Long-term Care Placement of Dementia Patients and Caregiver Health and Well-being
CONTEXT Placing a relative with dementia into a long-term care facility is common among caregivers. Placement transition and factors that affect caregiver health and well-being after placement of the patient are not well described. OBJECTIVE To assess the impact of placing a relative with dementia i...
Gespeichert in:
| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2004-08, Vol.292 (8), p.961-967 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 967 |
|---|---|
| container_issue | 8 |
| container_start_page | 961 |
| container_title | JAMA : the journal of the American Medical Association |
| container_volume | 292 |
| creator | Schulz, Richard Belle, Steven H Czaja, Sara J McGinnis, Kathleen A Stevens, Alan Zhang, Song |
| description | CONTEXT Placing a relative with dementia into a long-term care facility is common
among caregivers. Placement transition and factors that affect caregiver health
and well-being after placement of the patient are not well described. OBJECTIVE To assess the impact of placing a relative with dementia in a long-term
care facility on caregivers' health and well-being. DESIGN, SETTING, AND PARTICIPANTS Prospective study from 1996 to 2000 of the placement transition in a
sample of 1222 caregiver-patient dyads recruited from 6 US sites. A total
of 180 patients were placed in a long-term care facility during the 18-month
follow-up period. Data collected before and after placement were analyzed
to identify factors associated with placement, the nature of contact between
caregivers and their institutionalized relatives after placement, and the
relation of both of these factors to health outcomes among dementia caregivers. MAIN OUTCOME MEASURES Caregiver depression (symptoms on the Center for Epidemiological Studies-Depression
[CES-D] scale; range, 0-60) and anxiety (State Trait Inventory; range, 10-40)
and use of prescription medications for depression and anxiety. RESULTS Caregivers who institutionalized their relative reported depressive
symptoms and anxiety to be as high as they were while in-home caregivers.
Overall CES-D scores for depression did not change from before to after placement
(median [IQR], 15.0 [8-24.5] and 15.0 [7.7-28]; P =
.64). Overall anxiety scores on the State Trait Inventory also did not change
significantly (median [IQR], 22.0 [19-27] before vs 21.1 [18-27] after; P = .21). These effects were most pronounced among caregivers
who were married to the patient (P = .02 for depression),
visited more frequently (P = .01 for depression and P |
| doi_str_mv | 10.1001/jama.292.8.961 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_66817543</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>199315</ama_id><sourcerecordid>684790151</sourcerecordid><originalsourceid>FETCH-LOGICAL-a393t-54c165a147663595bf56a7c66c5fb9ad2ff83e854a8deeb6fcd0335506a7e8013</originalsourceid><addsrcrecordid>eNpd0V1LwzAUBuAgipvTW8EbKYLetSZNkyaXMj8mDJygeFlO25PZ0Y-ZtIL_3rBNBoZADsnD4U1CyDmjEaOU3a6ggSjWcaQiLdkBGTPBVciFVodkTKlWYZqoZEROnFtRPxhPj8nIo1j5OSav865dhj3aJpiCxWBRQ4ENtn3QmeB-U1UQLKCvfOUCaMuNW1bfaIMZQt1_bjY_sK7DHKt2eUqODNQOz3brhLw_PrxNZ-H85el5ejcPgWvehyIpmBTAklRKH1fkRkhICykLYXINZWyM4qhEAqpEzKUpSsq5ENQrVP4eE3Kz7bu23deArs-ayhU-BrTYDS6TUrFUJNzDq39w1Q229dmymDEey1THHl3u0JA3WGZrWzVgf7K_l_LgegfAFVAbC21Rub2TlAuphXcXW-c_Zn-qNfedfgE34X4X</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211326792</pqid></control><display><type>article</type><title>Long-term Care Placement of Dementia Patients and Caregiver Health and Well-being</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Schulz, Richard ; Belle, Steven H ; Czaja, Sara J ; McGinnis, Kathleen A ; Stevens, Alan ; Zhang, Song</creator><creatorcontrib>Schulz, Richard ; Belle, Steven H ; Czaja, Sara J ; McGinnis, Kathleen A ; Stevens, Alan ; Zhang, Song</creatorcontrib><description>CONTEXT Placing a relative with dementia into a long-term care facility is common
among caregivers. Placement transition and factors that affect caregiver health
and well-being after placement of the patient are not well described. OBJECTIVE To assess the impact of placing a relative with dementia in a long-term
care facility on caregivers' health and well-being. DESIGN, SETTING, AND PARTICIPANTS Prospective study from 1996 to 2000 of the placement transition in a
sample of 1222 caregiver-patient dyads recruited from 6 US sites. A total
of 180 patients were placed in a long-term care facility during the 18-month
follow-up period. Data collected before and after placement were analyzed
to identify factors associated with placement, the nature of contact between
caregivers and their institutionalized relatives after placement, and the
relation of both of these factors to health outcomes among dementia caregivers. MAIN OUTCOME MEASURES Caregiver depression (symptoms on the Center for Epidemiological Studies-Depression
[CES-D] scale; range, 0-60) and anxiety (State Trait Inventory; range, 10-40)
and use of prescription medications for depression and anxiety. RESULTS Caregivers who institutionalized their relative reported depressive
symptoms and anxiety to be as high as they were while in-home caregivers.
