Impact Of Family Caregiving Research Articles

The Role of Family Caregivers and Inappropriate Medication Use in the Community-Dwelling Older Adults with Dementia

Evaluation of: Thorpe JM, Thorpe CT, Kennelty KA, Gellad WF, Schulz R. The impact of family caregivers on potentially inappropriate medication use in noninstitutionalized older adults with dementia. Am. J. Geriatr. Pharmacother. 10(4), 230–241 (2012). The risk of potentially inappropriate medication (PIM), both prescription and over-the-counter use, in dementia patients is high. Informal caregivers often facilitate patients’ use of medications, but the effect of caregiver factors on PIM use has not been a focus of previous research. The aim of this study was to examine PIM use in dementia patients and caregivers, and identify caregiver risk factors for PIM use in dementia patients. The authors conducted a secondary data analysis of the baseline wave of the Resources for Enhancing Alzheimer’s Caregiver’s Health study. The sample comprised 566 persons with dementia aged 65 years and older and their co-residing family caregiver. PIM was defined using the 2003 Beers criteria and was examined in both dementia patients and their caregivers. Caregiver and patient risk factors included a range of sociodemographic and health variables. In dementia patients, 33% were taking at least one PIM and 39% of their caregivers were also taking a PIM. In fully adjusted models, the following caregiver factors were associated with an increased risk of dementia patient PIM use: caregiver’s own PIM use, spouse caregivers, Hispanic caregivers and greater number of years that the caregiver has lived in the USA. Increased caregiver age was associated with a decreased risk of PIM use in patients. PIM use may be higher in dementia patients and their informal caregivers compared with the general older adult population. Furthermore, patterns of medication use in one member of the dyad may influence PIM risk in the other dyad member. These results suggest that interventions to increase appropriate medication use in dementia patients and their caregivers should target both members of the dyad and target over-the-counter agents along with prescription medications.

The Impact of Family Caregivers on Potentially Inappropriate Medication Use in Noninstitutionalized Older Adults With Dementia

BackgroundThe risk of potentially inappropriate medication (PIM), both prescription and over-the-counter, use in dementia patients is high. Informal caregivers often facilitate patients' use of medications, but the effect of caregiver factors on PIM use has not been a focus of previous research. ObjectiveThe aim of this study was to examine PIM use in dementia patients and caregivers and identify caregiver risk factors for PIM use in dementia patients. MethodsWe conducted a secondary data analysis of the baseline wave of the Resources for Enhancing Alzheimer's Caregiver's Health study. The sample comprised 566 persons with dementia aged 65 and older and their coresiding family caregiver. PIM was defined using the 2003 Beers criteria and was examined in both dementia patients and their caregivers. Caregiver and patient risk factors included a range of sociodemographic and health variables. ResultsIn dementia patients, 33% were taking at least 1 PIM, and 39% of their caregivers were also taking a PIM. In fully adjusted models, the following caregiver factors were associated with an increased risk of dementia patient PIM use: caregiver's own PIM use, spouse caregivers, Hispanic caregivers, and greater number of years that the caregiver has lived in the United States. Increased caregiver age was associated with a decreased risk of PIM use in patients. ConclusionsPIM use may be higher in dementia patients and their informal caregivers compared with the general older adult population. Further, patterns of medication use in 1 member of the dyad may influence PIM risk in the other dyad member. These results suggest that interventions to increase appropriate medication use in dementia patients and their caregivers should target both members of the dyad and target over-the-counter agents along with prescription medications.

177: LVAD Therapy: Impact of Family Caregivers' Stress, Coping, Social Support on Perceived Burden & Quality of Life (QOL)

No prospective quantitative evaluation of perceived family caregiver burden and QOL and its influencers has been performed in LVAD caregivers. The purpose of this study was to gain a better understanding of their experience over time and to identify point(s) at which the LVAD team can focus support on those caregivers.

Perceptions of economic hardship and emotional health in a pilot sample of family caregivers.

Although several studies have quantified costs of cancer care; none to date have examined how cancer costs impact family caregivers' emotional health. This study was designed to evaluate how perceptions of economic hardship influence burden, depressive symptoms, and anxiety in family caregivers of persons with a primary malignant brain tumor. Caregiver (CG)/patient dyads (n = 33) were recruited at the time of diagnosis; data were collected at diagnosis and 4 months, and linear regression determined the impact of economic hardship on caregivers' emotional health. Economic hardship did not predict CG burden-schedule at diagnosis or 4 months. Economic hardship predicted burden-abandonment at diagnosis (P < 0.01), but not 4 months. There was a trend for economic hardship to predict CG depressive symptoms at 4 months (P = 0.09), but not at diagnosis. Economic hardship predicted CG anxiety at 4 months (P = 0.06), but not diagnosis. Results suggest caregivers' economic hardship is an important and dynamic aspect of the emotional health of neuro-oncology family caregivers.

