The Burden Experience of Formal and Informal Caregivers of Older Adults With Hip Fracture in Nigeria

Abstract

Introduction: The incidence of hip fracture among older adults in Nigeria is on the rise. As a result, there is increased frequency of hospitalization, patient suffering, family burden, and societal cost. One dimension that has not been sufficiently explored is the burden of care experienced by informal and formal caregivers. Objectives: To describe the care burden experience of informal and formal caregivers for older adults with hip fractures in a specialized orthopedic center in Nigeria and to explore in detail how their experience differs in caregiving roles. Method: This study was conducted in the phenomenological approach of qualitative methods. Face-to-face interviews and focus group interaction with 12 family caregivers and 5 health-care professionals were carried out until data saturation was achieved. Data were analyzed using thematic analysis. Results: The physical, emotional, and general health of elderly hip fracture patients are issues that affect caregiving. Factors that contribute to increased caregivers' burden include system factors (lack of personnel and health-care facilities) and patient factors: comorbidity, patient's cognitive status, and challenges completing activities of daily living (ADL). Social and financial barriers to care contribute to the type of burden experienced by the participants. Conclusions: Caregivers experience difficulty in helping patients complete their ADL because patients with hip fracture have mobility issues that are often complicated by comorbid physical and cognitive problems. Strategies to reduce caregivers' burden for older adults with hip fracture in Nigeria are needed. Greater access to health-care services and ADL aids, and training of caregivers on how to deal with cognitive and multimorbid health problems are potential solutions.

Resuming Normal Life as a Family Caregiver During Drip‐Like Recovery of Older Persons With Cognitive Impairment Recovering From Hip Surgery: A Grounded Theory

“…Family caregivers in this study described the recovery of hip‐fractured persons with cognitive impairment as slow as dripping water. Our findings are supported by prior reports that older hip‐fractured persons’ cognitive function influenced family caregivers’ role in providing instrumental and supervisory care at home and made caring difficult for family caregivers (Diameta et al, 2018; Ramazanu & Griffiths, 2017). Our study also adds to the knowledge base by identifying family caregivers’ experiences in providing care to hip‐fractured older persons with cognitive impairment during a slow recovery process, implementing strategies, and related contextual factors.…”

“…The cognitive function of older hip‐fractured persons was found to influence family caregivers’ role in providing instrumental and supervisory care at home and made care difficult for family caregivers (Diameta et al, 2018; Ramazanu & Griffiths, 2017). However, few studies were found on family caregiving processes for hip‐fractured persons with cognitive impairment.…”

Caring for the seniors with chronic illness: The lived experience of caregivers of older adults

“…In developed countries, many studies have been conducted among the older adults and their caregivers to examine prevalence and health effects of caregivers’ burden as well as coping and support strategies ( Herrera, Lee, Nanyonjo, Laufman, & Torres-Vigil, 2009 ; Schulz & Martire, 2004 ). Previous studies in the sub-Saharan ( Dotchin et al, 2014 and Mugisha et al, 2013 ) as well Nigerian studies on caregiving have focused on specific illness conditions especially mental illness ( Adeosun, 2013 and Jack‐Ide, Uys, & Middleton, 2013 ) and ( Yusuf, Nuhu, & Akinbiyi, 2009 ) older adults with hip fracture ( Diameta et al, 2018 ), cancer ( Akpan-Idiok & Anarado, 2014 ), and patients with End-Stage Renal Disease ( Oyegbile & Brysiewicz, 2017 ). Similarly, Faronbi (2018) and Faronbi and Olaogun (2017) quantitatively examined the burden of caregiving for older adults chronic illness.…”

Physiotherapists’ role during hospital-to-home transition for older adults with hip fracture and mobility limitation: A research protocol

“…1,2 Worldwide, the estimated number of hip fractures in older adults is expected to reach 6.3 million in 2050. 3 While there is no national directory that reports the incidence of hip fracture among older adults in Nigeria, there are 1 McMaster University, Canada 2 Emerging Researchers & Professionals in Ageing-African Network, Nigeria 3 University of Portharcourt Teaching Hospital, Nigeria 4 Mackenzie Physiotherapy Clinic, Nigeria 5 Obafemi Awolowo Teaching Hospital Complex, Nigeria 6 Cedacrest Hopitals, Nigeria 7 Lily Hospitals Limited, Nigeria 8 Western University, Canada 9 University of Nigeria, Nigeria 10 Humanity Hospital Limited, Nigeria 11 University of Manitoba, Canada 12 Peak Wellness Center, Abuja 13 Federal Medical Center, Nigeria 14 Elroi Mission Hospital, Nigeria 15 Glasgow Caledonian University, UK individual studies that have explored the incidence of hip fracture among older adults in different regions in Nigeria. For instance, Adebajo et al 4 reported a 2.1 per 100,000 and 2.0 per 100,000 incidents in hip fractures in men and women older than 50 years, respectively.…”

“…Since 98.6% of Nigerians pay out of pocket for most healthcare services including physiotherapy, 8 patients/relatives have reported a financial burden as a result of caring for older adults with hip fracture. 9 Mobility deficits in older adults with hip fractures are often missed during hospital-to-home transitions. [10][11][12] Additionally, studies have reported that functional deficits such as gait, speed, muscle strength or reduced activities in daily living after discharge are independent functional predictors for hospital readmission for older adults.…”