Examining Associations Between Caregiver Burden and Caregiver Mental Health in Three Governorates in Lebanon

Abstract

Background and Objective: There is a global aging trend and the share of older adults is expected to double by 2050. This trend will be accompanied by a higher demand for caregivers who need to be around older adults to provide emotional and physical support. Caregivers who care for older adults often face physical and mental health ailments, financial struggles and social withdrawal. The projected increase in the proportion of the elderly, accompanied by the expected increase in the demand for caregivers, emphasizes the importance of understanding the factors associated with care giver burden and care giver mental health. Studies available in Lebanon are scarce and indicate the need to further investigate burden of care and its effect on caregivers in order to provide evidence that would support development of interventions or policies for caregivers. The objective of this study is to assess caregiver burden, caregiver mental health, the association between caregiver burden and caregiver mental health and to examine this association according to gender in three governorates in Lebanon. Methods: This is based on secondary data analysis from two cross sectional studies conducted between 2013 and 2017 to assess dementia and other health issues of older adults aged 65 years and above. A multi-stage cluster sampling technique was utilized to randomly recruit participants and ensure a representative sample in both studies. The two studies have a total of 739 informants of older adults out of whom 144 took care of participants occasionally or much of the time and these were used in the analysis. Bivariate analysis was conducted using Yates-corrected Chi-square test to identify the significant correlates with caregiver burden and caregiver mental health. Also, simple and multiple binary logistic regression were used to calculate and report the unadjusted and adjusted odds ratios with their 95% confidence interval(CI). Results: 10% of the caregivers felt burden and 19% had mental health disorders. All of the caregivers who felt burden were females and non were males. Gender of the caregiver, living with the care-recipient, care-arrangement and type of care were significantly associated with caregiver burden. Burden was the only variable explaining caregiver mental health. Adjusting for care-arrangement, the odds of having mental health disorders among caregivers who felt burden was 17 times that of caregivers who felt no burden (95% CI = 4-74). No interaction with gender was shown. Conclusion: It is imperative to build targeted interventions that reduce caregiver burden and enhance the mental wellbeing of caregivers especially females while taking the Lebanese context into consideration. Further studies are warranted to look at burden of care considering a larger number of caregivers to see how different patient characteristics affect burden level.