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The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.

A modification of the Cost of Illness (COI)—the Comprehensive-COI (C-COI) was utilized to estimate three major diseases: cancer, heart disease, and cerebrovascular diseases (CVD). The C-COI consists of five parts: medical direct cost, morbidity cost, mortality cost, formal LTC cost and informal LTC cost. The latter was calculated by two approaches: opportunity cost approach (OC) and replacement approach (RA), which assumed that informal caregivers were substituted by paid caregivers.

The C-COI of cancer, heart disease and CVD in 2017 amounted to 10.5 trillion JPY, 5.2 trillion JPY, and 6.7 trillion JPY, respectively (110 JPY= 1 US$). The mortality cost was preponderant for cancer (61 percent) and heart disease (47.9 percent); while the informal LTC cost was preponderant for CVD (27.5 percent). The informal LTC cost of the CVD in OC amounted to 1.8 trillion JPY; while the RA amounted to 3.0 trillion JPY.

The LTC burden accounted for a significant proportion of the social burden of chronic diseases. The informal care was maintained by unsustainable structures such as the elderly providing care for the elderly. This result can affect health policy decisions.

The C-COI is more appropriate for estimating the social burden of chronic diseases including the LTC burden and can be calculated using governmental statistics.

The family caregivers play an important role in the good quality of life for the elderly, but most of them can easily have an emotional and psychological effect on caregiving. The purpose of this paper is to explore the correlation between conditions of caring for the elderly in the family and caregiver stress in a community setting, Chiang Mai Province, Thailand.

A cross-sectional exploratory descriptive research was conducted in Ban Klang Subdistrict, San Pa Tong District, Chiang Mai Province. Simple random sampling was used to collect data by using a structured interview via a questionnaire with 103 elderly caregivers. The χ² test was used to explain the conditions related to stress as being a caregiver.

Most of the caregivers were female and still in good health, but at the same time, underwent little stress. However, they did not receive any training beforehand for taking care of the elderly but mainly done by experience, relationship and gratitude. The conditions correlated with stress as being a caregiver were health status of caregivers, confidence of care, the relationship between caregiver and elderly person, and economic burden of care.

A necessary resource such as body of knowledge in elderly caregiving, long-term care system at the community level and social support from family and intimate persons will encourage confidence in taking care of the elderly in the family and also relieve caregivers’ stress.

This study aims to examine the factors predicting burden among the male caregivers of older adults with stroke.

This was a descriptive cross-sectional study. A simple random sampling technique was used to recruit 98 male caregivers in the outpatient department’s neurological clinic, at Banphaeo General Hospital. Data was collected using six questionnaires: the demographic questionnaire, the center for epidemiologic studies depression scale, the perceived health status interview form, the caregiver and patient relationship interview form, the Barthel ADL index and the Zarit burden interview. Descriptive statistics and stepwise multiple regression analysis were used for data analysis.

The male caregivers of older adults with stroke had a mild to moderate level of burden. Factors such as depression of caregivers and activities of daily living of older adults predicted the burden among male caregivers, explaining 53.6% of the variance. The findings imply that nurses can plan new approaches and interventions to alleviate the burden of male caregivers by reducing their depression levels and encouraging activities of daily living in the older adults. In addition, effective programs can be developed to provide informational support to caregivers for reducing their burden level.

Male caregivers with depressive symptoms had an increased caregiving burden. Therefore, health-care professionals should support and formulate guidelines to reduce the burden of caregiving among the male caregivers by considering predictive factors.

This paper aims to identify and examine burden(s) among stroke survivors’ familial caregivers for the purposes of future mitigation of such burdens. The purpose is so because these caregivers become the persons responsible for monitoring the daily living activities of their patients and are thus tasked with providing and managing a whole host of recovery, therapy and re-integrative activities to rebalance and re-establish the physical, mental and social well-being of patients.

This literature review summarized and synthesized existing literature about the burden(s) caregivers experience and the effects upon them across four primary spheres of influence.

Familial caregivers of stroke survivors suffer from high levels of “care burden” because they are the primary participant in the planning and provisioning of care to the patients. Care burden is examined across four primary spheres of influence: physical, psychological, social and economic impacts. The current review shows that familial caregivers experience substantive impacts across all four spheres.

A professional multidisciplinary team should support caregivers of stroke survivors. To do this, support should be considered among the patient’s overall family system, as well as expanded to address and consider the specifically designated caregivers’ social circles which at a minimum often consists of co-workers, friends and inter-familial relationships. Ideally, caregiver support would also consist of medical and professional case workers that can address further, and in an integrative delivery approach, all four of the highlighted spheres of influence to establish a “best practices” orientation to familial caregivers.

Schizophrenia, a chronic mental disorder, poses enormous threat to the individual, family and society. The advent of deinstitutionalization of the mentally ill transferred the burden of care to families especially close relatives. Few studies have described the families' subjective views in this context. Hence, this study aimed to explore impacts of caregiving and coping strategies for family caregivers of patients with schizophrenia in Enugu, South East Nigeria.

A descriptive qualitative design was employed, and 14 family caregivers of individuals with schizophrenia attending federal neuropsychiatric hospital Enugu were purposively selected. A semi-structured interview guide was used to generate information, and the transcribed data were content analyzed using a thematic approach.

Three major themes and 16 subthemes were derived to reflect the perceived impact of caregiving and coping strategies of family caregivers, which include burden of care (physical-self neglect, ill health, sleep deprivation; psychological-gross irritability, ruminations; social-stigmatization, social restrictions, diminished connections, reduced productivity); positive aspects (heightened understanding; empathetic attitude, strengthened ties) and adaptive resources (acceptance, optimism, social support, spiritual devotion).

