| Summary: | 碩士 === 國立臺灣大學 === 衛生政策與管理研究所 === 96 === Due to the increase in the number of elderly people, the aging process and age-related issues have been the focus of public health policies across the world. However, cognitive impairment in the elderly and the difficulties faced by their caregivers have been relatively neglected in native research and have always been given less priority in national health policy making. The objectives of this thesis are as follows: (1) to understand burdens of family caregivers of the disabled elderly population in Taiwan, and (2) to clarify the association between care recipients’ cognitive impairment and their family caregivers’ burden.
Data from the Department of Health, Executive Yuan (Jan. 2001 to Dec. 2002), were collected for analyses and a two-stage survey was conducted. A total of 7,630 pairs of care recipients and family caregivers were included for analysis.
Analysis of the entire burden experienced by family caregivers suggests that more family caregivers experienced light burden (53.8%) while a smaller proportion suffered from serious burden (5.7%). This trend was also observed separately in physical burden, emotional burden, relational burden, burden of time, and financial burden. More caregivers suffered from serious physical burden (17.4%), burden of time (21.5%), and financial burden (15.6%) than other types of burden. A multinomial logistic regression analysis of the influence of care recipients’ cognitive impairment on the family caregivers’ burden reveals statistically significant results. The odds ratio of care recipients’ cognitive impairment to their cognitive non-impairment are 1.925, 1.661, 2.538, 2.009, 1.258, and 1.926 for serious burden to light physical burden, emotional burden, relational burden, burden of time, financial burden, and entire burden, respectively. Other statistically significant factors are age of the patient, number of chronic illnesses of the patient, degree of impairment of activity of daily living (ADL), disturbing behavior of the patient, occupational status of the caregiver, health status of the caregiver, occupational conflict of the caregiver, perceived support from the caregiver, conflict among the caregivers, daily hours of care provided by the caregiver, and the additional monthly expenditure of the caregiver.
For males aged 65–69 years with cognitive impairment, a monthly household income between NTD 100,000 to 199,999, more than 5 chronic illnesses, more than mild ADL impairment, and exhibiting disturbing behaviors, and their family caregivers who are typically female graduates from junior high school, involved in a relationship of couple, with poor health status, occupational conflicts, poor support systems, and care conflicts, with a total care period of less than 1 year, daily care period of more than 8 hours, and an additional monthly expenditure of more than NTD 1,000, relieving the family caregivers of their physical burden is mandatory.
In the case of males aged 65–69 years with cognitive impairment, moderate to severe ADL impairment, and disturbing behaviors, and their family caregivers who have poor health status, occupational conflicts, poor support systems, and an additional monthly expenditure of NTD 5,000 to 100,000, relieving the family caregivers of their emotional burden is mandatory.
For males aged 65–69 years with cognitive impairment, a monthly household income of less than NTD 9,999, moderate to severe ADL impairment, and disturbing behaviors, and their family caregivers who are married, non-couples, with poor health status, occupational conflicts, poor support systems, total care period of less than 1 year, and daily care period of more than 8 hours, relieving the family caregivers of their relational burden is mandatory.
In the case of males aged 65–69 years, who are graduates from junior or senior high school, with cognitive impairment, more than 5 chronic illnesses, more than mild ADL impairment, and disturbing behaviors, and their family caregivers are jobless, with more than 6 years of education, poor health status, occupational conflicts, poor support systems, care conflicts, a total care period of less than 1 year, daily care period of more than 8 hours, and an additional monthly expenditure of more than NTD 1,000, relieving the family caregivers’ burden of time is mandatory.
For males aged 65–74 years, with cognitive impairment, a monthly household income of less than NTD 10,000, more than 3–4 chronic illnesses, more than mild ADL impairment, and disturbing behaviors, and their family caregivers who are illiterate, without couple, jobless, with poor health status, occupational conflicts, poor support systems, daily care period of more than 8 hours, and an additional monthly expenditure of more than NTD 1,000, relieving the family caregivers of financial burden is mandatory.
In the case of males aged 65–74 years with cognitive impairment, a monthly household income of less than NTD 10,000, more than 5 chronic illnesses, more than mild ADL impairment, and disturbing behaviors, and their family caregivers who are married, non-couple, and have poor health status, occupational conflicts, poor support systems, total care period of less than 1 year, daily care period of more than 8 hours, and an additional monthly expenditure of more than NTD 1,000, relieving the family caregivers of the entire burden is mandatory.
This study provides evidence of the association between care recipients’ cognitive impairment and the family caregivers’ burdens in the disabled elderly population in Taiwan. Based on the results of this study, we suggest that the public health policy makers should consider the care recipients’ cognitive impairment so as to provide appropriate support systems for various dimensions of a family caregiver’s burden.
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