a Kent School of Social Work , University of Louisville , Louisville , KY , 40292 , USA.
b School of Aging Studies, College of Behavioral and Community Sciences , University of South Florida , Tampa , FL , USA.
Aging Ment Health. 2018 Nov;22(11):1502-1509. doi: 10.1080/13607863.2017.1363869. Epub 2017 Aug 11.
Using national data on Medicare beneficiaries and their caregivers (CGs), we investigated CG and care recipient (CR) factors associated with the likelihood of remaining in the community.
We obtained data on 722 CG and CR dyads who lived in the community in 2011 from the National Study of Caregiving and the National Health Aging and Trend Study. We then used pooled data from 2011 to 2015 to track the CRs' likelihood of remaining in the community. Generalized Estimating Equation (GEE) analyses were used to assess the association between CG and CR factors and likelihood of community residence over five years.
The GEE analyses showed that the strongest CR factors predicting continued community residence include lower CR age, higher CR ADL capabilities, not having dementia, and having a heightened sense of community. CG factors predicting continued community residence included reporting no physical difficulties from caregiving, and higher positive aspects of caregiving.
In addition to widely found predictors of remaining in the community (e.g., CR age and dementia), psychosocial variables (CG positive aspects of caregiving, CR sense of community engagement) were also significant independent predictors. Interventions that emphasize not only traditional risk factors for placement, but also psychosocial factors such as promoting CG positive aspects of caregiving and strengthening CRs' linkages with their neighbors or community members deserves greater attention.
利用全国范围内的医疗保险受益人和他们的照顾者（CG）的数据，我们调查了与保持社区居住相关的 CG 和照顾接受者（CR）因素。
我们从国家照顾研究和国家健康老龄化趋势研究中获取了 2011 年居住在社区的 722 对 CG 和 CR 二人组的数据。然后，我们使用 2011 年至 2015 年的汇总数据来追踪 CR 留在社区的可能性。使用广义估计方程（GEE）分析来评估 CG 和 CR 因素与五年内社区居住可能性之间的关联。
GEE 分析表明，预测持续社区居住的最强 CR 因素包括 CR 年龄较低、CR 日常生活活动能力较高、没有痴呆症和社区参与感较强。预测继续社区居住的 CG 因素包括报告没有照顾带来的身体困难，以及更高的照顾积极方面。
除了广泛发现的保持社区居住的预测因素（例如，CR 年龄和痴呆症）外，心理社会变量（CG 照顾的积极方面，CR 与邻居或社区成员的联系感）也是重要的独立预测因素。干预措施不仅应强调传统的安置风险因素，还应强调促进 CG 照顾的积极方面和增强 CR 与邻居或社区成员的联系等心理社会因素，值得更多关注。
