Community care for demented and non-demented elderly people: a comparison study of financial burden, service use, and unmet needs in family supporters

Philp, Ian; McKee, Kevin; Meldrum, P; Ballinger, Brian R.; Gilhooly, Mary; Gordon, David S.; Mutch, William James; Whittick, Janice E.

doi:10.1136/bmj.310.6993.1503

Cited by 70 publications

(52 citation statements)

References 13 publications

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“…14,[41][42][43][44] In our study, 5% of caregivers had quit their job or declined advancement, and a large proportion lost work hours or used special leave or holidays to fulfill their caregiving responsibilities. The Senate report on end-of-life care 2 recommends income security and job protection for family members who care for people who are dying.…”

Section: Discussionmentioning

confidence: 60%

Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers

Grunfeld¹

2004

Canadian Medical Association Journal

796

673

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Background: The vital role played by family caregivers in supporting dying cancer patients is well recognized, but the burden and economic impact on caregivers is poorly understood. We prospectively examined the psychosocial, occupational and economic impact of caring for a person with a terminal illness. Methods: We studied 89 caregivers of women with advanced breast cancer receiving care at either the Ottawa or Hamilton regional cancer centres in Ontario. Patients were followed until their death or study completion at 3 years. Patients identified a principal caregiver to participate in the study. The Karnofsky Performance Status (KPS) index, the Medical Outcomes Study 36-item Short Form (SF-36), the Hospital Anxiety and Depression Scale, the Zarit Burden Inventory, FAMCARE and the Medical Outcomes Study Social Support Survey were administered during follow-up. Economic data were collected by means of a questionnaire administered by an interviewer. Assessments were conducted every 3 months during the palliative period (KPS score > 50) and every 2 weeks during the terminal period (KPS score ≤ 50). Results: Over half of the caregivers were male (55%) and the patient's spouse or partner (52%), with a mean age of 53 years. At the start of the palliative period, the caregivers' mean physical functioning score was better than the patients' (51.3 v. 35.1, 95% confidence interval [CI] 13.3-20.0); there were similar mean mental functioning scores (46.6 and 47.1 respectively); similar proportions were depressed (11% and 12%); and significantly more caregivers than patients were anxious (35% v. 19%, p = 0.009). More caregivers were depressed (30% v. 9%, p = 0.02) and had a higher level of perceived burden (26.2 v. 19.4, p = 0.02) at the start of the terminal period than at the start of the palliative period. Burden was the most important predictor of both anxiety and depression. Of employed caregivers, 69% reported some form of adverse impact on work. In the terminal period 77% reported missing work because of caregiving responsibilities. Prescription drugs were the most important component of financial burden. Interpretation: Caregivers' depression and perceived burden increase as patients' functional status declines. Strategies are needed to help reduce the psychosocial, occupational and economic burden associated with caregiving.

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Section: Discussionmentioning

confidence: 60%

Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers

Grunfeld¹

2004

Canadian Medical Association Journal

796

673

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“…즉, 소아 (Liberato et al, 2000), 아동집단 (Newacheck et al, 1998(Newacheck et al, , 2000Skinner et al, 2006), 청소년 (Liberats et al, 2000), 성인 (Shi & Stevens, 2005 ;Marina, 2009), 노인 (Philp et al, 1995 ;Alonso et al, 1997) 등 각 연령층을 대상으로 하거나, 천식 (Partridge, 2007), 뇌졸중 (op Reimer et al, 1999), 만성질환 (Sibley & Glazier, 2009), 급성질환과 만성질환 (Alam, 2007), 류마티스성 관절염 (Jacobi et al, 2004), 공황장애 (Crasker, 2005) (Kataoka et al, 2002), 에이즈치료서비스 (Bonuck, 2005 ;Adedigba et al, 2008), 장기요양서비스 (Lima & Allen, 2001), 일차의료서비스 (Zallman, et al, 2003 ;Diamant et al, 2004) …”

Section: ⅱ 기존 연구에 대한 고찰unclassified

Unmet Health Care Needs and Associated Factors among Patients with Hypertension and Those with Diabetes in Korea

Huh¹,

Lee²

2011

Korean Journal of Health Policy and Administration

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This study investigated unmet health care needs and associated factors among patients with hypertension and those with diabetes. Patients were identified by medical professionals. Patients who did not take pharmaceuticals to treat their disease(s) were defined as those with unmet health care needs. Using data from 2005 National Health and Nutrition Examination Survey, 3,635 hypertension patients and 1,431 diabetes patients were analyzed. A multivariate logistic regression analysis was employed to examine factors associated with unmet needs.Overall, 16.6% of hypertension patients, 20.3% of those with diabetes presented unmet needs. Common factors associated unmet needs for both hypertension and diabetes were sex, insurance type, self-reported health status and length of disease.Study findings suggest that hypertension and diabetes should be treated in early stage and further study is needed to examine the reasons for unmet needs to

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“…However, because ageing is associated with numerous health problems, it can be dicult to disentangle the eects of any single condition. Nevertheless, costs generally appear higher for people with Alzheimer's disease than for other elderly people supported in community settings (Ernst and Hay, 1994;Philp et al, 1995;Livingston et al, 1997). For example, the 5.6% of people with dementia in Livingston's representative sample of 700 people aged over 64 in a district of London consumed 15.6% of the community care resources, and this excluded long-term care and caregiver costs.…”

Section: The Cost Of Carementioning

confidence: 99%

The economic consequences of Alzheimer's disease in the context of new drug developments

Knapp

Wilkinson

Wigglesworth

1998

Int. J. Geriat. Psychiatry

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Community care for demented and non-demented elderly people: a comparison study of financial burden, service use, and unmet needs in family supporters

Abstract: Supervisory care for demented elderly people should be further developed within an expanded domiciliary service to meet supporters needs.

Cited by 70 publications

References 13 publications

Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers

Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers

Unmet Health Care Needs and Associated Factors among Patients with Hypertension and Those with Diabetes in Korea

The economic consequences of Alzheimer's disease in the context of new drug developments

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