The effect on caregiver burden of a problem-based home visiting programme for frail older people.
OBJECTIVE
caregiver effects of geriatric care models focusing primarily at the patient have not been consistently studied. We studied caregiver effects of a nurse-led comprehensive geriatric evaluation and management (GEM) programme for community-dwelling frail older people that showed-in a randomised comparison with usual care--health-related quality of life benefits for the care receivers.


METHODS
this randomised trial included 110 caregiver/patient dyads who were followed up for 6 months. Primary analyses were intention-to-treat analyses of caregiver burden assessed with Zarit Burden Interview (ZBI; 0-88; higher means more burden). Preplanned subgroup analyses were conducted for cognition, living arrangement and patient/caregiver co-residence.


RESULTS
overall, perceived caregiver burden showed no significant differences between study groups in changes over time. However, perceived burden was at baseline more than eight points higher in caregivers sharing a household with patients (n = 23) compared to caregivers living separately (n = 87). The intervention performed better in caregivers living together with the patient than in caregivers living separately (P for interaction = 0.04). Co-resident caregivers experienced six-Zarit point improvement compared with four-point deterioration in the non-co-resident caregivers.


CONCLUSIONS
GEM at home benefited patients, but maybe not caregivers. Caregiver effects are related to whether caregivers live with the patient or not.
Melis
René J F
RJ
Department of Geriatric Medicine 925, Radboud University Nijmegen Medical Centre, PO Box 9101, NL-6500 HB, Nijmegen, The Netherlands. r.melis@ger.umcn.nl
van Eijken
Monique I J
MI
van Achterberg
Theo
T
Teerenstra
Steven
S
Vernooij-Dassen
Myrra J F J
MJ
van de Lisdonk
Eloy H
EH
Rikkert
Marcel G M Olde
MG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003152:Community Health Nursing / Q000458:organization & administration*; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000523:psychology*; D005851:Geriatric Nursing / Q000458:organization & administration*; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015397:Program Evaluation; D011788:Quality of Life