Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 106

Many older adults will require the assistance of caregivers due to disability or impairment from cognitive, psychiatric, or medical conditions. Caregivers are friends or family members who provide support to a dependent person. In the US, as of 2017, there were an estimated 65.7 million unpaid caregivers. Approximately 100 million people are estimated to serve as caregivers in Europe (20% of the European population), and there are an estimated 2.7 million caregivers in Australia (just over 10% of the population). Caregivers are most likely to be female, middle‐aged adults.¹⁸

Caregivers provide various services, depending on their relationship to the patient and the patient's abilities. The vast majority of caregivers are unpaid and receive little to no education or emotional support for their work. A global survey of caregivers found that one in five reported adverse consequences to their career due to their caregiver role, most often due to missed workdays and/or absenteeism. Twelve percent had to give up their jobs entirely. Almost half of caregivers reported symptoms of depression, and over half (54%) reported being unable to manage their own healthcare.

Caregivers cite several unmet needs: lack of education about their loved one's condition or how to best serve in their own role, lack of available legal and financial resources, need for respite, and need for mental health care.¹⁹ A number of disease‐specific organizations (such as the Alzheimer's Association) and international caregiver alliances can provide education to caregivers and help caregivers identify local resources and community support.

Providers for older adults should acknowledge the critical role that caregivers play. Patients and caregivers should, in many ways, be treated as dyads: the health and well‐being of the caregiver are essential to the well‐being of the patient for whom they care. Caregivers can be screened for caregiver burden with formal instruments such as the Zarit Burden Scale.²⁰ Whenever possible, caregivers should be referred for support services and provided information to address unmet needs.