Caregiving for Dementia: Trends pre-post onset and predictive factors of family caregiving (2002-2018)

Bailey C Ingraham, D. Barthold, Paul Fishman, Norma B Coe
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Abstract

Persons living with Alzheimer’s and other related forms of Dementia rely heavily on care from family and friends for assistance with daily activities (“family care”), but little is known about care transitions over time. We analyzed data from the Health and Retirement Study to describe caregiving patterns, from 2 years before dementia onset and up to 6 years after. Using socio-demographic data from the interview prior to dementia onset, we determine if there are significant factors that predict receipt of family care at dementia onset. We found that a third (33%) of people living with dementia were receiving help with daily activities two years prior to their first positive dementia screen and this increased to 60% during the first positive screen. Nearly all of those receiving assistance received family care. We found multiple significant predictors of receiving family care at onset, including race, education, access to private health insurance, number of activities of daily living that were difficult, number of chronic conditions, and already receiving help. This demonstrates potential gaps in dementia care, and which subpopulations may benefit most from targeted interventions for household members that do not have adequate caregiving resources or programs that provide additional formal care.
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痴呆症的护理:痴呆症发病前后的趋势和家庭护理的预测因素(2002-2018 年)
阿尔茨海默氏症和其他相关形式的痴呆症患者在日常活动("家庭护理")方面主要依靠家人和朋友的照顾,但人们对随着时间推移的护理转变知之甚少。我们分析了 "健康与退休研究"(Health and Retirement Study)的数据,以描述从痴呆症发病前 2 年到发病后 6 年的护理模式。利用痴呆症发病前访谈中的社会人口学数据,我们确定是否有重要因素可以预测痴呆症发病时接受家庭护理的情况。我们发现,三分之一(33%)的痴呆症患者在首次痴呆症筛查呈阳性的两年前曾接受过日常活动帮助,而在首次筛查呈阳性期间,这一比例增加到了 60%。几乎所有接受帮助的人都得到了家人的照顾。我们发现了发病时接受家庭护理的多个重要预测因素,包括种族、教育程度、获得私人医疗保险的情况、日常生活中困难活动的数量、慢性疾病的数量以及已经接受帮助的情况。这显示了痴呆症护理方面的潜在差距,以及哪些亚人群可能从针对没有足够护理资源的家庭成员的干预措施或提供额外正规护理的计划中获益最多。
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