Predicting perceived medication-related hassles in dementia family caregivers

Abstract

Objective This study examined predictors of medication administration hassles reported by intergenerational dementia family caregivers. Methods A sample of 53 women who aided a cognitively impaired older adult with healthcare and who identified as inter-generational caregivers provided self-report medication management and psychosocial data. Results Hierarchical multiple regression analyses revealed that six independent variables hypothesized for this model, the total number of prescription medications managed by caregivers, educational attainment, care-recipient functional impairment, care-recipient cognitive impairment, caregiver depressive symptomatology, and self-reported feelings of preparedness for the caregiving role together significantly predicted caregiver medication administration hassles scores F(1, 48) = 4.90, p = .032, and accounted for approximately 25% of the variance of self-reported hassles (adjusted R= .247). Discussion Future interventions may reduce medication-related hassles by providing psychoeducation about healthcare, medication management, and strategies for coping with care-related stressors and depressed mood.

Tools to evaluate medication management for caregivers of people living with dementia: A systematic review

“…Schmidt et al 26 reported that almost an equal proportion of 152 caregivers were involved in decisions about dosages (80.9%) as they were involved in decisions to initiate/cease medications (80.3%). This finding was similarly reported by George and Steffen, who found that most caregivers in the study were involved in decisions regarding dosage changes (83.0%) and in initiating/ceasing medications for the person living with dementia (86.8%) 21 . Travis et al reported a correlation between increased complexity in medication selection (medication‐related decision‐making) and increased caregiver burden in medication management, which was indicated by elevated Hassles and Medication Complexity Index scores (Medication Complexity Index, r = .19, p = .05; Hassles Caregiver Strain Index, r = .44, p = .01) 27 .…”

“…Study designs included cross‐sectional studies ( n = 8), unblinded randomized‐controlled trials ( n = 1) and mixed‐methods studies ( n = 1), with sample size ranging from 53 to 1369 participants (Table 1). Only 1 22 out of the 10 included studies reported the stage of dementia diagnosis for their participants 5,21–29 . Medication selection was an aspect of medication management reported in 6 out of 10 studies, 21,23,26–29 supply 5,21,23,24,26–28 and monitoring/review 5,22,23,25–27,29 was captured in seven studies and administration was reported in nine studies 5,21–28 .…”

“…Caregiver involvement in medication administration showed a wide range, from 44% to 94.7%, across nine studies 5,21–28 . Two studies reported on administration in relation to the number of medications administered 21,23 .…”

“…Most caregivers were involved in decision‐making regarding medication changes for the person with dementia (77.1%–86.8%) 21,23,28 . Schmidt et al 26 reported that almost an equal proportion of 152 caregivers were involved in decisions about dosages (80.9%) as they were involved in decisions to initiate/cease medications (80.3%).…”

Reflections on quality of care for persons with dementia: moving toward an integrated, comprehensive approach

“…El-Saifi and colleagues’ (2018) study, which also focuses on informal caregivers, examines one of the most complicated, yet largely understudied, responsibilities of family caregivers of persons with dementia – securing appropriate medication adherence (George and Steffen, 2017). While previous studies have examined caregivers’ characteristics, associated with their own medication adherence (Wang et al , 2015), to the best of my knowledge, this is the first study to assess caregivers’ factors associated with care-receivers’ medication adherence.…”