50 research outputs found
Psychoactive plant- and mushroom-associated alkaloids from two behavior modifying cicada pathogens
T-cell based sieve analysis ties HLA A*02 to vaccine efficacy and IgA-C1 immune correlate in RV144 Thai trial
Caregiver support and place of death among older adults
Background/objectivesAs home becomes the most common place of death in the United States, information about caregiver support and place of death is critical to improve patient and caregiver experiences at end of life. We seek to examine (1) the association between family care availability and place of death; and (2) caregiving intensity associated with place of death.Design2017 National Health and Aging Trends Study and National Study of Caregiving; nationally representative crossâsectional study of deceased older adults and lastâmonthâofâlife (LML) caregivers.SettingUnited States; all places of deaths.ParticipantsThreeâhundred and seventyâfive decedents and 267 LML caregivers.MeasurementsPlace of death (home, hospital, and nursing or hospice facility), family care availability (spouse/partner, household size, number of daughters and sons), caregiving intensity (hours of help provided at LML and a binary indicator for high careârelated emotional difficulty).Results38.9% of older adults died at home, followed by hospital (33.1%), and nursing or hospice facility (28.0%). In an adjusted multinomial logistic regression, decedents with larger household size (odds ratio [OR]: 0.441; 95% confidence interval [CI]: 0.269â0.724) and more daughters (OR: 0.743 [95% CI: 0.575â0.958]) had lower odds of dying in nursing or hospice facility relative to dying at home. For older adults who died at home, caregivers provided 209.8âh of help at LML. In contrast, when death occurred in nursing or hospice facility, caregivers provided 91.6 fewer hours of help, adjusted for decedent and caregiver characteristics. Dying in hospital was associated with higher odds of caregiver emotional difficulty relative to home deaths (OR: 4.093 [95% CI: 1.623â10.323]).ConclusionsHousehold size and number of daughters are important determinants of place of death. Despite dying at home being associated with more hours of direct caregiving; caregiver emotional strain was experienced as higher for hospital deaths. Better support services for endâofâlife caregivers might improve patient and caregiver experiences for home and hospital deaths.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167853/1/jgs17055_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167853/2/jgs17055.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167853/3/jgs17055-sup-0001-Tables.pd
Outcomes in Veterans With Hepatocellular Carcinoma (HCC) â A Single Center Experience Over 10 Years
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Stressors and Resources Related to Medication Management: Associations With Spousal Caregivers' Role Overload.
Background and objectivesManaging medications can be stressful for spousal caregivers, but little is known about particular aspects of medication management that are most consequential for caregiving outcomes. We examined care stressors and resources related to medication management, their associations with role overload among spousal caregivers, and whether these links vary by care recipients' number of chronic health conditions and dementia status.Research design and methodsThis cross-sectional study included 377 spousal caregivers of adults aged 65 and older from the 2011 National Health and Aging Trends Study and National Study of Caregiving. Linear regressions were estimated to evaluate how medication-related stressors (ordering medication, keeping track of medications, giving injections) and resources (medication reminder systems, shared medication management within the spousal dyad) are associated with caregivers' role overload. Care recipients' number of chronic health conditions and dementia status were considered as moderators. Models controlled for caregivers' sociodemographic characteristics, chronic health conditions, and other care tasks.ResultsCaregivers who administered injections reported more role overload, whereas those who worked with care recipients to jointly manage medications reported less role overload. Keeping track of medications was linked to caregivers' greater role overload when care recipients had 5 or more chronic health conditions. Finally, care recipients' use of medication reminder systems was linked to less role overload for caregivers of a partner with dementia.Discussion and implicationsDevising strategies to assist spousal caregivers in the more onerous components of medication management and promote resources that mitigate medication-related stress may improve caregiver well-being