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Stress in Caregivers of Hospitalized Oldest-Old Patients

^a University of Tennessee College of Medicine—Chattanooga Unit, Department of Medicine, Tennessee
^b Marshfield Medical Research Foundation, Wisconsin
^c Division of Health Management & Policy, School of Public Health, University of Minnesota, Minneapolis
^d Center to Improve Care of the Dying, Washington, DC

Norman A. Desbiens, Department of Medicine, University of Tennessee College of Medicine—Chattanooga Unit, 975 East Third Street, Box 94, Chattanooga, TN 37403 E-mail: desbiena{at}erlanger.org.

Decision Editor: John E. Morley, MB, BCh

Background. Stress in caregivers of elderly patients is a well-recognized health care problem. However, little has been published about the stress in caregivers of the oldest-old patients, the most rapidly growing segment of our population.

Methods. A prospective cohort study was conducted in four teaching hospitals. Questionnaires were administered to patients 80 years of age and older and their surrogates (the person who would make decisions if the patient were unable to—usually a family member) who identified themselves as the primary caregivers for the patients. Data were abstracted from medical records.

Results. Caregivers tended to be female and 50 years of age or older. About one in five described her own health as fair or poor; nearly half of them lived with the patient. About one quarter spent at least 8 h/d caring for the patient, and they had few persons available to help them with care. Most of the caregivers reported mild-to-moderate levels of stress. After adjustment, higher stress scores were associated with female caregivers, poorer caregiver health, more hours per day spent caring for the patient, and the presence of patient depression and hearing impairment.

Conclusion. Stress is common in caregivers of the hospitalized oldest-old patients. Women who are in poor health and spend 8 or more hours every day caring for relatives aged 80 and over are at high risk for caregiver stress. Treatment of patient depression and hearing impairment may ameliorate caregiver stress.

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