Health Care Decision Making by the Elderly: I Get by with a Little Help from My Family

Kapp, Marshall B.

doi:10.1093/geront/31.5.619

Cited by 52 publications

(33 citation statements)

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“…With increased anticipation of disability-free life expectancy, not all late-life planning revolves around anticipation of death or frailty. Yet planning ahead ultimately also includes care and end-of-life plans, which can potentially help forestall giving up autonomy in health care decision-making (Kapp, 1991).…”

Section: Traditional Adaptations--preventivementioning

confidence: 99%

Emerging lifestyles and proactive options for successful ageing

Kahana

Kercher

2003

Ageing Int.

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Section: Traditional Adaptations--preventivementioning

confidence: 99%

Emerging lifestyles and proactive options for successful ageing

Kahana

Kercher

2003

Ageing Int.

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“…[1][2][3][4] The burden of chronic illnesses rests not only on an individual patient but can often affect an entire family. [4][5][6][7] Caregiver assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) has been well documented, and this direct care provision can influence the caregiver's physical health through increased risk of injury, poor self-care, and elevated stress hormones. [8][9][10][11][12] However, ADL and IADL measures fail to capture the full scope of caregiving which can include many tasks related to health care management.…”

Section: Introductionmentioning

confidence: 99%

Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults

et al. 2011

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BACKGROUND: Family caregivers provide assistance with health care tasks for many older adults with chronic illnesses. The difficulty they experience in providing this assistance, and related implications for their well-being, have not been well described. OBJECTIVE: The objectives of this study are: (1) to describe caregiver's health care task difficulty (HCTD), (2) determine the characteristics associated with HCTD, and (3) explore the association between HCTD and caregiver well-being. DESIGN: This is a cross-sectional study. PARTICIPANTS: Baseline sample of caregivers to older (aged 65+years) multimorbid adults enrolled in an ongoing cluster-randomized controlled trial (N=308). MAIN MEASURES:The HCTD scale (0-16) is comprised of questions measuring self-reported difficulty in assisting older adults with eight health care tasks, including taking medication, visiting health care providers, and managing medical bills. Caregivers were categorized using this scale into no, low, medium, and high HCTD groups. We used ordinal logistic regression and multivariate linear regression analyses to examine the relationships between HCTD, caregiver self-efficacy, caregiver strain (Caregiver Strain Index), and depression (Center for Epidemiological Studies Depression Scale), controlling for patient and caregiver socio-demographic and health factors. KEY RESULTS: Caregiver age and number of health care tasks performed were positively associated with increased HCTD. The quality of the caregiver's relationship with the patient, and self-efficacy were inversely associated with increased HCTD. A onepoint increase in self-efficacy was associated with a significant lower odds of reporting high HCTD (OR, 0.64; 95% CI, 0.54, 0.77).Adjusted linear regression models indicated that high HCTD was independently associated with significantly greater caregiver strain (B, 2.7; 95% CI, 1.12, 4.29) and depression (B, 3.01; 95% CI, 1.06, 4.96). CONCLUSIONS: This study demonstrates that greater HCTD is associated with increased strain and depression among caregivers of multimorbid older adults. That caregiver self-efficacy was strongly associated with HCTD suggests health-system-based educational and empowering interventions might improve caregiver well-being.

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“…These companions are not simply present; they actively participate in communication (Laidsaar-Powell et al, 2013;Wolff & Roter, 2011) and remain involved over time (Wolff, Boyd, Gitlin, Bruce, & Roter, 2012), which suggests that companions may play a role in the coordination of care between healthcare providers. Individuals who are older (Deimling, Smerglia, & Barresi, 1990;Ende, Kazis, Ash, & Moskowitz, 1989;Kapp, 1991), less educated (Wolff & Roter, 2008), and with lower health literacy (Gaglio, Glasgow, & Bull, 2012;Smith, Dixon, Trevena, Nutbeam, & McCaffery, 2009) often desire and benefit from the active involvement of a companion when communicating during medical visits.…”

Section: The Family Caregiver Workforce: Size Composition and Scopementioning

confidence: 99%