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Age and Ageing Advance Access originally published online on July 2, 2009
Age and Ageing 2009 38(5):542-547; doi:10.1093/ageing/afp101
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The effect on caregiver burden of a problem-based home visiting programme for frail older people

René J. F. Melis1, Monique I. J. van Eijken2, Theo van Achterberg2, Steven Teerenstra3, Myrra J. F. J. Vernooij-Dassen2, Eloy H. van de Lisdonk4 and Marcel G. M. Olde Rikkert1

1 Department of Geriatric Medicine 925, Radboud University Nijmegen Medical Centre, PO Box 9101, NL-6500 HB, Nijmegen, The Netherlands
2 IQ Health Care 114, Radboud University Nijmegen Medical Centre, PO Box 9101, NL-6500 HB, Nijmegen, The Netherlands
3 Department of Epidemiology, Biostatistics, and HTA 133, Radboud University Nijmegen Medical Centre, PO Box 9101, NL-6500 HB, Nijmegen, The Netherlands
4 Department of General Practice 117, Radboud University Nijmegen Medical Centre, PO Box 9101, NL-6500 HB, Nijmegen, The Netherlands

Address correspondence to: R. J. F. Melis. Tel: (+31) 24 3616772; Fax: (+31) 24 3617408. Email: r.melis{at}ger.umcn.nl

Objective: caregiver effects of geriatric care models focusing primarily at the patient have not been consistently studied. We studied caregiver effects of a nurse-led comprehensive geriatric evaluation and management (GEM) programme for community-dwelling frail older people that showed—in a randomised comparison with usual care-–health-related quality of life benefits for the care receivers.

Methods: this randomised trial included 110 caregiver/patient dyads who were followed up for 6 months. Primary analyses were intention-to-treat analyses of caregiver burden assessed with Zarit Burden Interview (ZBI; 0–88; higher means more burden). Preplanned subgroup analyses were conducted for cognition, living arrangement and patient/caregiver co-residence.

Results: overall, perceived caregiver burden showed no significant differences between study groups in changes over time. However, perceived burden was at baseline more than eight points higher in caregivers sharing a household with patients (n = 23) compared to caregivers living separately (n = 87). The intervention performed better in caregivers living together with the patient than in caregivers living separately (P for interaction = 0.04). Co-resident caregivers experienced six-Zarit point improvement compared with four-point deterioration in the non-co-resident caregivers.

Conclusions: GEM at home benefited patients, but maybe not caregivers. Caregiver effects are related to whether caregivers live with the patient or not.

Keywords: elderly, primary health care, frail elderly, health services for the aged, clinical trial, caregivers

Received 19 November 2008; accepted in revised form 12 April 2009.


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