Archived project

Services for Supporting Family Carers of Elderly People in Europe: Characteristics, Coverage and Usage - EUROFAMCARE

Goal: https://www.uke.de//extern/eurofamcare/

Methods: Qualitative Interview, Focus Group, Health Policy Analysis, interview-based longitudinal surveys

Date: 1 January 2003 - 31 December 2005

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Mirko Di Rosa
added 2 research items
Objective: The aim of the analysis is to assess the impact of privately employed migrant care workers (MCWs) on the burden of Italian family members who care for a disabled older person. Methods: EUROFAMCARE is a one-year prospective survey carried out to provide evidence on the availability and use of support services by family carers of older people in Europe. In Italy, 990 family caregivers were enrolled and successful follow-ups were completed for 863 subjects. The survey also assessed the level of caregiver burden using the COPE index, which has three sub-sections: 'Positive Value' (PV), 'Quality of Support' (QS) and 'Negative Impact' (NI). We used the one-year change of the COPE-NI as dependent variable and we realised multilevel regression models to estimate the longitudinal predictors of caregivers' burden increase. Results: At a cross-sectional level, most burdened caregivers are those caring for a demented relative (COPE-NI = 13.6), with no educational title (14.5) and looking after their own spouses (15.1). Longitudinally those employing an MCW are significantly protected against burden increase (regression coefficient: -1.52; p < 0.01) while those who cannot rely on the support of other family members are exposed to the risk of burden increase (0.991; p < 0.05). Other formal services do not have any protective effect. Conclusion: Our study suggests that employing an MCW, rather than using formal services, is associated with a reduction of caregiving burden. Further research should assess whether the shift in care responsibilities to the MCWs also implies a transfer of care burden, and understand how these workers can be better supported by existing formal services.
Barbara Bien
added 4 research items
Objectives The aim of this article was to identify the best predictors of distress suffered by family carers (FCs) of geriatric patients. Methods A cross-sectional study of 100 FC-geriatric patient dyads was conducted. The negative impact of care (NIoC) subscale of the COPE index was dichotomized to identify lower stress (score of ≤15 on the scale) and higher stress (score of ≥16 on the scale) exerted on FCs by the process of providing care. The set of explanatory variables comprised a wide range of sociodemographic and care-related attributes, including patient-related results from comprehensive geriatric assessments and disease profiles. The best combination of explanatory variables that provided the highest predictive power for distress among FCs in the multiple logistic regression (LR) model was determined according to statistical information criteria. The statistical robustness of the observed relationships and the discriminative power of the model were verified with the cross-validation method. Results The mean age of FCs was 57.2 (±10.6) years, whereas that of geriatric patients was 81.7 (±6.4) years. Despite the broad initial set of potential explanatory variables, only five predictors were jointly selected for the best statistical model. A higher level of distress was independently predicted by lower self-evaluation of health; worse self-appraisal of coping well as a caregiver; lower sense of general support; more hours of care per week; and the motor retardation of the cared-for person measured with the speed of the Timed Up and Go (TUG) test. Conclusion Worse performance on the TUG test was only the patient-related predictor of distress among the variables examined as contributors to the higher NIoC. Enhancing the mobility of geriatric patients through suitably tailored kinesitherapeutic methods during their hospital stay may mitigate the burden endured by FCs.
The aim of the longitudinal study was the evaluation of the changing socio-medical conditions of the old citizens of Bialystok during a 5 year period of observation. The study was based on the analysis of 6 age/sex cohorts of 100 men and 100 women born in 1899, 1909, 1919. A stratified systematic sampling of the entire population of the city in the required generation was used. The survey was conducted twice, in 1979 and 1984, and employed a questionnaire prepared by the Editorial Board of the Comparative Study of Eleven Countries developed by WHO. The questionnaire included items concerning personal data, occupation, housing conditions, health status, functional ability, the use of health services, social activity and life satisfaction. The data allow us to consider aging in all its aspects — health status, life style, opinions and feelings of the elderly — according to age group (cross-sectional analysis) and according to the progression of chronological age in the same cohorts (longitudinal analysis).
