Caregiving burnout of community-dwelling people with dementia in Hong Kong and New Zealand: a cross-sectional study

Abstract

Background Informal caregiving for people with dementia can negatively impact caregivers’ health. In Asia-Pacific regions, growing dementia incidence has made caregiver burnout a pressing public health issue. A cross-sectional study with a representative sample helps to understand how caregivers experience burnout throughout this region. We explored the prevalence and contributing factors of burnout of caregivers of community-dwelling older people with dementia in Hong Kong (HK), China, and New Zealand (NZ) in this study. Methods Analysis of interRAI Home Care Assessment data for care-recipients (aged ≥65 with Alzheimer’s disease/other dementia) who had applied for government-funded community services and their caregivers was conducted. The sample comprised 9976 predominately Chinese in HK and 16,725 predominantly European in NZ from 2013 to 2016. Caregiver burnout rates for HK and NZ were calculated. Logistic regression was used to determine the adjusted odds ratio (AOR) of the significant factors associated with caregiver burnout in both regions. Results Caregiver burnout was present in 15.5 and 13.9% of the sample in HK and NZ respectively. Cross-regional differences in contributing factors to burnout were found. Care-recipients’ ADL dependency, fall history, and cohabitation with primary caregiver were significant contributing factors in NZ, while primary caregiver being child was found to be significant in HK. Some common contributing factors were observed in both regions, including care-recipients having behavioural problem, primary caregiver being spouse, providing activities-of-daily-living (ADL) care, and delivering more than 21 h of care every week. In HK, allied-health services (physiotherapy, occupational therapy and speech therapy) protected caregiver from burnout. Interaction analysis showed that allied-health service attenuates the risk of burnout contributed by care-recipient’s older age (85+), cohabitation with child, ADL dependency, mood problem, and ADL care provision by caregivers. Conclusions This study highlights differences in service delivery models, family structures and cultural values that may explain the cross-regional differences in dementia caregiving experience in NZ and HK. Characteristics of caregiving dyads and their allied-health service utilization are important contributing factors to caregiver burnout. A standardized needs assessment for caregivers could help policymakers and healthcare practitioners to identify caregiving dyads who are at risk of burnout and provide early intervention.

Longitudinal Cohort Study of Depression and Anxiety Among Older Informal Caregivers Following the Initial COVID-19 Pandemic Response in Aotearoa New Zealand

“…The impacts of providing care on psychological stress of informal caregivers is understood to be influenced by the caregiver’s background and contextual factors, as well as these primary and secondary impacts of the care situation ( Pearlin et al, 1990 ), with a misfit of demands and available resources associated with experiences of ‘burnout’ among informal caregivers ( Roth et al, 2015 ). In New Zealand, prior research with informal caregiver groups indicate significant deficits in formal support available in the provision of care roles under normal circumstances ( Jorgensen et al, 2010 ), with care for activities of daily living (ADLs), falls history and cohabitation with care recipient significant contributors to burnout among informal caregivers of people with dementia ( Chan et al., 2021 ).…”

Caregiver burden and its associated factors among family caregivers of persons with dementia in Shanghai, China: a cross-sectional study

“…Caregiver burnout was associated with PWDs’ activities of daily living (ADLs) dependence and history of falls in the previous 90 days. Factors such as primary caregivers being adult children and the utilisation of allied health services were found to be protective to caregiver burn-out 13. As the social services and healthcare systems are different between Hong Kong and mainland China, factors contributing to caregiver burden may also differ between the two settings.…”

“…Factors such as primary caregivers being adult children and the utilisation of allied health services were found to be protective to caregiver burn-out. 13 As the social services and healthcare systems are different between Hong Kong and mainland China, factors contributing to caregiver burden may also differ between the two settings. Studies on caregiver burden of dementia caregivers conducted in northern cities of China showed that the average score of caregiver burden measured by the Zarit Burden Interview was 12.2±13.2, which lies in the mild range.…”

Caregivers’ Experience of End-of-Life Stage Elderly Patients: Longitudinal Qualitative Interview

“…Despite efforts made advocating “aging in place”, Hong Kong has one of the highest institutionalization rates in the world, at 6.8%, with other countries ranging from 1.0% to 5.4% [ 12 ]. One of the possible reasons for this is the inability of families to shoulder the responsibility of such care [ 13 ]. Therefore, in order to support family members to provide care in the community, this study aims to increase our understanding of the caregivers’ experience along the end of life journey to strengthen interventions and further enhance policy formulation to support “aging well in place”.…”