Katherine A. Ornstein (
Amy S. Kelley is an associate professor in the Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.
Health Aff (Millwood). 2017 Jul 1;36(7):1184-1192. doi: 10.1377/hlthaff.2017.0134.
To date, knowledge of the experiences of older adults' caregivers at the end of life has come from studies that were limited to specific diseases and so-called primary caregivers and that relied on the recollections of people in convenience samples. Using nationally representative, prospective data for 2011, we found that 900,000 community-dwelling Medicare beneficiaries ages sixty-five and older who died within the following twelve months received support from 2.3 million caregivers. Nearly nine in ten of these caregivers were unpaid. Compared to other caregivers, end-of-life caregivers provided nearly twice as many hours of care per week and, especially in the case of spousal caregivers, reported more care-related challenges. Yet older adults at the end of life were not significantly more likely than other older adults to receive caregiving funded by government, state, or private insurance. To meet the needs of older adults at the end of life, their unpaid caregivers must receive greater recognition and expanded access to supportive services.
迄今为止,有关老年人临终照护者体验的知识主要来自于对特定疾病和所谓主要照护者的研究,这些研究依赖于方便样本中人们的回忆。我们利用 2011 年具有全国代表性的前瞻性数据发现,在接下来的 12 个月内,有 90 万年龄在 65 岁及以上、居住在社区的医疗保险受益人死亡,他们得到了 230 万照护者的支持。这些照护者中近九成是无偿的。与其他照护者相比,临终照护者每周提供的护理时间几乎多出一倍,尤其是配偶照护者,他们报告的护理相关挑战更多。然而,临终的老年人与其他老年人相比,获得政府、州或私人保险资助的护理的可能性并没有显著增加。为了满足临终老年人的需求,他们的无偿照护者必须得到更多的认可,并扩大获得支持性服务的机会。