Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-19T07:16:08.435Z Has data issue: false hasContentIssue false
  • English
  • Français

The unmet support needs of carers of older Australians: prevalence and mental health

Published online by Cambridge University Press:  25 May 2018

Jeromey B. Temple Open the ORCID record for Jeromey B. Temple [Opens in a new window]  and
Briony Dow
Jeromey B. Temple*
Affiliation:
Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
Briony Dow
Affiliation:
Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia National Ageing Research Institute (NARI), Melbourne, Victoria, Australia
*
Correspondence should be addressed to: Jeromey B. Temple, Associate Professor, Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, VIC 3010Australia. Phone: +61-3-90359900. Email: [email protected].
Get access

Abstract

Background:

Population aging places greater demands on the supply of informal carers. The aims of this study were to examine (1) the types of unmet support needs of carers of older Australians and (2) the association of unmet needs with mental health.

Methods:

Utilizing new data from the 2015 Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers, we calculated the prevalence of carers experiencing specific and multiple unmet needs for support, using single and multiple item measures. Logistic regression models were fitted to examine the association between unmet needs and psychological distress (using the Kessler psychological distress scale), once demographic and health factors were controlled for.

Results:

In 2015, 35% of carers of older Australians cited at least one unmet need for support. Among this group, almost two-thirds cited multiple unmet support needs (64.7%). The most prevalent types of unmet needs included financial (18%), physical (13%), and emotional support (12%), as well as additional respite care and support to improve carer health (12%). After controlling for demographic and health characteristics of the carer, having any unmet need for support increased the odds of psychological distress by twofold (OR = 2.20, 95% CI = 1.65, 2.94). With each successive unmet need for support, the odds of psychological distress increased 1.37 times (OR = 1.36, 95% CI = 1.22, 1.54). Those who had received assistance with care, but required further support were 1.95 times more likely (OR = 1.95, 95% CI = 1.17, 3.24) to be in distress and those who had not received care assistance were about 2.4 times more likely (OR = 2.38 95% OR = 1.56, 3.62) to be in distress relative to those with no unmet need.

Conclusions:

Addressing unmet support needs of carers is important, not only for the planning of services for carers in an aging population, but also because of the association between unmet support needs and carers mental health.

Keywords

caringinformal careagingpsychological distress
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 12: Issue Theme: Positive Psychiatry , December 2018 , pp. 1849 - 1860
Copyright
Copyright © International Psychogeriatric Association 2018 

