{"id":1614,"date":"2018-08-29T10:49:29","date_gmt":"2018-08-29T14:49:29","guid":{"rendered":"http:\/\/www.healthinaging.org\/blog\/?p=1614"},"modified":"2018-08-29T10:49:29","modified_gmt":"2018-08-29T14:49:29","slug":"managing-multiple-health-conditions-what-care-recipients-and-caregivers-want-each-other-to-know","status":"publish","type":"post","link":"https:\/\/www.healthinaging.org\/blog\/managing-multiple-health-conditions-what-care-recipients-and-caregivers-want-each-other-to-know\/","title":{"rendered":"Managing Multiple Health Conditions: What Care Recipients and Caregivers Want Each Other to Know"},"content":{"rendered":"<p><strong><em><a href=\"https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic.jpg\"><img loading=\"lazy\" class=\"alignleft wp-image-1223 size-thumbnail\" src=\"https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic-150x150.jpg 150w, https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic-300x300.jpg 300w, https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic.jpg 350w\" sizes=\"(max-width: 150px) 100vw, 150px\" \/><\/a><span style=\"color: #800080;\">Journal of the American Geriatrics Society<\/span><\/em><span style=\"color: #800080;\">\u00a0Research Summary<\/span><\/strong><\/p>\n<p>In the United States, four out of five older adults have <a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:managing-multiple-health-problems\/\">multiple chronic health<\/a>\u00a0<a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:managing-multiple-health-problems\/\">conditions<\/a>. Many of these people rely on the active support of a family <a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:caregiver-health\/\">caregiver<\/a> to help manage their conditions.<\/p>\n<p>Studies of older adults with <a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:dementia\/resource:tools-and-tips\/\">dementia<\/a> and their caregivers have shown that very often, the older adult\u2019s desire to be self-sufficient often clashes with the caregiver\u2019s concerns about the individual\u2019s safety. However, researchers have also identified areas of friction among older adults who do not have dementia and their caregivers.<\/p>\n<p>For example, according to one study among older adults who have severe <a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:heart-failure\/\">heart disease<\/a>, these individuals don\u2019t appreciate unwanted or excessive phone contact\u2014or advice they haven\u2019t requested\u2014from family and friends. In another study, older adults with <a href=\"https:\/\/medlineplus.gov\/lupus.html\">lupus<\/a>\u00a0(an autoimmune disease caused when your immune system attacks your own body tissue) said they\u2019d received advice from friends and family that they felt wasn\u2019t well-informed. They also reported they received support that felt \u201coverprotective.\u201d<\/p>\n<p>Noting that we need more understanding of caregiver and care recipient relationships, a research team designed a study using interviews with caregivers and the older adults receiving care. These interviews were designed to explore experiences, attitudes, and preferences about caregiving relationships. The study appeared in the <em>Journal of the American Geriatrics Society<\/em>.<!--more--><\/p>\n<p>The researchers recruited older adults from primary-care and specialty clinics and from assisted-living facilities in Connecticut. The care recipients were 65-years-old or older, had more than two chronic conditions, did not have problems thinking or making decisions, and had an unpaid caregiver (relative or friend) who was involved in their health care.<\/p>\n<p>The older adults were first asked to name their chronic conditions, and then to describe how their caregivers helped them manage those conditions. Researchers also learned about the care recipients\u2019 reactions to the assistance they received. Caregivers were invited to respond to their care recipients\u2019 answers, provide their own examples, and discuss how they felt about the assistance they provided.<\/p>\n<p>After the interview, the care recipients completed a questionnaire about age, gender, race, education, marital status, living arrangements, and their relationship to their caregivers. Caregivers completed a separate questionnaire about their age, gender, race, education, marital and employment status, and living arrangements.<\/p>\n<p>The care recipients were around 82-years-old; most were white and female. Caregivers were around 70-years-old, two-thirds were women, and most were either a spouse or an adult child of the person receiving care.<\/p>\n<p>The researchers learned about caregiving activities that were common to most caregiver\/care recipient pairs. These included managing medications, coordinating healthcare appointments, managing paid caregivers, and speaking with medical professionals.<\/p>\n<p>Relationships that were \u201csupportive\u201d included these behaviors:<\/p>\n<ul>\n<li><strong>Agreement about caregiver\u2019s level of involvement.