Variation in cost of informal caregiving and formal-service use for people with Alzheimer's desease

Abstract

This study used a geographically diverse sample to estimate the total cost of informal care and formal services for community-residing Alzheimer's disease (AD) care recipients. Baseline data were used for 1200 family caregivers from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) study, a multisite intervention trial. The replacement-wage-rate approach estimated informal cost. Formal services were assigned a cost based on secondary sources. Annual cost per care recipient amounted to 23,436 dollars for informal care and 8064 dollars for formal services. Variation in informal cost was almost entirely due to instrumental activities of daily living (IADLs) assistance. Cross-site differences in cost persisted after controlling for caregiver and care-recipient characteristics. Geographic variation may suggest regional preferences or ethnic/cultural values. Further study is needed to determine whether this reflects differences in access or availability or how including a control group for care recipients with nondementia diagnoses might have affected these findings.

Assessing the relationship between health utilities, quality of life, and health services use in Alzheimer's disease

“…Our findings are also consistent with those few examining the relationship between service use in AD and general health rating (Chan et al, 2003;Harrow et al, 2004), in addition to the relationship between self-rated health and the SF-36 and service use in chronically ill and elderly populations (Miller and Weissert, 2000;Sprenkl et al, 2004). Thus, the present study reinforces the dynamic between health and health services identified elsewhere, albeit using a previously unexplored combination of population (AD patients) and assessment methodology (the HUI-III).…”

“…Although several studies have examined the correlates of nursing home use in AD (Hux et al, 1998;Gaugler et al, 2000;Smith et al, 2000;Chan et al, 2003;Phillips and Diwan, 2003;Gaugler et al, 2004;Mausbach et al, 2004;Hill et al, 2006), and some the correlates of inpatient hospital use (Fillenbaum et al, 2000;Small et al, 2002;Porell and Carter, 2005), outpatient medical use (Fillenbaum et al, 2001;Small et al, 2002), and use of various home-and communitybased services (Hux et al, 1998;Montgomery et al, 2002;Toseland et al, 2002;Harrow et al, 2004), few examine the correlates of both institutional and noninstitutional service use in the same study population (Hux et al, 1998) and none do so using quality of life and health utilities, two increasingly important outcomes in AD research. To the extent that quality of life and/or health utilities are related they could be used to help predict service use among those suffering from AD.…”

The Influences of Gender and Religiousness on Alzheimer Disease Caregivers' Use of Informal Support and Formal Services

“…Thus, we elected not to combine these items in the analysis. See detailed information about these measures in Harrow et al (2004).…”

“…Thus, we elected not to combine these items in the analysis. See detailed information about these measures in Harrow et al (2004).Informal support was measured by the amount of actual help the caregiver reported receiving using an 11-item instrument based on work by Krause and Markides (1990). Specific items included tangible support, (e.g., help with transportation), emotional support, (e.g., having others listen and show interest), and informational support, (e.g., sharing suggestions).…”

Effectiveness of a psychoeducational intervention program in the reduction of caregiver burden in alzheimer's disease patients' caregivers

“…The increasing dependence of sufferers requires a significant effort from those closest to them, since more than 70% of people with dementia live at home, and virtually 75% of the necessary care is provided by family and friends. It has been estimated that the main carer of an AD patient can dedicate around 70 hours per week to the task of caring (Boada et al, 1999;Langa et al, 2001;Harrow et al, 2004). Obviously, the efforts undertaken by the family carers mean a substantial saving for the social and healthcare services, but carers get in exchange a series of negative consequences, collectively referred to as 'caregiver burden' (Donaldson and Burns, 1999).…”