title: The effect on caregiver burden of a problem-based home visiting programme for frail older people.
abstract: 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.
authors: Department of Geriatric Medicine 925, Radboud University Nijmegen Medical Centre, PO Box 9101, NL-6500 HB, Nijmegen, The Netherlands. r.melis@ger.umcn.nl
authors: René J F
authors: RJ
authors: Melis
authors: Monique I J
authors: MI
authors: van Eijken
authors: Theo
authors: T
authors: van Achterberg
authors: Steven
authors: S
authors: Teerenstra
authors: Myrra J F J
authors: MJ
authors: Vernooij-Dassen
authors: Eloy H
authors: EH
authors: van de Lisdonk
authors: Marcel G M Olde
authors: MG
authors: Rikkert
mesh_terms: 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