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Our observational research, published in the Journal of Applied Gerontology, demonstrates a meaningful connection between home-based caregiving and longer lives for homebound older adults.
The U.S. population is aging. In fact, the number of people older than 65 is expected to reach 78.3 million around 2040, according to the U.S. Department of Health and Human Services. For perspective, just 35 million Americans were older than 65 in 2000.
According to the results of our pilot study, homebound adults over the age of 85 who receive support from a caregiver may live longer—a significant and exciting finding that’s prompting a deeper dive into caregiving research.
For older adults at home, caregivers provide crucial daily support, functioning as the eyes and ears of a doctor. Their daily engagement with a homebound person helps ensure:
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Developing illnesses are noticed early
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Medical emergencies are treated promptly
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Medications are taken appropriately
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The home environment remains safe and free from trip hazards
Home-based care has a significant association with survival.
Our observational pilot study found that the presence of a caregiver, whether a family member or a personal care aide, or both, was associated with a lower risk of death.
In our study, we explored the association between caregiving and mortality among patients enrolled in home-based care. Patient records were grouped into four categories: having a family caregiver, a personal care aide, both a family caregiver and a personal care aide, or no caregiver.
After statistical analysis, we found that patients in all the groups with caregivers had a lower risk of death. In fact, the risk of death was lowered by two-thirds for homebound older adults who received regular caregiving support.
This work helps us better understand the importance of caregiving and points the way toward other avenues of research to improve the quality of life for an aging population.
Distinguishing family caregivers from personal care aides.
In the field of geriatrics, we often think of home-based caregivers in terms of paid medical professionals (personal care aides) and unpaid family or friends (family caregivers) with no formal medical training.
The family caregiving role can be intense, especially for individuals with no prior career background in healthcare. They assist their homebound loved one with activities of daily living (ADLs) that can include:
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Administering and managing medications to be sure their loved one is taking the correct dose at the right time
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Bathing
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Dressing
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Toileting
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Transferring from bed to a chair and vice versa
A personal care aide is a caregiver with professional training who is paid to provide home-based care services, such as those mentioned above. However, there are some restrictions on what an aide may be able to do, such as direct wound care or dispensing food through a feeding tube. These types of needs are often met by family caregivers who are not subject to the same level of training and oversight.
Determining whether a family caregiver or a personal care aide is the right choice for in-home care depends on several factors, including personal finances and the availability of family or friends to provide support. Your medical provider can discuss options tailored to your specific circumstances with you.
Related reading: MedStar Health Chosen by CMS to Implement New “GUIDE Model” for Supporting Dementia Patients and Caregivers.
More caregiving research is still to come.
This early research has prompted more exploration into caregiving outcomes. Our next study will examine qualitative data to define homebound status better and understand the nuances of caregiving, including the hours of care and the barriers caregivers may encounter.
These results may help us better understand specific needs surrounding home-based care, which could potentially lead to more supportive services for patients.
At the end of the day, the results of our observational research validate what clinicians have long observed: Home-based caregivers of any type are essential in the lives and health of older people.
