Stressed Caregivers, Higher Health Care Costs: Studying the ‘Pop Drop’ Phenomenon

Although it’s difficult to find hard data about the phenomenon, a new University of Michigan study suggests that tired family caregivers are associated with more frequent ER visits and higher health care costs for the patient. In a paper in the Journal of the American Geriatrics Society, U-M researchers report their findings from a study of 3,101 couples ages 65 and older with one spouse acting as caregiver for his or her disabled partner. Caregiver spouses took standard tests to measure their fatigue, mood, sleep habits, health and happiness. Over the next six months, researchers looked at the Medicare payments and emergency department visits for the disabled spouses. During that stretch, emergency department visits were 23 percent higher among patients whose caregivers had scored high for fatigue or low on their own health status — even after accounting for many other factors about the patients.

“Many of us who work in clinical settings feel that patients with high home caregiving needs, such as dementia, often rely on the medical system as a source of respite for their spouses or other caregivers, because other respite isn’t paid for,” says lead author Claire Ankuda, M.D., MPH. “But there hasn’t been a lot of data about it, and only recently has our society been talking about caregivers and potential ways to incentivize and support them as a way of keeping patients living at home.”

“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, M.D., MPH, an assistant professor of internal medicine and neurology at U-M. “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.”

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