The Caregiver

Question 1

Who are the Caregivers?

Answer 1

1. the “invisible workforce”
2. wide range of ages
3. 60% are female
4. 20% are spouses, 50% are adult children
5. most (86%) are caring for a relative, most often a parent/in-law
6. ⅓ of caregivers are the sole source of support: typically older, more hrs of caregiving, caring for spouse/partners
7. cost of caregiving → financial, social, emotional, and physical

Question 2

what kind of caregiving?

Answer 2

1. household tasks
2. self-care, mobility
3. emotional/social support
4. health/medical care
5. advocacy and care coordination
6. surrogacy

Question 3

where do PTs fit into caregiving?

Answer 3

1. sharing your expertise
2. providing education on safety and efficacy of a task
3. assisting with home modifications, equipment needs
4. finding community resources
5. learning from the caregiver

Question 4

list stresses of caregiving

Answer 4

1. physical health
   
   1. physical strain, injuries from lifting, transferring, repetitive actions, etc.
2. psychological health/QOL
   
   1. emotional distress including depression, anxiety
3. social well-being
   
   1. reduced access to social network, decreased conflict resolution
4. economic well-being
   
   1. direct cost of caregiving, loss of income, taking on debt, financial strain

Question 5

what are the dimensions of caregiver burden in dementia?

Answer 5

1. direct impact of caregiving on caregivers’ lives
   
   1. predicted by level of relationship satisfaction w/pts and pts functional independence
   2. predicted by caregiver depression and age (younger age > guilt)
2. guilt
   
   1. predicted by caregiver depression and age
3. frustration/embarrassment
   
   1. predicted by pts behavioral problems and level of relationship satisfaction w/pt

Question 6

___________ is a strong predictor of nursing home placement

Answer 6

behavioral problems

Question 7

what is a widely used measure of caregiver burden?

Answer 7

Zarit Burden Interview

Question 8

describe the Zarit Burden Interview

Answer 8

1. 22 items assessing burdens associated with patient behavioral and functional impairments
2. covers impact of caregiver on caregiving in their health, relationships, and finances
3. utilized as a single measure of caregiver burden but may be able to address various dimensions
4. interventions to address caregiver burden should be tailored to the subtype of burden

Question 9

list caregiver outcomes

Answer 9

1. Physical health → physical strains associated with care; caregivers may neglect their own health
2. psychological health/QOL → nearly 50% of caregivers report emotional difficulty; associated with depression and anxiety
3. Social Well-being → reduced time for social/leisure pursuits increases emotional stress; potential for family conflict
4. Economic well-being → nearly 40% report moderate-high degree of financial strain
5. rewards of caregiving → reciprocation of care, feeling appreciated, closer family relationships, increased meaning/purpose

Question 10

describe Burnout Syndrome

Answer 10

1. emotional exhaustion
2. depersonalization
3. reduction in personal fulfillment

Question 11

with burnout there is an increased risk for _________

Answer 11

abuse or neglect

Question 12

aspects of caregiver support

Answer 12

1. Caregiver Advise, Record, Enable (CARE) act
2. intervention programs
   
   1. professional support
   2. psychoeducational
   3. behavior management/skills training
   4. counseling/psychotherapy
   5. self-care/relaxation techniques
   6. environmental redesign