Online Program

Cultural differences in burden experienced among caregivers of the urban homebound elderly adults

Monday, November 4, 2013

Keosha T. Bond, MPH, CHES, Health and Behavior Studies, Columbia University Teachers College, New York, NY
Anastasia Sofianou, MPH, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
Ania Wajnberg, MD, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
David Russell, Ph.D, Center for Home Care Policy and Research, Visiting Nurse Service of New York, New York, NY
Joseph S. Ross, MD, MHS, Internal Medicine, Yale University School of Medicine, CT
Alex Federman, MD, MPH, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
Limited research has explored whether the level of burden associated with caring for a homebound elderly patient tends to vary across racial groups or by relationship status. Drawing from a larger prospective study of homebound elderly patients, we surveyed 46 informal caregivers to examine the level of burden experienced among caregivers across racial groups and relationship status. Burden was measured using the Zarit Caregiver Burden Scale. Caregivers had an average age of 57 (SD=14), 76% were female, 37 % Black, 35% Hispanic, 28% white, 46% completed high school or an equivalent degree, and 11% pursued higher degrees. 81% of Hispanic caregivers identified as the children of patients in comparison to 71% of blacks and 62% of whites. Overall, informal caregivers of homebound patients experience high levels of burden [28.1 (SD=14.8)] associated with providing this care, with 19.2% experiencing moderate to severe caregiver burden. White caregivers had significantly higher average caregiver burden [37(SD=12)] than Black and Latino caregivers [25(SD=14), 23 (SD=14), respectively; (p=0.02). Burden was higher amongst caregivers who reported being spouses or partners of the patient [43(SD=10)], in comparison to those who identified as children [25(SD=14)] or other family or friends [26(SD=7); p =0.004]. Identifying as a spouse/partner, but not race,remained a significant predictor of increased burden after adjusting for caregiver race, age, relationship to patient, patient age, and patient limitations [B(SE) 15.9 (7.1), p=0.03]. Studies designed to further understand and support the needs of spouse-caregivers as well as cultural attitudes to providing care to homebound seniors are warranted.

Learning Areas:

Chronic disease management and prevention
Provision of health care to the public

Learning Objectives:
Compare the racial differences in caregiver burden among individuals who provide care to home bound elderly patients. Identify the level of burden experience by caregivers who provide care to home bound elderly patients based on their relationship to the patient.

Keyword(s): Frail Elderly, Family Involvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the project manager for this research study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.