The Well-Being of Carers of Older Aboriginal People Living in the Kimberley Region of Remote Western Australia: Empowerment, Depression, and Carer Burden

Abstract

Objective: To describe demographic features and well-being of carers of Aboriginal Australians aged ≥45 years in remote Western Australia. Method: Carer burden, empowerment, and depression were assessed in 124 Aboriginal carers in four remote Aboriginal communities. Results: Carers were aged 38.8 ± 15.0 years, 73.4% were female, and 75.8% were children or grandchildren of the person cared for. The mean Zarit-6 score was 3.7 ± 3.6. Attending high school (odds ratio [OR] = 0.3; 95% confidence interval [CI] = [0.1, 0.7]) and feeling empowered (OR = 0.2; 95% CI = [0.1, 0.8]) were inversely associated with carer burden; female carers were less likely to feel empowered (OR = 0.4; 95% CI = [0.2, 0.9]); and empowerment was inversely associated with depression (OR = 0.3; 95% CI = [0.1, 0.7]). Discussion: Aboriginal carers in remote communities are relatively young and most are children or grandchildren. Carer burden was lower than anticipated. However, existing tools may not adequately measure Aboriginal perspectives. Education and empowerment are key factors which support programs must consider.

Assessment tools measuring health-related empowerment in psychosocially vulnerable populations: a systematic review

“…The various methods of assessing content validity reported in six of the studies included brief descriptions of content revision [ 31 , 45 ], calculation of the content validity ratio and content validity index [ 32 ], rating of measurement tool scale items by expert panels [ 20 , 43 ], and independent item ratings and participants readability and clarity [ 44 ]. The face validity of measurement tools, for example, difficulty and relevance of response items, was assessed with a participant feedback approach in only two studies [ 20 , 32 ].…”

“…Of the 26 studies reviewed, seven reported one or more aspects of measurement tool feasibility and/or clinical utility in terms of who carried out the assessment [ 15 , 45 ], the number of missing responses [ 17 , 20 , 48 ], participants self-reported experiences of using the tool [ 20 , 39 , 43 , 48 ], as well as the amount of time needed to complete an assessment [ 20 , 39 , 43 ].…”

“…Whilst some empowerment scales have been successfully validated across populations, settings and cultures, they may not measure up in a cursory assessment of their feasibility or clinical application. For example, the GEM was developed and validated with Aboriginal Australians and studies have reported that it effectively captured changes within Indigenous people participating in specific empowerment programs [ 13 , 17 , 45 ]. The GEM requires significant investment for implementation as it encourages participants to reflect on their life experiences and requires an average of 30 min to complete the scale [ 49 ].…”

Prevalence of functional limitations in older remote‐living Aboriginal Australians

“…Although most people with functional limitations were receiving support, this was predominantly provided by family members and friends, with potential implications for carers' health and well-being. 24,25 Our data were collected prior to the advent of Australia's National Disability Insurance Scheme (NDIS) and My Aged Care, which Islander people access aged care at lower than expected rates given their high level of need, and that access to culturally safe services is limited. 26 Aboriginal and Torres Strait Islander people living in remote areas have significantly reduced access to services.…”

“…Although most people with functional limitations were receiving support, this was predominantly provided by family members and friends, with potential implications for carers' health and well‐being 24,25 . Our data were collected prior to the advent of Australia's National Disability Insurance Scheme (NDIS) and My Aged Care, which provide funding to individuals with disability to access support and services.…”