Evaluation of the Caregiver Preparedness Scale in African American and White Caregivers of Persons With Dementia During Post-Hospitalization Transition

Abstract

Background and PurposeThe Preparedness for Caregiving Scale (PCS) is a widely used instrument to measure caregiver preparedness. The purpose was to evaluate the PCS in African American and White caregivers of patients with dementia upon discharge from the hospital.MethodsFactor structure, measurement invariance, and predictive validity of the PCS were assessed in a sample of 292 family caregivers/patient dyads.ResultsOne-factor structure of the PCS and measurement invariance by race was fully supported. Predicative validity revealed significant association between the PCS and anxiety (β = −.41, t = −7.61(287), p < .001), depression (β = −.44, t = −8.39(287), p < .001), and strain (β = −.48, t = −9.29(287), p < .001).ConclusionThe PCS is a valid and meaningful tool to measure preparedness in African American and White family caregivers of persons with dementia during post-hospitalization transition.

Predictive model for the preparedness level of the family caregiver

“…The transition from hospital to home represents a vulnerable moment for care-dependent people, as their caregivers must learn to face new challenges. Uncertainty about how to provide care or a lack of support or information can increase caregiver stress and lead caregivers to compromise their own well-being and effectiveness (Kuzmik et al, 2021). It is common for caregivers to request information from nurses.…”

Caregiver preparedness is associated with desire to seek long‐term care admission of hospitalized persons with dementia

“…This is consistent with prior work where caregivers report lack of preparedness to meet the increased needs during post‐hospital transition, 22–24 which could lead to unwanted nursing home placement. An instrument like the PCS could be implemented during hospitalization to target specific areas of need that could be addressed by discharge planners and case managers to improve caregiver preparedness, and potentially avoid admission to a long‐term nursing facility 32 . Also, the needs of the caregiver can be communicated to the post‐acute provider (home health care agency, primary care provider, and in‐home case workers).…”

“…An instrument like the PCS could be implemented during hospitalization to target specific areas of need that could be addressed by discharge planners and case managers to improve caregiver preparedness, and potentially avoid admission to a long-term nursing facility. 32 Also, the needs of the caregiver can be communicated to the post-acute provider (home health care agency, primary care provider, and in-home case workers). Future research that engages the preferences of the hospitalized persons with dementia is warranted, as all too often, their preferences are not considered during hospitalization.…”

“…The PCS has strong evidence of validity in samples of caregivers of carerecipients with stroke, heart failure, palliative care, and persons with dementia at hospital discharge. [31][32][33][34] Caregiver strain was evaluated using the Modified Caregiver Strain Index (MCSI). 35 The MCSI is a 13-item instrument that includes five domains: financial, physical, psychological, social, and personal.…”

“…Responses are rated between 0 (not at all prepared) to 4 (very well prepared), with higher scores indicating greater perceived preparedness. The PCS has strong evidence of validity in samples of caregivers of care‐recipients with stroke, heart failure, palliative care, and persons with dementia at hospital discharge 31–34 …”