Few family caregivers get formal training

Less than one in 10 family caregivers receive training for assisting older adults with disabilities, a U.S. study suggests.

Nearly 18 million family caregivers provide help with daily tasks and manage medical needs for older Americans with disabilities, researchers note in JAMA Internal Medicine. An emerging body of research suggests that education and training can benefit these caregivers and their care recipients, but little is known about what factors might influence whether caregivers receive any training.

For the current study, researchers examined survey data from 1,861 family caregivers of 1,230 adults aged 65 and older who had insurance through Medicare, the U.S. health insurance program for the elderly and disabled. Overall, just 7.3 percent of the caregivers received any training.

“This matters because family caregivers often report feeling unprepared for their caregiving role,” said lead study author Julia Burgdorf, a researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

“Prior research suggests that training caregivers reduces their stress and improves health outcomes for the older adults they are caring for,” Burgdorf said by email.

Many family caregivers spend several hours a day helping spouses, parents, partners and other loved ones. In addition to aiding with daily tasks like bathing, dressing and eating, family caregivers often provide complicated care such as giving injections, operating medical equipment and wound care.

Compared to adult children living with and caring for older parents, spouses were twice as likely to receive some training, the new study found.

And, compared to unpaid family caregivers, those who received some pay for this work were more than four times more likely to get education and training.

Older adults who had been hospitalized in the past year were twice as likely to have paid family caregivers compared to older adults who were not hospitalized, researchers found.

Caregivers who reported “some” or “a lot” of burden from providing this help were 73 percent more likely to get training than family caregivers who reported no burden at all.

And compared to caregivers who only helped with household chores, those who assisted with self-care like eating, dressing, bathing and toileting were 86 percent more likely to get training.

Family caregivers who helped with health tasks like managing medications, wound care, blood testing, or injections were 64 percent more likely to get training than their counterparts who just helped with household chores.

The study wasn’t designed to prove whether education or training might directly improve outcomes for caregivers or for their adult charges. It also wasn’t designed to assess what type of education might be most beneficial, or which caregivers might need the most training to assist loved ones at home.

Still, the results highlight a missed opportunity to improve patient care, said the coauthor of an accompanying editorial, Dr. Karina Berg of the University of Connecticut School of Medicine in Farmington.

“Caregivers are an invaluable resource for our healthcare system, saving millions of dollars every year, yet funding for caregiver training programs is very limited,” Berg said by email.

“Family caregiving is often overlooked and many caregivers suffer from isolation,” Berg added. “Caregivers should know that opportunities for training do exist and that if they don’t get the training they need from a healthcare provider, they can ask for referral to a social worker, nurse navigator or home care agency.”

SOURCE: and JAMA Internal Medicine, online April 8, 2019.