Caregiver Emotional Wellbeing Is Related to Nursing Home Admissions Among Veterans.

Shepherd-Banigan ME, Li Z, Patel PR, Smith IZ, Lo J, Majette NT, Jacobs JC, Gersten-Harris ML, Jobin T, Pai AV, Van Houtven CH, Miller KE. Caregiver Emotional Wellbeing Is Related to Nursing Home Admissions Among Veterans. Journal of the American Geriatrics Society. 2025 Sep 26 DOI: 10.1111/jgs.70087.

Related HSR&D Project(s)

• IIR 22-134 – Homemaker Home Health Aide Use and Veteran-Centered Outcomes

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Abstract:

BACKGROUND: Approximately 14 million US adults require long-term care; most of this care is provided in the community by family caregivers. High intensity care can decrease caregiver wellbeing; caregiver burden is a determinant of nursing home admission. This study extends past research to evaluate the association between caregiver subjective burden, depression, and loneliness and subsequent Veteran nursing home admission. METHODS: This study is a time-to-event analysis of Veteran/caregiver pairs. The sample population (n = 1539) includes Veterans aged 26-102 and their caregivers enrolled in the VA's Program of General Caregiver Supports and Services (PGCSS). PGCSS caregivers participated in a telephone survey to assess self-reported caregiver wellbeing (exposure variables: burden, depression, loneliness). The outcome, time to nursing home visits at 3 and 5 years post-survey, was constructed using Veteran medical records. We examined this relationship using the cumulative incidence function stratifying by levels of caregiver burden and depression as well as covariate-adjusted Cox proportional hazard models. RESULTS: We observed a significantly higher incidence of nursing home admission at the 3-year follow-up for Veterans whose caregivers reported higher burden and depression at baseline. Adjusted Cox models also revealed significantly higher risks of Veteran nursing home entry at the 3-year follow-up when caregivers reported greater depression, burden, and loneliness at baseline. CONCLUSIONS: Our study demonstrates that Veterans were more likely to transition from home-based care to facility-based care within 3 years if their caregivers reported higher rates of burden, depression, and loneliness at baseline. These findings illuminate the importance of support services that improve caregiver emotional wellbeing.