Is health literacy of family carers associated with carer burden, quality of life, and time spent on informal care for older persons living with dementia? (original) (raw)
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Aging Clinical and Experimental Research
Aim The aim of this study was to measure the prevalence of inadequate health literacy (HL) in a sample of family caregivers of older adults with dementia, and to assess the relationship of HL with characteristics of caregiver and persons with dementia. Methods The study followed a cross-sectional design. Persons with dementia and their family caregivers were enrolled in an outpatients’ geriatric memory clinic. For the caregivers, the following information was collected: socio-demographic data, level of HL, cognitive impairment (using the Mini-Cog). For persons with dementia, the following data were collected: socio-demographic data, functional status (using the Basic and Instrumental Activities of Daily Living), cognitive impairment (using the Mini Mental State Evaluation, and the Global Deterioration Scale) behavioral and psychological symptoms associated with dementia (assessed using the Neuropsychiatric Inventory). Results A total of 174 person with dementia/caregiver dyads were ...
Health literacy and its correlates in informal caregivers of adults with memory loss
Geriatric Nursing, 2018
This secondary analysis examined health literacy among informal caregivers of communitydwelling older adults with memory loss and assessed correlates of caregiver health literacy using the Abilities, Skills and Knowledge Model. Caregiver health literacy (n=91) was assessed by the Newest Vital Sign. Limited health literacy presented in 38.5% caregivers, with significantly low document literacy. Health literacy was associated bivariately with age, education, global cognitive function, executive function, and working memory (all ps<.001), as well as medication knowledge (p=.015). Hierarchical regression analyses revealed that older age (p=.017), and lower global cognitive function (p<.001), working memory (p=.001), and academic skills (years of education) (p=.004), independently predicted lower health literacy (R 2 =.54). Medication knowledge, however, was not found to be an independent predictor in the model. Findings suggest limited health literacy is a potential issue among informal caregivers of adults with memory loss. Appropriate assessment and personalized support are needed for informal caregivers who are at high risk for poor health literacy.
International Psychogeriatrics, 2015
Background: Few studies have estimated care burden in large, representative, multi-ethnic Asian populationbased informal caregivers of older adults with care needs. This study describes informal caregivers' care participation for a population-based sample of older adults with care needs in Singapore, investigates differences by dementia status, and examines correlates of caregivers' burden. Methods: Data collected from 693 pairs of older adults, aged 60 to 100 years, having any care needs, and their informal caregivers, who were aged 21 to 88 years, closely involved in their care and "knew the older resident best," and were interviewed during a cross-sectional national survey, were used. Clinical characteristics of older adults, including behavioral and psychological symptoms of dementia (BPSD) and dementia diagnosis, care needs, and socio-demographic characteristics of participants were obtained. Care burden was assessed with the Zarit Burden Interview. Results: Informal caregivers' participation was highest in activities related to communication (35.1%), feeding (32%), and bathing (21.1%). Among the older adults with any care need, 356 (51.4%) had dementia. Care burden was significantly associated with married caregivers (odds ratio (OR) 2.4 vs. never married), when their relative belonged to a younger cohort (OR 2.5 vs. >84 years), needed care much of the time (OR 2.5 vs. no care needed), exhibited BPSD (OR 3.5 vs. no BPSD), and had dementia (OR 2.52 vs. no dementia). Conclusions: Factors related to older adults-more care needs, presence of BPSD, and dementia-were significant contributors to informal caregivers' burden, and these should be considered while planning interventions to alleviate care burden.
Inadequate Health Literacy Among Paid Caregivers of Seniors
Journal of General Internal Medicine, 2011
Background Many seniors rely on paid non-familial caregivers to maintain their independence at home. Caregivers often assist with medication reminding and activities of daily living. No prior studies have examined the health literacy levels among paid non-familial caregivers. Objectives To determine health literacy levels and the health-related responsibilities of paid non-familial caregivers of seniors. Design One-on-one face-to-face surveys. The Test for Functional Health Literacy (TOFHLA) was administered to identify health literacy levels. Caregivers were asked to demonstrate their skill in medication use by following directions on pill bottles and sorting medications into pill boxes. Participants Ninety-eight paid unrelated caregivers of seniors recruited at physician offices, caregiver agencies, senior shopping areas, and independent living facilities. Results Average age of caregivers was 49.5 years, and 86.7% were female. Inadequate health literacy was found in 35.7% of caregivers; 60.2% of all caregivers made errors with the pillbox test medications, showing difficulty in following label directions. Health-related tasks (i.e., medication reminding, sorting, dispensing, and accompanying seniors to physician appointments) were performed by 85.7% of caregivers. The mean age of their seniors was 83.9 years (range 65–99 years), and 82.1% were female. Conclusion Paid non-familial caregivers are essential for many seniors to remain independent and maintain their health. Many caregivers perform health-related duties, but over 1/3 have inadequate health literacy and have difficulties following medication-related instructions. Educating caregivers and ascertaining their health literacy levels prior to assigning health-related tasks may be an important process in providing optimal care to seniors.
