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Understanding and Improving the Burden and Unmet Needs of Informal Caregivers of Homebound Patients Enrolled in a Home-Based Primary Care Program

Columbia University The Mount Sinai Visiting Doctors Program, New York, katherine.ornstein{at}mssm.edu

Kristofer L. Smith

The Samuel Bronfman Department of Medicine, The Mount Sinai School of Medicine, New York

Jeremy Boal

Long Island Jewish Medical Center, North Shore-LIJ Health System

The growing homebound population is heavily reliant on informal caregivers, who are increasingly burdened by their roles. This study describes informal caregivers of the homebound who remain caregivers at a 9-month follow-up and examines the impact of a home-based primary care (HBPC) program on caregiver burden and unmet needs using a prospective design with a pre—post intervention assessment. Informal caregivers of the urban homebound are similar to caregivers of other populations and have a broad range of unmet needs. The intervention described is the regular provision of multidisciplinary HBPC. Hundred fourteen caregivers of newly admitted patients complete a baseline interview. For the 56 caregivers who complete a 9-month follow-up interview, participation in HBPC is associated with a statistically significant decrease in overall caregiver burden. At 9 months, caregivers demonstrate an overall decrease in unmet needs, with a statistically significant decrease across two measured domains. These results suggest that the regular provision of multidisciplinary care in the home can mitigate the deleterious impact of informal caregiving.

Key Words: peer homebound • caregiving • home care • home-based primary care

This version was published on August 1, 2009

Journal of Applied Gerontology, Vol. 28, No. 4, 482-503 (2009)
DOI: 10.1177/0733464808329828


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