Caring For The Frail Elderly: An International Review

Merlis, Mark

doi:10.1377/hlthaff.19.3.141

Cited by 35 publications

(20 citation statements)

References 3 publications

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“…51 Especially salient is how the U.S. long-term care system will be organized and financed to meet the increasing needs of those with dementia and their families. 52 In the meantime, physicians caring for individuals with chronic disease should be aware of current public and private resources designed to provide information and support for caregivers, and make referrals to such programs when appropriate. For instance, the recently established National Family Caregiver Support Program provides federal funds to state and local agencies so that information, counseling, and respite opportunities will be more accessible to family caregivers.…”

Section: Discussionmentioning

confidence: 99%

National Estimates of the Quantity and Cost of Informal Caregiving for the Elderly with Dementia*

et al. 2001

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OBJECTIVE:Caring for the elderly with dementia imposes a substantial burden on family members and likely accounts for more than half of the total cost of dementia for those living in the community. However, most past estimates of this cost were derived from small, nonrepresentative samples. We sought to obtain nationally representative estimates of the time and associated cost of informal caregiving for the elderly with mild, moderate, and severe dementia. DESIGN:Multivariable regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people age 70 years or older (N = 7,443).SETTING: National population-based sample of the community-dwelling elderly. MAIN OUTCOME MEASURES:Incremental weekly hours of informal caregiving and incremental cost of caregiver time for those with mild dementia, moderate dementia, and severe dementia, as compared to elderly individuals with normal cognition. Dementia severity was defined using the Telephone Interview for Cognitive Status. R E S U L T S :A f te r a d j u s t i n g fo r s oc i o d e m o g r a p h i c s , comorbidities, and potential caregiving network, those with normal cognition received an average of 4.6 hours per week of informal care. Those with mild dementia received an additional 8.5 hours per week of informal care compared to those with normal cognition (P < .001), while those with moderate and severe dementia received an additional 17.4 and 41.5 hours (P < .001), respectively. The associated additional yearly cost of informal care per case was $3,630 for mild dementia, $7,420 for moderate dementia, and $17,700 for severe dementia. This represents a national annual cost of more than $18 billion. CONCLUSION:The quantity and associated economic cost of informal caregiving for the elderly with dementia are substantial and increase sharply as cognitive impairment worsens. Physicians caring for elderly individuals with dementia should be mindful of the importance of informal care for the well-being of their patients, as well as the potential for significant burden on those (often elderly) individuals providing the care.

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Section: Discussionmentioning

confidence: 99%

National Estimates of the Quantity and Cost of Informal Caregiving for the Elderly with Dementia*

et al. 2001

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“…The growing elderly population, budget constraints, and technological advances in North America have led to reduced inpatient hospital stays, a shortage of available nursing home beds, and an emphasis on community care (Merlis, 2000). This shift in care to the community has placed increased demands on families trying to cope with the changing needs associated with caring for a person with progressive dementia at home, contributing to increased levels of physical, psychosocial, and financial burden (Durand, Krueger, Chambers, & Grek, 1995;Grunfeld, Glossop, McDowell, & Danbrook, 1997).…”

Section: Caregiver Support Interventionsmentioning

confidence: 99%

Seeking to Understand Telephone Support for Dementia Caregivers

2005

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Caregivers of persons with dementia encounter particular challenges in their roles and often experience unmet needs for information and emotional support. This article describes a qualitative descriptive study designed to explore the intervention of telephone support for such caregivers. Data were collected from both caregivers and telephone support providers. Results revealed that telephone support met four specific needs of dementia caregivers: the need for (a) information and education, (b) referral and/or assistance required to navigate through the system, (c) emotional support, and (d) caregiver support that is convenient and hassle free. Caregivers' main experience with the intervention was the sense of companionship, whereas service providers experienced mixed feelings of helplessness and an opportunity to empower caregivers.

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“…Yet the relation between these trends, and their impact on public expenditures, remains unclear (Jacobzone, 2000;Merlis, 2000). A number of studies from the 1980s, done mostly in fee-for-service settings in the United States, suggest that home care is not a cost-saving substitute for nursing home care.…”

Section: Introductionmentioning

confidence: 99%