September 10, 2021 – Results of a study published this week in the Journal of Gerontological Nursing examining the association of patient factors, patient/caregiver relationships and living arrangements with caregiver burden due to delirium.

The sample included a subset of older hospitalized adults (>70 years) who experienced delirium  from the Better Assessment of Illness (BASIL) Study. Results indicate that impairment of the activity of daily living (ADL) related to impaired mobility and requiring assistance was transfer was significantly associated with higher caregiver burden scores. Additionally, adult children, siblings and other relatives living with or apart from the patient reported significantly higher caregiver burden compared to spouse/partners indicating caregiver relationship and living arrangement are associated with caregiver burden after delirium.

“Our study has begun to reveal the complicated nature of the relationship between the family caregiver/care recipient dyad and highlights the need for policy support and development of additional resources to enable family caregiving and speed patient recovery.”
Patricia A. Tabloski, Ph.D., GNP-BC, FGSA, FAAN
Patricia Tabloski

Patricia Tabloski, Ph.D., GNP-BC, FAAN

Patricia Tabloski, Ph.D., GNP-BC, FAAN, Associate Professor, Boston College School of Nursing and Franchesca Arias, PhD., Associate Scientist, Aging Brain Center, Hebrew SeniorLife are co-first authors. Sharon K Inouye, M.D.,M.P.H. director of the Aging Brain Center in the Marcus Institute and Professor of Medicine, Harvard Medical School, is principal investigator and senior author of the study. 

Delirium is a common, serious clinical problem for older adults, often occurring as a complication of surgery.  The sudden onset of delirium symptoms and its overall negative effect on healing and recovery can serve as a source of stress on family caregivers resulting in feelings of burden. 

Nurses, physicians and many members of the healthcare team all have expressed interest in developing skills and mechanisms to ease feelings of caregiver burden and improve the quality of care offered to older adults and their families after an episode of delirium. 

A total of 352 patients were enrolled in the BASIL study between October 20, 2015 and March 15, 2017. Patients older than 70 years, who were: English speaking, admitted or transferred as either emergency or elective admissions, and residing within 40 miles of a large medical center in Boston were eligible. Exclusion criteria included legal blindness or severe deafness impairment, active alcohol abuse, alcohol withdrawal within the last 6 months, diagnosis of schizophrenia or active psychosis, and those with immediate discharge plans or imminent death. This analysis included patient/caregiver dyads enrolled in the BASIL study with patients assessed daily during hospitalization and caregivers completing the DEL-B caregiver burden scale (DEL-B-C) one month after hospital discharge. Of the 352 patients enrolled in BASIL, a subset of 207 dyads were included with 214 caregivers completing the DEL-B-C within 1 month of hospitalization.  

“Our study has begun to reveal the complicated nature of the relationship between the family caregiver/care recipient dyad and highlights the need for policy support and development of additional resources to enable family caregiving and speed patient recovery,” said Dr. Tabloski. “Our study is one of many that we hope will aid older patients and their families to better manage the sometimes devastating after-effects of an episode of delirium,” said Dr. Inouye.   

Collaborating institutions of the study included Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, Brown University and Binghamton University. 

The study was supported in part by grants from the National Institute on Aging; grant no. P01AG031720, R24AG05429, and RO1AG044518.

About Boston College School of Nursing

The mission of the Boston College William F. Connell School of Nursing is to prepare compassionate, professionally competent nurses whose practice and scholarship are scientifically based and grounded in humanizing the experience of health and illness. In keeping with the University's Jesuit, Catholic ideals, we focus on formation of the whole person and promotion of social justice. The William F. Connell School of Nursing educates students as reflective lifelong learners who use knowledge in service to others. The faculty develops and disseminates knowledge for the advancement of professional nursing practice and the improvement of health and health care for a diverse and global society.

About the Hinda and Arthur Marcus Institute for Aging Research

Scientists at the Hind and Arthur Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age.  The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-marking.

About Hebrew SeniorLife

Hebrew SeniorLife, an  affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging.  Based in Boston, the nonprofit organization has provided communities and health care for seniors, research into aging, and education for geriatric care providers since 1903.  For more information about Hebrew SeniorLife, visit https://hebrewseniorlife.org.

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