<\/strong> Caregivers were responsive to the care recipient\u2019s desired level of assistance. In visits with healthcare providers, for example, caregivers were mindful of the care recipient\u2019s desire to speak directly to the provider but asked clarifying questions to make sure they understood all the information.<\/li>\n<li><strong>Mutual understanding.<\/strong> Care recipients tried to be less demanding of caregivers by being \u201cgood patients\u201d and following their treatment regimens. Caregivers acknowledged the challenges these individuals faced in managing their health conditions and in losing physical function.<\/li>\n<li><strong>Making decisions together.<\/strong> Care recipients and caregivers worked together to make treatment decisions that were satisfactory to both parties. The caregiver made sure that the individual\u2019s preferences for care were recognized, and the care recipient made sure that the caregiver\u2019s needs were taken into account.<\/li>\n<\/ul>\n<p>Relationships with conflicts included these behaviors:<\/p>\n<ul>\n<li><strong>Disagreement about caregivers\u2019 level of involvement.<\/strong> Some care recipients felt that their caregivers were too involved. In visits with healthcare providers, the individuals felt that, with their caregivers present, their own voices were not getting heard. Caregivers felt that their involvement was necessary to impart accurate information when the care recipients lacked English-language skills or intentionally withheld information from healthcare providers.<\/li>\n<li><strong>Disagreement about one another\u2019s competency to perform disease management tasks. <\/strong>Some care recipients did not trust their caregivers to administer medications, although caregivers felt equipped to perform this task. Caregivers in these situations also were skeptical of care recipients\u2019 abilities to carry out treatment regimens, manage medications, or communicate adequately with healthcare providers, even though care recipients felt able to perform these activities without assistance.<\/li>\n<li><strong>Under-appreciation.<\/strong> In \u201cconflict\u201d relationships, care recipients often felt that the caregiver had unrealistic expectations of their abilities to manage their health conditions. Caregivers described their roles as being \u201cthe mother of a toddler\u201d or as an \u201cunpaid slave,\u201d stating that the person being cared for did not fully recognize the stress associated with caregiving.<\/li>\n<li><strong>Disagreement over decision-making and disease management.<\/strong> Some care recipients and caregivers disagreed over decisions about healthcare, including rehabilitation and the day-to-day management of a care recipient\u2019s health conditions (e.g., diet, exercise, number of blood draws, and the use of assistive devices).<\/li>\n<\/ul>\n<p>While older adults with multiple chronic illnesses and their family caregivers perform a universal set of disease management activities, their preferences for accepting or providing assistance with those activities are highly personal. The researchers said their findings support a family-centered approach to working with these individuals and their caregivers.<\/p>\n<p><strong>This summary is from <\/strong><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1111\/jgs.15501\"><strong>\u201cPatient and Caregiver Perspectives on Managing Multiple Health Conditions.\u201d<\/strong><\/a><strong> It appears online ahead of print in the <em>Journal of the American Geriatrics Society<\/em>. The study authors are Catherine Riffin, PhD; Peter H. Van Ness, PhD, MPH; Lynne Iannone, MA; and Terri Fried, MD.<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Journal of the American Geriatrics Society\u00a0Research Summary In the United States, four out of five older adults have multiple chronic health\u00a0conditions. Many of these people rely on the active support of a family caregiver to help manage their conditions. Studies &hellip; <a href=\"https:\/\/www.healthinaging.org\/blog\/managing-multiple-health-conditions-what-care-recipients-and-caregivers-want-each-other-to-know\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[4,91],"tags":[67,7,60],"_links":{"self":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts\/1614"}],"collection":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/comments?post=1614"}],"version-history":[{"count":2,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts\/1614\/revisions"}],"predecessor-version":[{"id":1616,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts\/1614\/revisions\/1616"}],"wp:attachment":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/media?parent=1614"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/categories?post=1614"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/tags?post=1614"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}