Friday, 14 January 2005 - 8:00 AM

This presentation is part of: Family Caregiving

The Development of a Family Caregiver Assessment Instrument to Guide Clinical Practice

Purpose: This paper will report findings from the first phase of a program of research undertaken to develop an efficient assessment instrument that can be used by social workers to assess the needs of family caregivers and guide the effective delivery of support services to families caring for elderly members. The implementation of the National Family Caregiver Support Program (NFCSP) by the Administration on Aging has fostered the use of social workers as care managers to support family caregivers. However, many social workers who assume these new care manager positions have little knowledge or experience working with family caregivers. Historically, the focus of service agencies has been on the frail and disabled older persons rather than the family caregiver. Equally problematic few state or local agencies have developed assessment instruments that have been shown to be valid and reliable measures of caregiver needs. Nor have scores or data from these assessment tools been linked to critical outcomes such as depression, quality of care, abuse, or nursing home placement. To address this critical need, a multi-phase research program has been undertaken by the investigators working collaboratively with state and local service agencies to develop and test an assessment instrument that includes a three factor measure of caregiver burden (Montgomery & Borgatta, 2000) as a key component.

Methods: The initial project included secondary analysis of three large culturally diverse national data sets that include data from over 7,000 family caregivers and analysis of primary data from over 400 caregivers served through the NFCSP in the state of Georgia. The initial analyses included the assessment of the psychometric properties of the Montgomery-Borgatta Burden Measure and tests for invariance across populations as defined by race and familial relationship. Additionally, regression analyses were conducted to determine the relationship between the three burden measures and variables that define unique care contexts such as familial relationship, functional status, type of disease and, length of caregiving.

Results: The findings indicate that three factors consistently emerge from the burden measure and these factors identify three types of caregiver stress that are related but unique. Also the analyses indicate that the measures are reliable, sensitive to change and invariant across groups. The findings also indicate that the three factors have different sets of predictors and that these predictors vary across care contexts.

Implications for Practice: The results from this study indicate that the burden measures are potentially useful as a clinical tool for guiding social work practice with family caregivers. When working with family caregivers it is important for the provider to know exactly which type of burden or stress is most salient at a given point in time. It is clinically useful to distinguish between the different types of burden so that specific interventions may be tailored to meet individual caregiver needs. Interventions that are most appropriate to address one type of burden may not be useful to address a different type of burden. This knowledge should help providers identify appropriate support strategies.

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