Predictors of Dyadic Relationship Quality of Women in Substance Abuse Treatment

ABSTRACT Objectives: The quality of relationship between family caregivers and care recipients with dual disorders can impact care recipients' well-being and treatment outcomes as well as caregivers' well-being and involvement in care. This paper examines the impact of caregiver stressors and well-being on relationship quality of family caregivers of women with substance use disorders or co-occurring substance and mental disorders. Methods: Eighty-two women receiving in-patient or out-patient substance abuse treatment and the family member/significant other, nominated by each woman, who provided her with the most social support, were interviewed in this nonexperimental cross-sectional study. A stress-coping model was utilized to identify the impact of family caregivers' stressors (care recipient behavioral, substance abuse, and mental health problems) and caregiver well-being (burden and depressive symptomatology) on caregivers' perceptions of the quality of their relationship with their care recipient. Results: Findings from multiple regression analyses, across four types of caregiver well-being, show that greater perceived support to the caregiver was predicted by fewer perceived care recipient substance abuse problems, whereas higher levels of undermining of the caregiver was predicted by greater care recipient behavioral problems and by the family caregiver being a significant other of the care recipient. Care recipient classification as having a current dual disorder as compared to a current substance use disorder only was not a significant predictor of perceived support given to the caregiver or of perceived undermining of the family member. Conclusions: The findings suggest interventions for family caregivers need to be tailored to address different and possibly multiple groups of caregivers, specific types of stressors, and care recipient behavioral problems.

Current Status and Future Directions in Family Caregiving and Aging People with Intellectual Disabilities

Abstract Family caregiving is increasingly recognized as an important clinical and public policy issue across diverse age groups, and for care recipients with varying physical and mental impairments. While families provide extensive care for aging individuals with intellectual disabilities (ID), family issues directly related to the aging of persons with ID have been understudied. We review major findings in the broader literature on the impact of family caregiving on the caregiver, and the existing research on aging, caregiving, and ID. Aging caregivers for people with ID may be at special risk because of age‐related health and behavioral declines in the aging care recipient and caregiver, the extensive duration of the caregiving role, and concerns about the long‐term care of the care recipient. Balancing these concerns are the normative nature of parental caregiving, and expertise and sense of mastery possibly gained by long‐term caregivers, which may serve to offset the wear and tear of years of caregiving and additional strains of aging. Topics deserving greater attention in future research on caregiving, aging and ID include longitudinal studies of caregiver adaptation, racial/ethnic diversity issues, and assessment of the mental health, physical health, social, and economic impacts on caregivers compared with non‐caregiving age‐matched controls. Intervention studies are also needed to identify evidence‐based interventions to support family caregivers.

Concerns of family caregivers of patients with cancer facing palliative surgery for advanced malignancies.

To describe the concerns of family caregivers of patients undergoing palliative surgeries for advanced malignancies. Descriptive study with repeated measures. A National Cancer Institute-designated Comprehensive Cancer Center in the western United States. Family caregivers (N = 45) of patients with cancer. Family caregivers were assessed prior to planned palliative surgery and at two weeks and six weeks postsurgery. Quantitative assessment of caregiver quality of life (QOL) occurred at each interval. A subset of nine caregivers also participated in a structured interview presurgery and at two weeks postsurgery. Caregiver concerns, QOL, decision making. Family caregivers have important QOL concerns and needs for support before and after surgery for advanced disease. Psychological issues were most pronounced, and common concerns included uncertainty, fears regarding the future, and loss. Family caregivers have concerns about surgical risks and care after surgery and voiced recognition of the declining status of patients. Surgery is an important component of palliative care and profoundly impacts family caregivers of patients with cancer. The needs of family caregivers are multiple and complex, requiring ongoing assessment to provide interventions that help them cope and ultimately improve their QOL. This important topic requires further research and clinical attention. Findings suggest that family caregivers experience their own trajectory during the course of their loved ones' cancer, with surgery being a part of the course. This includes their profound emotions that may swing like a pendulum from one minute to the next. Nurses need to assess family caregivers in addition to patients to provide support and resources that will help increase caregivers' QOL.