Subjective and objective burden and psychological distress in care partners of older adults with traumatic brain injury.

Abstract

Purpose/Objective: In care partners of older persons (65 years and older) having sustained traumatic brain injury (TBI), the objectives were (a) to describe subjective burden (emotional, social, financial, and physical burden), objective burden (new roles and responsibilities), and psychological distress at 4 months postinjury, and (b) to explore the predictors of subjective burden and psychological distress. Research Method/Design: This is an observational study of care partners of older adults with TBI (n = 46; Mage = 65.2 years, SD = 11.2, 87% female). Participants completed the Zarit Burden Interview, the Hospital Anxiety and Depression Scale, the Brain Injury Complaint Questionnaire (measuring difficulties of the injured older adult perceived by the care partner), and the modified Medical Outcomes Study Social Support Survey. Results: A majority of care partners (88%) reported at least one form of objective burden (e.g., increased/decreased time spent in certain activities post-TBI), 29% perceived at least mild subjective burden, and 27% reported either significant anxiety or depressive symptoms. Linear regressions indicated that a higher number of difficulties reported regarding the injured person and poorer perceived social support predicted higher subjective burden and psychological distress. A younger age of the care partner also predicted a higher subjective burden. Conclusions/Implications: This study provides a better understanding of the potential impacts of TBI in older age for care partners. Future research should examine how to support adequately care partners in their psychological adaptation after TBI in an elderly person.

Challenges and facilitators in the experience of caregiving for an older adult with traumatic brain injury: A longitudinal qualitative study in the first-year postinjury.

“…Family caregivers, for example, spouses or children of the injured person, are known to be those who will most commonly compensate for the physical and cognitive limitations of their loved one with TBI, rendering their help essential to the daily functioning of this person, especially in a context of limited healthcare resources (Lamontagne et al, 2009; Lefebvre et al, 2008). They take on new or increased responsibilities of support and care (Bayen et al, 2013; Lamontagne et al, 2009; Villeneuve et al, 2023), which, as we observed, may limit their own activities (theme “decrease in activities and outings”), but can facilitate the maintenance of the injured person in their home and contribute to their quality of life. Indeed, in severely injured participants with significant sequelae, our team previously showed that being at home was a salient feature in the well-being of the dyad, regardless of the persistent sequelae present in the injured relative (Souesme et al, 2022).…”

“…To date, however, there are very few studies documenting the extent and experience of burden in caregivers of older adults with TBI. Recently, our team (Villeneuve et al, 2023) found that, at 4 months postinjury, 88% of care partners reported at least one form of objective burden (e.g., increased responsibilities, decreased time for themself), and 28% perceived at least mild subjective burden. In addition, 27% reported either significant anxious or depressive symptoms.…”