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Khan N, Malingagio A, Briceño EM, Mehdipanah R, Lewandowski-Romps L, Heeringa SG, Garcia N, Levine DA, Langa KM, Gonzales XF, Morgenstern LB. A Community-Based Study of Cognitive Impairment Caregiving Outcomes Pre- and During the COVID-19 Pandemic. J Appl Gerontol 2024; 43:700-705. [PMID: 37991816 PMCID: PMC11052669 DOI: 10.1177/07334648231215155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
The impact of the COVID-19 pandemic on informal caregiving was examined in a Mexican American (MA) and Non-Hispanic White (NHW) population-based cohort. 395 participants age > 65 years were recruited via door-to-door and phone recruitment as part of the Brain Attack Surveillance in Corpus Christi-Cognitive (BASIC-C) project. Both recipients and caregivers answered questions regarding the recipient's health and the COVID-19 pandemic. 15% of caregivers saw their caregiving recipient less than before the pandemic and 18% saw their recipient more than before. 55% of caregivers reported a slight to severe impact of the pandemic on their caregiving, and 45% reported no impact. For most caregivers, their caregiving role did not change markedly during the pandemic. MA and NHW caregivers had similar survey responses.
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Affiliation(s)
- Noreen Khan
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | | | | | - Steven G Heeringa
- University of Michigan Institute for Social Research, Ann Arbor, MI, USA
| | - Nelda Garcia
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Kenneth M Langa
- University of Michigan Medical School, Ann Arbor, MI, USA
- University of Michigan Institute for Social Research, Ann Arbor, MI, USA
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | | | - Lewis B Morgenstern
- University of Michigan Medical School, Ann Arbor, MI, USA
- University of Michigan School of Public Health, Ann Arbor, MI, USA
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Mage S, Benton D, Gonzalez A, Zaragoza G, Wilber K, Tucker-Seeley R, Meyer K. "I Lay Awake at Night": Latino Family Caregivers' Experiences Covering Out-of-Pocket Costs When Caring for Someone Living With Dementia. THE GERONTOLOGIST 2024; 64:gnad011. [PMID: 36786288 PMCID: PMC10733120 DOI: 10.1093/geront/gnad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The financial burden of caregiving has received less research attention than physical and emotional costs. This is especially true for underserved ethnic minorities. Financial strain affects mental and physical health and is unequally distributed across caregivers of different races and ethnicities. Although caregivers overall spend, on average, one quarter of their income on caregiving, Latino caregivers, the focus of this study, spend nearly half. RESEARCH DESIGN AND METHODS To better understand this disparity, we conducted 11 qualitative interviews with 14 Latino caregivers of persons living with dementia located in either California or Texas. Interview transcripts were thematically coded, guided by a material-psychosocial-behavioral conceptual model of financial strain. RESULTS We identified 3 themes: daily needs and costs, psychological distress caused by financial issues, and stressful barriers to accessing family and societal support. Furthermore, interviews revealed how Latino culture may influence spending patterns and management of costs. Findings suggest that preference by Latino families to care for a family member in the home may be met with a financial disadvantage due to the high out-of-pocket costs of care. DISCUSSION AND IMPLICATIONS A better understanding of the factors contributing to high costs for Latino caregivers and how these costs affect caregivers will inform approaches at both the individual and policy levels and develop culturally relevant interventions to help Latino families to lower caregiving costs. This is especially important as the number of Latinos living with dementia is expected to increase over the next 4 decades and effective interventions are lacking.
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Affiliation(s)
- Susanna Mage
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Donna Benton
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Alexander Gonzalez
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | | | - Kate Wilber
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Reginald Tucker-Seeley
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- ZERO—The End of Prostate Cancer, Alexandria, Virginia, USA
| | - Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Leng M, Sun Y, Li C, Han S, Wang Z. Usability Evaluation of a Knowledge Graph-Based Dementia Care Intelligent Recommender System: Mixed Methods Study. J Med Internet Res 2023; 25:e45788. [PMID: 37751241 PMCID: PMC10565620 DOI: 10.2196/45788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/21/2023] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Knowledge graph-based recommender systems offer the possibility of meeting the personalized needs of people with dementia and their caregivers. However, the usability of such a recommender system remains unknown. OBJECTIVE This study aimed to evaluate the usability of a knowledge graph-based dementia care intelligent recommender system (DCIRS). METHODS We used a convergent mixed methods design to conduct the usability evaluation, including the collection of quantitative and qualitative data. Participants were recruited through social media advertisements. After 2 weeks of DCIRS use, feedback was collected with the Computer System Usability Questionnaire and semistructured interviews. Descriptive statistics were used to describe sociodemographic characteristics and questionnaire scores. Qualitative data were analyzed systematically using inductive thematic analysis. RESULTS A total of 56 caregivers were recruited. Quantitative data suggested that the DCIRS was easy for caregivers to use, and the mean questionnaire score was 2.14. Qualitative data showed that caregivers generally believed that the content of the DCIRS was professional, easy to understand, and instructive, and could meet users' personalized needs; they were willing to continue to use it. However, the DCIRS also had some shortcomings. Functions that enable interactions between professionals and caregivers and that provide caregiver support and resource recommendations might be added to improve the system's usability. CONCLUSIONS The recommender system provides a solution to meet the personalized needs of people with dementia and their caregivers and has the potential to substantially improve health outcomes. The next step will be to optimize and update the recommender system based on caregivers' suggestions and evaluate the effect of the application.
