Emergency department visits are higher among patients whose family caregivers felt sad or fatigued.
Tired family caregivers are associated with more ED visits and higher overall healthcare costs for the person they care for finds a new University of Michigan study published in Journal of the American Geriatrics Society.
Researchers studied 3,101 couples over the age of 65, each with one spouse acting as caregiver for their disabled partner. They looked at Medicare payments and ED visits for the disabled spouses in the six months after the caregiver spouses took standard tests to measure their fatigue, mood, sleep habits, health and happiness.
In those six months, ED visits were 23% higher among patients whose caregivers scored high for fatigue or low on their own health status. Over the same time frame, patients with fatigued or sad caregivers had higher Medicare costs—$1,900 more if the caregiver scored high for fatigue, and $1,300 more if the caregiver scored high for sadness.
“Informal caregivers, including spouses, enable older adults with functional disability to stay out of the nursing home and live at home where they’d prefer to be,” says senior author Deborah Levine, MD, MPH, an assistant professor of internal medicine and neurology at University of Michigan. “Our findings suggest that we need to do a better job of identifying and supporting caregivers experiencing distress, in order to help caregivers feel better and hopefully improve outcomes in older adults with disability.”
Respite Support Needed
Nearly 15 million older adults receive help with activities of daily living from spouses and other family or friend caregivers, but Medicare does not pay for or offer formal respite coverage for family or friends who regularly care for older adults.
Given the increased use of healthcare resources when caregivers are unsupported, it may make financial sense to change this policy.
“I definitely think there are specific services that could help caregivers, if we can identify those people who are highest risk and provide a basic level of support such as an around-the-clock geriatric care call line that could help caregivers feel less isolated and talk to a nurse about whether, for example, to go to the emergency department,” says lead author Claire Ankuda, MD, MPH. “This is a high-cost, vulnerable population.”
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.