Effects of family caregivers on the use of formal long-term care in South Korea
ABSTRACT We investigated whether the presence and characteristics of a family caregiver affect the use of formal long-term care under the new Korean long-term care system.
In July 2008, Korea introduced public long-term care insurance, a form of social insurance, in order to cope with the reality of the growing elderly population and the increasing demand for long-term care.
The family caregivers of 271 applicants for long-term care insurance who had a caregiver and 36 applicants without a caregiver living in one city participated in this cross-sectional study. Data were collected from November 2010 to June 2011 using self-report questionnaires. Variables included the applicant's gender; age; physical and cognitive function; type of long-term care used; presence and type of family caregivers; caregiver's gender, age, education level, marital status, and employment status; and service use covered by long-term care insurance. Logistic multiple regression was used.
The effect of the presence and characteristics of a family caregiver on the use of a long-term care facility was significant. A nursing home was used for care more frequently when the applicant had no family caregiver. An elderly subject who had a spouse as a caregiver used home healthcare services more often than nursing home services.
The decision to use formal services may depend not only on the care level required by the applicant, but also on the presence and type of caregivers. To successfully implement the new long-term care insurance system, consideration of the caregiver situation should be included in policy development.
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ABSTRACT: The aim of this study was to examine the emotional and physical health and experiences of daughter-in-law (DIL) caregivers compared with daughter caregivers who care for cognitively and/or functionally impaired older people in Korea. In Korea, DILs are the predominant caregivers of impaired older people, but little is known about DIL caregivers. A study which explores the emotional and physical health outcomes of DIL caregivers who care for impaired parents-in-law in the sociocultural context of Korea is necessary. A cross-sectional descriptive correlational study was conducted to examine the emotional and physical health of 93 DIL caregivers compared with 27 daughter caregivers who care for the cognitively and/or functionally impaired older people in Korea. This study hypothesized that DIL caregivers would have poorer emotional and physical health than daughter caregivers and that the type of relationship with the care-recipient is an important predictor of caregivers' health outcomes. t-tests, chi-square and hierarchical regression analyses were used for hypotheses testing. Contrary to expectations, this study found that caregivers' health outcomes were very similar for DILs and daughters in Korean families. The type of relationship was not an important predictor of caregivers' health outcomes, and neither was the quality of intergenerational relationship. However, Korean DIL and daughter caregivers reported relatively poor emotional and physical health compared to those of Western caregivers in previous studies. Daughter-in-laws caregivers were not at greater risk group of negative health outcomes than daughter caregivers. However, DIL and daughter caregivers in Korea were a vulnerable group regardless of their relationship with the care-recipient. The cultural norms and social expectations regarding family-centred caregiving in Korea may cause negative health outcomes for Korean caregivers. Further family caregiving studies in the Korean context are recommended.Journal of Advanced Nursing 12/2001; 36(3):399-408. DOI:10.1046/j.1365-2648.2001.01987.x · 1.69 Impact Factor
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ABSTRACT: In April 2000, the system for caring for the elderly in Japan was changed drastically with the launch of new long-term care insurance. Unlike the previous system, the maximum monthly amount of insured services is now decided solely by an applicant's physical condition, regardless of family support. We investigated whether the presence and kinship of a family caregiver still affect service use under the new system. A cross-sectional, mailed, self-administered questionnaire survey and analysis using multiple logistic regression. One month after the introduction of long-term care insurance in Japan. The main family caregivers of 237 applicants for long-term care insurance with a caregiver and 33 applicants without a caregiver, living in the community in one city. The applicants' sex, age, and eligible care level, existence of a family caregiver, family caregiver's sex, age, and kinship, and service use for each service covered by long-term care insurance. Caregiver factors significantly affected use of the main services. The most popular service, nursing-home daycare, was utilized most when a wife was caring for her husband. As the level of care increased, this service was utilized less. Home help, the second most popular service, was most utilized when a wife was caring for her husband or when there was no caregiver. The use of major services may be decided more by the needs of caregivers than by the care level of the applicant. To successfully implement the new system, consideration of the caregiver situation should be included in policy making.International Journal for Quality in Health Care 09/2002; 14(4):295-303. DOI:10.1093/intqhc/14.4.295 · 1.58 Impact Factor
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ABSTRACT: The objective of the present study was to identify predictors of institutionalization in African Americans who suffer from dementia. Data were derived from the Medicare Alzheimer's Disease Demonstration Evaluation (MADDE), which collected information on Alzheimer's patients and their family caregivers over a 3-year period. The baseline MADDE sample included 667 older African Americans suffering from dementia recruited from eight catchment areas in the United States. A Cox proportional hazards model was used to create a predictive model of institutionalization. Subsequent analyses found that care recipient age, sex, Medicaid eligibility, and cognitive impairment; site; and caregiving burden were significant predictors of time to placement. The results, among the first to examine predictors of nursing home placement of cognitively impaired African Americans, emphasize the clinical implications and complex interplay of race, dementia, and caregiving context in the institutionalization process.Journal of the American Geriatrics Society 04/2004; 52(3):445-52. DOI:10.1111/j.1532-5415.2004.52120.x · 4.22 Impact Factor