Family caregivers

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Not to be confused with Personal Care Assistant.
See also: Caregiver, Carers rights movement, Caregiving and dementia, and Long-term care

Family caregivers provide a wide variety of services to care recipients: administering medications and physical therapy, assisting with daily tasks, meeting with healthcare providers, coordinating treatment regimens and schedules, helping with financial and administrative aspects of medical care, health insurance and more. They can also provide emotional support for coping with disease.

A recent study says that 26.5% of all American adults today are family caregivers.[1]

Family caregivers are typically female baby boomers [2] whose needs for information, resources, advice and emotional support can be as great as—or even greater than—the needs of their care recipients.

The value of the voluntary, "unpaid" caregiving service provided by caregivers was estimated at $310 billion in 2006 — almost twice as much as was actually spent on home care and nursing services combined.[1] It's more than the US government spent on Medicaid, and greater than the Federal budget deficit.

Contents

[edit] The family caregiver experience

According to a November, 2007 survey on family caregiving, most family caregivers feel more positive about their experiences than they did just before they took on the responsibility, with significant differences in expectation prior to becoming a caregiver and the actual experience.

The survey also found that caregivers are often burdened by high out-of-pocket costs in caring for a spouse or parent, but:

  • Sixty percent of the caregivers called the experience "very or extremely rewarding," a 50% jump over the number of caregivers who thought in advance they would find the experience "very or extremely rewarding." Nearly 80% (78.8%) percent of the caregivers found the experience to be at least "rewarding," an increase of more than one-third from initial expectation.
  • A majority of the caregivers-nearly 54%-formed a stronger bond with the patient during the time they were together.
  • Almost 60% of the respondents reported an improvement in the quality of their relationship with the person for whom they cared. By contrast, fewer than 10% said that their relationship got worse during the time they were caregivers.
  • Social activities of the caregiver tend to diminish. However, the diminished social activities are replaced with an increased quality of relationship with the care recipient.
  • More than 2/3 of all caregivers (68.7%) said they enjoy the tasks associated with caregiving. However, prior to assuming the role, fewer than half (45.5%) thought they would enjoy caregiving.
  • The amount of satisfaction with caregiving is directly related to the type of disease from which the care recipient suffers. Caregivers of depression sufferers, cancer and cardiac disease have more difficulty than those caring for patients who suffer from diabetes, high blood pressure and arthritis.
  • More than ¾ of caregivers are female. Nearly ¾ range in age from 35 to 59.

Other information about US caregivers:

  • More than 50 million people provide care for a chronically ill, disabled or aged family member or friend during any given year. [3] [4]
  • 1.4 million children ages 8 to 18 provide care for an adult relative; 72% are caring for a parent or grandparent. Fortunately, most are not the sole caregiver.[5]
  • 30% of family caregivers caring for seniors are themselves aged 65 or over; another 15% are between the ages of 45 to 54.[3]


Caregiver Gain

As discussed above, there are benefits to the caregiving experience. New research even reports gains in cognitive function in older women who provide informal (unpaid) care on a continuing basis (Bertrand et al., 2011). This cross-sectional study tested over 900 participants at baseline and again after two years for memory and processing speed, functions which are necessary for many caregiving tasks. The participants were divided into three groups, those who were caregivers over the entire two-year period, those who were caregivers at the start of the study but not at the two-year follow-up, and those who were not caregivers at any time during the research period. At follow-up, those who were caregivers throughout the study had the highest scores for both cognitive functions but also the highest reported levels of stress, while those participants who were not caregivers at any time during the study had the lowest scores for both cognitive funtions and the lowest reported levels of stress. These results are consistent with the healthy caregiver hypothesis which states that while those older adults who are more likely to be caregivers are healthier to start with, it is the work of caregiving that helps keep them healthier than older adults who are not caregivers. This model contrasts with the long-held idea that the stress of caregiving results in poorer functioning over time.

Taking Care of the Caregiver

Although caregiving can be rewarding for many, it is undeniably stressful as well. There are, however, strategies that caregivers and communities can use to reduce the effects of this added stress. Information, resources and support are often available through senior centers and local public health departments, but more research is needed to determine what services are helpful. Two studies that investigated the effectiveness of different interventions on the health of caregivers are described below.

The Resources for Enhancing Alzheimer's Caregiver Health (REACH) II intervention (Elliot, Burgio, & DeCoster, 2010) was a randomized clinical trial that provided self-care educational information and training on self-care skills, tailored to each caregiver's needs, to the intervention group, or a basic health information packet and two non-educational phone calls to the control group. Each intervention was designed to deal with a participant's personal issues using information provided by the caregiver at the beginning of the study, and researchers were personally involved during the 12 face-to-face and telephone sessions. At the end of the six-month study period, those receiving the intervention reported better physical and emotional health and less "burden and bother" with their caregiving duties than those in the control group.

Another study tested the effectiveness of three different interventions (a support group, provision of literature on self-care and caregiving, and creative movement) on five mental health variables of caregiving daughters of frail mothers (Donorfio, Vetter, & Vracevic, 2010). Each study participant chose the intervention that appealed to her most, rather than being randomly assigned to one. Study participants were then evaluated for self-reported irritability, depression, anxiety, stress, and concentration, and asked to assess the chosen intervention on an on-going basis. Comparing the outcomes of the five variables, the support group's self-ratings suggested greater improvement than the literature group, while the creative movement group was too small for a meaningful comparison. The participants' assessments of all three interventions were positive, with caregivers using words such as "validation," "reinforcement," and "relaxing." Those in the support group found the intervention so helpful that they continued to meet after the study's completion. All study participants agreed that they would choose to participate again, and in the same intervention group.

[edit] See also

[edit] National and international organizations

[edit] References and additional reading

  1. ^ a b Peter S. Arno (Fall 2006) (presentation), presented at the NIH Care Coordination and the Caregiving Forum 
  2. ^ National Alliance for Caregiving and AARP (2004) (presentation), Caregiving in the U.S. 
  3. ^ a b U.S. Department of Health and Human Services (1998) (presentation), U.S. Department of Health and Human Services 
  4. ^ National Family Caregivers Association (Summer 2000) (presentation), National Family Caregivers Association 
  5. ^ National Alliance for Caregiving and the United Hospital Fund (2005) (presentation), National Alliance for Caregiving and the United Hospital Fund 

Bertrand, R.M., Saczynski, J.S., Mezzacappa, C., Hulse, M., Ensrud, K., & Fredman. L. (2011). Caregiving and cognitive function in older women: Evidence for the healthy caregiver hypothesis. Journal of Aging and Health, 24(1), 48-66.

Donorfio, L.K.M., Vetter, R., & Vracevic, M. (2010). Effects of three caregiver interventions: Support, educational literature, and creative movement. Journal of Women and Aging, 22, 61-75.

Elliot, A.F., Burgio, L.D., & DeCoster, J. (2010). Enhancing caregiver health: Findings from the Resources for Enhancing Alzheimer's Caregiver Health II intervention. Journal of the American Geriatrics Society, 58, 30-37.' '

[edit] External links

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