Overall CES-D scores for depression did not change from before to after placement
(median [IQR], 15.0 [8-24.5] and 15.0 [7.7-28]; P =
.64). Overall anxiety scores on the State Trait Inventory also did not change
significantly (median [IQR], 22.0 [19-27] before vs 21.1 [18-27] after; P = .21). These effects were most pronounced among caregivers
who were married to the patient (P = .02 for depression),
visited more frequently (P = .01 for depression and P<.001 for anxiety), and were less satisfied with the
help they received from others (P = .003 for depression
and P<.001 for anxiety). The use of antidepressants
did not change significantly before (21.1%) to after (17.9%) placement (P = .16). The use of anxiolytics before to after placement
increased from 14.6% to 19% (P = .02), and nearly
half of caregivers (48.3%) were at risk for clinical depression following
placement of their relative. CONCLUSIONS The transition to institutional care is particularly difficult for spouses,
almost half of whom visit the patient daily and continue to provide help with
physical care during their visits. Clinical interventions that better prepare
the caregiver for a placement transition and treat their depression and anxiety
following placement may be of great benefit to these individuals.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.292.8.961</identifier><identifier>PMID: 15328328</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Aged ; Aged, 80 and over ; Anxiety - epidemiology ; Biological and medical sciences ; Caregivers ; Caregivers - psychology ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Dementia ; Dementia - nursing ; Depression - epidemiology ; Female ; General aspects ; Health Status ; Home health care ; Humans ; Institutionalization ; Life Change Events ; Long-Term Care ; Male ; Medical sciences ; Mental depression ; Mental Health ; Middle Aged ; Neurology ; Nursing Homes ; Patient Admission ; Prospective Studies ; Stress, Psychological ; United States</subject><ispartof>JAMA : the journal of the American Medical Association, 2004-08, Vol.292 (8), p.961-967</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright American Medical Association Aug 25, 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a393t-54c165a147663595bf56a7c66c5fb9ad2ff83e854a8deeb6fcd0335506a7e8013</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.292.8.961$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.292.8.961$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3340,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16035695$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15328328$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schulz, Richard</creatorcontrib><creatorcontrib>Belle, Steven H</creatorcontrib><creatorcontrib>Czaja, Sara J</creatorcontrib><creatorcontrib>McGinnis, Kathleen A</creatorcontrib><creatorcontrib>Stevens, Alan</creatorcontrib><creatorcontrib>Zhang, Song</creatorcontrib><title>Long-term Care Placement of Dementia Patients and Caregiver Health and Well-being</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Placing a relative with dementia into a long-term care facility is common
among caregivers. Placement transition and factors that affect caregiver health
and well-being after placement of the patient are not well described. OBJECTIVE To assess the impact of placing a relative with dementia in a long-term
care facility on caregivers' health and well-being. DESIGN, SETTING, AND PARTICIPANTS Prospective study from 1996 to 2000 of the placement transition in a
sample of 1222 caregiver-patient dyads recruited from 6 US sites. A total
of 180 patients were placed in a long-term care facility during the 18-month
follow-up period. Data collected before and after placement were analyzed
to identify factors associated with placement, the nature of contact between
caregivers and their institutionalized relatives after placement, and the
relation of both of these factors to health outcomes among dementia caregivers. MAIN OUTCOME MEASURES Caregiver depression (symptoms on the Center for Epidemiological Studies-Depression
[CES-D] scale; range, 0-60) and anxiety (State Trait Inventory; range, 10-40)
and use of prescription medications for depression and anxiety. RESULTS Caregivers who institutionalized their relative reported depressive
symptoms and anxiety to be as high as they were while in-home caregivers.
