The Influence of Neurodegenerative Disease on Older Veterans and Their Family Caregivers
Lauren Moo1, Steven Shirk2, Victoria Ngo1, Elizabeth Marfeo3, Maria Venegas2, Bret Hicken4, Elizabeth Chamberlin2
1GRECC, VA Bedford Healthcare System, 2VA Bedford Healthcare System, 3Community Health, Tufts University, 4Veterans Rural Health Resource Center, VA Salt Lake City Healthcare System
Objective:
To characterize community-dwelling older veterans living with neurodegenerative disease (ND) and the impact on their family caregivers (CG).
Background:
The progressive nature of ND leads not only to declines in activities of daily living (ADL) functioning and related increasing dependency but often also to prominent neuropsychiatric symptoms. These additional features can contribute to adverse physical and psychological impacts on the family CGs of these patients.
Design/Methods:
A cross-sectional Qualtrics-based online survey to English-speaking adult CGs of older US veterans (≥65 yo) with high medical complexity who need assistance attending medical visits. Analyses included descriptive statistics and bivariate comparisons.
Results:
Approximately 27% of respondents (137/511) were CGs for an older adult with ND. Older adults with ND were more likely to have had an inpatient stay (76.6% vs. 57.8%) or ER visit (78.1% vs. 58.3%) in the previous year than those without ND. Those with ND had higher ADL independence (p <0.0001) but lower IADL independence (p < 0.0001). Veterans with ND demonstrated greater problematic neuropsychiatric behaviors in the hours preceding an in-person medical appointment (16.1% vs. 9.6%), and their CGs reported greater stress during the medical visits (35.0% vs. 19.3%). CGs assisting those with ND reported poorer Quality of Life (QoL) (p = 0.018).
Conclusions:
Based on the reports of family CGs, older adult veterans with ND require more assistance with IADLS, are more likely to be hospitalized, and exhibit more behavioral disruption related to medical visits than those without ND. These factors not only partially explain the lower QoL among caregivers of people with dementia and other ND disorders but highlight potential opportunities to decrease patient stress and caregiver burden through efforts to reduce in-person medical appointments, such as through telemedicine.