Quality of life of elderly people who care for other elderly people with neurological diseases

Oliveira, Julimar Fernandes de; Delfino, Lais Lopes; Batistoni, Samila Sathler Taveres; Neri, Anita Liberalesso; Cachioni, Meire

doi:10.1590/1981-22562018021.180077

Abstract

Objective:

to investigate the relationships between the perceived quality of life of elderly people who care for other elderly people with neurological diseases (dementia and strokes) and the gender, age and caregiver burden, diagnosis, functional dependence, and cognitive status of the care recipient.

Method:

75 caregivers aged over 60 years were interviewed using the Quality of Life Scale (CASP-19) and Zarit Burden Interview. The levels of physical vulnerability of the elderly were identified through the Lawton and Brody questionnaires and the Katz scale and the cognitive assessment of elderly care recipients was assessed with the Clinical Dementia Rating. The data were analyzed by chi-squared test (for comparison of categorical variables), Mann-Whitney and Kruskal-Wallis U tests (for comparison of continuous variables). To study the associations between variables, univariate logistic regression analysis was performed, followed by multivariate logistic regression analysis.

Results:

the age, gender of the caregiver, type of neurological condition, and physical and cognitive functioning of the care recipient did not statistically influence the quality of life of the caregiver. Elderly caregivers with higher levels of burden (≥29) were 11.4 times more likely to have a worse quality of life score (CI: 3.16-36.77; p <0.001).

Conclusion:

the quality of life of the elderly caregiver is negatively influenced by the burden involved in caring for another elderly person. Identifying the negative emotional aspects of caregivers that negatively affect their quality of life should be considered a target for intervention by health teams.

Keywords:
Quality of Life; Caregivers; Elderly

[1] Correspondence: Julimar Fernandes de Oliveira julimarfernandes@yahoo.com.br

			Group A*	Group B**
Variable	Condition	n (total)	n (%)	n (%)	p-value
Gender	Men	14	10 (22.2)	4 (13.3)	0.333
Gender	Women	61	35 (77.8)	26 (86.7)	0.333
Age	60-64	23	11 (24.5)	12 (40.0)	0.339
	65-69	33	21 (46.7)	12 (40.0)
	75 and +	19	13 (29.8)	6 (20.0)
Burden	<20	23	14 (31.1)	9 (30.0)	0.556
	21 to 28	27	18 (40.0)	9 (30.0)
	>29	25	13 (29.9)	12 (40.0)
Role-related stress (Factor 1 of the burden scale)	< 9	25	15 (36.6)	10 (33.4)	0.056
	10 to 15	23	17 (33.0)	6 (20.0)
	>16	23	9 (41.0)	14 (46.6)
Intrapsychic stress (Factor 2 of the burden scale)	<1	27	17 (38.6)	10 (33.3)	0.692
	2 to 4	24	15 (34.2)	9 (30.0)
	>5	23	12 (27.3)	11 (36.7)
Presence or absence of competencies and expectations related to care. (Factor 3 of the burden scale)	<3	27	14 (34.1)	13 (43.3)	0.642
	4 a 9	22	14 (34.1)	8 (26.6)
	>10	24	15 (31.8)	9(30.0)
Perceived quality of life	<38	25	15 (35.0)	10 (33.2)	0.382
	39 a 46	24	12 (27.3)	12 (40.0)
	>47	26	18 (40.0)	8 (26.8)
Sense of self-realization and pleasure (Factor 1 of perceived quality of life scale)	<22	27	16 (37.2)	11 (36.6)	0.375
	23 a 26	21	10 (23.3)	11 (36.6)
	>27	25	17 (39.5)	8 (26.8)
Sense of control and autonomy (Factor 2 of perceived quality of life scale)	<9	20	12 (27.2)	8 (27.5)	0. 765
	10 a 12	27	15 (34.0)	12 (41.3)
	>13	26	17 (38.8)	9 (31.2)

