Nurse-facilitated guided care for elders and their caregivers leads to improved perceptions of quality of care
Strong evidence of caregiving burdens borne by family members and friends caring for older adults with multiple chronic illnesses has motivated the development of intervention strategies. Guided Care (GC) is a model of health care that is primary care-based and provided through a nurse-physician partnership to older adults with multiple illnesses, which includes training and support for patients' family and caregivers.
Researchers from Johns Hopkins University found that among the 196 primary caregivers participating in the GC study, there was a statistically significant positive change in their perceptions of the quality of care received by their family members compared with caregivers of patients who received usual care. However, there were no differences among the two groups of caregivers for reported depressive symptoms, strain, and productivity, each of which was measured by a separate scale.
A trend toward increased work productivity was found among caregivers of GC patients who were employed. The higher quality of chronic illness care for patient participants was reported by their caregivers at an 18-month followup interview. The quality of chronic illness care was assessed using a modified version of the Patient Assessment of Chronic Illness Care, which includes five subscale scores (patient activation, decision support, goal setting, problem solving, and coordination of care). For the GC trial, 7 nurses were recruited, trained, and integrated into 7 randomly selected primary care provider teams (from a pool of 14). Patient participants were, on average, 78 years old and afflicted with 4.6 chronic conditions. Caregiver participants were, on average, 61 years old, mostly female and married, and helped patients an average of 20.6 hours per week at baseline. This study was supported by the Agency for Healthcare Research and Quality (HS14580).
See "Effects of guided care on family caregivers," by Jennifer L. Wolff, Ph.D., Erin R. Giovannetti, Ph.D., Cynthia M. Boyd, M.D., M.P.H., and others in The Gerontologist 50(4), pp. 459-470, 2010.
Return to Contents
Proceed to Next Article