Factors affecting long-term care use in Hong Kong

Key Messages: 1. Psychological factors play the most significant role in contributing to long-term care choices. Older people’s positive attitude towards community care services (CCS) and strong structural solidarity of the family are two key factors. 2. Stronger family structural solidarity is associated with the use of CCS, whereas family structural solidarity tends to be confined to nuclear families rather than intergenerational families, which implies that spouse and children caregivers have different needs. Caregiver support services targeting the elderly couple’s families and children as caregivers should be differentiated and more specifically targeted. 3. In general, CCS serve frail elders with acute rehabilitation needs, who are more likely to be cared for by family members and/or domestic helpers, whereas residential care services serve frail elders with a higher level of cognitive impairment.published_or_final_versio

A community study on burden and depressive symptoms among carers of demented relatives

Background: Most mild to moderate demented patients are cared at home. Studies have shown that carers face increased stress and are prone to depression. In order to understand their needs, a collaboration study between District Board, Community Rehabilitation Network and local hospitals was done. Objective: (1) To understand care needs of demented patients and their carers in the family. (2) To assess difficulties faced by carers and evaluate their stress. (3) To find out which factors may aggravate or relieve carer stress. Method: The study was performed by interviewing 100 carers by questionnaire. Three main themes were studied: (1) presence of depression by Center for Epidemiological Studies Depression Scale (CES-D), (2) caregiver burden by Zarit Burden Interview (ZBI), patients’ memory and behavioural problems by Revised Memory and Behaviour Problems Checklist (RMBPC), patient ADL performance, and (3) carer coping abilities by Brief COPE and perceived social support by Multidimensional Scale of Perceived Social Support (MSPSS). Results: 49% of patients are in moderate to severe stage, with moderate to high ADL dependency level (mean ADL score: 62.4, with 40% of patients scoring 60 or below). On average carers spent 13.8 hours per day on their relative. 24% of carers have rated self-perceived health status as poor or very poor. 36% have little or no knowledge about the dementia illness. Regarding carer depression, 49% had CES-D score in the moderately and severely depressed range. Caregiver burden was high with ZBI score of 38.2 (>24 being highly associated with depression). Memory and behavioural symptoms were common with mean RMBPC 38.2. Carer coping abilities as measured by Brief COPE was 24.6. Perceived social support as measured by MSPSS was 56.2. Carer depression was found to be correlated with cognitive and behaviour problems as well as carer burden; whereas it was negatively correlated with social support. After multiple linear regression analysis, caregiver burden was the most significant factor contributing to caregiver depression (β=0.55, T=5.43, p<0.001). Conclusions: This cohort of carers, having spent long hours caring for their demented relatives had limited knowledge, poor perceived health and emotional problems. They had high burden and showed signs of depression. Caregiver depression was found to be associated with a higher level of burden.published_or_final_versio

Psychological factors affecting long-term care utilization in Hong Kong

Conference Theme: From Theory to Practic

Factors affecting long-term care utilization in Hong Kong: policy implications

2 Themes of the Symposium: Application of statistical and mathematical models to understand infectious disease dynamics (RFCID theme) and Cost-effectiveness in health services research (HHSRF theme

Characteristics of elderly people who prefer to stay in the community

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