Academic journal article Australian Health Review

The Impact of Care Recipient Falls on Caregivers

Academic journal article Australian Health Review

The Impact of Care Recipient Falls on Caregivers

Article excerpt

Background

Informal caregivers provide up to 80% of support to older people in Australia, enabling them to stay at home rather than enter residential care.1 Caregivers provide assistance for core activities of daily living, such as dressing, mobility and shopping,2 have a positive impact on the care recipient's quality of life1 and contribute in excess of $40 billion to the Australian economy.3

However, caregivers have higher levels of stress and depression and lower subjective wellbeing and physical health than noncaregivers, 4 experiencing the lowest level of wellbeing in the Australian community.5 One in three people over 65 years fall each year,6 impacting on healthcare costs and the older person's independence and quality of life. Little is known about the impact of these falls on the caregiver. This paper explores the impact of care recipient falls on caregivers, using a mixed-method approach.

Method

The Melbourne Health Human Research Ethics Committee approved the research.

Recruitment

Participants were care recipients aged >60 years and their coresident, adult family caregivers from two caregiver agencies in metropolitan and regional Victoria. A recruitment flyer was sent to potential participants by the agencies, asking them to contact the researchers if interested. All participants provided written consent.

Procedure

An experienced physiotherapist conducted baseline assessments in participants' homes. Data collected included age, gender, years spent caring, relationship to care recipient, current health status of both the caregiver and care recipient, and current use of health services. For the care recipient, self-report history of falls (last 12 months), with caregiver verification if required, and a suite of physical, psychological and self-rated health measures were recorded (see Table 1 and protocol paper).7 A fall was defined as 'unintentionally coming to the ground or some lower level and other than as a consequence of sustaining a violent blow, loss of consciousness, sudden onset of paralysis as in stroke or an epileptic seizure'.8 Following the baseline assessment, caregivers received a 12-month calendar to record accidents.9 Participants were asked to return the calendars each month. If they were not received within 2 weeks of the end of the month, a reminder phone call was made to the participant.

Participants were reassessed up to 10 times, if an accident was recorded at home, during residential respite care or hospital admission. The average time between accident and follow-up home visit was 31.7 days (range 1-94 days). Full details of the event were obtained, including change in care levels, need for additional services and changes to the caregiver's usual routine. At each post-accident assessment, caregivers repeated all questionnaires, except for the Baseline Carer Demographic Survey, and care recipients completed the Modified Barthel Index and Lawton's Instrumental Activities of Daily Living tool.

All participants completing the 12-month study (n = 80 dyads, 83.4%) underwent a final assessment with all questionnaires except the Baseline Carer Demographic Survey. Reasons for non-participation in final assessment were: care recipient in permanent care (8.3%); death of care recipient (3.1%); and no longer wishing to participate (5.2%). After the final assessment, all caregivers were invited to a focus group (two in regional Victoria and one in Melbourne). They were asked about the influence of accidents on their caring role, how they had or would have dealt with an accident, whether accidents were preventable and what additional supports might minimise the likelihood and impact of accidents.

Statistical analysis

Statistical Package for Social Sciences (SPSS) Version 18.0(IBM Corporation, Armonk, NY, USA) was used and appropriate descriptive statistics calculated. Measures taken at the post-fall assessment for the first fall by care recipients were compared with baseline scores using repeated-measures t-tests. …

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