Overall CES-D scores for depression did not change from before to after placement
(median [IQR], 15.0 [8-24.5] and 15.0 [7.7-28]; P =
.64). Overall anxiety scores on the State Trait Inventory also did not change
significantly (median [IQR], 22.0 [19-27] before vs 21.1 [18-27] after; P = .21). These effects were most pronounced among caregivers
who were married to the patient (P = .02 for depression),
visited more frequently (P = .01 for depression and P<.001 for anxiety), and were less satisfied with the
help they received from others (P = .003 for depression
and P<.001 for anxiety). The use of antidepressants
did not change significantly before (21.1%) to after (17.9%) placement (P = .16). The use of anxiolytics before to after placement
increased from 14.6% to 19% (P = .02), and nearly
half of caregivers (48.3%) were at risk for clinical depression following
placement of their relative. CONCLUSIONS The transition to institutional care is particularly difficult for spouses,
almost half of whom visit the patient daily and continue to provide help with
physical care during their visits. Clinical interventions that better prepare
the caregiver for a placement transition and treat their depression and anxiety
following placement may be of great benefit to these individuals.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anxiety - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Caregivers</subject><subject>Caregivers - psychology</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Dementia</subject><subject>Dementia - nursing</subject><subject>Depression - epidemiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Health Status</subject><subject>Home health care</subject><subject>Humans</subject><subject>Institutionalization</subject><subject>Life Change Events</subject><subject>Long-Term Care</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Mental Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Nursing Homes</subject><subject>Patient Admission</subject><subject>Prospective Studies</subject><subject>Stress, Psychological</subject><subject>United States</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0V1LwzAUBuAgipvTW8EbKYLetSZNkyaXMj8mDJygeFlO25PZ0Y-ZtIL_3rBNBoZADsnD4U1CyDmjEaOU3a6ggSjWcaQiLdkBGTPBVciFVodkTKlWYZqoZEROnFtRPxhPj8nIo1j5OSav865dhj3aJpiCxWBRQ4ENtn3QmeB-U1UQLKCvfOUCaMuNW1bfaIMZQt1_bjY_sK7DHKt2eUqODNQOz3brhLw_PrxNZ-H85el5ejcPgWvehyIpmBTAklRKH1fkRkhICykLYXINZWyM4qhEAqpEzKUpSsq5ENQrVP4eE3Kz7bu23deArs-ayhU-BrTYDS6TUrFUJNzDq39w1Q229dmymDEey1THHl3u0JA3WGZrWzVgf7K_l_LgegfAFVAbC21Rub2TlAuphXcXW-c_Zn-qNfedfgE34X4X</recordid><startdate>20040825</startdate><enddate>20040825</enddate><creator>Schulz, Richard</creator><creator>Belle, Steven H</creator><creator>Czaja, Sara J</creator><creator>McGinnis, Kathleen A</creator><creator>Stevens, Alan</creator><creator>Zhang, Song</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20040825</creationdate><title>Long-term Care Placement of Dementia Patients and Caregiver Health and Well-being</title><author>Schulz, Richard ; Belle, Steven H ; Czaja, Sara J ; McGinnis, Kathleen A ; Stevens, Alan ; Zhang, Song</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a393t-54c165a147663595bf56a7c66c5fb9ad2ff83e854a8deeb6fcd0335506a7e8013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anxiety - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Caregivers</topic><topic>Caregivers - psychology</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Dementia</topic><topic>Dementia - nursing</topic><topic>Depression - epidemiology</topic><topic>Female</topic><topic>General aspects</topic><topic>Health Status</topic><topic>Home health care</topic><topic>Humans</topic><topic>Institutionalization</topic><topic>Life Change Events</topic><topic>Long-Term Care</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Mental Health</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Nursing Homes</topic><topic>Patient Admission</topic><topic>Prospective Studies</topic><topic>Stress, Psychological</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schulz, Richard</creatorcontrib><creatorcontrib>Belle, Steven H</creatorcontrib><creatorcontrib>Czaja, Sara J</creatorcontrib><creatorcontrib>McGinnis, Kathleen A</creatorcontrib><creatorcontrib>Stevens, Alan</creatorcontrib><creatorcontrib>Zhang, Song</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schulz, Richard</au><au>Belle, Steven H</au><au>Czaja, Sara J</au><au>McGinnis, Kathleen A</au><au>Stevens, Alan</au><au>Zhang, Song</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term Care Placement of Dementia Patients and Caregiver Health and Well-being</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2004-08-25</date><risdate>2004</risdate><volume>292</volume><issue>8</issue><spage>961</spage><epage>967</epage><pages>961-967</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Placing a relative with dementia into a long-term care facility is common
