The Determinants of Informal Caregivers’ Burden in the Care of Frail Older Persons: A Dynamic and Role-Related Perspective
Open accessAbstract
Research into informal caregivers' burden does not distinguish between different stages of impairment. This study explored the determinants of burden from an in-depth perspective in order to identify which determinants apply to which phases of impairment. METHODS: This was a cross-sectional study including frail older persons aged 65 and above. Instruments used were the interRAI Home Care, the Zarit-12 interview and an ad hoc economic questionnaire. A combination of variables from the Stress Process Model and Role Theory and a sub-group analysis enabled refined multivariate logistic analyses. RESULTS: The study population consisted of 4175 older persons (average age: 81.4 ± 6.8, 67.8% female) and their informal caregivers. About 57% of them perceived burden. Depressive symptoms, behavioral problems, IADL impairment, previous admissions to nursing homes and risk of falls yielded significant odds ratios in relation to informal caregivers' burden for the whole sample. These determinants were taken from the Stress Process Model. When the population was stratified according to impairment, some factors were only significant for the population with severe impairment (behavioral problems OR:2.50; previous admissions to nursing homes OR:2.02) and not for the population with mild or moderate impairment. The informal caregiver being an adult child, which is a determinant from Role Theory, and cohabitation showed significant associations with burden in all strata. CONCLUSION: Determinants of informal caregivers' burden varied according to stages of impairment. The results of this study can help professional caregivers gain a greater insight into which informal caregivers are most susceptible to perceive burden. ABBREVIATIONS: NIHDI: National Institute for Health and Disability Insurance; ZBI12: Zarit Burden Interview - 12 items; InterRAI HC: interRAI Home Care instrument; ADL: Activities of Daily Living; ADLH: interRAI Activities of Daily Living Hierarchy scale; IADL: Instrumental Activities of Daily Living; IADLP: InterRAI Instrumental Activities of Daily Living Performance scale; CPS2: InterRAI Cognitive Performance scale 2; DRS: InterRAI Depression Rating scale.
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Adult children living together as caregivers experiencing role conflicts reported highest level of burden.
“adult children living together as caregivers experiencing role conflicts reported highest level of burden [7].”
From Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol (2022) · cites this paper as [7]
The Multivariate analysis (page not provided) finds that being an adult child and cohabiting were each associated with greater odds of perceived caregiver burden; it also identifies conflict with family as a determinant. It does not establish that caregivers with all three characteristics reported the highest burden, or equate family conflict with experienced role conflict. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPerceived burden and depressive symptoms of caregivers are associated with severe impairments of care recipients.
“Western studies have consistently reported that perceived burden and depressive symptoms of caregivers are associated with severe impairments of care recipients”
From Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol (2022) · cites this paper as [7]
The Sub-group analysis (page not provided) reports that perceived burden was higher among caregivers of older persons with severe impairment: nearly 70%, versus about 53% in the mild and moderate groups. It also reports higher depression in the severe-impairment group, but those depressive symptoms belong to the older care recipients, not their caregivers. The paper therefore does not support the claim about caregivers’ depressive symptoms. (LLM, conf=0.90)
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- This is a chapter. In: Muller, S., Kubitschke L., (Eds.) Beyond Silos -The why and how of integrated eCare (pp.202-226) Hershey IGI: ISBN: 9781466661387
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Gérain, P., & Zech, E. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01748 · Cited by 342 · see citing works
Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol
Lo, H. H. M., Au, A., Cho, W. V., Lau, E. N. S., Wong, J. Y. H., Wong, S. Y. S., & Yeung, J. W. K. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095447 · Cited by 8 · see citing works
“Similarly, Western studies have consistently reported that perceived burden and depressive symptoms of caregivers are associated with severe impairments of care recipients, and adult children living together as caregivers experiencing role conflicts reported highest level of burden [7].”
Background
- Authors
- Mello, J. D. A., Macq, J., Van Durme, T., Cès, S., Spruytte, N., Van Audenhove, C., & Declercq, A.
- Affiliations
- KU Leuven (BE)
- UCLouvain (BE)
- Université Catholique de Louvain, Institut de Recherche Santé et Société (IRSS), Woluwe-Saint-Lambert, Belgium
- KULeuven, LUCAS, Leuven, Belgium
- Corresponding author
- Mello, J. de Almeida
- Venue
- Aging & Mental Health
- Publisher
- Informa UK Limited
- Published
- 2016-04-07
- Volume
- 21
- Issue
- 8
- Pages
- 838-843
- ISSN
- 1360-7863 (ISSN-L)
- 1364-6915
- OpenAlex
- W2330982115
- Cited by
- 107
- References
- 37
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 9 · 2023: 15 · 2022: 16 · 2021: 14 · 2020: 7 · 2019: 14 · 2018: 10 · 2017: 5 · 2016: 2
- FWCI
- 23.89
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- other-oa
- Locations
- Aging & Mental Health (publishedVersion)
- PubMed (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Digital Access to Libraries (submittedVersion)
- Funders
- Institut National d'assurance Maladie-Invalidité
- Topics
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- informal caregivers, caregiver burden, frail elderly, stress process model, role theory, depressive symptoms, behavioral problems, nursing home admission, fall risk, adult children as caregivers, cohabitation, instrumental activities of daily living, activities of daily living
- MeSH terms
- Aged, Aged, 80 and over, Aging, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Stress, Psychological, Frail Elderly, Caregivers, Cost of Illness, Spouses, Adult Children
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