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Elder Care News
Caregiving for Elderly at End of Life Rewarding
Despite Challenges
Family or friends care for almost 75% of older adults
living in community in last year of life
 January 8, 2007 - Family or friends served as
informal caregivers to almost three-quarters of disabled older adults
living in the community during their final year of life, according to an
article in the January 8 issue of Archives of Internal Medicine, one of
the JAMA/Archives journals. More than two-thirds of these caregivers
found their role rewarding despite providing more than 40 hours of care
per week and making little use of caregiver-focused supportive services.
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Elder Care News |
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Family and friends serve as the main providers of
care for patients with long-term disabilities and those at the end of
life, according to background information in the article. Studies have
found that these caregivers provide high levels of assistance and often
experience associated emotional, physical and financial strains. It is
recognized that these individuals also derive rewards from their
caregiving role, but this concept has been little explored in research.
Jennifer L. Wolff, Ph.D., and colleagues at the
Johns Hopkins Bloomberg School of Public Health, Baltimore, assessed the
dynamics of providing care among 1,149 caregivers who participated in a
national survey. The participants and the older adults for whom they
provided care completed surveys in 1999. Investigators then monitored
the pairs to determine if the older patient died within 12 months. Of
the 1,149 caregivers who participated, 182 cared for a person who then
died within one year, and 967 for a person who did not.
Among the 11.2 percent of disabled,
community-dwelling older adults who died within one year of being
interviewed, 72.3 percent were receiving help from an informal caregiver
(compared with 48.6 percent of older adults who did not die within one
year).
Among the caregivers of adults in the last year of
life, 41.5 percent were spouses, 39 percent were children and 19.5
percent were other family members or friends; 75.1 percent of them were
female, and they had an average age of 64 years. They provided an
average of 43 hours of care per week, and 84.4 percent of them provided
daily assistance.
Less than 5 percent of caregivers used respite care
(in which a temporary caregiver provides a break by caring for the ill
individual) or caregiving support groups, while 62.3 percent reported
using assistive devices, 37.2 percent used personal or nursing care
services and 28.3 percent used home modificationsall interventions
designed to help the disabled or ill older adult.
While end-of-life caregivers reported significant
emotional (28.9 percent), physical (18.4 percent) and financial (14
percent) strains, more than two-thirds endorsed personal rewards related
to their helping role, the authors write.
About 70 percent agreed that their role makes me
feel good about myself and enables me to appreciate life more, and 76
percent said they felt useful and needed. Many also identified benefits
they received from the person for whom they were caring; 65 percent
reported that the person kept them company, 26 percent said that they
helped financially and 20.8 percent said that they helped with household
chores.
Seriously ill patients have expressed the
importance of ongoing daily interactions with family and friends, and
the ability to help others as components of a good death, the authors
conclude. Data from this study indicate that primary caregivers were
readily able to identify reciprocated emotional, instrumental and
financial exchanges afforded to them by the person to whom they provided
assistance.
Editor's Note: This study was supported in part
by a grant from the National Institute of Aging and an unrestricted
grant from Pfizer Inc.
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