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Health Services Research & Development

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2009 HSR&D National Meeting Abstract

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National Meeting 2009

3107 — Enhancing Quality of Informal Care for Frail Veterans Receiving VA home care services: A Pilot Study of Perceived Need for Caregiver Training

Van Houtven CH (COE-Durham), Weinberger, M (COE-Durham), Oddone EZ (COE-Durham)

Objectives:
To describe the informal care network of veterans referred to Homemaker Home Health (H/HHA) and home-based primary care (HBPC) at the Durham VAMC, including: care-dyad relationships, quantity and types of tasks provided by informal and VA providers, and perceived need for caregiver training.

Methods:
Patients receiving primary care at the Durham VAMC and referred to VA H/HHA or HBPC during the preceding 3 months were sent questionnaires in May 2007. Caregivers were sent questionnaires if a patient gave us permission to contact him/her.

Results:
Patient Data (n = 89): 76 percent of patients referred to H/HHA or HBPC were receiving such care. Forty-eight percent of caregivers were spouses, 12.4 percent daughters, and 9 percent sons, the rest were friends or other relatives. Sixty-one percent of care-dyads co-resided, one-third of these were non-spouses. Caregivers provided care 66 hours per week (versus 17 hours by HBPC and/or H/HHA) and helped with an average of 9.3 I/ADL and medical tasks each (3.2 by HBPC and/or H/HHA). Caregiver Data (n = 17): Caregivers were very confident in taking care of the Veteran’s physical needs (65 percent), but not about how to obtain services (24 percent). Fifty-six percent of caregivers reported receiving training by the VA on how to provide care. Combined Data (n = 106): patients and caregivers considered the same top three items to be the most useful in a caregiver training program: when and how to ask for more help, taking care of yourself as a caregiver. and coping with caregiving. Twenty-five percent of caregivers would be able to take part in weekly phone training, and 26 percent in monthly training at the VA. Health, transportation, and time were the main barriers.

Implications:
Informal caregiver training needs to be tailored to cover diverse patient conditions and to overcome barriers due to time burden and caregiver frailty. Caregivers felt confident about the care they provide, but not in securing added services. Diverse caregiving arrangements exist, suggesting training could target all primary caregivers, not just spouses.

Impacts:
Informal caregivers represent a resource that can work with VA home-care services to maintain veterans at home. Understanding their needs is paramount to designing quality-enhancing training programs for caregivers.


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