Tim Pauley1, Byung Wook Chang, Anne Wojtak, Gayle Seddon, John Hirdes. 1. Tim Pauley, MSc, is the Manager, Research & Knowledge Mobilization at the Toronto Central Community Care Access Center. Winner of two international research awards (ISPRM; ISPO) and author of numerous journal articles, his work includes support of informal caregivers, community-based diabetes management, engagement of clients/caregivers in knowledge mobilization, amputee, and stroke rehabilitation. Byung Wook Chang, PhD, is a Senior Analyst at University Health Network. He graduated from the Aging, Health, and Well-being program supervised by Dr John Hirdes. His areas of research include home care quality indicators, minority health, and inpatient rehabilitation. Anne Wojtak, DrPH, MHSc, BSc, is the Chief Performance Officer at the Toronto Central Community Care Access Centre and is an Adjunct Faculty member at the University of Toronto, in the Institute of Health Policy, Management and Evaluation. Her research focuses on public reporting on health care performance and quality, and she has published numerous articles on home care, with a particular focus on patient experience Gayle Seddon, BScN, MHSc, is the Director of Community Programs at the Toronto Central Community Care Access Centre. She has extensive experience with delivery of community-based person-centered care programs and services. John Hirdes, PhD, FCAHS, is a professor in the School of Public Health and Health Systems at the University of Waterloo. He is a board member of interRAI, and chairs both the interRAI Network of Excellence in Mental Health (iNEMH) and the interRAI Network of Canada.
Abstract
PURPOSE OF STUDY: The purpose of this study was to identify factors predictive of new onset and improved caregiver distress among informal caregivers providing assistance for clients receiving home care. PRIMARY PRACTICE SETTINGS: Home care. METHODOLOGY AND SAMPLE: The sample included 323,409 clients receiving home care from a Community Care Access Centre between March 2002 and March 2015 for whom data were available from two subsequent Resident Assessment Instrument-Home Care (RAI-HC) assessments. Separate multivariate logistic regression models were created for onset of and improvement in caregiver distress. RESULTS: Variables that increase the odds in onset of caregiver distress included primary caregiver is not satisfied with support received from family and friends; client lives with primary caregiver; 65 years and older; has Alzheimer and other related dementia; has condition or disease that makes cognition, activities of daily living, mood, or behavior patterns unstable; took sedatives in the last 7 days; Method for Assigning Priority Levels (MAPLe) score 4 or more; demonstrates persistent anger; has difficulty using the telephone; is married; requires 20 hr or more of informal help weekly; and Clinical Risk Scale score 4 or more. Variables that increased the odds of improved caregiver distress include client now lives with other persons (as compared with 90 days ago); demonstrates good prospects for recovery; treatment changes in last 30 days; surgical wound; female; one or more hospital visits in last 90 days; greater number of months between RAI-HC assessments; and two or more hours of physical activities in the last 3 days. Variables that decreased the odds of improved caregiver distress (i.e., persistent distress) include MAPLe score 4 or more; persistent anger; difficulty using telephone; Alzheimer, related dementia; requires interpreter; and lives with primary caregiver. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Informal caregivers provide essential support for home care clients. Factors predictive of new onset and improved caregiver distress can be used by case managers for comprehensive care planning that addresses the collective needs of the client-caregiver dyad.
PURPOSE OF STUDY: The purpose of this study was to identify factors predictive of new onset and improved caregiver distress among informal caregivers providing assistance for clients receiving home care. PRIMARY PRACTICE SETTINGS: Home care. METHODOLOGY AND SAMPLE: The sample included 323,409 clients receiving home care from a Community Care Access Centre between March 2002 and March 2015 for whom data were available from two subsequent Resident Assessment Instrument-Home Care (RAI-HC) assessments. Separate multivariate logistic regression models were created for onset of and improvement in caregiver distress. RESULTS: Variables that increase the odds in onset of caregiver distress included primary caregiver is not satisfied with support received from family and friends; client lives with primary caregiver; 65 years and older; has Alzheimer and other related dementia; has condition or disease that makes cognition, activities of daily living, mood, or behavior patterns unstable; took sedatives in the last 7 days; Method for Assigning Priority Levels (MAPLe) score 4 or more; demonstrates persistent anger; has difficulty using the telephone; is married; requires 20 hr or more of informal help weekly; and Clinical Risk Scale score 4 or more. Variables that increased the odds of improved caregiver distress include client now lives with other persons (as compared with 90 days ago); demonstrates good prospects for recovery; treatment changes in last 30 days; surgical wound; female; one or more hospital visits in last 90 days; greater number of months between RAI-HC assessments; and two or more hours of physical activities in the last 3 days. Variables that decreased the odds of improved caregiver distress (i.e., persistent distress) include MAPLe score 4 or more; persistent anger; difficulty using telephone; Alzheimer, related dementia; requires interpreter; and lives with primary caregiver. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Informal caregivers provide essential support for home care clients. Factors predictive of new onset and improved caregiver distress can be used by case managers for comprehensive care planning that addresses the collective needs of the client-caregiver dyad.
Authors: Shauni Van Doren; David De Coninck; Kirsten Hermans; Anja Declercq Journal: Int J Environ Res Public Health Date: 2021-11-11 Impact factor: 3.390
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