Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking

• Published in: International psychogeriatrics 2012-11, Vol.24 (11), p.1836-1845
• Main Authors: Werner, Shirli, Auslander, Gail K., Shoval, Noam, Gitlitz, Tamar, Landau, Ruth, Heinik, Jeremia
• Format: Article
• Language: English
• Subjects: Activities of Daily Living - psychology; Adult; Aged; Aged, 80 and over; Behavior; Biological and medical sciences; Caregivers; Caregivers - psychology; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognition Disorders - psychology; Cognitive ability; Cognitive Impairment; Dementia; Dementia - complications; Dementia - diagnosis; Dementia - physiopathology; Dementia - psychology; Dependent Ambulation - psychology; Female; Geographic Information Systems; Geriatric Assessment - methods; Geriatrics; Global positioning systems; GPS; Hebrew language; Humans; Interview, Psychological; Male; Medical sciences; Mental Competency; Middle Aged; Mobility; Mobility Limitation; Older people; Outcome and Process Assessment (Health Care); Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Transportation of Patients - methods
• ISSN: 1041-6102; 1741-203X
• DOI: 10.1017/S1041610212001135

Background: Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology. Methods: Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden. Results: The strongest predictors of burden were care-recipients’ lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients’ behavioral and emotional states were also positively related to caregiver burden. Conclusions: The findings stress the importance of maintaining older persons’ out-of-home mobility during cognitive decline.