This study addresses the relationship between caregiver burden and the use of home health services among older adults with cognitive impairment. Analyses draw on data from personal interviews conducted with 327 older adults with cognitive impairment and living in the community of their primary caregivers. Using the Andersen-Newman framework, the results of ordinary least squares and logistic regression analyses reveal that caregiver burden and formal home health service use are only weakly related. Possible explanations for the findings are discussed.
Get full access to this article
View all access options for this article.
References
1.
Andersen, R. , & Newman, J. F. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly, 51, 95-124.
2.
Bass, D. M. , & Noelker, L. S. (1987). The influence of family caregiver on elder's use of in-home services. Journal of Health and Social Behavior, 28, 184-196.
3.
Bergmann, K. , Foster, E. M., Justice, A. W., & Matthews, V. (1978). Management of the demented elderly patient in the community. British Journal of Psychiatry, 132, 441-449.
4.
Biegel, D. E. , Bass, D. M., Schulz, R., & Morycz, R. (1993). Predictors of in-home and out-of-home service use by family caregivers of Alzheimer's disease patients. Journal of Aging and Health, 5, 419-438.
5.
Birkel, R. C. , & Jones, C.J. (1989). A comparison of the caregiving networks of dependent elderly individuals who are lucid and those who are demented. The Gerontologist, 29, 114-119.
6.
Branch, L. G. , & Meyers, A. R. (1988). Long-term care in the United States. In E. Rathbone-McCuan and B. Havens (Eds.), North American elders: United States and Canadian perspectives (pp. 89-108). New York: Greenwood.
7.
Canadian Study of Health and Aging Working Group . (1994). The Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899-913.
8.
Chappell, N. L. (1988). Long-term care in Canada. In E. Rathbone-McCuan & B. Havens (Eds.), North American elders: United States and Canadian perspectives (pp. 73-88). New York: Greenwood.
9.
Chappell, N. L. (1991). Living arrangements and sources of caregiving. Journal of Gerontology: Social Sciences, 46, S1-S8.
10.
Chappell, N. L. , & Blandford, A. A. (1987). Health service utilization by elderly persons. Canadian Journal of Sociology, 12, 195-215.
11.
Chappell, N. L. , & Guse, L. (1989). Linkages between informal and formal support. In K. S. Markides & C. L. Cooper (Eds.), Aging, stress and health (pp. 219-237). New York: Wiley.
12.
Chenoweth, B. , & Spencer, B. (1986). Dementia: The experience of caregivers. The Gerontologist, 26, 267-272.
13.
Coulton, C. , & Frost, A. K. (1982). Use of social services by the elderly. Journal of Health and Social Behavior, 23, 330-339.
14.
Deimling, G. T. , & Bass, D. M. (1986). Symptoms of mental impairment among elderly adults and their effects on family caregivers. Journal of Gerontology, 41, 778-784.
15.
Dillehay, R. C. , & Sandys, M. R. (1990). Caregivers for Alzheimer's patients: What are we learning from research?International Journal of Aging and Human Development, 30, 263-285.
16.
Folstein, M. , Anthony, J. C., Parhad, I., Duffy, B., & Gruenberg, E. M. (1985). The meaning of cognitive impairment in the elderly. Journal of the American Geriatrics Society, 33, 228-235.
17.
George, L. K. , & Gwyther, L. R. (1986). Caregiver well-being: A multidimensional examination of family caregivers of demented adults. The Gerontologist, 26, 253-259.
18.
Gonyea, J. (1987). The family and dependency: Factors associated with institutional decision-making. Journal of Gerontological Social Work, 10, 61-77.
19.
Levine, N. B. , Dastoor, D. P., & Gendron, C. E. (1983). Coping with dementia: A pilot study. Journal of the American Geriatrics Society, 31, 12-18.
20.
Lund, D. A. , Pett, M. A., & Caserta, M. S. (1987). Institutionalizing dementia victims: Some caregiver considerations. Journal of Gerontological Social Work, 11, 119-135.
21.
McAuley, W. J. , & Arling, G. (1984). Use of in-home care by very old people. Journal of Health and Social Behavior, 5, 54-64.
22.
McFall, S. , & Miller, B. (1992). Caregiver burden and nursing home admission of frail elderly persons. Journal of Gerontology: Social Sciences, 47, S73-S79.
23.
Miller, B. , & McFall, S. (1991). The effect of caregiver's burden on change in frail persons' use of formal helpers. Journal of Health and Social Behavior, 32, 165-179.
24.
Moritz, D. J. , Kasl, S. V., & Berkman, L. F. (1989). The health impact of living with a cognitively impaired elderly spouse: Depressive symptoms and social functioning. Journal of Gerontology: Social Sciences, 44, S17-S27.
25.
Morycz, R. K. (1985). Caregiving strain and the desire to institutionalize family members with Alzheimer's disease: Possible predictors and model developmentResearch on Aging, 7, 329-361.
26.
Novak, M. , & Guest, C. (1990). Caregiver response to Alzheimer's disease. International Journal of Aging and Human Development, 28, 67-79.
27.
Pearson, J. L. , Cherrier, M., & Ten, L. (1989). The Mini-Mental State Exam and the Mental Status Questionnaire: Depression in Alzheimer's patients. Clinical Gerontologist, 8, 31-37.
28.
Poulshock, S. W. , & Deimling, S. T. (1984). Families caring for the elderly in residence: Issues in the measurement of burden. Journal of Gerontology, 39, 230-239.
29.
Rabins, P. V. , Mall, N. L., & Lucas, M. J. (1982). The impact of dementia on the family. Journal of American Medical Association, 248, 333-335.
30.
Strain, L. A. (1991). Use of health services in later life: The influence of health beliefs. Journal of Gerontology: Social Sciences, 46, S143-S150.
31.
Teng, E. L. , & Chui, H. C. (1987). The Modified Mini-Mental State Examination.Journal of Clinical Psychiatry, 48, 314-318.
32.
Teng, E. L. , Chui, H. C., & Gong, A. (1990). Comparisons between the Mini-Mental State Exam (MMSE) and its modified version-the 3MS Test. In K. Hasegawa & A. Homma (Eds.), Psychogeriatrics: Biomedical and Social Advances (pp. 189-192). Amsterdam: Excerpta Medical.
33.
Tennstedt, S. L. , Crawford, S., & McKinlay, J. B. (1993). Determining the pattern of community care: Is coresidence more important than caregiver relationship?Journal of Gerontology: Social Sciences, 48, S74-S83.
34.
Tombaugh, T. N. , & McIntyre, N. J. (1992). The Mini-Mental State Examination: A comprehensive review. Journal of the American Geriatrics Society, 40, 922-935.
35.
Webber, P. A. , Fox, P., & Burnette, D. (1994). Living alone with Alzheimer's disease: Effects on health and social service utilization. The Gerontologist, 34, 8-14.
36.
Young, R. , & Kahana, E. (1989). Specifying caregiver outcomes: Gender and relationship aspects of caregiving strain. The Gerontologist, 29, 600-666.
37.
Zarit, S. H. , Reever, K. E., & Bach-Peterson, J. (1980). Relatives of impaired elderly: Correlates of feeling of burden. The Gerontologist, 20, 649-655.
38.
Zarit, S. H. , Todd, P. A., & Zarit, J. M. (1986). Subjective burden of husbands and wives as caregivers: A longitudinal study. The Gerontologist, 26, 260-266.