Variable	Categories	p-value	O.R*	CI 95% O.R**
Gender	Male (ref.)***	---	1.00	---
Gender	Female	0.283	1.81	0.61 - 5.36
Age	60-64 years (ref.)	---	1.00	---
	65-74 years	0.233	1.83	0.68 - 4.91
	≥75 years	0.491	1.48	0.48 - 4.56
Diagnosis of Recipient of Care	Dementia (ref.)	---	1.00	---
Diagnosis of Recipient of Care	Stroke	0.496	1.34	0.57 - 3.15
Number of partially or totally impaired BADL and IADL**** of care recipients	1-8 (ref.)	---	1.00	---
	9-12	0.570	0.69	0.19 - 2.47
	13	0.903	1.06	0.42 - 2.68
Care recipient score in the measure of impairment of cognitive function	0-0.5 (ref.)	---	1.00	---
	1-2	0.319	1.85	0.55 - 6.17
	3	0.484	1.47	0.50 - 4.34
Caregiver score in total perceived burden	≤20 (ref.)	---	1.00	---
	21-28	0.056	2.87	0.97 - 8.47
	≥29	<0.001	11.43	3.46 - 37.76
Caregiver score in role-related stress (factor 1 of burden scale)	≤9 (ref.)	---	1.00	---
	10-15	0.0100	4.33	1.43 - 13.15
	≥16	<0.001	7.89	2.48 - 25.06
Caregiver score in intrapsychic stress (factor 2 of burden scale)	≤1 (ref.)	--	1.00	---
	2-4	0.336	1.65	0.60 - 4.58
	≥5	0.090	2.46	0.87 - 7.00
Caregiver score in presence or absence of competences and expectations related to care (factor 3 of burden scale)	≤3 (ref.)	---	1.00	---
	4-9	0.030	3.28	1.12 - 9.58
	≥10	0.070	2.61	0.93 - 7.36

Variables	Categories	p-valor	O.R.*	CI95% O.R.**
Gender of caregiver	Male (ref.)***	---	1.00	---
Gender of caregiver	Female	0.209	2.11	0.66 - 6.76
Age of caregiver	60-64 years (ref.)	---	1.00	---
	65-74 years	0.160	2.06	0.75 - 5.63
	≥75 years	0.725	1.22	0.40 - 3.76
Diagnosis of Recipient of Care	Dementia (ref.)	---	1.00	---
Diagnosis of Recipient of Care	Stroke	0.555	1.30	0.55 - 3.06
Number of partially or totally impaired BADL and IADL**** of care recipients	1-8 (ref.)	---	1.00	---
	9-12	0.687	0.77	0.21 - 2.76
	13	0.967	1.02	0.40 - 2.63
Care recipient score in the measure of impairment of cognitive function	0-0.5 (ref.)	---	1.00	---
	1-2	0.574	1.42	0.42 - 4.82
	3	0.731	1.21	0.40 - 3.67
Caregiver score in total perceived burden	≤20 (ref.)	---	1.00	---
	21-28	0.052	2.97	0.99 - 8.93
	≥29	<0.001	10.12	3.06 - 33.48
Caregiver score in role-related stress (factor 1 of burden scale)	≤9 (ref.)	---	1.00	---
	12-15	0.072	2.68	0.92 - 7.86
	≥16	0.003	5.35	1.74 - 16.40
Caregiver score in intrapsychic stress (factor 2 of burden scale)	≤1 (ref.)	---	1.00	---
	2-4	0.638	1.28	0.46 - 3.53
	≥5	0.009	4.36	1.44 - 13.18
Caregiver score in presence or absence of competences and expectations related to care (factor 3 of burden scale)	≤3 (ref.)	---	1.00	---
	4-9	0.148	2.22	0.76 - 6.53
	≥10	0.019	3.59	1.23 - 10.43

Variables	Categories	p-value	O.R.*	CI 95% O.R**
Gender of caregiver	Male (ref.)***	---	1.00	---
Gender of caregiver	Female	0.212	2.06	0.66 - 6.41
Age of caregiver	60-64 years (ref.)	---	1.00	---
	65-74 years	0.513	0.72	0.26 - 1.94
	≥75 years	0.685	1.23	0.41 - 3.86
Diagnosis of Recipient of Care	Dementia (ref.)	---	1.00	---
Diagnosis of Recipient of Care	Stroke	0.663	1.21	0.51 - 2.88
Number of partially or totally impaired BADL and IADL**** of care recipients	1-8 (ref.)	---	1.00	---
	9-12	0.582	1.43	0.40 - 5.09
	13	0.752	0.86	0.34 - 2.20
Care recipient score in the measure of impairment of cognitive function	0-0.5 (ref.)	---	1.00	---
	1-2	0.834	1.14	0.34 - 3.76
	3	0.702	0.81	0.27 - 2.40
Caregiver score in total perceived burden	≤20 (ref.)	---	1.00	---
	21-28	0.173	2.12	0.72 - 6.21
	≥29	0.001	6.93	2.18 - 22.01
Caregiver score in role-related stress (factor 1 of burden scale)	≤9 (ref.)	---	1.00	---
	10-15	<0.001	8.45	2.60 - 27.53
	≥16	<0.001	8.45	2.57 - 27.84
Caregiver score in intrapsychic stress (factor 2 of burden scale)	≤1 (ref.)	---	1.00	---
	2-4	0.369	1.60	0.58 - 4.44
	≥5	0.215	1.94	0.68 - 5.55
Caregiver score in presence or absence of competences and expectations related to care (factor 3 of burden scale)	≤3 (ref.)	---	1.00	---
	4-9	0.246	1.87	0.65 - 5.41
	≥10	0.425	1.52	0.54 - 4.27