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Caregiver Experience During Advanced Chronic Illness and Last Year of Life
Ist Teil von
Journal of the American Geriatrics Society (JAGS), 2014-06, Vol.62 (6), p.1082-1090
Ort / Verlag
Hoboken, NJ: Blackwell Publishing Ltd
Erscheinungsjahr
2014
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Objectives
To compare the prevalence and predictors of caregiver esteem and burden during two different stages of care recipients' illnesses—advanced chronic illness and the last year of life.
Design
Longitudinal, observational cohort study.
Setting
Community sample recruited from outpatient clinics at Duke University and Durham Veterans Affairs Medical Centers.
Participants
Individuals with advanced cancer, congestive heart failure, or chronic obstructive pulmonary disease and their primary caregiver, retrospectively coded as chronic‐illness (n = 62) or end‐of‐life (EOL; n = 62) care recipient–caregiver dyads.
Measurements
Caregiver experience was measured monthly using the Caregiver Reaction Assessment, which includes caregiver esteem and four domains of burden: schedule, health, family, and finances.
Results
During chronic illness and at the end of life, high caregiver esteem was almost universal (95%); more than 25% of the sample reported health, family, and financial burden. Schedule burden was the most prevalent form of burden; EOL caregivers (58%) experienced it more frequently than chronic‐illness caregivers (32%). Caregiver esteem and all dimensions of burden were relatively stable over 1 year. Few factors were associated with burden.
Conclusion
Caregiver experience is relatively stable over 1 year and similar in caregivers of individuals in the last year of life and those earlier in the course of chronic illness. Schedule burden stands out as most prevalent and variable among dimensions of experience. Because prevalence of burden is not specific to stage of illness and is relatively stable over time, multidisciplinary healthcare teams should assess caregiver burden and refer burdened caregivers to supportive resources early in the course of chronic illness.