Examining What Caregivers Do During Respite Time to Make Respite More Effective

Study Aim/Purpose: The study described and analyzed consistency between family caregivers’ desired and actual use of their time while their relatives were receiving adult day services. The study then sought to examine the relationship between this level of consistency (or inconsistency) and caregivers satisfaction with respite time-use, their feeling of burden, depression and satisfaction with caregiving. 

Summary of Methods: The study collected information from 52 family caregivers age 50 and older using in-home interviews and respite activity logs filled out by the caregivers over a one-week period. The caregivers were recruited from three adult day centers in two moderately sized cities in the western United States. Each completed an initial interview that included demographic data and detailed information on their desired activities for the upcoming week during respite time. During the week they logged total respite time and actual use of respite time each day. After receiving respite services, they answered questions about their satisfaction with respite and provided information to measure the following outcomes: 1) caregiver burden (using the Multidimensional Caregiver Burden Inventory), 2) depression (using the Center for Epidemiological Studies Depression scale), and 3) satisfaction with caregiving (using the Caregiving Appraisal Instrument). 

Summary of Key Results: The caregiver responses indicated that caregivers “pursue a wide range of activities during respite time” and there was a strong association with respite satisfaction and how consistent caregivers were in doing the types of activities they wanted to do during their respite time. Caregivers who were very satisfied with their respite time also had significantly lower depression scores than those who were not very satisfied. Likewise, the high consistency group (i.e. highly consistent in actual vs. desired activities) had significantly lower depression scores compared to those who were not as consistent in their time-use during respite. Furthermore, depression scores were highest among the group of caregivers who had both low consistency in use of respite time (actual vs. desired) and low satisfaction with their respite time. 

Study Limitations (as cited by authors): The authors cite the small and homogenous sample, the limited age of caregivers included, and the one-week data collection period as limitations of their ability to capture the dynamic aspects of caregiving circumstances and experiences. In addition, the study focused exclusively on those who used adult day services for respite. Other forms of formal and informal respite were not included. Lastly, how study participants differed from those who declined to participate was unknown. 

Authors’ Discussion/Conclusions: The authors recommend that, based on their study findings, more attention should be paid to helping caregivers carry out satisfying activities during available respite time. They recommend that providers and researchers help respite users in the following ways: “(a) assessing their situations, resources, and needs; (b) determining what types and amount of respite activities might be most beneficial to them given their preferences and areas in which their lives are being most negatively affecting by caregiving; c) setting specific goals for how to use their upcoming respite time; (d) developing a plan to make their goals achievable…; (e) evaluating the effectiveness of the outcomes of respite; and (f) making goal setting and evaluation ongoing activities…” In terms of future research, the authors suggest “that studies place an emphasis on theoretically based interventions and longitudinal designs that are tailored to the individual needs of each caregiver…Also needed are studies that assess diverse forms of formal and informal respite services and include more diverse populations and provide appropriate culturally sensitivity to the ethnic and racial differences among caregivers.”