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Care-Receiver and Caregiver Assessments of Functioning: Are There Gender Differences?*

Published online by Cambridge University Press:  31 March 2010

Julie C. Shaver  and
Diane E. Allan
Julie C. Shaver*
Affiliation:
Centre on Aging, University of Victoria
Diane E. Allan
Affiliation:
Centre on Aging, University of Victoria
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Julie C. Shaver or Diane E. Allan, Centre on Aging, Sedgewick Building, Room A104, University of Victoria, PO Box 1700, Station CSC, Victoria, BC V8W 2Y2. (jshaver@uvic.ca)
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Abstract

In situations where care-receivers cannot respond to questions about their functional status, caregiver proxies are often substituted. Yet studies addressing caregiver-care-receiver agreement remain limited in scope, focusing primarily on cognitive functioning and caregiver relationship. This study broadens the range of research in this area by examining caregiver and care-receiver reports of individual IADL and AADL items by gender of care-receiver. As well, the degree to which the care-receiver's age and mental and physical health status influence agreement are investigated. Data for this study come from a sample of 388 Manitoba older adults aged 65 and over. Results (using Cohen's kappa) suggest less agreement on the presence of disability for men than for women, particularly among those aged 75–84. Differences by health status were also revealed. The implications of the findings for assessments of functioning are considered.

Résumé

Lorsque les prestataires de soins ne sont pas en mesure de répondre aux questions relatives à leurs capacités fonctionnelles, les fournisseurs de soins sont souvent amenés à se substituer à eux. Cependant, les études portant sur les ententes entre les fournisseurs et les prestataires de soins demeurent d'une portée relativement restreinte, mettant surtout l'accent sur les fonctions cognitives ainsi que la relation avec le fournisseur de soins. Cette étude vise à élargir la portée des recherches dans ce domaine par l'étude des comptes rendus effectués par les fournisseurs et les prestataires de soins à l'égard des diverses activités de la vie quotidienne (AVQ) et des activités instrumentales de la vie quotidienne (AIVQ), en fonction du sexe du prestataire de soins. En outre, la recherche étudie l'étendue de l'influence de l'âge du prestataire et de son état de santé mentale et physique sur les ententes. Les donnés pour cette étude proviennent d'un échantillon de 388 Manitobains âgés de 65 ans et plus. Les résultats (fondés sur le facteur kappa de Cohen) révélent que les ententes sont moins fréquentes, en ce qui a trait à l'existence d'une incapacité, chez les hommes que chez les femmes, en particulier chez les personnes ãgées de 75 à 84 ans. Les différences selon l'état de santé sont également indiquées. L'incidence des résultats sur l'évaluation du fonctionnement est abordée.

Keywords

care-receiverscaregiversphysical functioninggender differencesagingprestataires de soinsfournisseurs de soinsfonctions physiquesdifférences selon le sexe
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 24 , Issue 2 , Summer/Été 2005 , pp. 139 - 150
Copyright
Copyright © Canadian Association on Gerontology 2005

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Footnotes

*

The production of this paper was partially supported by a Michael Smith Foundation for Health Research Unit Infrastructure grant – Centre on Aging, University of Victoria. The data reported here were collected as part of the Manitoba Study of Health and Aging. This project was funded by Manitoba Health. The authors would also like to thank Neena Chappell for her comments.

