Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-13T01:55:36.421Z Has data issue: false hasContentIssue false

Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking

Published online by Cambridge University Press:  03 July 2012

Shirli Werner*
Affiliation:
Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
Gail K. Auslander
Affiliation:
Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
Noam Shoval
Affiliation:
Department of Geography, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
Tamar Gitlitz
Affiliation:
Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel Mishan Quality Senior Living, Histadrut General Federation of Labor in Israel, Tel Aviv, Israel
Ruth Landau
Affiliation:
Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
Jeremia Heinik
Affiliation:
Margoletz Psychogeriatric Center, Ichilov Hospital, Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
*
Correspondence should be addressed to: Dr. Shirli Werner, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem 91905, Israel. Phone: +972-2-5881377; Fax: +972-2-5883927. Email: shirlior@mscc.huji.ac.il.

Abstract

Background: Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology.

Methods: Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden.

Results: The strongest predictors of burden were care-recipients’ lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients’ behavioral and emotional states were also positively related to caregiver burden.

Conclusions: The findings stress the importance of maintaining older persons’ out-of-home mobility during cognitive decline.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Algase, D. L., Beattie, E. R. A., Song, J. A., Milke, D., Duffield, C. and Cowan, B. (2004). Validation of the Algase wandering scale (Version 2) in a cross cultural sample. Aging & Mental Health, 8, 133142.CrossRefGoogle Scholar
Algase, D. L., Antonakos, C. L., Beattie, E., Beel-Bates, C. A. and Yao, L. (2009). New parameters for daytime wandering. Research in Gerentological Nursing, 2, 5868.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Andrieu, S. et al. (2007). New assessment of dependency in demented patients: impact on the quality of life in informal caregivers. Psychiatry and Clinical Neurosciences, 61, 234242.CrossRefGoogle ScholarPubMed
Auslander, G. K., Werner, S., Shoval, N., Isaccson, M., Landau, R. and Heinik, J. (2010). Cooperation with complex research protocols: the use of global positioning systems with cognitively impaired elders—a preliminary report. Open Longevity Science, 4, 18.CrossRefGoogle Scholar
Bachner, Y. G. and Ayalon, L. (2010). Initial examination of the psychometric properties of the short Hebrew version of the Zarit Burden Interview. Aging & Mental Health, 14, 725730.CrossRefGoogle ScholarPubMed
Bedard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A. and O'Donnell, M. (2001). The Zarit Burden Interview: a new short version and screening version. Gerontologist, 41, 652657.CrossRefGoogle ScholarPubMed
Ben-Zur, H. (2002). Coping, affect and aging: the roles of mastery and self-esteem. Personality and Individual Differences, 32, 357372.CrossRefGoogle Scholar
Bruce, J. M., McQuiggan, M., Williams, V., Westervelt, H. and Tremont, G. (2008). Burden among spousal and child caregivers of patients with mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 25, 385390.CrossRefGoogle ScholarPubMed
Chumbler, N. R., Grimm, J. W., Cody, M. and Beck, C. (2003). Gender, kinship and caregiver burden: the case of community-dwelling memory impaired seniors. International Journal of Geriatric Psychiatry, 18, 722732.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.CrossRefGoogle ScholarPubMed
Di Mattei, V. E., Prunas, A., Novella, L., Marcone, A., Cappa, S. F. and Sarno, L. (2008). The burden of distress in caregivers of elderly demented patients and its relationship with coping strategies. Neurological Sciences, 29, 383389.CrossRefGoogle ScholarPubMed
Fauth, E. B., Zarit, S. H., Femia, E. E., Hofer, S. M. and Stephens, M. A. P. (2006). Behavioral and psychological symptoms of dementia and caregivers’ stress appraisals: intra-individual stability and change over short-term observations. Aging & Mental Health, 10, 563573.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Heinik, J. et al. (2004). Clock Drawing Test-Modified and Integrated Approach (CDT-MIA): description and preliminary examination of its validity and reliability in dementia patients referred to a specialized psychogeriatric setting. Journal of Geriatric Psychiatry and Neurology, 17, 7380.CrossRefGoogle ScholarPubMed
Lewin-Epstein, N., Sagiv-Schifter, T., Shabtai, E. L. and Shmueli, A. (1998). Validation of the 36-item short-form Health Survey (Hebrew version) in the adult population of Israel. Medical Care, 36, 13611370.CrossRefGoogle ScholarPubMed
Miyamoto, Y., Ito, H., Otsuka, T. and Kurita, H. (2002). Caregiver burden in mobile and non-mobile demented patients: a comparative study. International Journal of Geriatric Psychiatry, 17, 765773.CrossRefGoogle ScholarPubMed
Mollenkopf, H., Marcellini, F., Ruoppila, I., Szeman, Z. and Tacken, M. (eds.) (2005) Enhancing Mobility in Later Life: Personal Coping, Environmental Resources and Technical Support. The Out-Of-Home Mobility of Older Adults in Urban and Rural Regions of Five European Countries. Amsterdam: IOS Press.Google Scholar
Perkins, E., Lynn, N. and Haley, W. (2007). Caregiver issues associated with wandering. In Nelson, A. and Algase, D. L. (eds.), Evidence-Based Protocols for Managing Wandering Behaviors. New York: Springer Publishing Company.Google Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of International Medicine, 256, 183194.CrossRefGoogle ScholarPubMed
Phinney, A., Chaudhury, H. and O'Connor, D. L. (2007). Doing as much as I can do: the meaning of activity for people with dementia. Aging & Mental Health, 11, 384393.CrossRefGoogle Scholar
Roth, M., Huppert, F. A., Tym, E. and Mountjoy, C. Q. (1998). CAMDEX-R: The Cambridge Examination for Mental Disorders of the Elderly – Revised. Cambridge, UK: Cambridge University Press.Google Scholar
Schaie, K. (2003). Mobility for what? In Schaie, K. W., Wahl, H. W., Mollenkopf, H. and Oswald, F. (eds.), Aging Independently: Living Arrangements and Mobility. New York: Springer Publishing Company.Google Scholar
Shoval, N. et al. (2011). Use of the global positioning system to measure the out-of-home mobility of older adults with differing cognitive functioning. Ageing & Society, 31, 849869.CrossRefGoogle Scholar
Son, J., Erno, A., Shea, D. G., Femia, E. E., Zarit, S. H. and Stephens, M. A. P. (2007). The caregiver stress process and health outcomes. Journal of Aging and Health, 19, 871887.CrossRefGoogle ScholarPubMed
Ware, J. E. and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473483.CrossRefGoogle ScholarPubMed
Watson, D., Clark, L. A. and Carey, G. (1988). Positive and negative affect and their relation to anxiety and depressive disorders. Journal of Abnormal Psychology, 97, 346353.CrossRefGoogle Scholar
Winblad, B. et al. (2004). Mild cognitive impairment –beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240246.CrossRefGoogle Scholar
Yesavage, J. A. et al. (1982–1983). Development and validation of a Geriatric Depression Screening Scale: a preliminary report. Journal of Psychiatric Research, 17, 3749.CrossRefGoogle Scholar
Zalsman, G., Aizenberg, D., Sigler, M., Nahshoni, E. and Weizman, A. (1998). Geriatric Depression Scale –short form: validity and reliability of the Hebrew version. Clinical Gerontologist, 18, 39.CrossRefGoogle Scholar