Measuring the Effect of Carers on Patients' Risk of Adverse Healthcare Outcomes Using the Caregiver Network Score

• Type: Article in International Scientific Journal
• Date: 2016

Authors

O'Caoimh, R (Author) Other; Cornally, N (Author) Other; Svendrovski, A (Author) Other; Weathers, E (Author) Other; FitzGerald, C (Author) Other; Healy, E (Author) Other; O'Connell, E (Author) Other; O'Keeffe, G (Author) Other; O'Herlihy, E (Author) Other; Gao, Y (Author) Other; O'Donnell, R (Author) Other; O'Sullivan, R (Author) Other; Leahy Warren, P (Author) Other; Orfila, F (Author) Other; Constança Paúl (Author) ICBAS; Clarnette, R (Author) Other; Molloy, DW (Author) Other

Journal

Title: The Journal of frailty & aging

Vol. 5

Pages: 104-110

ISSN: 2260-1341

Publisher: Serdi Publishing Company

Indexing

Scopus - 12 Citations

Other information

Authenticus ID: P-00M-W6P

DOI: 10.14283/jfa.2016.86

Abstract (EN): BACKGROUND: Although caregivers are important in the management of frail, community-dwelling older adults, the influence of different caregiver network types on the risk of adverse healthcare outcomes is unknown.OBJECTIVE: To examine the association between caregiver type and the caregiver network subtest of The Risk Instrument for Screening in the Community (RISC), a five point Likert scale scored from one ("can manage") to five ("absent/liability"). To measure the association between caregiver network scores and the one-year incidence of institutionalisation, hospitalisation and death.DESIGN: Observational cohort study.SETTING AND PARTICIPANTS: Community-dwelling adults, aged >65, attending health centres in Ireland, (n=779). PROCEDURE AND MEASUREMENTS: The caregiver network subtest of the RISC was scored by public health nurses. Caregivers were grouped dichotomously into low-risk (score of one) or high-risk (scores two-five).RESULTS: The majority of patients had a primary caregiver (582/779; 75%), most often their child (200/582; 34%). Caregiver network scores were highest, indicating greatest risk, when patients had no recognised primary caregiver and lowest when only a spouse or child was available. Despite this, patients with a caregiver were significantly more likely to be institutionalised than those where none was required or identified (11.5% versus 6.5%, p=0.047). The highest one-year incidence of adverse outcomes occurred when state provided care was the sole support; the lowest when private care was the sole support. Significantly more patients whose caregiver networks were scored high-risk required institutionalisation than low-risk networks; this association was strongest for perceived difficulty managing medical domain issues, odds ratio (OR) 3.87:(2.22-6.76). Only perceived difficulty managing ADL was significantly associated with death, OR 1.72:(1.06-2.79). There was no association between caregiver network scores and risk of hospitalisation.CONCLUSION: This study operationalizes a simple method to evaluate caregiver networks. Networks consisting of close family (spouse/children) and those reflecting greater socioeconomic privilege (private supports) were associated with lower incidence of adverse outcomes. Caregiver network scores better predicted institutionalisation than hospitalisation or death.

Language: English

Type (Professor's evaluation): Scientific