Burden in Caregivers of Cognitively Impaired Elderly Adults at Time of Hospitalization: A Cross-Sectional Analysis

Authors

  • Kalpana N. Shankar MD, MSc, MSHP,

    Corresponding author
    1. Boston Medical Center, Boston, Massachusetts
    2. School of Medicine, Boston University, Boston, Massachusetts
    • Address correspondence to: Kalpana N. Shankar, Boston Medical Center, One Boston Medical Center Place, Dowling 1 South, Boston, MA 02118. E-mail: kns1@bu.edu

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  • Karen B. Hirschman PhD, MSW,

    1. New Courtland Center for Transitions and Health, University of Pennsylvania, Philadelphia, Pennsylvania
    2. School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
    3. Institute on Aging, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Alexandra L. Hanlon PhD,

    1. New Courtland Center for Transitions and Health, University of Pennsylvania, Philadelphia, Pennsylvania
    2. School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Mary D. Naylor PhD, FAAN, RN

    1. New Courtland Center for Transitions and Health, University of Pennsylvania, Philadelphia, Pennsylvania
    2. School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
    3. Institute on Aging, University of Pennsylvania, Philadelphia, Pennsylvania
    4. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Abstract

Objectives

To describe the factors associated with burden that caregivers of cognitively impaired older adults (dementia, delirium, or both) at the time of hospitalization experienced.

Design

Cross-sectional data analyses.

Setting

Three hospitals—one academic tertiary hospital and two associated community hospitals.

Participants

Caregivers (N = 495) of cognitively impaired older adults at the time of hospital admission.

Measurements

Multivariable linear regression was performed to analyze the effect of the independent variables (caregiver: demographic characteristics, depressive symptoms, self-efficacy; older adult: neuropsychiatric symptoms, delirium, functional deficits) on caregiver burden.

Results

Higher burden was associated with younger caregiver age (P = .02), being a spouse (P = .03), depressive symptoms (< .001), caregivers’ lower perceived self-efficacy in managing care recipient symptoms (P = .002), and limited finances at the end of the month (P = .01). Caregiver burden was also strongly associated with the care recipient factors distressing neuropsychiatric symptoms (P = .001), delirium (P = .001), and greater functional deficits in basic activities of daily living (P = .001).

Conclusion

These findings suggest that caregivers of older adults who were cognitively impaired at hospital admission experience burden. Understanding the factors that contribute to burden at the time of hospitalization for caregivers of persons with cognitive impairment can inform the development of interventions targeted throughout the hospitalization that have the potential to decrease burden.

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