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Abstract: TH-PO778

Informal Caregiving Networks of Older Adults With Dementia Superimposed on ESRD: A Social Network Study

Session Information

Category: Geriatric Nephrology

  • 1200 Geriatric Nephrology

Authors

  • Song, Mi-Kyung, Emory University, Atlanta, Georgia, United States
  • Paul, Sudeshna, Emory University, Atlanta, Georgia, United States
  • Happ, Mary Beth, The Ohio State University, Columbus, Ohio, United States
  • Lea, Janice P., Emory University, Atlanta, Georgia, United States
  • Turberville-Trujillo, Linda, Emory University, Atlanta, Georgia, United States
  • Pirkle, James L., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
Background

It is common for older adults with ESRD to have multiple caregivers to provide instrumental help and care-related decision making. Yet, most caregiving research has been focused on the primary caregivers. This study was to characterize informal/unpaid caregiving networks of older adults with moderate to severe cognitive impairment superimposed on ESRD and their associations with caregiver and older adult health outcomes.

Methods

We conducted an egocentric social network study to obtain caregiving information of 46 older adults on hemodialysis with cognitive impairment. Starting with the primary family caregiver (FCG), up to 2 additional FCGs were recruited for each patient, totaling 76 FCGs (46 primary, 30 non-primary). FCGs completed a social network survey and measures of caregiving burden and reward, financial hardship, and depressive symptoms. We abstracted information about patient’s ED visits and hospital admissions during the past 12 months from the medical records.

Results

Most patients were Black (n=35, 77.8%), 22 (47.8%) were male. The mean age was 73.9 years. Most FCGs were a child of the patient (n=39, 51.3%) and female (n=57, 75%), and had a mean age of 54.2 years. Of the 46 networks, 16 (35%) included only one FCG (singletons). Multimember networks (n=30, 65%) provided longer caregiving than singletons (7.7 vs 3.8 years, p=0.008). The average network size was 3.8. The density (overall member connection) was 0.9, and mean degree and maximum degree (number of ties per member to other network members) were 2.5 and 2.8, respectively. Among the caregiver outcomes, the primary FCG’s financial hardship decreased as the network density increased but at the expense of increased non-primary FCGs’ financial hardship (p<0.001). For every one unit increase in mean and maximum degrees, the odds of no hospital admission increased by 3.7 (p=0.03) and 3.6 folds (p=0.04), respectively.

Conclusion

Our study using a social network approach revealed the scope and potential impact of informal caregiving networks of older adults with ESRD and dementia. Our findings may have significant implications for future intervention development and implementation strategies targeting ESRD population and caregivers but need to be confirmed in a larger, longitudinal study.

Funding

  • Other NIH Support