Increases in informal caregiver psychological distress and physical health symptoms lead to poor quality of care over time
Smith, Gregory Rush
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Informal caregivers of elderly care recipients are at a higher risk for both psychological distress and physical health problems compared to noncaregivers. Few studies have addressed how psychological and physical health outcomes affect the quality of care caregivers are able to provide – especially over time. This study examined individual-level, longitudinal relations between multiple dimensions of quality of informal care, caregiver resentment, and caregiver physical health. Analyses were based on caregiver data from the second Family Relationships in Late Life (FRILL2) Project. A sample of 441 caregivers provided data at Time 1 (T1), 284 of these caregivers completed interviews at Time 2 (T2), and 176 caregivers completed all three waves. Caregivers provided information on demographic characteristics, feelings of resentment, comorbid health conditions, potentially harmful behavior, neglect, exemplary care, and injuries, financial exploitation, and social isolation of the care recipient. Longitudinal analyses examined T1 – T2 (1.5 year) and T1 – T3 (3 year) changes between caregiver health and each dimension of quality of care. From T1 – T2, increases in caregiver resentment were associated with increases in potentially harmful behavior, financial exploitation, and decreases in exemplary care. Changes in caregiver comorbid conditions were not related to changes in quality of care. From T1 – T3, increases in caregiver resentment were related to increases in potentially harmful behavior and decreases in exemplary care. Increases in caregiver comorbid conditions were associated with increases in care recipient social isolation and increases in exemplary care. The findings of the current study provide enhanced evidence for points of intervention to prevent deterioration in quality of care over time. A primary focus of informal caregiver intervention strategies should be on finding ways to prevent or lessen feelings of resentment in caregivers. In addition, health professionals should stress the importance of caregivers maintaining good physical health. Overall, this study expands research on informal caregiver health outcomes to include relations over time with multiple dimensions of quality of care. It also raises new questions about the relative effects of caregiver psychological distress and physical health as each relates to quality of care over the course of the caregiving experience.