Caregivers’ Sense of Coherence: Implications on Direct and Indirect Costs of Dementia Care

Article type: Research Article

Authors: Turró-Garriga, Oriol^{a; b; *} | Viñas-Díez, Vanesa^c | Conde-Sala, Josep Lluís^{a; c} | Calvó-Perxas, Laia^a | Cullell-Juncà, Marta^d | Mas-Vall-llosera, Glòria^d | Flaqué, Margarida^e | Turon-Estrada, Antoni^b | Juvinyà-Canal, Dolors^f | Mioshi, Eneida^g | Garre-Olmo, Josep^{a; b; h}

Affiliations: [a] Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia | [b] Registry of Dementia of Girona (ReDeGi), Institut d’Assistència Sanitària, Salt, Catalonia | [c] Faculty of Psychology, University of Barcelona, Barcelona, Catalonia | [d] Centre Socio Sanitari Bernat Jaume, Fundació Salut Empordà, Figueres, Catalonia | [e] Centre Socio Sanitari Palamós Gent Gran, Serveis Sanitaris Integrats del Baix Empordà, Palamós, Catalonia | [f] Health Promotion Chair, University of Girona, Girona, Catalonia | [g] School of Health Sciences, University of East Anglia, Norwich, United Kingdom | [h] Department of Medical Sciences, University of Girona, Girona, Catalonia

Correspondence: [*] Correspondence to: Oriol Turró-Garriga, Edifici Mancomunitat 1, Parc Hospitalari Martí i Julià, Dr. Castany s∖n 17190, Salt (Girona), Catalonia. Tel.: +34 972182600 (ext. 1831); E-mail: oriol.turro@ias.cat.

Abstract: Background:Dementia care is associated with physical, emotional, and monetary impact on the informal carers providing unpaid care. Differences in the personal characteristics of caregivers may help explain the variations in the costs of dementia care. Objective:The aim of this study was to analyze the effect of caregivers’ sense of coherence (SOC) on direct and indirect costs in dementia care. Methods:A cross-sectional study was conducted in community dwelling caregivers of patients with Alzheimer’s disease. Data of healthcare services were obtained from clinical registries, and information was collected from caregivers regarding their use of social care resources and time spent caregiving. The transformation of all costs into Euros was made assigning a fixed cost of 10.29 € /h and 16.24 € /h for assisting in instrumental and basic activities of daily living, respectively. Caregivers’ SOC was assessed using the Orientation to Life Questionnaire (OLQ-13). Adjusted regression models were developed, with different types of costs as dependent variables. Results:A sample of 147 caregivers was recruited. The mean OLQ-13 score was 73.3 points (SD = 11.6). The regression models showed a small association between caregivers’ SOC and direct costs, mainly linked to the use of social care resources (r2 = 0.429; β= –15.6 € /month), and a greater association between SOC and indirect costs (r2 = 0.562; β= –222.3 € /month). Conclusion:Increasing caregivers’ SOC could reduce dementia care costs by decreasing the use of social care resources and caregiving time.

Keywords: Alzheimer’s disease, caregiver, cost of illness, dementia, direct service cost, healthcare cost, sense of coherence

DOI: 10.3233/JAD-200350

Journal: Journal of Alzheimer's Disease, vol. 78, no. 1, pp. 117-126, 2020