By Geralyn Magan
Findings from a new study could inform the design of interventions to reduce caregiving-related stress and burden.
A new study shows that long-distance caregivers may experience less care-related stress if their care recipient receives home care services.
The study, published by The Gerontologist on June 24, was led by Francesca B. Falzarano from Weill Cornell Medicine. Verena Cimarolli, director of health services research and partnerships at the LeadingAge LTSS Center @UMass Boston, was a co-author. The study was funded by the National Institute on Aging (PI: A. Horowitz: R21 AG050018).
The article defines long-distance caregivers as individuals providing substantial care for a family member or friend who lives two or more hours away. Although long-distance caregivers experience similar and often more severe caregiving-related stress when compared to geographically close caregivers, there is no research examining caregiving-related stress in these caregivers.
The study’s sample included 166 long-distance caregivers in the United States who provide and manage care for a community-dwelling care recipient living two or more hours away. Participants in the study reported on the:
- Care recipient’s cognitive and functional status.
- Perceived interference of caregiving with work and other family responsibilities.
- Care recipient’s use of home care services.
Results indicate that a care recipient’s home care service utilization may prevent care-related strain from spilling over to a long-distance caregiver’s work and family domains. The authors suggest that these findings can be used to inform the design of interventions to alleviate caregiving-related stress and burden in long-distance caregivers.
THE LONG-DISTANCE CAREGIVING EXPERIENCE
The authors cite research showing the rising number of caregivers providing care from afar to an older adult with chronic illness. These caregivers offer types of assistance that are similar to assistance provided by geographically proximate caregivers, including financial assistance, care management, and emotional support. Distance adds an extra layer of complexity to the caregiving role and could intensify care-related stress and burden, according to the article.
Many long-distance caregivers find it necessary to arrange for long-term services and supports (LTSS) to help provide care and assistance to their care recipient. Home care services are the most widely used and preferred formal service option designed to provide assistance to frail older adults and support caregivers in managing care tasks, report the authors.
KEY FINDINGS
Researchers report two key findings from their study:
- Long-distance caregivers whose care recipient used more hours of home care did not perceive that the care recipient’s functional impairment interfered with the caregiver’s work and other family responsibilities.
- Similarly, use of home care by the care recipient lessened long-distance caregivers’ perceptions that the care recipient’s cognitive impairment negatively interfered with the caregiver’s work and other family responsibilities.
The authors clarify that these findings could be influenced by the tendency of geographically close caregivers to seek out formal services like home care when their caregiving-related stress is already too high to be mitigated by home care service use. On the other hand, long-distance caregivers may draw on home care services as a preventative measure. This “may explain why the use of home care services in this study was shown to reduce perceived strain in long-distance caregivers,” write Falzarano and colleagues.
IMPLICATIONS
The authors identify several implications for practice that can be taken from their research. The findings, they write, support efforts to:
- Screen all caregivers—both distant and proximate—for sources of distress, and design personalized interventions that link caregivers to relevant resources, such as home care, that could alleviate caregiving-related stress.
- Develop “No Wrong Door” initiatives that seek to streamline access to LTSS formal service options and facilitate the integration of caregivers into the service system.
- Take a family-centered care approach to care that emphasizes the importance of integrating care recipients and caregivers into staff-led care teams in formal LTSS settings.
“Awareness and knowledge of the unique experiences and challenges that long-distance caregivers face can inform the adaptation of such initiatives to ensure that (caregivers) have equitable access to needed resources and beneficial formal supports that can alleviate the stress associated with caregiving from afar,” the authors conclude.