among caregivers. Placement transition and factors that affect caregiver health
and well-being after placement of the patient are not well described. OBJECTIVE To assess the impact of placing a relative with dementia in a long-term
care facility on caregivers' health and well-being. DESIGN, SETTING, AND PARTICIPANTS Prospective study from 1996 to 2000 of the placement transition in a
sample of 1222 caregiver-patient dyads recruited from 6 US sites. A total
of 180 patients were placed in a long-term care facility during the 18-month
follow-up period. Data collected before and after placement were analyzed
to identify factors associated with placement, the nature of contact between
caregivers and their institutionalized relatives after placement, and the
relation of both of these factors to health outcomes among dementia caregivers. MAIN OUTCOME MEASURES Caregiver depression (symptoms on the Center for Epidemiological Studies-Depression
[CES-D] scale; range, 0-60) and anxiety (State Trait Inventory; range, 10-40)
and use of prescription medications for depression and anxiety. RESULTS Caregivers who institutionalized their relative reported depressive
symptoms and anxiety to be as high as they were while in-home caregivers.
Overall CES-D scores for depression did not change from before to after placement
(median [IQR], 15.0 [8-24.5] and 15.0 [7.7-28]; P =
.64). Overall anxiety scores on the State Trait Inventory also did not change
significantly (median [IQR], 22.0 [19-27] before vs 21.1 [18-27] after; P = .21). These effects were most pronounced among caregivers
who were married to the patient (P = .02 for depression),
visited more frequently (P = .01 for depression and P<.001 for anxiety), and were less satisfied with the
help they received from others (P = .003 for depression
and P<.001 for anxiety). The use of antidepressants
did not change significantly before (21.1%) to after (17.9%) placement (P = .16). The use of anxiolytics before to after placement
increased from 14.6% to 19% (P = .02), and nearly
half of caregivers (48.3%) were at risk for clinical depression following
placement of their relative. CONCLUSIONS The transition to institutional care is particularly difficult for spouses,
almost half of whom visit the patient daily and continue to provide help with
physical care during their visits. Clinical interventions that better prepare
the caregiver for a placement transition and treat their depression and anxiety
following placement may be of great benefit to these individuals.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>15328328</pmid><doi>10.1001/jama.292.8.961</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2004-08, Vol.292 (8), p.961-967 |
| issn | 0098-7484 1538-3598 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_66817543 |
| source | MEDLINE; American Medical Association Journals |
| subjects | Aged Aged, 80 and over Anxiety - epidemiology Biological and medical sciences Caregivers Caregivers - psychology Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Dementia Dementia - nursing Depression - epidemiology Female General aspects Health Status Home health care Humans Institutionalization Life Change Events Long-Term Care Male Medical sciences Mental depression Mental Health Middle Aged Neurology Nursing Homes Patient Admission Prospective Studies Stress, Psychological United States |
| title | Long-term Care Placement of Dementia Patients and Caregiver Health and Well-being |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T21%3A06%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long-term%20Care%20Placement%20of%20Dementia%20Patients%20and%20Caregiver%20Health%20and%20Well-being&rft.jtitle=JAMA%20:%20the%20journal%20of%20the%20American%20Medical%20Association&rft.au=Schulz,%20Richard&rft.date=2004-08-25&rft.volume=292&rft.issue=8&rft.spage=961&rft.epage=967&rft.pages=961-967&rft.issn=0098-7484&rft.eissn=1538-3598&rft.coden=JAMAAP&rft_id=info:doi/10.1001/jama.292.8.961&rft_dat=%3Cproquest_pubme%3E684790151%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=211326792&rft_id=info:pmid/15328328&rft_ama_id=199315&rfr_iscdi=true |