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Mature Focus: Feb. 12

Caregivers lacking care

Millions of Americans who regularly care for loved ones may be neglecting their own care, a recent study found. [Adobestock photo]

More than 43 million adults in the U.S. now act as regular caregivers for family members, friends and loved ones each year, according to data from the National Alliance for Caregiving and the AARP.  Yet millions of people who provide care to others may be neglecting their own care, mainly by not having health insurance or by putting off needed health services due to cost, according to the American Psychological Association [APA]. 

A recent APA study analyzed information from more than 24,000 participants in a U.S. Centers for Disease Control and Prevention [CDC] annual survey. The study focused solely on people who provided unpaid care to family and friends, rather than professional caregivers. The majority of them provided care for up to eight hours a week, typically doing household tasks such as cleaning, managing money or preparing meals.

The analysis found that, compared to those without caregiving responsibilities, caregivers had a 26% greater chance of having no health insurance coverage. They were at a much higher risk [59%] of not seeing a doctor or getting other necessary healthcare. One-fourth of the caregivers also reported that they had been diagnosed with a depressive disorder at some point – a 36% increased risk over non-caregivers.

“Caregivers provide tremendous benefits for their loved ones, yet they may be at risk for lacking access to needed services, which puts their health in jeopardy,” said Jacob Bentley, Ph.D., of Seattle Pacific University, the study’s co-author. Bentley said he believes caregivers may face financial hardships because their duties make them unable to seek employment outside of the home. Many cannot move forward in their careers due to their need for flexible schedules, he added.

Bentley noted the enormous economic benefit that informal caregivers provide in America today, valuing their services at more than $600 billion. But with more and more people taking on caregiving roles, the obstacles they face will likely grow. “Despite the economic benefits for society and valuable assistance provided to care recipients, attention must also be given to caregivers’ own financial, physical and emotional challenges,” he said. 

The value of “prehab”

An inexpensive program to help surgery patients get ready for their upcoming operations may get them home faster afterward and reduce their overall costs too, according to new research involving 21 hospitals across Michigan.

Prehabilitation, also known as “prehab,” involves preparing patients both physically and mentally for a planned surgery. The program encourages patients to move more, eat healthier, cut back on tobacco, breathe more deeply, reduce their stress and establish specific goals for recovery after their operations.

The recent study focused on more than 500 patients at high risk of complications after surgery due to underlying health conditions. The participants’ median age was 70. All of them, as well as a control group of more than 1,000 similar patients who did not receive prehab, underwent one of 26 common surgeries.

The study found that on average, patients who participated in several weeks of prehab prior to surgery left the hospital one day earlier than patients who did not. More of them also were able to bypass skilled nursing facilities and go straight home after surgery, compared with similar patients treated at the same hospital. Total costs for all care up to three months after surgery also averaged nearly $3,200 less per prehab patient.

“We now recognize that prehab’s physical training may work partly because it empowers the patient to engage in their own recovery,” said Michael Englesbe, M.D., a University of Michigan professor of surgery and director of the Michigan Surgical Quality Collaborative. “Patient empowerment is the ‘secret sauce’ and we hope to harness it even more.”

Englesbe and his team urged that more hospitals adopt prehab for their surgery candidates in a paper they recently published in Annals of Surgery.

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