By Geralyn Magan
A new study found that long-distance caregivers utilize relatively few supportive services, and that certain variables are significantly related to their service utilization.
What supportive services do long-distance caregivers use and what factors predict their supportive service utilization? A study funded by the National Institute on Aging attempted to answer that question with help from 304 long-distance caregivers. Findings from the study were published in December by the Journal of Gerontological Social Work.
Verena Cimarolli, director of health services research and partnerships at the LeadingAge LTSS Center @UMass Boston, was a co-author of “Long-Distance Caregivers’ Use of Supportive Services,” along with Jillian Minahan Zucchetto, Molly J. Wylie, Francesca Falzarano, and Amy Horowitz. Wylie, a PhD candidate in the Department of Gerontology at the University of Massachusetts Boston, worked on the study while completing an internship at the LTSS Center.
FACTORS ASSOCIATED WITH SERVICE USE
The researchers used the Andersen Model of Health Care Utilization to describe the types and frequency of supportive services used by long-distance caregivers and to identify three sets of variables associated with supportive service use among the study’s sample:
- Predisposing variables, such as age, gender, ethnicity/race, and relationship to the care recipient.
- Enabling variables, such as the care recipient’s living situation, the long-distance caregiver’s income adequacy, employment status, instrumental support, and emotional support.
- Need-related variations, such as caregiver burden, depression, health status, distance from the care recipient, time spent helping the care recipient, and the care recipient’s cognitive and functional status.
Researchers found relatively low utilization of supportive services among long-distance caregivers. A little over half of study participants reported not using any supportive services, while about a third used only one service. The most frequently used supportive service was technology that allowed long-distance caregivers to see the care recipient from afar using video phone or webcam systems. Engaging with a therapist/counselor to talk about caregiving issues was the second most frequently used service.
The study’s analysis showed that certain variables were significantly related to the use of supportive services by long-distance caregivers. For example, younger age was associated with increased service utilization. However, the researchers note that it is possible younger adults felt more comfortable using technology-based services compared to older long-distance caregivers.
Need-related variables turned out to be the most important factors influencing service use among long-distance caregivers. Those factors included:
- Higher caregiver burden.
- Greater depressive symptoms.
- More time spent helping the care recipient.
- Worse functional status on the part of the care recipient.
LONG-DISTANCE CAREGIVING
Long-distance caregivers make up approximately 12% of the estimated 41.8 million Americans serving as unpaid caregivers for an older relative or friend. These individuals provide care from a distance of at least one hour away. But, the authors report, long-distance caregivers, on average, live approximately 450 miles away from their care recipients.
Despite this distance, long-distance caregivers provide assistance that is similar to the caregiving activities carried out by caregivers who are geographically close. For example, the authors cite research showing that one-third of long-distance caregivers visit care recipients at least one day a week, while one-half of long-distance caregivers reported performing caregiving tasks, either remotely or in person, for one full day per week. Those caregiving tasks include:
- Providing financial assistance.
- Managing care.
- Providing emotional support.
- Performing practical and nursing tasks.
“To our knowledge, this is one of the first studies using Andersen’s Model of Health Care Utilization to specifically investigate supportive service utilization in (long-distance caregivers),” the authors conclude. “Although long-distance caregiving is receiving increased empirical attention, there is still a lack of research examining the nature and consequences of care provision in long-distance caregivers.”