title: Can burdened caregivers be effective facilitators of elder care-recipient health care?
abstract: BACKGROUND
  Caregiving by informal family caregivers of dependent older people in the community may be affected by burden and by the personal and social resources available to the caregiver. Given the increase in the dependent older population, study of factors affecting informal caregiving is necessary.
  
  
  OBJECTIVE
  To examine caregiver resources, burden and competence as predictors of health-care facilitation on behalf of older patients.
  
  
  METHODS
  Cross-sectional data were collected by an interview schedule from 240 randomly sampled spousal and filial caregivers in Jerusalem. Study variables included caregiver background variables, general self-concept and feelings of caregiver competence, informal and formal social support, burden and levels of health-care facilitation. Path analysis was performed to clarify the direct and indirect predictors of health-care facilitation.
  
  
  RESULTS
  Caregiver facilitation of health-care was positively related both to the presence of personal and social resources and to burden levels. The results suggest that quality caregiving can coexist with burden, provided that ample caregiver resources are present. The most important resources were caregiver sense of competence and support from the professional health-care provider.
  
  
  CONCLUSIONS
  Caregiving burden is not readily reducible, given the chronic nature of older people's health problems. However, caregiver resources can be bolstered, particularly by health professionals. Nurses, who are orientated to holistic family centred care, are especially well-suited for this important intervention.
authors.affiliation: Director, Department of Testing, Israel Ministry of Health, Nursing Division; Director, School of Nursing, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Haya
authors.initials: H
authors.lastname: Greenberger
authors.forename: Howard
authors.initials: H
authors.lastname: Litwin
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology* / Q000592:standards*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006701:Home Nursing / Q000523:psychology*; D006801:Humans; D007557:Israel; D010349:Patient Compliance; D040841:Resource Allocation; D012649:Self Concept; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology*