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Dementia caregiver burdens predict overnight hospitalization and hospice utilization
- Suzanne S. Sullivan, Cristina de Rosa, Chin-Shang Li, Yu-Ping Chang
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- Journal:
- Palliative & Supportive Care / Volume 21 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 20 October 2022, pp. 1001-1015
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- Article
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Objectives
To determine sociodemographics and caregiver burdens associated with overnight hospitalization, hospice utilization, and hospitalization frequency among persons with dementia (PWD).
MethodsCross-sectional analysis of PWD (n = 899) of the National Health and Aging Trends Study linked to the National Study of Caregiving. Logistic and proportional odds regression determined the effects of caregiver burdens on overnight hospitalization, hospice use, and hospitalization frequency. Differences between PWD alive not-alive groups were compared on overnight hospitalization and frequency.
ResultsAlive PWD (n = 804) were 2.36 times more likely to have an overnight hospital stay (p = 0.004) and 1.96 times more likely to have multiple hospitalizations when caregivers found it physically difficult to provide care (p = 0.011). Decedents aged 65–74 (n = 95) were 4.55 times more likely to experience overnight hospitalizations than 85+, hospitalizations were more frequent (odds ratio [OR] = 4.84), and there was a significant difference between PWD alive/not alive groups (p = 0.035). Decedents were 5.60 times more likely to experience an overnight hospitalization when their caregivers had financial difficulty, hospitalizations were more frequent when caregivers had too much to handle (OR = 8.44) and/or no time for themselves (OR = 10.67). When caregivers had no time for themselves, a significant difference between alive/not alive groups (p = 0.018) was detected in hospitalization frequency. PWD whose caregivers had emotional difficulty helping were 5.89 times more likely to utilize hospice than caregivers who did not report emotional difficulty.
Significance of resultsCare transitions among PWD at the end of life are impacted by the circumstances and experiences of their caregivers. Subjective caregiver burdens represent potentially modifiable risks for undesired care transitions and opportunities for promoting hospice use. Future work is warranted to identify and address these issues as they occur.
Contributors
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- By Giustino Albanese, Andrew Amaranto, Brandon H. Backlund, Alexander Baxter, Abraham Berger, Mark Bernstein, Marian E. Betz, Omar Bholat, Suzanne Bigelow, Carl Bonnett, Elizabeth Borock, Christopher B. Colwell, Alasdair Conn, Moira Davenport, David Dreitlein, Aaron Eberhardt, Ugo A. Ezenkwele, Diana Felton, Spiros G. Frangos, John E. Frank, Jonathan S. Gates, Lewis Goldfrank, Pinchas Halpern, Jean Hammel, Kristin E. Harkin, Jason S. Haukoos, E. Parker Hays, Aaron Hexdall, James F. Holmes, Debra Houry, Jennifer Isenhour, Andy Jagoda, John L. Kendall, Erica Kreisman, Nancy Kwon, Eric Legome, Matthew R. Levine, Phillip D. Levy, Charles Little, Marion Machado, Heather Mahoney, Vincent J. Markovchick, Nancy Martin, John Marx, Julie Mayglothling, Ron Medzon, Maurizio A. Miglietta, Elizabeth L. Mitchell, Ernest Moore, Maria E. Moreira, Sassan Naderi, Salvatore Pardo, Sajan Patel, David Peak, Christine Preblick, Niels K. Rathlev, Charles Ray, Phillip L. Rice, Carlo L. Rosen, Peter Rosen, Livia Santiago-Rosado, Tamara A. Scerpella, David Schwartz, Fred Severyn, Kaushal Shah, Lee W. Shockley, Mari Siegel, Matthew Simons, Michael Stern, D. Matthew Sullivan, Carrie D. Tibbles, Knox H. Todd, Shawn Ulrich, Neil Waldman, Kurt Whitaker, Stephen J. Wolf, Daniel Zlogar
- Edited by Eric Legome, Lee W. Shockley
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- Book:
- Trauma
- Published online:
- 07 September 2011
- Print publication:
- 16 June 2011, pp ix-xiv
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Contributors
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- By Charles E. Argoff, Gerard A. Banez, Samantha Boris-Karpel, Barbara K. Bruce, Alexandra S. Bullough, Annmarie Cano, Victor T. Chang, Elizabeth A. Clark, Daniel J. Clauw, June L. Dahl, Tam K. Dao, Amber M. Davis, Courtney L. Dixon, Michael H. Ebert, Robin M. Gallagher, Gerald W. Grass, Carmen R. Green, Jay Gunkelman, Bradford D. Hare, Jennifer A. Haythornthwaite, Jaclyn Heller Issner, W. Michael Hooten, Mark P. Jensen, Mark E. Jones, Robert D. Kerns, Raphael J. Leo, Morris Maizels, Mary E. Murawski, Brooke Myers-Sorger, Akiko Okifuji, Renata Okonkwo, John D. Otis, Stacy C. Parenteau, Laura E. Pence, Donald B. Penzien, Donna B. Pincus, Ellyn Poltrock Stein, Wendy J. Quinton, Jeanetta C. Rains, M. Carrington Reid, Thomas J. Romano, Jeffrey D. Rome, Robert L. Ruff, Suzanne S. Ruff, Steven H. Sanders, Ingra Schellenberg, John J. Sellinger, Howard S. Smith, Brenda Stoelb, Jon Streltzer, Mark D. Sullivan, Kimberly S. Swanson, Gabriel Tan, Stephen Thielke, Beverly E. Thorn, Cynthia O. Townsend, Dennis C. Turk, Stephanie C. Wallio, Lawrence J. Weinberger, David A. Williams, Hilary Wilson
- Edited by Michael H. Ebert, Yale University, Connecticut, Robert D. Kerns, Yale University, Connecticut
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- Book:
- Behavioral and Psychopharmacologic Pain Management
- Published online:
- 10 January 2011
- Print publication:
- 25 November 2010, pp ix-xii
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