Do informal caregivers of demented patients refuse clinic comprehensive medico-psycho-social assessment? Prevalence and reasons for refusal

Abstract

Objective: Caregivers do not usually use services that could alleviate their burden. The objectives were to determine the refusal's prevalence and the reasons why informal caregivers of demented patients refuse clinic medico-psycho-social assessment in the first day care hospital dedicated to caregivers in France.

Methods: Caregivers of patients hospitalized in geriatric ward were prospectively asked to fill in a questionnaire (demographic data, risk for depression and caregiver burden (Zarit scale) about their willingness to benefit from a clinic checkup. If caregivers refused eleven close questions were asked. Characteristics of the caregivers were compared according to the caregivers' agreement or refusal to the clinic checkup.

Results: Seventy-seven caregivers (mean age (standard deviation): 68.2 (11.5)) were included: 68.8% of women, 51.9% of children and 35.1% of spouses, mean Zarit scale score was 32.8 (8.8)/88. Clinic checkup was accepted by 28 caregivers. Agreement was associated with exhaustion (p<0.001), depression (p=0.003), memory complaints (p<0.001) and higher burden (p=0.008). Reasons for refusal were mostly the belief that support was sufficient (67.3%) and good self-perceived health (44.9%). Nearly 1/4 of caregivers though that the clinic checkup would be useless.

Conclusion: Two third of caregivers refused the evaluation because subjective feeling of good physiological and psychological health and that currently provided support was sufficient. Studies to address caregivers 'needs should be conducted.

Keywords: caregiver's reluctance to help; caregivers’ burden; comprehensive clinic check-up; prevalence and reasons for refusal.