitivity), and the concept of the caregiver about the relative with dementia. The results confirm the importance of the symbolic dimension of personal experience in managing care and seeking medical treatment. The presence of dementia in the family creates interpersonal dilemmas that caregivers experience. The solutions are framed in the sociocultural context.

Economic burden to primary informal caregivers of hospitalized older adults in Mexico: a cohort study

BackgroundThe burden of out of pocket spending for the Mexican population is high compared to other countries. Even patients insured by social security institutions have to face the cost of health goods, services or nonmedical expenses related to their illness. Primary caregivers, in addition, experience losses in productivity by taking up responsibilities in care giving activities. This situation represents a mayor economic burden in an acute care setting for elderly population. There is evidence that specialized geriatric services could represent lower overall costs in these circumstances and could help reduce these burdens.The aim of this study was to investigate economic burden differences in caregivers of elderly patients comparing two acute care services (Geriatric and Internal Medicine). Specifically, economic costs associated with hospitalization of older adults in these two settings by evaluating health care related out of pocket expenditures (OOPE), non-medical OOPE and indirect costs.MethodsA comparative analysis of direct and indirect costs in hospitalised elderly patients (60-year or older) and their primary informal caregivers in two health care settings, using a prospective cohort was performed. Economic burden was measured by out of pocket expenses and indirect costs (productivity lost) due to care giving activities. The analysis included a two-part model, the first one allowing the estimation of the probability of observing any health care related and non-medical OOPE; and the second one, the positive observations or expenditures.ResultsA total of 210 subjects were followed during their hospital stay. Of the total number of subjects 95% reported at least one non-medical OOPE, being daily transportation the most common expense. Regarding medical OOPE, medicines were the most common expense, and the mean numbers of days without income were 4.12 days. Both OOPE and indirect costs were significantly different between type of services, with less overall economic burden to the caregivers of elderly hospitalized in the geriatric unit. The final model showed that type of service and satisfaction had the largest coefficients (-0.68 and 0.662 respectively, p<0.001).ConclusionsThis study allowed us to identify associated factors of economic burden in elderly hospitalized in acute care units. It opens as well, an issue that should not be overlooked in framing public policies regarding elderly health care.

Adaptação transcultural da Dementia Management Strategies Scale ao português brasileiro

O presente estudo tem por objetivo apresentar a adaptação transcultural da Dementia Management Strategies Scale ao português brasileiro. Essa escala foi desenvolvida para verificar a frequência do uso de três tipos de estratégias de gerenciamento da demência, utilizadas por familiares cuidadores de idosos: crítica, gerenciamento ativo e encorajamento. Participaram do processo de adaptação 3 tradutores, 100 juízes não especialistas, 5 juízes especialistas e 15 cuidadores. Os procedimentos utilizados foram duas traduções independentes, elaboração de uma versão síntese das duas traduções, avaliação do instrumento pelos juízes e, por fim, a condução de estudo piloto com 15 cuidadores de idosos com demência do tipo Alzheimer. Após as adaptações realizadas em todas as etapas do processo de adaptação transcultural, constatou-se equivalência satisfatória entre as versões.