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Health Impacts of Caregiving: FINDINGS FROM THE SINGAPORE INFORMAL CARE SURVEY

Health Impacts of Caregiving: FINDINGS FROM THE SINGAPORE INFORMAL CARE SURVEY. Authors : Angelique Chan, Chetna Malhotra, Rahul Malhotra, Truls Ostbye Institution : Program in Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore. Introduction.

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Health Impacts of Caregiving: FINDINGS FROM THE SINGAPORE INFORMAL CARE SURVEY

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  1. Health Impacts of Caregiving: FINDINGS FROM THE SINGAPORE INFORMAL CARE SURVEY Authors: Angelique Chan, Chetna Malhotra, Rahul Malhotra, Truls Ostbye Institution: Program in Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore

  2. Introduction • Singapore is one of the most rapidly aging countries in Asia, by 2030, 19% of the population will be aged 65+ • Caregiving is primarily provided by the family • Use of institutional care very low • Caregiving causes chronic stress • How is “stress” defined? • (Revised Pearlin et. Al. 1990) • Self-reported stress

  3. Objectives • To identify the predictors of self-reported stress among family caregivers of older adults with ADL limitations • To assess whether predictors of stress vary by type of caregiver (spouse or adult child)

  4. methods

  5. Dataset • Singapore Survey on Informal Caregiving (N=1,290 dyads) • National survey of community dwelling Singaporeans >75 years receiving human assistance for at least 1 ADL limitation and their self-identified primary caregiver

  6. Sampling • Sampling • Target sample: 1500 care recipient caregiver dyads • Random sample of 20,000 Singaporeans >75 years drawn from national database of dwellings • 5,613 administered ADL screener • 1211 met the criteria of being a care recipient and identified a caregiver • 1190 caregivers also gave consent for survey • 655 (55%) care recipients used a proxy due to health reasons

  7. Measures • Dependent variable – Caregiver stress • “On a scale of 1 to 10 where 1 is not much stress at all, and 10 is a great deal of stress, how much stress do you have in your daily life?” • Independent variables • Caregiver characteristics • Demographics: Age, gender, ethnicity, educational status, type of housing • Amount of care provided (in hours) • Caregiver Reaction Assessment Scale (Given et al) • Disrupted schedule and health problems due to caregiving • Financial Problems due to caregiving • Lack of family support in caregiving • Self-esteem of the caregiver

  8. Measures • Caregiver characteristics (contd.) • Perceived emotional support • Number of chronic diseases • Help received from a foreign domestic worker/maid • Care recipient characteristics • Demographics – age, gender • ADL limitations • Revised Behavior and Memory Checklist • Memory problems • Problem behaviors • Depressive symptoms

  9. Statistical analysis • Descriptive statistics – overall sample and by type of caregiver (spousal/ adult child) • 39 other caregivers excluded (other than spouse or adult child) • Ordinary least squares regression model • Unadjusted estimates • Main effects model • Interaction of type of caregiver (spousal/adult child) with other independent variables

  10. results

  11. Table 1: Caregiver characteristics, by type of caregiver(N=1,151, Mean & SD)

  12. Table 1 (contd.): Caregiver characteristics, by type of caregiver

  13. Table 1 (contd.): Caregiver characteristics, by type of caregiver a

  14. Table 2: Care recipient characteristics, by type of caregiver

  15. Table 2: Standardized regression estimates for stress scores on various caregiver and care-recipient characteristics (N=1150) **p<0.001; *p<0.05

  16. Table 2 (contd.): Standardized regression estimates for stress scores on various caregiver and care-recipient characteristics (N=1150) **p<0.001; *p<0.05

  17. Table 2 (contd.): Standardized regression estimates for stress scores on various caregiver and care-recipient characteristics (N=1150) **p<0.001; *p<0.05

  18. SUMMARY • Lower caregiver stress: • Caregivers are older, have higher SES and self-esteem • Higher caregiver stress: • Caregiver disrupted schedule and health problems • Depressed care recipient • Spousal caregivers more stressed due to disrupted schedule and health problems compared to adult child caregivers

  19. CONCLUSION • Caregiver stress can be identified in several ways: self-reported stress, depression, health care utilization and labor force participation • Spousal caregivers are under particular stress and will require caregiving support to manage their schedules and health • Lower fertility  increasing number of spousal caregivers • Reliance on foreign domestic care workers is not sustainable • Promote caregiving in the community • Need to understand the dynamics of use of LTC services in Singaporean community

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