Evaluation of the Home Help Service and its impact on the informal caregiver’s burden of dependent elders

Author(s): Carretero, S., Garces, J., and Rodenas, F.

Published In: Int J Geriatr Psychiatr, 22 (8): 738-49

Study Aim/Purpose: This study had two aims. The first was descriptive, to describe the characteristics of users and services received from and satisfaction with the Home Help Service (HHS), a respite program serving elders in Comunidad Valenciana in Spain. The second study aim was to measure the impact of HHS use on the burden of care among informal caregivers. 

Summary of Methods: The authors compared caregiver burden among two randomly collected samples– 117 users of HHS with informal caregivers and 36 non-users of HHS on the waiting list for this service who also had informal caregivers at home. Burden of informal caregiving was measured using the “Zarit Burden Interview” which comprises 22 items with five scale answers ranging from never (0) to nearly always (4) with a total score ranging from 0-88. 

Summary of Key Results: Descriptive analysis of the characteristics of the HHS shows that it provides “low coverage and low frequency of care,” and that HHS “workers lack professional training in home care.” The survey results found that both carers of HHS users and carers of non-HHS users “experience great burden in their daily work.” Although mean burden overall was higher among carers of non-HHS users, the difference was not statistically significant. Breaking down the components of the Zarit Burden scale, both groups have a “rather strong perception of the negative repercussions of caregiving in their lives, and there is no significant differences between the two groups in this factor. Additionally, “both groups appear to report low feelings of incompetence to continue in their caregiving role,” with carers of non-HHS users having significantly higher feelings of incompetence. Neither group shows “negative feelings toward the dependent people in their care.” 

Study Limitations (as cited by the authors): None cited. 

Authors’ Discussion/Conclusions: The authors state that “informal caregivers of dependent elders have high burden levels that could endanger the continuity and quality of their caregiving.” However, their evaluation results found that “HHS provision does not significantly reduce” that burden. The authors conclude that improvements are needed in HHS and other respite care programs to address caregiver burden. Their recommendations include extending the type and duration of services provided and focusing on primary caregivers’ needs, with the offering of psychoeducational efforts to relieve informal caregivers’ emotional stress and give them skills and coping strategies.