A Mixed Methods Assessment of Strain and Related Support Needs of Family Caregivers of Hospitalized Older Adults with Delirium

Background: High distress is common among delirium caregivers, yet little is known about their caregiver strain and support needs across a comprehensive spectrum including physical, financial, and spiritual domains. Purpose: The purpose of this sequential mixed methods study was to assess strain and related support needs of family caregivers of older adults with delirium. Patients and Methods: Family caregivers of older adults hospitalized with delirium were recruited from an Acute Care for Elders (ACE) Unit at an academic medical center. Semi-structured interviews were used to expand on caregiver perceptions of strain and related support needs that were initially reported in quantitative assessments. A side-by-side tabular joint display was used to display quantitative and qualitative results, then weaving was used to explain and integrate the results from both phases in narrative form. Results: An attempt to screen 380 caregiver/patient dyads resulted in 16 dyads enrolled in the study with 2 caregiver interviews. Caregivers were predominantly female (75%), in good health or better (81%), had some college or higher (82%), and half of the caregivers were White (56%). Many caregivers (69%) reported high levels of strain. Descriptively, strain scores were higher among caregivers who were female, White, and older, with no previous delirium experience, and with no delirium education. Good communication with staff, facilitation of family communication, and peer social support were emphasized as being important for their ability to cope. Conclusion: With an understanding of delirium caregiver strain and support needs, healthcare professionals are better positioned to buffer the impact of strain on family caregiver health and well-being. The findings of this study can inform future interventions to decrease delirium caregiving strain. Keywords: acute care for elders unit, caregiver burden, caregivers, delirium, hospitalization, social support