Impact of additional community services provision on dementia caregiver burden: an interrupted time-series analysis of 12-year interRAI assessments in Hong Kong

Autor: Crystal Ying Chan, Patsy Y K Chau, Eng-kiong Yeoh, Eliza L Y Wong
Rok vydání: 2022
Předmět:
Zdroj: BMJ open. 12(11)
ISSN: 2044-6055
Popis: ObjectivesTo evaluate the impact of providing additional dementia caregiver support services on caregiver burden.DesignInterrupted time-series analysis using territory-wide panel data.SettingsAll public-funded district elderly community centres in Hong Kong (HK).ParticipantsPrimary caregivers for older adults (age over 65 years) living with dementia assessed through International Residential Assessment in HK between 1 October 2004 and 31 September 2016. Paid caregivers were excluded.InterventionsIn April 2014, US$280 million was allocated to provide additional psychological support, education and respite care for dementia caregivers in HK.Main outcome measuresCaregiver burden was measured by two age-standardised rates: (1) caregivers in emotional distress; and (2) caregivers with long care time in a week (more than 20 hours a week). We fitted the two time-series into Autoregressive Integrated Moving Average models to evaluate intervention impacts, with follow-up analyses to consider a 6-month transition period of policy implementation. Segmented linear regressions and Holt-Winter exponential smoothening models were used as sensitivity analyses.Results36 689 dementia caregivers were included in this study, of which 14.4% caregivers were distress and 31.9% were long-hours caregivers after the policy intervention in April 2014. Providing additional caregiver service significantly reduced standardised rates of caregivers in distress (β (95% CI)=−3.93 (−7.85 to −0.01), pConclusionOur study finds that strengthening caregiver services provision could reduce distress rates among primary caregivers for older adults living with dementia. Expanding community services for caregiver could be a solution to the escalating burden of informal care for people living with dementia.
Databáze: OpenAIRE
Popis
Abstrakt:ObjectivesTo evaluate the impact of providing additional dementia caregiver support services on caregiver burden.DesignInterrupted time-series analysis using territory-wide panel data.SettingsAll public-funded district elderly community centres in Hong Kong (HK).ParticipantsPrimary caregivers for older adults (age over 65 years) living with dementia assessed through International Residential Assessment in HK between 1 October 2004 and 31 September 2016. Paid caregivers were excluded.InterventionsIn April 2014, US$280 million was allocated to provide additional psychological support, education and respite care for dementia caregivers in HK.Main outcome measuresCaregiver burden was measured by two age-standardised rates: (1) caregivers in emotional distress; and (2) caregivers with long care time in a week (more than 20 hours a week). We fitted the two time-series into Autoregressive Integrated Moving Average models to evaluate intervention impacts, with follow-up analyses to consider a 6-month transition period of policy implementation. Segmented linear regressions and Holt-Winter exponential smoothening models were used as sensitivity analyses.Results36 689 dementia caregivers were included in this study, of which 14.4% caregivers were distress and 31.9% were long-hours caregivers after the policy intervention in April 2014. Providing additional caregiver service significantly reduced standardised rates of caregivers in distress (β (95% CI)=−3.93 (−7.85 to −0.01), pConclusionOur study finds that strengthening caregiver services provision could reduce distress rates among primary caregivers for older adults living with dementia. Expanding community services for caregiver could be a solution to the escalating burden of informal care for people living with dementia.
ISSN:20446055