Prevalence and correlates of anxiety and depression in caregivers to assisted living residents during COVID-19: a cross-sectional study

Lane, Natasha E.; Hoben, Matthias; Amuah, Joseph E.; Hogan, David B.; Baumbusch, Jennifer; Gruneir, Andrea; Chamberlain, Stephanie; Griffith, Lauren; McGrail, Kimberlyn; Corbett, Kyle; Maxwell, Colleen J.

doi:10.1186/s12877-022-03294-y

Cited by 13 publications

(12 citation statements)

References 45 publications

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“…The reasons for this decline if confirmed by other studies warrant further research. Both AL experts 42 and family/friend caregivers 43,44 felt the pandemic negatively impacted the mood of AL residents. Depression in both AL and NHs is a major problem 45 .…”

Section: Discussionmentioning

confidence: 99%

“…The differences in both resident characteristics 46 and in their design and functioning might explain the lower baseline rates of depression found in AL compared to NHs, but the decline in depressive symptoms in AL at the start of the pandemic is harder to explain. The contributions of family/friend caregivers are particularly important to resident care in AL 43,44 . Therefore, visitor restrictions, particularly at the start of the pandemic, might have contributed to greater psychological distress for AL residents.…”

Section: Discussionmentioning

confidence: 99%

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Comparing quality of care outcomes between assisted living and nursing homes before and during the COVID‐19 pandemic

Hoben

Hogan

Poss

et al. 2023

J American Geriatrics Society

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BackgroundWhile assisted living (AL) and nursing home (NHs) residents in share vulnerabilities, AL provides fewer staffing resources and services. Research has largely neglected AL, especially during the COVID‐19 pandemic. Our study compared trends of practice‐sensitive, risk‐adjusted quality indicators between AL and NHs, and changes in these trends after the start of the pandemic.MethodsThis repeated cross‐sectional study used population‐based resident data in Alberta, Canada. Using Resident Assessment Instrument data (01/2017–12/2021), we created quarterly cohorts, using each resident's latest assessment in each quarter. We applied validated inclusion/exclusion criteria and risk‐adjustments to create nine quality indicators and their 95% confidence intervals (CIs): potentially inappropriate antipsychotic use, pain, depressive symptoms, total dependency in late‐loss activities of daily living, physical restraint use, pressure ulcers, delirium, weight loss, urinary tract infections. Run charts compared quality indicators between AL and NHs over time and segmented regressions assessed whether these trends changed after the start of the pandemic.ResultsQuarterly samples included 2015–2710 AL residents and 12,881–13,807 NH residents. Antipsychotic use (21%–26%), pain (20%–24%), and depressive symptoms (17%–25%) were most common in AL. In NHs, they were physical dependency (33%–36%), depressive symptoms (26%–32%), and antipsychotic use (17%–22%). Antipsychotic use and pain were consistently higher in AL. Depressive symptoms, physical dependency, physical restraint use, delirium, weight loss were consistently lower in AL. The most notable segmented regression findings were an increase in antipsychotic use during the pandemic in both settings (AL: change in slope = 0.6% [95% CI: 0.1%–1.0%], p = 0.0140; NHs: change in slope = 0.4% [95% CI: 0.3%–0.5%], p < 0.0001), and an increase in physical dependency in AL only (change in slope = 0.5% [95% CI: 0.1%–0.8%], p = 0.0222).ConclusionsQIs differed significantly between AL and NHs before and during the pandemic. Any changes implemented to address deficiencies in either setting need to account for these differences and require monitoring to assess their impact.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing quality of care outcomes between assisted living and nursing homes before and during the COVID‐19 pandemic

Hoben

Hogan

Poss

et al. 2023

J American Geriatrics Society

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“…Qualitative evidence [11,26] suggests that visiting restrictions "disrupted regular care routines, limited families' opportunities for social engagement with residents, and interfered with regular monitoring of their relative's well-being" [4, p. 237]. In line with this qualitative evidence, our own research involving 673 caregivers to AL residents in Western Canada [8,9] suggests that not being able to visit and assist the resident with care tasks was associated with increased depressive and anxiety symptoms among caregivers, as well as increased concern about the resident's loneliness and mental well-being. Building on our previous studies of AL caregivers [8,9], our objectives were to describe the nature and extent of caregiver involvement and concerns with the care of AL residents prior to the COVID-19-related visitor restrictions and how these outcomes changed during pandemic waves 1 (Mar to Jun 2020) and 2 (Oct 2020 to Feb 2021).…”

Section: Introductionmentioning

confidence: 86%

Caregiver Involvement and Concerns with Care of Residents of Assisted Living before and during the COVID-19 Pandemic