Ageing & Society, 2020
Community health-care services for older, home-dwelling persons with dementia tend to be underutilised. Family care-givers provide substantial care, and they often arrange for and co-ordinate health-care services on behalf of persons with dementia. The aim of this study was to examine family care-givers’ knowledge of unused services and their self-reported reasons for non-use of such services. We gathered cross-sectional survey data from 430 family care-givers of older persons with dementia in Northern Norway. Multinomial logistic regression analysis was used to identify predictors of family care-givers’ knowledge of unused services. An open-ended question regarding reasons for non-use of services was analysed by thematic text analysis. Characteristics of family care-givers (e.g. education level) and factors related to the care-giving circumstances (e.g. negative impact of care-giving) predicted family care-givers’ knowledge of unused services. Reasons for non-use of services were m...
2019
BACKGROUND: The literacy level of the elderly is predictive of health behaviors, average hospitalization in health centers, and the type of verbal interaction with health service providers; as the level of literacy changes, the quality of life may also change. This study aimed to determine the relationship between health literacy level and quality of life among the elderly living in nursing homes in 2018–2019. MATERIALS AND METHODS: This study was of a descriptive-analytic, correlation type that was performed on 175 elderly of selected nursing homes in Tehran. The research tools included the Abbreviated Mental Test; Control, Autonomy, Pleasure and Self-realization questionnaire-19; and Health Literacy of Iranian Adults Questionnaire (HELIA). Data were analyzed using descriptive and inferential statistics by SPSS 22 software. RESULTS: The total score of health literacy and the quality of life of the elderly was 51.01 and 47.75, respectively. The literacy of most of the studied sample...
Dimensions of informal care and quality of life among elderly family caregivers
Scandinavian Journal of Caring Sciences, 2004
The aim was to investigate dimensions of caregiving activities among elderly (75+) caregivers based on Nolan's model and to study the dimensions in relation to healthrelated quality of life (Short Form 12). Responses to a Swedish postal survey (n ¼ 4278, response rate 75-79 years old: 60%; 80-84: 56%; 85-89: 48% and 90+: 42%) showed that 783 persons (18%) were helping another person due to that person's impaired health, 41.6% women, mean age for women 81.8 years (SD 4.96) and for men 81.7 years (SD 4.32). The postal questionnaire included SF-12, demographic data and questions about caregiving activities derived from Nolan's model, social network and contacts with health care. Adapting their activities to be prepared if something happened (52%), having regular contact to prevent problems (35%), helping in contacts with the hospital (57%), helping with instrumental activities of daily living (49%), personal activities of daily living (14%), medical care (11%) and helping to improve functions (14%) were the activities reported. Adapting own activities, regular contact, weak economy and needing instrumental help with daily living oneself predicted low MCS12. The importance of early involvement on the part of the caregivers was emphasized.
Age and Ageing, 2019
Objectives: The burden often associated with informal caregiving for patients with dementia is associated with negative effects on health, both physiologically and in terms of caregiver cognition. There is wide variation in the level of burden experienced by dementia caregivers. To better understand caregiver burden, it is thus important to understand the factors associated with level of burden. Methods: In the current study, we collected carer burden and putative associated factors at baseline, 6 and 12 months. Hierarchical regression was used to assess the impact of these factors on caregiver burden. We assessed self-reported carer burden, patient behavioural and safety issues, and level of difficulty associated with providing assistance with activities of daily living (ADL). Patients' age was also recorded, and trained nurses assessed patient cognitive performance using the quick mild cognitive impairment screen. Results: At baseline, patients' age, cognition and ADLs were associated with burden, and safety and challenging behaviour were both significantly associated with burden independent of the other factors. Change in burden was associated with change in carer-reported safety at 6-month follow-up, and with change in safety and change in carer-reported challenging behaviours at 12-month follow-up. Conclusions: Safety issues and challenging behaviours are associated with carer burden, even after accounting for cognitive and functional impairment in the person with dementia. As dementia progresses, monitoring these factors may help to inform stress-management strategies for caregivers.
Health Literacy among Non-Familial Caregivers of Older Adults: A Study Conducted in Tuscany (Italy)
International Journal of Environmental Research and Public Health, 2019
Many older adults who live at home depend on a caregiver. When familial support cannot provide the necessary care, paid caregivers are frequently hired. Health literacy (HL) is the knowledge and competence required of people to meet the complex demands of health in modern society. The aim of this study is to assess the HL level of paid non-familial caregivers who were enrolled through two different sources: from the homes of assisted people in two Tuscan health districts (first sample) and during job interviews in a home care agency operating in Florence (second sample). The two different recruitment contexts allow us to provide a broader view of the phenomenon, presenting a picture of the HL level of those who are already working and those who are looking for a new job in this field. One-on-one face-to-face interviews, which include the administration of the Newest Vital Sign (NVS) to measure HL, were conducted. Recruitment resulted in 84 caregivers in the first sample and 68 in th...
Dementia (London, England), 2018
Longitudinal studies of caregiver burden when caring for persons with dementia living at home are sparse. The aim of the study was to identify factors associated with caregiver burden and predicting increased burden related to caregivers, persons with dementia and formal care. Data were collected through interviews with 1223 caregivers in eight European countries. Bivariate and multivariate regression analyses were performed. Factors associated with caregiver burden included extensive informal care provision, decreased well-being and reduced quality of life for the caregiver and reduced cognition, decreased quality of life, severe neuropsychiatric symptoms and depression in the person with dementia and caregivers' negative experience of quality of care. Factors predicting an increased burden were diminished caregiver well-being, severe neuropsychiatric symptoms of the person with dementia and caregivers' negative perception of quality of care. The knowledge gained in this st...