References

Andresen, E.M., Vahle, V.J., & Lollar, D. (2001). Proxy reliability: Health-related quality of life (HRQoL) measures for people with disability. Quality of Life Research, 10(7), 609–619.CrossRefGoogle ScholarPubMed
Canadian Study of Health and Aging Working Group. (1994). Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150(6), 899–913.Google Scholar
Christensen, H., Jorm, A.F., Henderson, A.S., MacKinnon, A.J., Korten, A.E., & Scott, L.R. (1994). The relationship between health and cognitive functioning in a sample of elderly people in the community. Age and Ageing, 23, 204–212.CrossRefGoogle Scholar
Clipp, E.C., & Elder, G.H. (1987). Elderly confidants in geriatric assessment. Comprehensive Gerontology Section B: Behavioural, Social, and Applied Sciences, 1(1), 35–40.Google ScholarPubMed
Cohen, J. (1968). Weighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit. Psychological Bulletin, 70(4), 213–220.CrossRefGoogle ScholarPubMed
Dorman, P.J., Waddell, F., Slattery, J., Dennis, M., & Sandercock, P. (1997). Are proxy assessments of health status after stroke with the EuroQol questionnaire feasible, accurate, and unbiased? Stroke, 28, 1883–1887.Google ScholarPubMed
Duncan, P.W., Min Lai, S., Tyler, D., Perera, S., Reker, D.M., & Studenski, S. (2002). Evaluation of proxy responses to the Stroke Impact Scale. Stroke, 33, 2593–2599.CrossRefGoogle Scholar
Elam, J.T., Graney, M.J., Beaver, T., ElDerwi, D., Applegate, W.B., & Miller, S.T. (1991). Comparison of subjective ratings of function with observed functional ability of frail older persons. American Journal of Public Health, 81(9), 1127–1130.CrossRefGoogle ScholarPubMed
Ellis, B.H., Bannister, W.M., Cox, J.K., Fowler, B.M., Shannon, E.D., Drachman, D., Adams, R.W., & Giordano, L.A. (2003). Utilization of the Propensity Score method: An exploratory comparison of the proxy-completed to self-completed responses in the Medicare Health Outcomes Survey. Health and Quality of Life Outcomes, 1(47). Retrieved March 23, 2005, from http://www.hqlo.com/content/1/1/47.CrossRefGoogle ScholarPubMed
Epstein, A.M., Hall, J.A., Tognetti, J., Son, L.H., & Conant, L. (1989). Using proxies to evaluate quality of life: Can they provide valid information about patients' health status and satisfaction with medical care? Medical Care, 27(3), S91–S98.Google ScholarPubMed
Fleiss, J.L. (1973). Statistical methods for rates and proportions. New York: Wiley.Google Scholar
Karagiozis, H., Gray, S., Sacco, J., Shapiro, M., & Kawas, C. (1998). The direct assessment of functional abilities (DAFA): A comparison to an indirect measure of instrumental activities of daily living. Gerontologist, 38(1), 113–121.CrossRefGoogle Scholar
Kiyak, H.A., Teri, L., & Borson, S. (1994). Physical and functional health assessment in normal aging and in Alzheimer's disease: Self-reports vs. family reports. Gerontologist, 34(3), 324–330.CrossRefGoogle ScholarPubMed
Long, K., Sudha, S., & Mutran, E.J. (1998). Elder-proxy agreement concerning the functional status and medical history of the older person: The impact of caregiver burden and depressive Symptomatology. Journal of the American Geriatrics Society, 46(9), 1103–1111.CrossRefGoogle ScholarPubMed
Magaziner, J. (1992). The use of proxy respondents in health studies of the aged. In Wallace, R.B. & Woolson, R.F. (Eds.), The epidemiologic study of the elderly (pp. 120–129). New York: Oxford University Press.Google Scholar
Magaziner, J. (1997). Use of proxies to measure health and functional outcomes in effectiveness research in persons with Alzheimer disease and related disorders. Alzheimer Disease and Associated Disorders, 11(6), 168–174.Google ScholarPubMed
Magaziner, J., Bassett, S., Hebel, J.R., & Gruber-Baldini, A. (1996). Use of proxies to measure health and functional status in epidemiologic studies of community-dwelling women aged 65 years and older. American Journal of Epidemiology, 143(3), 283–292.CrossRefGoogle ScholarPubMed
Medical Research Council Cognitive Function and Ageing Study. (2000a). Survey into health problems of elderly people: A comparison of self-report with proxy information. International Journal of Epidemiology, 29, 684–697.CrossRefGoogle Scholar
Medical Research Council Cognitive Function and Ageing Study. (2000b). Survey into health problems of elderly people: Multivariate analysis of concordance between self-report and proxy information. International Journal of Epidemiology, 29, 698–703.CrossRefGoogle Scholar
Neumann, P.J., Araki, S.S., & Gutterman, E.M. (2000). The use of proxy respondents in studies of older adults: Lessons, challenges, and opportunities. Journal of the American Geriatrics Society, 48(12), 1646–1654.CrossRefGoogle ScholarPubMed
Ostbye, T., Tyas, S., McDowell, I., & Koval, J. (1997). Reported activities of daily living: Agreement between elderly subjects with and without dementia and their caregivers. Age and Ageing, 26, 99–106.CrossRefGoogle ScholarPubMed
Radloff, L.S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Rothman, M.L., Hedrick, S.C., Bulcroft, K.A., Hickam, D.H., & Rubenstein, L.Z. (1991). The validity of proxy-generated scores as measures of patient health status. Medical Care, 29(2), 115–124.CrossRefGoogle ScholarPubMed
Rubenstein, L.Z., Schairer, C., Wieland, G.D., & Kane, R. (1984). Systematic biases in functional status assessment of elderly adults: Effects of different data sources. Journal of Gerontology, 39(6), 686–691.CrossRefGoogle ScholarPubMed
Santos-Eggimann, B., Zobel, F., & Bérod, A.C. (1999). Functional status of elderly home care users: Do subjects, informal and professional caregivers agree? Journal of Clinical Epidemiology, 52(3), 181–186.Google Scholar
Shaw, C., McColl, E., & Bond, S. (2001). Functional abilities and continence: The use of proxy respondents in research involving older people. Quality of Life Research, 9(10), 1117–1126.CrossRefGoogle Scholar
Teng, E.I., & Chiu, H.C. (1987). The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry, 48(8), 314–318.Google ScholarPubMed
Uriel, P., Wood-Dauphinee, S., Korner-Bitensky, N., Gayton, D., & Hanley, J. (1998). Proxy use of the Canadian SF-36 in rating health status of the disabled elderly. Journal of Clinical Epidemiology, 51(11), 983–990.Google Scholar
Verbrugge, L.M. (1989). Gender, aging, and health. In Markides, K.S. (Ed.), Aging and health: Perspectives on gender, race, ethnicity and class (pp. 23–78). Newbury Park: Sage.Google Scholar
Wilcox, V.L., Kasl, S.V., & Idler, E.L. (1996). Self-rated health and physical disability in elderly survivors of a major medical event. Journals of Gerontology: Social Sciences, 51B(2), S96–S104.CrossRefGoogle Scholar
Wolinsky, F.D., Callahan, C.M., Fitzgerald, J.F., & Johnson, R.J. (1993). Changes in functional status and the risks of subsequent nursing home placement and death. Journals of Gerontology: Social Sciences, 48(3), S94–S101.Google ScholarPubMed
Yip, J.Y., Wilber, K.H., Myrtle, R.C., & Grazman, D.N. (2001). Comparison of older adult subjects and proxy responses on the SF-36 health-related quality of life instrument. Aging and Mental Health, 5(2), 136–142.CrossRefGoogle ScholarPubMed