Hoben¹,

Li²,

Dampf³

et al. 2023

Gerontology

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Introduction Family/friend caregivers play an essential role in promoting the physical and mental health of older adults in need of care – especially during the COVID-19 pandemic and especially in assisted living (AL) homes, were resident care needs are similarly complex as in long-term care homes but fewer staffing resources and services are available. However, little research is available on caregiver involvement and concerns with care of AL residents prior to and during waves 1 and 2 of the COVID-19 pandemic. This study addressed this important knowledge gap. Methods This prospective cohort study used baseline and follow-up online surveys with primary caregivers to AL residents in Western Canada who were 65 years or older and had lived in the AL home for at least 3 months before Mar 1, 2020. Surveys assessed the following outcomes in the three months prior to and during waves 1 and 2 of the pandemic: socio-demographics, 5 ways of visiting or communicating with residents, involvement in 16 care tasks, concerns with 9 resident physical/mental health conditions, perceived lack of resident access to 7 care services, and whether caregivers felt well informed and involved with resident care. Results Based on 386 caregiver responses, in-person visits dropped significantly in wave 1 of the pandemic and so did caregiver involvement in nearly all care tasks. While these rates increased in wave 2, most did not return to pre-pandemic levels. Correspondingly, caregiver concerns (already high before the pandemic) substantially increased in wave 1 and stayed high in wave 2. These were particularly elevated among caregivers who did not feel well informed/involved with resident care. Discussion/Conclusions Restricted in-person visiting disrupted resident care and was associated with worse perceptions of resident health and wellbeing. Continued caregiver involvement in resident care and communication with caregivers even during lockdowns is key to mitigating these issues.

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“…Furthermore, caregiver concerns about resident care and difficulties staying involved in resident care can negatively affect caregivers’ mental health ( Puurveen et al, 2018 ). In our own research ( Lane et al, 2022 ), we surveyed 673 caregivers of AL residents in the Canadian provinces of Alberta and British Columbia between October 2020 and March 2021 and found significant anxiety in 29% and clinically meaningful depressive symptoms in 39% of the participants. Those whose concerns about the resident being depressed increased or remained consistently high in the 3 months after (vs. before) the start of the pandemic were more likely (risk ratios between 1.6 and 2.1) to experience moderate or severe depressive and anxiety symptoms ( Lane et al, 2022 ).…”

mentioning

confidence: 99%

“…In our own research ( Lane et al, 2022 ), we surveyed 673 caregivers of AL residents in the Canadian provinces of Alberta and British Columbia between October 2020 and March 2021 and found significant anxiety in 29% and clinically meaningful depressive symptoms in 39% of the participants. Those whose concerns about the resident being depressed increased or remained consistently high in the 3 months after (vs. before) the start of the pandemic were more likely (risk ratios between 1.6 and 2.1) to experience moderate or severe depressive and anxiety symptoms ( Lane et al, 2022 ). During the Severe Acute Respiratory Syndrome (SARS) outbreaks in Toronto, Canada, in 2003, caregivers of nursing home residents experienced fear, worry, loss of control, frustration, and guilt as a consequence of visiting restrictions ( McCleary et al, 2006 ).…”

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confidence: 99%

Caregivers’ Concerns About Assisted Living Residents’ Mental Health During the COVID-19 Pandemic: A Cross-Sectional Survey Study

et al. 2022

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Family or friend caregivers’ concerns about assisted living (AL) residents’ mental health are reflective of poor resident and caregiver mental health. COVID-19-related visiting restrictions increased caregiver concerns, but research on these issues in AL is limited. Using web-based surveys with 673 caregivers of AL residents in Western Canada, we assessed the prevalence and correlates of moderate to severe caregiver concerns about residents’ depressed mood, loneliness, and anxiety in the 3 months before and after the start of the COVID-19 pandemic. Caregiver concerns doubled after the start of the pandemic (resident depressed mood: 23%–50%, loneliness: 29%–62%, anxiety: 24%–47%). Generalized linear mixed models identified various modifiable risk factors for caregiver concerns (e.g., caregivers’ perception that residents lacked access to counseling services or not feeling well informed about and involved in resident care). These modifiable factors can be targeted in efforts to prevent or mitigate caregiver concerns and resident mental health issues.

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Prevalence and correlates of anxiety and depression in caregivers to assisted living residents during COVID-19: a cross-sectional study

Cited by 13 publications

References 45 publications

Comparing quality of care outcomes between assisted living and nursing homes before and during the COVID‐19 pandemic

Comparing quality of care outcomes between assisted living and nursing homes before and during the COVID‐19 pandemic

Caregiver Involvement and Concerns with Care of Residents of Assisted Living before and during the COVID-19 Pandemic

Caregivers’ Concerns About Assisted Living Residents’ Mental Health During the COVID-19 Pandemic: A Cross-Sectional Survey Study

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