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

Australian Bureau of Statistics (ABS) (2013). Catalogue Number 3222.0 – Population Projections, Australia, 2012 to 2101. Canberra: Australian Bureau of Statistics.Google Scholar
Australian Bureau of Statistics (ABS) (2016a). Catalogue Number 4430.0 – Disability, Ageing and Carers, Australia: Summary of Findings. Canberra: Australian Bureau of Statistics.Google Scholar
Australian Bureau of Statistics (ABS) (2016b). A Profile of Carers in Australia. Information Sheet. Canberra: Australian Bureau of Statistics.Google Scholar
Agingcare (2017). Available at: https://www.agingcare.com/articles/quit-job-to-care-for-parents-150227.htm; last accessed August 2017.Google Scholar
Anderson, T. M., Sunderland, M., Andrews, G., Titov, N., Dear, B. F. and Sachdev, P. S. (2013). The 10-item Kessler psychological distress scale (K10) as a screening instrument in older individuals. American Journal of Geriatric Psychiatry, 21, 596.Google Scholar
Australian Government (2017). Carer Gateway. Available at: https://www.carergateway.gov.au/; last accessed August 2017.Google Scholar
Australian Institute of Health and Welfare (AIHW) (2007). Dementia in Australia: National Data Analysis and Development. Canberra: AIHW. Available at: http://www.aihw.gov.au/publications/index.cfm/title/10368.Google Scholar
Belsley, D., Kuh, E. and Welsch, R. (1980). Regression Diagnostics: Identifying Influential Data and Sources of Collinearity. New York: John Wiley & Sons, Inc.Google Scholar
Bertrand, R., Fredman, L. and Saczynski, J. (2006). Are all caregivers created equal? Stress in caregivers to adults with and without dementia. Journal of Aging and Health, 18, 534–551.Google Scholar
Bruvika, F. K., Ulsteina, I. D., Ranhoff, A. H. and Engedala, K. (2012). The quality of life of people with dementia and their family carers. Dementia and Geriatric Cognitive Disorders, 34, 7–14Google Scholar
Carers Australia (2017). Available at: http://www.carersaustralia.com.au/, accessed August 2017.Google Scholar
Carers UK (2015). Facts About Carers: Policy Briefing. London: Carers UK.Google Scholar
Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R. and Livingston, G. (2010). The determinants of family carers' abusive behavior to people with dementia: results of the CARD study. Journal of Affective Disorders, 121, 136–142.Google Scholar
Cummins, R. A., Hughes, J., Tomyn, A., Gibson, A., Woerner, J. and Luffana, L. (2007). Special Report – The Wellbeing of Australians: Carer Health and Wellbeing. Australian Unity Wellbeing Index, Survey 17.1, Report 17.1. Melbourne: Australian Unity.Google Scholar
Dahlberg, L., Demack, S. and Bambra, C. (2007). Age and gender of informal carers: a population-based study in the UK. Health and Social Care in the Community, 15, 439–445.Google Scholar
Deloitte Access Economics (2015). The Economic Value of Informal Care in 2015. Report for Carers Australia. Canberra: Deloitte Access Economics.Google Scholar
Douglass, C. and Fox, P. (1999). Health care utilization among clients with Alzheimer's disease: public policy implications from the California Alzheimer's Disease Diagnostic and Treatment Center Program. Journal of Applied Gerontology, 18, 99–121.Google Scholar
Douglass, C. and Visconti, C. (1998). Factors influencing the use of adult day care by individuals with Alzheimer's disease: a multivariate examination of the California Alzheimer's Disease Diagnostic and Treatment Center Program. Home Health Care Services Quarterly, 17, 53–69.Google Scholar
Dow, B. and McDonald, J. (2003). Social support or structural change? Social work theory and research on care giving. Australian Social Work, 56, 197–208.Google Scholar
Dow, B., Sparrow, P., Moore, K., Gaffy, E. and Yates, I. (2013). What do older Australians want? Australasian Journal on Ageing, 32, 236–240.Google Scholar
Essue, B. et al. (2010). Informal care and the self-management partnership: implications for Australian health policy and practice. Australian Health Review, 34, 414–422.Google Scholar
Gaugler, J. E., Anderson, K. A., Leach, M. R., Smith, C. D., Schmitt, F. A. and Mendiondo, M. (2004). The emotional ramifications of unmet need in dementia caregiving. American Journal of Alzheimer's Disease and Other Dementias, 19, 369–380.Google Scholar
Gaugler, J. E., Yu, F., Krichbaum, K. and Wyman, J. F. (2009). Predictors of nursing home admission for persons with dementia. Medical Care, 47, 191–198.Google Scholar
Horner, B. and Boldy, D. (2008). The benefit of ‘ageing-in-place’ in an aged care community. Australian Health Review, 32, 356–365.Google Scholar
Hosmer, D., Hosmer, T., Le Cessie, S. and Lemeshow, S. (1997). A comparison of goodness-of-fit tests for the logistic regression model. Statistics in Medicine, 16, 965–980.Google Scholar
Kosloski, K., Schaefer, J., Allwardt, D., Montgomery, R. and Karner, T. (2002). The role of cultural factors on clients’ attitudes toward caregiving, perceptions of service delivery, and service utilization. Home Health Care Services Quarterly, 21, 65–88.Google Scholar
Loi, S. M. et al. (2016). Factors associated with depression in older carers. International Journal of Geriatric Psychiatry, 31, 294–301.Google Scholar
Lucke, J. et al. (2008). Few urban-rural differences in older carers’ access to community services. Australian Health Review, 32, 684–690.Google Scholar
Montoro-Rodriguez, J., Kosloski, K. and Montgomery, R. (2003). Evaluating a practice-oriented service model to increase the use of respite services among minorities and rural caregivers. The Gerontologist, 43, 916.Google Scholar
National Alliance for Caregiving (2015). Caregiving in the US. Available at: http://www.caregiving.org/wp-content/uploads/2015/05/2015_CaregivingintheUS_Executive-Summary-June-4_WEB.pdf; last accessed 10 August 2017.Google Scholar
Neri, A. L., Yassuda, M. S., Fortes-Burgos, A. C. and Guariento, M. (2012). Relationships between gender, age, family conditions, physical and mental health, and social isolation of elderly caregivers. International Psychogeriatrics, 24, 472–483.Google Scholar
O'Connell, B., Bailey, S. and Walker, A. (2003). Promoting the health and well being of older carers: a proactive strategy. Australian Health Review, 26, 78–86.Google Scholar
O'Dwyer, S., Moyle, W., Zimmer-Gembeck, M. and De Leo, D. (2013). Suicidal ideation in family carers of people with dementia: a pilot study. Geriatric Psychiatry, 28, 1182–1188.Google Scholar
Phillipson, L. (2016). Rethinking dementia care. Australian Journal of Dementia Care. Available at: http://journalofdementiacare.com/rethinking-respite-care/; last accessed 24 November 17.Google Scholar
Phillipson, L., Jones, S. C. and Magee, C. (2014). A review of the factors associated with the non-use of respite services by carers of people with dementia: implications for policy and practice. Health and Social Care in the Community, 22, 1–12.Google Scholar
Productivity Commission (2011). Caring for Older Australians. Report No. 53. Final Inquiry Report. Canberra: Productivity Commission.Google Scholar
Raftery, A. (1995). Bayesian model selection in social research. Sociological Methodology, 25, 111–163.Google Scholar
Robinson, K., Buckwalter, K. and Reed, D. (2005). Predictors of use of services among dementia caregivers. Western Journal of Nursing Research, 27, 126–140.Google Scholar
Schofield, H., Bloch, S., Herrman, H., Murphy, B. and Nankervis, J. (eds.) (1998). Family Caregivers: Disability, Illness and Ageing. Melbourne: Allen and Unwin.Google Scholar
Stata Corporation (2017). Stata/SE 15.0 for Windows 64 Bit. College Station, TX: Stata Corporation.Google Scholar
Stirling, C., Andrews, S., Croft, T., Vickers, J., Turner, P. and Robinson, A. (2010). Measuring dementia carers’ unmet need for services – an exploratory mixed method study. BMC Health Services Research, 10, 122. doi:10.1186/1472-6963-10-122Google Scholar
Vecchio, N. (2008a). Understanding the use of respite services among informal carers. Australian Health Review, 32, 459–467.Google Scholar
Vecchio, N. (2008b). The use of support systems by informal caregivers: an Australian experience. Australian Journal of Primary Health, 14, 27–34.Google Scholar
Victorian Equal Opportunity and Human Rights Commission (2012). Mature-Age Workers and the Equal Opportunity Act: Know Your Rights. Melbourne: Victorian Equal Opportunity and Human Rights Commission.Google Scholar
Winter, N. (2008). SVR: Stata module to compute estimates with survey replication based standard errors. Available at: https://ideas.repec.org/c/boc/bocode/s427502.html; last accessed March 2017.Google Scholar
Wolfer, K. (1985). Introduction to Variance Estimation. New York: Springer-Verlag.Google Scholar