Dementia Caregivers' Use of Services for Themselves.
Health care and social services such as physician visits and support groups used by dementia caregivers for themselves were examined. Caregivers (N = 642) were from the Resources for Enhancing Alzheimer's Caregivers Health (REACH II) study.



Caregiver predisposing, enabling, and need variables were examined using chi-squared and t-tests to characterize service users. Stagewise linear regression was used to explain numbers of services used.



Predisposing, enabling, and need variables were significantly related to dementia caregivers' service use. In regression, caregivers who were older, more educated, married, not employed, depressed, with functional disability needs, more illness-related reduced activity days, more medications, more symptoms, and fewer hours on duty per day used significantly more services for themselves. The statistically significant model explained 22.2% variance in numbers of services used. Service users, compared with nonusers, evidenced greater burden, bother with behaviors, and more desire to institutionalize.



This study shows that caregiver service use is related to caregiver characteristics. Future work should examine the impact of caregiving on health care and social service use and costs. The societal costs of caregiving may be better understood when we account for additional service use by caregivers themselves. A significant clinical and policy issue is who should assess and support the caregiver. Possibilities include the care recipient's health care practitioner, the caregiver's health care practitioner, or a formal caregiver-focused program based in the health care system or the social service network.
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.|Veterans Affairs Medical Center Memphis, Tennessee.
Jennifer
J
Martindale-Adams
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis. linda.nichols@va.gov.|Veterans Affairs Medical Center Memphis, Tennessee.
Linda O
LO
Nichols
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.|Veterans Affairs Medical Center Memphis, Tennessee.
Jeffrey
J
Zuber
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.|Geriatrics Group of Memphis, Tennessee.
Robert
R
Burns
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.|Veterans Affairs Medical Center Memphis, Tennessee.
Marshall J
MJ
Graney
D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D017028:Caregivers / Q000706:statistics & numerical data*; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D008297:Male; D017533:Marital Status; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012657:Self-Help Groups / Q000706:statistics & numerical data*; D014478:Unemployment
Caregiving—informal; Dementia; Health services; REACH II