Family caregivers of individuals with schizophrenia experience bio-psychosocial burden as a result of caregiving. Coping with challenges of caregiving can prevent distress and burnout. Hence, there is need for mental health professionals to recognize caregivers as person in need of emotional and practical support and care for the mentally ill in the context of a family-centered approach.

Purpose – This study examines parents’ financial stress associated with obtaining care for young children while employed in unstable low-wage jobs. The child care subsidy program aims to both improve child care quality and support employment, and we expect that a substantial infusion of resources into this program would reduce parents’ financial stress.

Methodology/approach – We use a mixed-methods research design to study parents’ financial costs of child care, how predictable the cost of child care is to a parent, and what strategies parents employ to manage child care costs.

Findings – We find that parents perceive the subsidy program essential to their ability to manage the needs of their children and working. Yet, receiving subsidies does not appear to alleviate parents’ financial stress because child care costs continue to consume a large share of the family's income and subsidy policies make it difficult for parents to predict their portion of the costs. Parents manage the large and unpredictable expense of child care by decreasing other expenditures and increasing debt.

Practical implications – Changing subsidy policies so they better fit the reality of these families’ lives could result in a more substantive stress reduction. States can reduce unpredictability by reducing and stabilizing participants’ child care cost burden and revising eligibility policy.

Originality/value of paper – This research project fills an important gap in our knowledge about financial stress of low-income working families, provides insights into the role subsidy program participation plays in these parents’ lives, and informs discussion of subsidy policy.

Scholars have explained how people in Japan feel ashamed when elderly members of the family are cared for by formal services such as day care or government/commercial-based nursing homes due to the cultural norms of the consciousness of social appearance. However, this consciousness of social appearance plays a minimum role when it comes to elderly Japanese immigrant women's preference to utilize formal care services in the United States. They see receiving family based care as a burden on their middle-aged children (or grandchildren) and they prefer purchasing formal long-term care services when they can no longer feel confident about maintaining their independent lives. Elderly Japanese immigrant women hold rather positive views on formal care in the United States, including nursing homes. This chapter suggests that elderly Japanese immigrant women may not consider it shameful to utilize formal care as many previous scholars have suggested.

The purpose of this study is to explore the lived experiences of the constraints of older adult family caregivers with chronic diseases in caring for and accessing health services during the COVID-19 pandemic.

This study used the descriptive phenomenology qualitative method. The sampling method was purposive sampling involving 16 older adult family caregivers.

The results of this study showed three themes such as difficulties in health services in hospitals during the COVID-19 pandemic (complaints of services provided by doctors, older adult treatment control problems and difficulty getting to hospital health facilities); difficulties accompanying taking older adult medicine (older adult non-compliance response to taking medication and older adult medicine assistance); and psychosocial complaints caring for and accompanying the older adult (negative emotions for the older adult, difficulty interacting with the older adult and the economic burden of caring for the older adult).

Barriers to family caregivers in caring for older adults with chronic diseases can help health-care service providers understand and support families caring for and assisting older adults, which may contribute to the quality of life and care for both family caregivers and older adults.

This study showed that Indonesian family caregivers faced difficulties caring for and living with older adults with chronic diseases during the pandemic. Family caregivers’ experiences are essential when developing an intervention to support and manage health care for older adults with chronic illnesses.

A systematic review of the literature was completed to examine the needs of those who provide care to people with intellectual disability and dementia. The purpose of this paper was to develop an understanding of the complexities, challenges and support available to meet the needs of an ageing population.

A qualitative evidence synthesis was used to appraise 12 studies. An evidence synthesis approach was used to better understand the challenges caregivers experience in caring for a person with intellectual disability and dementia. Aggregating and integrating findings from multiple studies allowed to identify inconsistencies, quality, relationships and trends to enhance the awareness of gaps in care provision.

There were six main domains identified from the available literature which included: gaps in knowledge and skills, early identification of dementia and associated difficulties, managing behaviour, coping, burden of care and Impact on confidence.

To the best of the authors’ knowledge, this is the first paper to use qualitative evidence synthesis to understand the challenges of caring for a person with intellectual disability and dementia.

This paper theoretically and empirically analyzes the effects of the elderly’s physical health status on their need for care and the choice of care models in China.

Empirically, the estimation results of a large-sample randomized intervention trial with chronic obstructive pulmonary disease (COPD) patients through the difference-in-difference method indicated the following: (1) After the COPD intervention trial, the physical health status of the elderly in the treatment group improved significantly, the need for care was substantially reduced and the health improvement led to a 35.5% reduction in the probability of using elderly care. (2) The reduction in the need for care regarding the treatment group occurred mainly in social care. The probability of using social care decreased by 67.8% due to the elderly’s health improvement, while that of home care remained unchanged generally. (3) Further heterogeneity tests suggested that families with fewer potential internal resources for caregiving had a more pronounced decline in the need for social care.

Theoretically, these empirical results support the existence of the “pecking order” theory in the family’s choice of elderly care model, that is, families tend to employ all internal resources for caregiving before resorting to social care, resulting in a higher sensitivity of social care to health.

The main policy implication of this paper is that ex ante preventive health intervention policies can significantly alleviate the burden of care, especially social care, on families. And preventive health intervention policies are particularly effective in reducing the burden of the families with relatively few resources for informal internal care.