A Canadian study has found that caregivers of ICU survivors experience symptoms of depression up to 1 year after their relative is discharged (Cameron et al. 2016). Factors associated with worse mental health symptoms included younger age and less social support and sense of control over life. Older caregivers caring for a spouse, with a higher income and better social support and sense of control had better health outcomes. No patient variables were consistently associated with caregiver outcomes over time.
In an email to ICU Management & Practice, lead author Jill Cameron, PhD, Affiliate Scientist at Toronto RehabilitationInstitute-University Health Network (UHN) and Associate Professor, Department of Occupational Science and Occupational Therapy, Graduate Department of Rehabilitation Science, Faculty of Medicine, University of Toronto, explained that the study is one of the first to take a comprehensive look at caregiver outcomes. The research team enrolled 280 caregivers of patients in 10 hospitals across Canada, who received 7 days or more of mechanical ventilation in an ICU.
“We simultaneously examined patient illness severity, aspects of the caregiving situation (e.g. amount of care provided, impact on everyday life of providing care), and aspects of the caregiver (e.g. their social support network, their ability to maintain control over situations). When you consider all factors at the same time, the most important seem to be those related to the caregiving situation and the caregiver. This suggests that even in situations where the illness is fairly mild, and the disability is low, caregivers without adequate supports, or who don't have good control over their situation may experience depression and need help”, said Cameron.
- Caregivers’ average age: 53
- Gender: 70% female
- Role: 61% caring for a spouse
- Depression symptoms:
- 67% at 7 days
- 43% at 1 year
- Improvement in depression symptoms: 84%
The next phase will focus on developing models of rehabilitation for patient recovery and a programme for caregivers to better prepare. Dr. Cameron said that many interventions have been developed and tested for different caregiving populations. She added: “We may be able to identify those caregivers most in need of support and target them for specific support. This would allow the healthcare system to make the best use of available resources and still meet the needs of those caregivers who need more support.”