Factors associated with informal caregiver's ability to continue care: a subgroup analysis

Abstract

Background/objective: maintaining informal caregiver's ability to continue care can prevent early institutionalisation and decrease health care costs, contributing to sustainable health care. This study aims to identify factors associated with informal caregiver's ability to continue care across several degrees of cognitive decline and risk of burden.

Methods: this is a cross-sectional study that collected nationwide data on frail older people and their informal caregivers living in the community. Instruments used were InterRAI Home Care, Zarit Burden Interview and questionnaire for the informal caregiver. Multivariate logistic regression analyses and a stratification of the population were performed.

Results: a total of 8,309 people had at least one primary caregiver, and a majority of them were able to continue care (68.2%). Cognitive impairment was a risk factor for being able to continue care, even the borderline (odds ratios (ORs): 0.72; 95% CI: 0.61-0.85) or mild condition (OR: 0.52; 95% CI: 0.43-0.61). Protective factors like social participation of older people, strong family support and availability of a secondary caregiver showed the highest association in subgroups with mild cognitive impairment (ORs: 2.20, 2.08, 1.64) and in subgroups at low risk of burden (ORs: 1.91, 2.77, 1.64).

Conclusion: factors associated with informal caregiver's ability to continue care vary across several degrees of cognitive decline and risk of burden. Interventions related to family and social support resources are recommended, and informal caregivers at a lower level of risk may benefit most. Supportive counselling should be proactively provided to informal caregivers, considering the changes of associated factors with the ongoing caregiving situation.

Keywords: continuity of informal care; determinants; family support; mild cognitive problems; older people; risk of burden.