The Effectiveness and Cost-Effectiveness of Respite for Caregivers of Frail Older People

Centre for Health Economics, University of York, York, United Kingdom.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 03/2007; 55(2):290-9. DOI: 10.1111/j.1532-5415.2006.01037.x
Source: PubMed


The proportion of frail elderly people in the industrialized world is increasing. Respite care is a potentially important way of maintaining the quality of life for these people and their caregivers. The objective of this systematic review was to determine the effectiveness and cost-effectiveness of different models of community-based respite care for frail older people and their caregivers. To identify relevant studies, 37 databases were searched, and reference checking and citation searches were undertaken. Well-controlled effectiveness studies were eligible for inclusion, with uncontrolled studies admissible only in the absence of higher-quality evidence. Studies assessed the effect of community-based respite on caregivers of frail elderly people relative to usual care or to another support intervention. Eligible economic evaluations also addressed costs. Where appropriate, data were synthesized using standard meta-analytic techniques. Ten randomized, controlled trials, seven quasi-experimental studies and five uncontrolled studies were included in the review. For all types of respite, the effects upon caregivers were generally small, with better-controlled studies finding modest benefits only for certain subgroups, although many studies reported high levels of caregiver satisfaction. No reliable evidence was found that respite care delays entry to residential care or adversely affects frail older people. The economic evaluations all assessed day care, which tended to be associated with similar or higher costs than usual care. Given the increasing numbers of frail elderly people and the lack of up-to-date, good-quality evidence for all types of respite care, better-quality evidence is urgently needed to inform current policy and practice.

Download full-text


Available from: Anne Rosemary Mason,
  • Source
    • "This will necessitate new, innovative ways of delivering services to older people. However, no reliable evidence was found that respite care delays entry to residential care or adversely affects frail older people [8]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to describe nurses' experiences of their collaboration and relationships with family members in institutional respite care for the elderly. The family has a particularly important role in respite care, which is an extension of care provided at home. However no published studies were found on this subject. The data were collected through qualitative interviews (N = 22). Content analysis of the nurses' descriptions of their collaboration with family members yielded four main categories as follows: (1) conscious ignoring, (2) attempting to understand the family's situation, (3) hinting at private family matters, and (4) being a friend. The results lend support to earlier findings which emphasize the complexity of relationships between nurses and family carers. A novel finding here is that these relationships may also develop into friendships. Greater emphasis must be placed on primary nursing so that the nurse and informal carer can build up a genuine relationship of trust. If periods of respite care are to help older people and their families to manage independently, it is imperative that nurses have the opportunity to visit their patients at home.
    03/2013; 2013:967084. DOI:10.1155/2013/967084
  • Source
    • "In summary, the multicomponent intervention and specifically those involving the patient are usually the most effective interventions. It is worthy to mention that the respite care, despite it improves the satisfaction, does not affect the overburden and they neither reach to postpone the institutionalization [23,24]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The need of home care services is becoming an increasingly common scenario. These cares are mainly provided by the dependents’ relatives specifically, by the women part of the family. This situation might take years, decreasing the physical and psychological health of the caregiver. In Spain, the Act of Promotion of Personal Autonomy and Care for dependent persons, guarantees those dependent persons and their caregivers to have access to social services or to financial grants. The aim of this study is to Know the possible effects of the benefits provided by this Act in regards to the mental health, the quality of life and use of health services by the family caregivers assisting their relatives in situation of dependency. Methods and design A longitudinal descriptive study following-up a cohort of patients and caregivers. The study shall be carried out in Andalusia. It shall include the baseline assessment of the variables in those caregivers free from the exposure factor (reception of assistance pursuant to the Act). Following, once the benefits have been received, this cohort shall be followed-up. The study shall take three years, and the starting date for its development as well as its funding is January 2011. Discussion The longitudinal assessment of the rate of change of the variables studied shall allow us to know the implications which might be potentially generated as well as the natural evolution of those.
    BMC Health Services Research 12/2012; 12(1):462. DOI:10.1186/1472-6963-12-462 · 1.71 Impact Factor
  • Source
    • "Health-related quality of life (HRQOL) is a multidimensional measure that assesses patients' perceptions of their functional limitations as it relates to their physical, social, and emotional functional. HRQOL may be a key measure to assess ADS outcomes because it potentially could inform individual care plans and quality assessments (Kane, 2003; Mason et al., 2007; Norris et al., 2008). However, little is known whether ADS attendance is associated with participants' quality of life. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable community-dwelling older adults who did not attend an ADHC. Assessments were conducted at study enrollment, 6 and 12 months. ADHC participants (n = 57) and comparison group subjects (n = 67) were similar at baseline in age, ethnic diversity, medical conditions, depression, cognition, immigration history, education, income, and marital status. Significantly more comparison group subjects lived alone (p = .002). One year after enrollment, the SF-36 domains role physical and role emotional improved significantly. Adjusted role physical scores for ADHC participants improved (23 vs. 36) but declined for the comparison group (38 vs. 26, time by group interaction p = .01), and role emotional scores improved for ADHC participants (62 vs.70) but declined for the comparison group (65 vs. 48, time by group interaction p = .02). Secondary analyses revealed that changes in daily physical functioning, depressed affect, or cognitive functioning did not explain the improvements found in role physical and role emotional scores for ADHC participants. No significant differences in trends for the 2 groups occurred for the SF-36 domains physical functioning, social functioning, and mental health. ADHC participation may enhance older adults' quality of life. Quality of life may be a key measure to inform care planning, program improvement, and policy development of ADHC.
    The Gerontologist 08/2010; 50(4):531-40. DOI:10.1093/geront/gnp172 · 3.21 Impact Factor
Show more