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Affiliation(s)
- Minmin Leng
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- School of Nursing, Peking University, Beijing, China
| | - Yue Sun
- School of Nursing, Peking University, Beijing, China
| | - Ce Li
- Department of Cardiac Adult Postoperative Surgical Recovery Room, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuyu Han
- School of Nursing, Peking University, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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Díaz-Venegas C, Samper-Ternent R, Wong R. Caregiving to Older Adults With a Physical Limitation: Evidence From the Mexican Health and Aging Study. Innov Aging 2023; 7:igac081. [PMID: 36815015 PMCID: PMC9940624 DOI: 10.1093/geroni/igac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Indexed: 01/11/2023] Open
Abstract
Background and Objectives Many older adults face physical limitations to performing activities of daily life (ADLs) and instrumental activities of daily life (IADLs) and seek help performing them. In Mexico, family caregivers, especially spouses and adult children, traditionally take care of older adults. However, a detailed characterization of the care received has not been thoroughly provided. We sought to identify socioeconomic, demographic, and health-related differences in receiving help among older adults reporting physical limitations. Research Design and Methods Using the 2012 wave of the Mexican Health and Aging Study, we provided information on adults aged 60 and older who reported one or more physical limitations and whether they received help or not. We estimated 2 logistic regression models to obtain the odds ratios (ORs) of receiving help among individuals with an ADL limitation and those with an IADL limitation. Results Adults with ADL limitations received, on average, approximately 10.7 hr of assistance per day, whereas those with at least 1 IADL limitation received around 7.7 hr of help per day. Women were more likely to receive help with ADLs than men (OR = 2.35). Individuals with chronic conditions such as hypertension, diabetes, and arthritis also received more help with both ADLs and IADLs. Discussion and Implications Our work suggests that help received does respond to the care needs of older adults, but future research should focus on the burden of care for caregivers and expand this analysis using a longitudinal data approach.
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Affiliation(s)
| | - Rafael Samper-Ternent
- Department of Management, Policy and Community Health, School of Public Health, the University of Texas Health Science Center in Houston, Houston, Texas, USA
| | - Rebeca Wong
- Department of Population Health and Health Disparities and WHO/PAHO Collaborating Center on Aging and Health, the University of Texas Medical Branch, Galveston, Texas, USA
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Khan N, Garcia N, Mehdipanah R, Briceño EM, Heeringa SG, Levine DA, Gonzales XF, Langa KM, Longoria R, Morgenstern LB. Lack of Any Caregiving for Those with Dementia. J Alzheimers Dis 2022; 86:531-535. [PMID: 35068465 PMCID: PMC8960337 DOI: 10.3233/jad-215418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Older adults with significant cognitive impairment require help with activities of daily living. The BASIC-Cognitive Project, set in Nueces County, Texas, is a community-based study examining trends in cognition among Mexican Americans and non-Hispanic Whites. Using cross-sectional data from a cohort study, we found that at least 7% of individuals aged 65 and older with a Montreal Cognitive Assessment (MoCA) score of < 20 (or < 15 for telephone MoCA), did not receive any caregiving help. This conservative estimate highlights an important community need for those with significant cognitive impairment and has implications regarding safety and care for older adults.
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Affiliation(s)
- Noreen Khan
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nelda Garcia
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Roshanak Mehdipanah
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Emily M Briceño
- Department of Physical Medicine & Rehabilitation, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Steven G Heeringa
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Deborah A Levine
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Xavier F Gonzales
- Department of Life Sciences, Texas A&M University, Corpus Christi, TX, USA
| | - Kenneth M Langa
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.,Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Ruth Longoria
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Lewis B Morgenstern
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA.,Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
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