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Caregiver Burden in the Management of Frail Elderly Patients with Diabetes in Internal Medicine

Dependence is associated with advanced age, is a consequence of fragility, and entails some degree of support from others (caregivers) to carry out, supplement and assist in activities of daily living. However, caregiver burden can have negative effects on health, especially on mental health (mainly anxiety and depression), although it is also associated with physical complaints (back pain, headache and muscle pain). Moreover, the convergence of social isolation, lack of free time, family strife and a deteriorating economic situation have given rise to what some authors call “caregiver syndrome”. This condition has a negative impact on caregivers’ quality of life, necessitating a comprehensive approach that encompasses care for both patients and the people who look after them.

In this paper, an observational, retrospective e, single-center study was carried out to assess the impact of improved management in diabetes on caregiver burden. The authors assessed patients’ performance of activities of daily living using the Barthel scale and also collected data on social, demographic and clinical variables for both patients and caregivers. Caregivers had a mean (SD) age of 59.9 ± 16.7 years old, and 63.3% were women. They dedicated an average 10.7 ± 7.2 hours per day to caregiving activities. And 60 patients included in the analysis had a mean age of 83.1 ± 4.9 years old, and 63.3% were men. The primary outcome was caregiver burden, as assessed using the Zarit scale. 

At baseline, 81.4% of the caregivers reported severe overburden (>55 points on the Zarit scale). At three months, the proportion of caregivers reporting this level of burden had dropped to 76.7% and remained stable at six months (77.1%). In contrast, 8.5% of the caregivers reported moderate overburden (47 to 55 points) at baseline, compared to 13.3% at three months and 12.5% at six. The proportion of caregivers reporting no overburden (<47 points) was similar at all-time points (10.2%, 10.0% and 10.4% at baseline, three months and six months, respectively). 

In conclusion, caregiver burden remained persistently high, decreasing only slightly after six months. Based on the results, there is an urgent need for designing and implementing techniques that ease, improve or support caregivers in their labor. Besides, the caregivers of multipathological, frail, elderly people may require emotional, social, financial and health-related interventions. Effectively addressing their needs will allow them to continue to look after their charges without compromising their own well-being.


Article by José Miguel Seguí Ripoll, et al, from Spain.

Full access: http://mrw.so/4TTd68

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