Identification of optimal predictors of the 5.5-year survival in former geriatric inpatients.Investigation of the direction and shape of the relationship between mortality risk and its predictors. Retrospective survival analysis with the application of the Cox proportional hazards model. Teaching geriatric unit. 478 inpatients (mean age 77.9; +6.8) discharged from geriatric ward during year 2008, without any exclusion criteria. Comprehensive geriatric assessment of numerous health variables, body mass index (BMI), clinical and biochemical findings, and outcomes of the final diagnosis. Records on the dates of deaths were obtained from the Provincial Office of Population Register. During the 5.5-year follow-up 209 (43.7%) patients died. In the multivariate setup, six risk factors with an independent impact on mortality were identified: age (p=0.036), cognitive functioning on the Blessed test (p=0.005), score on instrumental ADL (p<0.0001), score on Charlson comorbidity index (p<0.0001), cholesterol level (p<0.0001), BMI (p<0.0001), and hemoglobin level (p=0.02). The latter two predictors exhibited a significant inverted J-shaped association with mortality, i.e., considerably higher risk of death corresponds to the lower values of these variables in comparison to their higher levels. Older age, worse IADL and cognitive functioning, and higher comorbidity were recognized as endangering one's long-term survival. On the other hand, moderate obesity (BMI 36), higher cholesterol and the absence of anemia (hemoglobin 13.6 g/dL) are associated with longer survival. Therefore, irrespective of the individualized treatment and physical exercise, nutrient-dense food seems to be a key recommendation to prevent frailty or malnutrition in the oldest and comorbid population.
Mirko Di Rosa
added 2 research items
"Il Secondo Rapporto NNA inizia dalla discussione dei più recenti dati disponibili (la “Bussola” di NNA). Poi presenta un bilancio delle azioni compiute dal governo, discute gli interventi realizzati dalle diverse Regioni e, infine, analizza la più recente sanatoria delle badanti. La parte successiva propone un approfondimento monografico sui servizi domiciliari. Ne illustra le principali caratteristiche in Italia, ne esamina i modelli organizzativi e s’interroga sulla loro capacità di rispondere ai bisogni del territorio. Conclude un confronto tra il nostro Paese e l’estero. Così come il precedente, il Secondo Rapporto NNA è scaricabile gratuitamente dal sito www.maggioli.it/rna Pubblichiamo questo articolo di Di Rosa, Melchiorre, Lamura che offre una visione strategica e molto attuale dei servizi domiciliari in Italia. È stato ripreso dal Secondo Rapporto Non Autosufficienza, recentemente pubblicato da Maggioli Editore a cura del Network Non Autosufficienza. La tematica è al centro dell’attenzione di chi si occupa di malattie croniche e quindi di grande interesse per i lettori di Psicogeriatria, attenti alle dinamiche che caratterizzano la continua ricerca di nuovi equilibri nei servizi."
This paper presents the EUROFAMCARE study findings, examining a typology of care situations for family carers of older people, and the interplay of carers with social and health services. Despite the complexity of family caregiving situations across Europe, our analyses determined the existence of seven “caregiving situations,” varying on a range of critical indicators. Our study also describes the availability and use of different support services for carers and care receivers, and carers’ preferences for the characteristics of support services. Our findings have relevance for policy initiatives in Europe, where limited resources need to be more equitably distributed and services should be targeted to caregiving situations reflecting the greatest need, and organized to reflect the preferences of family carers. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Daniel Lüdecke
added a research item
Objectives: As in nearly all European countries, demographic developments in Germany have led to both a relative and an absolute increase in the country’s elderly population. The care and support needed by these people is primarily provided by relatives or friends and close acquaintances within the home environment. The major challenges for society are to sustain, promote and support these informal resources. In order to achieve this, it is crucial that family caregivers are provided with situation-specific services that support them and relieve their burden of care. The major challenges for society are therefore to sustain, promote and support informal resources and to provide the opportunity for the use of services aimed at assisting and relieving the burden of family caregivers. Methods: In the context of the EUROFAMCARE study, 1,003 family caregivers from Germany were interviewed at home about their experiences using a standardized questionnaire. Included in the study were primary caregivers providing at least four hours of personal care or support per week to a relative aged 65 years or older. Subjects solely providing financial support were excluded. In this paper, a linear regression analysis has been conducted to analyse impact of sociodemographic factors on the utilisation of support services. Results: The family caregivers were 54 years on average (SD=13.4), 76% of them were female. The dependent elderly were 80 years on average (SD=8.3), and 69% of them were women. 60% of them were receiving long-term care insurance benefits. Use of support services aimed directly at family caregivers is very low. After including certain services aimed primarily at those in need of care but also often serving as a source of relief for family caregivers, the percentage of caregivers using support services increased slightly. Among sociodemographic characteristics, caregivers’ gender and education level have the greatest influence on services use. Other influential factors are caregivers’ perception of their caregiving burden and their assessment of the dependent family member’s need for assistance and support.
Christopher Kofahl
added a project goal