Reduced caregiver overload after supervised training in pluripathological and palliative elderly
Abstract
Objective. To know the relationship between the level of independence of a group of chronic-pluripatological and palliative elders (ACP-P) and the overload of their caregivers, after a multicomponent training program adapted to the home environment.
Design. Mixed, quantitative and quasi-experimental design, with repeated measures in the training factor, and two grouping factors: age (70-79 and ≥80 years) and the ambulation level of the ACP-P (walk / don't walk).
Location. Intervention carried out in the Home Hospitalization Unit (HHU) of the General Hospital of Alicante, during 2014-2016.
Participants. 17 ACP-P patients [81.6 years (SD5.6)].
Intervention. 3 weekly sessions for 26 weeks of the EFAM-UVH© multicomponent training program (functional + cognitive); 3 phases, progressively reducing the presence of the coach to promote autonomy (28 supervised and 20 autonomous sessions in total).
Main measurements. Evaluation of caregiver overload (Zarit) and level of independence (Barthel Index “BI”) of the ACP-P, supported by physiological and functional indicators.
Results. BI improved with supervised training (p <0.05), and remained or fell slightly, although not significantly, when increasing the autonomy. These improvements were accompanied by a reduction in the overload of the caregiver, with a similar dynamic, mainly in the caregivers of the group <79 years and those who do not walk. No relationship was found between IB and Zarit, but the deltas of both variables were associated in the supervised phases (r = -0.596, p = 0.015), reflecting the impact of physical exercise.
Conclusions. Multicomponent exercise training at the HHU helps to contain the caregiver's overload, reduced concomitantly to the increased of independence of the trained ACP-P. This indirect benefit maximizes the need of multidisciplinary teams, and early and supervised physical exercise training programs.
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References
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