Caregiver dissatisfaction affects outpatient care for the elderly with dementia

Elderly/Long-Term Care
Caregiver dissatisfaction affects outpatient care for the elderly with dementia

Taking care of family members with dementia and Alzheimer's disease can place a great strain on family caregivers. Most individuals with some form of dementia (7 out of 10) live at home and receive 75 percent of their care from their families and friends (informal care). However, how satisfied family caregivers feel with their lives can have a direct impact on their loved one's receipt of professional outpatient care, reveals a new study. It found that low levels of caregiver satisfaction were linked with less likelihood that patients with dementia received outpatient primary, specialty, and mental health care.

A sample of 1,269 veterans participating in the National Longitudinal Caregiver Survey was used for the study. All were men with dementia who received care from a primary female informal caregiver. The researchers analyzed 12 months of outpatient claims to determine visits to primary care providers, specialists, and mental health practitioners. The family caregivers were surveyed to determine how much care they delivered, their financial situation, and how much the veteran's daily life was affected by other medical conditions.

Only 17 percent of the caregivers surveyed reported finding life "very satisfying." The majority (68 percent) felt they were fairly satisfied and 15 percent were not satisfied. Veterans with caregivers who reported being dissatisfied with life were 56 percent less likely to receive a primary care visit and 47 percent less likely to receive a mental health visit. Other factors also affected receipt of outpatient care. Those with black caregivers were 50 percent less likely to receive mental health visits. Veterans living with their caregiver were 2.8 times more likely to receive a specialty care visit. Greater impairment in veterans' abilities to carry out activities of daily living was associated with a decreased likelihood of receiving primary care. Finally, veterans with caregivers who reported needing much more help with care were less likely to receive a mental health visit than caregivers who wanted just somewhat more help. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00032).

See "Barriers to outpatient care in community-dwelling elderly with dementia: The role of caregiver life satisfaction," by Joshua M. Thorpe, Ph.D., Courtney Harold Van Houtven, Ph.D., and Betsy L. Sleath, Ph.D., in the Journal of Applied Gerontology 28(4), pp. 436-460, 2009.