Factors Affecting Family Caregivers' Burden and Depression in Home-based Long-Term Care Service under the Long-Term Care Insurance System

Abstract

This study tried to identify changes in family burden after the introduction of the long-term care insurance and to examine the factors influencing subjective and objective caring burden and depression of family caregivers of elders receiving home-based long-term care. Methods: Data were collected from 203 family caregivers of elders from August 1 to 31, 2015 using questionnaires. They were analyzed in descriptive statistics, t test, ANOVA test, and multiple regression analysis. Results: The mean score of depression was 7.24, which suggested mild depression level. The subjective family burden was 2.71 and the objective burden 3.04. The factors affecting depression included subjective burden (t=5.08, p<.001), objective burden (t=2.80, p=.006), time of elderly care per day (t=-3.61, p< .001), caregiving duration (t=3.33, p=.001), age (t=3.13, p=.002), family relationship (t=2.48, p=.014), and economic status (t=1.99, p=.047). Conclusion: The family burden was most important influencing factor on caregiver's depression. Therefore, services and supports to alleviate caregivers' burden in the home-based care should be added to long-term care.

The moderating effect of care time on care-related characteristics and caregiver burden: differences between formal and informal caregivers of dependent older adults

“…Furthermore, 13 of 32 studies considered in a systematic review on care burden in families with dementia reported that care time had a significant negative relationship to family care burden ( 10 ). The current study was conducted during the COVID-19 pandemic (August 2021 to October 2022), and average care time per day was 8.70 h (formal caregivers 8.59 h, informal caregiver 9.13 h), compared to 7.50 h in Australia ( 4 ) and 7.34 h in Korea ( 17 ) in family caregivers before COVID-19.…”

“…Recently, although many studies have been conducted on the caregiver burden of older adults in Korea, they separately have analyzed formal caregivers ( 26 ) or informal caregivers ( 9 , 17 ). There were limitations in exploring and comparing the differences in the degree of care burden and influencing factors between formal and informal caregivers.…”

“…Care-recipient factors influencing care burden were physical disability (11)(12)(13), mental dependency (11), and behavioral and psychological symptoms of dementia (13). Caregiver factors were gender (11), age (13)(14)(15), satisfaction with care (16), caring time (10,17,18), duration of caregiving (11), care attitude (19), and stress (6,11). Lastly, the utilization of community services (20) and perceived social support (11,20) were social factors reported to affect caregiver burden of care.…”

Working Conditions Affecting Home Care Workers’ Stress and Turnover Intention

“…Meanwhile, paid family home care workers may bear verbal abuse and injuries/illness at work rather than express turnover intention because of a sense of obligation or because they have few alternatives. Lee and Kim (2018) demonstrated that paid family home care workers could not find persons to replace themselves, in caring for older families, due to the increase in nuclear family and female labor force participation. Thus, lo-institutional & hi-recipient working conditions are likely to increase stress but not to lead to turnover intention as a result of socio-cultural contexts, including means of living, obligations, lack of substitutes due to change in family structure, etc.…”

Relationship between filial obligation and caregiver depression among adult children: A systematic review and meta‐analysis

“…Previous studies also revealed that some demographic or contextual factors, such as caregiver's gender, education level, economic status, care demand, motivation, cultural expectations and support resources, may confound the influence of filial obligation on caregiver depression (Hu et al, 2018 ; Lee & Kim, 2018 ; Zhang et al, 2021 ). For example, caregiving to parents is expected to be a duty of adult children in Asian, Latin American, or Mediterranean countries, while institutionalisation is common in North‐American and European countries (Atakere & Adams, 2018 ; Mureşan & Hărăguş, 2015 ).…”