II. Definitions
- Caregiver
- Family or friend who offers unpaid assistance to a person with chronic or disabling condition
III. Epidemiology
- Of those adults requiring Longterm Care, 80% live in the community
- Unpaid Caregivers provide 90% of the care for these patients (nearly 25 hours/week on average)
- Nearly all require assistance in Instrumental Activities of Daily Living
- Nearly 60% require assistance in Activities of Daily Living
- More than half were hospitalized in the last 12 months
- https://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-united-states-2015-report-revised.pdf
IV. Mechanism: Caregiver Burden
- Caregiving has benefits of personal satisfaction, feeling useful and needed, and finding purpose and meaning in life
- However, caregiving also is associated with significant persistent, uncontrollable and unpredictable stressors
- Comprises physical, psychological and financial burdens (one third of Caregivers rate the burden as high)
- Caregivers are more likely to miss work and have reduced work hours with loss of salary and benefits
- Caregivers have higher rates of Major Depression, emotional stress, Insomnia and serious illness
- Caregivers report neglecting health habits and self-care, and less time for other family and friends
V. Evaluation: Caregiver
- See Caregiver Burden Scale
- Caregiver Assessment via Guided Care Model
- Modified Caregiver Strain Index
- Adapted Zaret Burden Interview
VI. Management: General
- Caregiver well-being
- Take a break from caregiving
- Support group
- Pursue own interests (e.g. hobbies)
- Maintain own health including healthy lifestyle
- Family and Medical Leave Act (FMLA)
- Caregiver education
- Caregiver training for medical tasks
- AARP Prepare to Care: A Caregiving Planning Guide for Families
- Referrals
- Elder agencies in local area
- Home health services
- Adult day programs
- Meal delivery services
-
General patient management
- Early Palliative Care
- Advance Care Planning
- Improve quality of life with symptom management
- Address ways to unburden the Caregiver in specific conditions (e.g. Dementia, cancer, stroke)