Depressive symptoms and use of home-based respite time in family caregivers

Author(s): Mensie, L.C. and Steffen, A.M.

Published In: Home Health Care Services Quarterly, 29: 120-137

Study Aim/Purpose: This study investigated the relationship between how family caregivers used in-home respite time and subsequent symptoms of depression. Specifically, the study sought to determine whether there were different effects of respite time used by caregivers for “pleasant activities” versus respite times used to catch up on non-caregiving chores. 

Summary of Methods: The study collected information from 74 family caregivers who were living with older adults diagnosed with cognitive impairment or requiring assistance with at least two activities of daily living (ADLs) and receiving 4 hours of in-home respite care from the Caregiver Support Program of a Midwestern Area Agency on Aging (AAA). Information on past use of respite services was obtained from the AAA administrative data. A caregiver questionnaire and telephone interview provided information on the following contextual variables: demographics of caregivers and care recipients; the care recipient’s functional impairment and frequency of behavioral problems; and information on receipt of non AAA caregiving assistance in the past month. Caregivers were also asked to report the amount of time spent on a typical in-home respite day in both discretionary activities (i.e., family interaction, social interaction, religious activities, reading, listening to the radio, watching television, recreation/leisure, and rest/relaxation) and non-care related household chores. Caregiver depressive symptoms were measured using the CES-D 20-item self-report measure. 

Summary of Results: The authors found no significant relationship between contextual variables, care recipient functional impairment and level of behavioral problems or caregiver use of respite time for discretionary activities with caregiver depression level. However, they found a modestly significant relationship between the use of respite time to accomplish non-care related chores and lower levels of caregiver depression, even after controlling for the effects of contextual variables, care recipient functional and behavioral problems, and dosage of respite and prior use of respite. 

Study Limitations (as cited by authors): Authors suggested that the lack of relationship between caregiver discretionary time and depression may be due to the fact that when caregivers receive only 4 hours of respite per week, they may prioritize doing chores during respite time and have little opportunity to pursue discretionary activities. 

Authors’ Discussion/Conclusions: Authors pointed out that the study does not confirm the directionality of the relationship between respite time spent on chores and depression. That is, caregivers with fewer depressive symptoms may be those who have more energy to complete chores and those with greater depressive symptoms may have less energy and motivation to carry out non-care related chores during respite time. They also note the practical implication of their findings suggesting that advice to caregivers about the benefits of respite should have a balanced emphasis on using the time for pleasant activities with the advantages of catching up on household obligations that they may fall behind on because of the demands of caregiving.