Paid Caregivers in the Community-based Dementia Care Team: Do Family Caregivers Benefit?
Paid Caregivers in the Community-based Dementia Care Team: Do Family Caregivers Benefit?
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DOI：
10.1016/j.clinthera.2021.03.022
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发表时间：
2021-06
影响因子：
3.2
通讯作者：
Ornstein KA
中科院分区：
文献类型：
--
作者：
Reckrey JM;Boerner K;Franzosa E;Bollens-Lund E;Ornstein KA
患有痴呆症的老年人通常依赖两种付费照顾者（即，家庭健康助理、个人护理员和其他直接护理人员）和家庭护理人员（即，配偶、子女和其他无报酬的个人）留在社区。本研究概念化付费照顾者作为协作性痴呆症护理团队的一部分，并探讨了接受付费护理和主要家庭照顾者经验之间的关联。使用与国家护理研究（NSOC）相关的国家健康和老龄化趋势研究（NHATS）的3波（2011年，2015年，2017年）数据，我们确定了年龄≥67岁的社区居住医疗保险受益人患有晚期痴呆症（n=338观察结果）。我们比较了无、兼职（<40小时/周）和全职（≥40小时/周）有偿护理的主要家庭照顾者的经验，并使用多变量模型评估全职有偿护理与家庭照顾者压力之间的关联（例如，由于疲劳而不堪重负）和活动限制（例如，由于照顾而无法工作获得报酬）。大约一半的社区老年痴呆症患者接受了有偿护理：30%的人接受了兼职有偿护理，18%的人接受了全职有偿护理。家庭照顾者的经验，那些接受兼职和没有有偿照顾没有显着差异。在调整了家庭照顾者和照顾对象的特征后，接受全职有偿照顾与因生育而导致活动受限的几率降低近70%（OR 0.31，p=0.01）和平均照顾者压力评分降低（-0.73，p=0.04）相关。高护理者压力（评分≥5）的几率与接受有偿护理之间无统计学显著相关性（OR 0.65，p=0.33）。向社区中的痴呆症患者提供有偿护理可能会使家庭照顾者受益。未来的工作应该承认付费护理人员为协作性痴呆症护理团队的所有成员做出贡献的重要方式。
Older adults with dementia often rely on both paid caregivers (i.e., home health aides, personal care attendants, and other direct care workers) and family caregivers (i.e., spouses, children, and other unpaid individuals) to remain in the community. This study conceptualizes paid caregivers as part of the collaborative dementia care team and examines the association between receipt of paid care and primary family caregiver experience. Using data from 3 waves (2011, 2015, 2017) of the National Health and Aging Trends Study (NHATS) linked to the National Study of Caregiving (NSOC), we identified community-dwelling Medicare beneficiaries aged ≥67 with advanced dementia (n=338 observations). We compared primary family caregiver experiences among those with zero, part-time (<40 hours/week), and full-time (≥40 hours/week) paid care and used multivariable models to evaluate the associations between full-time paid care and family caregiver strain (e.g., being overwhelmed due to caregiving) and activity restriction (e.g., being unable to work for pay due to caregiving). About half of the community-dwelling older adults with advanced dementia received paid care: 30% had part-time paid care and 18% had full-time paid care. The experiences of family caregivers of those receiving part-time and no paid care were not significantly different. After adjusting for family caregiver and care recipient characteristics, receipt of full-time paid care was associated with a nearly 70% reduced odds of having activity restrictions due to caregiving (OR 0.31, p=0.01) and a reduction in mean caregiver strain score (−0.73, p=0.04). There was no statistically significantly association between the odds of high caregiver strain (score ≥5) and receipt of paid care (OR 0.65, p=0.33). The provision of paid care to individuals with dementia in the community may benefit family caregivers. Future work should acknowledge the important ways that paid caregivers contribute to outcomes for all members of the collaborative dementia care team.
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DOI：
10.1016/j.jalz.2017.10.006
发表时间：
2018-01
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Samus QM;Black BS;Bovenkamp D;Buckley M;Callahan C;Davis K;Gitlin LN;Hodgson N;Johnston D;Kales HC;Karel M;Kenney JJ;Ling SM;Panchal M;Reuland M;Willink A;Lyketsos CG
通讯作者：
Lyketsos CG
DOI：
10.3233/jad-170819
发表时间：
2018
期刊：
Journal of Alzheimer's disease : JAD
影响因子：
--
作者：
Forloni G;Balducci C
通讯作者：
Balducci C
影响因子：
5.7
作者：
Franzosa, Emily;Tsui, Emma K.;Baron, Sherry
通讯作者：
Baron, Sherry
DOI：
10.3390/ijerph14040384
发表时间：
2017-04-01
影响因子：
--
作者：
Muramatsu, Naoko;Yin, Lijuan;Lin, Ting-Ti
通讯作者：
Lin, Ting-Ti
影响因子：
120.7
作者：
Schulz, R;Beach, SR
通讯作者：
Beach, SR