Caregiver Burden

There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide.

COVID-19 pandemic in Argentina has affected the care of older adults with dementia deeply. Our objective was to study how the obligatory social isolation affected stress caregiver and burden of care of family members of subjects living with dementia in the community after the initial 4 weeks of quarantine in our setting. We did a questionnaire survey among 80 family caregivers of persons with Alzheimer's disease (AD) or related dementia collected on April 2020. We designed a visual analog scale to test the level of the burden of care. Characteristics of people with dementia and their caregivers were analyzed with descriptive (mean, standard deviation, frequency and percent) and inferential statistics (chi-square test). The sample included older adults (mean age: 80.51 ± 7.65) with different stages of dementia. Family was the primary provider of care in 65%. Overall, COVID-19 confinement increased stress caregiver independently of the dementia stage, but those caring for severe cases had more stress compared to milder forms of the disease. Other findings were that half of the subjects with dementia experienced increased anxiety and that most family members discontinued all sort of cognitive and physical therapies. Family members' main concerns were for severe dementia cases, fear of absence of the paid caregiver during the epidemic, and for mild cases fear of spreading the disease while assisting patients with instrumental activities. A partnership between departments of public health, care workers and families must be planned to guarantee continuity of care during these unique COVID-19 times.

BackgroundFamily carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association.ObjectiveTo establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics.MethodsWe searched major databases such as PubMed, CINAHL, PsycINFO, Scopus and ISI Proceedings up to March 2018, and conducted a meta-analysis of included studies. Summary estimates of the association were obtained using a random-effects model to improve generalisation of findings.ResultsAfter screening of 4,688 articles, 55 studies were included providing a total of 56 independent comparisons with a total of 9,847 carers from data across 20 countries. There was a large, positive association between subjective caregiver burden and depressive symptoms ([Formula: see text] = 0.514; 95% CI = 0.486, 0.541), with very low heterogeneity amongst individual studies (I2 = 8.6%). Sensitivity analyses showed no differences between cross-sectional or repeated measures ([Formula: see text] = 0.521; 95% CI = 0.491, 0.550; 51 samples) and longitudinal studies ([Formula: see text] = 0.454; 95% CI = 0.398, 0.508; 6 samples). We found a higher effect size for those caring for people living with dementia compared to those caring for frail older people, and stroke survivors. Carer sex, age and kinship did not change the estimate of the effect.ConclusionsSubjective caregiver burden is a significant risk factor for depressive symptoms in carers of older people and may precipitate clinical depression. Those caring for people with dementia experience greater burden. There is a need for longitudinal evaluations examining the effects of potential mediators of the association of subjective burden and depressive symptoms. Future interventions should test whether minimizing subjective burden may modify the risk of developing depression in carers of older relatives.

ObjectivesFamily caregivers often face significant challenges, such as insufficient sleep, fatigue due to aging, difficulty engaging in social activities, and fewer interactions with friends and neighbors. However, some family caregivers manage to maintain active lifestyles while providing home care. This study is aimed at exploring the relationship between family caregivers' sense of coherence (SOC) and their perception of caregiving burden.MethodsThis cross-sectional study recruited 74 family caregivers of community-dwelling older adults who used day-care insurance services; 64 were included in the final analysis. Data were collected using a questionnaire that included the SOC-13 scale, rated on a 5-point Likert scale. Multiple regression analysis was conducted to identify the factors influencing caregivers' perception of caregiving burden, with SOC subfactors serving as explanatory variables.ResultsComprehensibility, one of the SOC subscales, showed a significant negative association with caregiver burden, and the association was strengthened after adjustment (Model 2: B = -0.376, β = -0.534, p = 0.005). Daily caregiving hours were positively associated with burden, whereas meaningfulness and manageability were not significant.ConclusionsThis study highlights the importance of comprehensibility in influencing caregivers' sense of burden. The findings provide valuable insights into the relationship between caregivers' SOC and their perceived caregiving burden. Moreover, they emphasize the relevance of this relationship to the field of occupational therapy, as occupational therapists can play a key role in enhancing caregivers' comprehensibility, thereby helping them alleviate the caregiving burden through targeted interventions.Clinical implicationsThese findings underscore the importance of promoting comprehensibility among family caregivers to alleviate their perceived burden and support sustained caregiving. Occupational therapy interventions focused on improving caregivers' understanding of the caregiving process can contribute to better mental and physical health outcomes, benefiting both caregivers and care recipients.