title: Factors decreasing caregiver burden to allow patients with cerebrovascular disease to continue in long-term home care.
abstract: BACKGROUND
  This study attempted to assess continued long-term home care by examining patients' independent activities of daily living (ADLs) and caregivers' free time.
  
  
  METHODS
  We surveyed the main caregivers of 52 patients with cerebrovascular disease with continuous home care from 1999 to 2010. Survey items were patients' ADLs, the frequency of use of care services, care requirements, and caregiver sense of burden. We compared the survey results between years.
  
  
  RESULTS
  ADLs of excretory control, verbal expression, verbal comprehension, and range of activities showed significant deterioration from 1999 to 2010. Patient need for care increased significantly but use of care services did not. Main caregivers were typically spouses who aged together with the patients. Main caregivers rarely changed; occasionally, a son or daughter-in-law became the main caregiver. Patients typically required less than 3 hours of care daily, which did not change over time. Caregivers had significantly more difficulty maintaining their own health in 2010 than 1999. However, they did not identify increases in difficulties with housework or coping with work. They felt that caregiving was a burden but did not indicate that the family relationship had deteriorated.
  
  
  CONCLUSIONS
  Regardless of degree of independence of patients' ADLs, caregiver burden was severe. To decrease caregiver burden, it is necessary to use care services, reduce care time, and allow caregivers free time. In addition, it is possible to continue long-term home care by maintaining their relationships.
authors.affiliation: Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan. Electronic address: aki.wtnb@kitasato-u.ac.jp.
authors.forename: Aki
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Michinari
authors.initials: M
authors.lastname: Fukuda
authors.affiliation: Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Habata
authors.affiliation: Department of Neurology, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: Tsugio
authors.initials: T
authors.lastname: Akutsu
authors.affiliation: Department of Physical Therapy, School of Health Sciences, Toyohashi Sozo University, Aichi, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kanda
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D002561:Cerebrovascular Disorders / Q000628:therapy*; D017281:Cost of Illness; D005260:Female; D006701:Home Nursing; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D018454:Spouses
keywords: Caregiver burden; cerebrovascular disease; home care