Unique Challenges for Family Members of Patients with Acute and Chronic Critical Illness: The Older Caregiver

Abstract

Informal caregivers are the primary source of long-term care in the United States, and their numbers are only expected to rise. With the changing demographics, there will be an increase in the numbers of older intensive care unit (ICU) patients and survivors, and subsequently the number of caregivers over the age of 65 years will also rise. Evidence continues to emerge that caregivers of individuals with acute and chronic critical illness may be at increased risk for adverse outcomes. In the acute ICU setting, family and caregivers commonly experience symptoms of anxiety and depression that may persist after ICU discharge. In long-term caregivers of individuals with chronic critical illness, psychiatric symptoms frequently persist, with further increased risks for poor physical health outcomes, loneliness and social isolation, and financial strain. Older caregivers are understudied and may face unique challenges and increased risk for adverse outcomes. They are more likely to be the primary caregiver, work more hours, be unemployed, and have poor personal health. These personal factors may negatively impact their roles as caregivers in the acute ICU and long-term outpatient settings. Research into caregiver support interventions remains limited and lacking in meaningful clinical outcomes. Informal caregivers serve a vital role in healthcare and to their loved ones, frequently at a high personal cost to themselves. More research is needed regarding how to effectively support this vulnerable group, with an additional focus on the unique older caregiver population.