Impact of working situation on mental and physical health for informal caregivers of older people with Alzheimer’s disease in Italy. Results from the UP-TECH longitudinal study

Abstract

Objectives

This longitudinal study explores whether the working situation (no change in working hours despite care, reduction of working hours due to care or not working) moderates mental and physical health of informal caregivers of older people with Alzheimer’s disease (AD) in Italy.

Methods

Data from a sample of 146 caregivers of older people with moderate AD involved in the UP-TECH trial across three waves were analysed. Multivariate analyses were used to study the association between independent variables (caregivers’ work situation) and dependent variables (caregivers’ psycho-physical health). In a second model, elements relating to the caregiver, the cared-for individual and the caregiving situation were added as controls.

Results

Being forced to reduce working hours due to care tasks or not being employed independently from care was negatively associated with informal caregiver’s physical health, compared with working carers not experiencing reduction of working hours. In the extended model, this result was confirmed. In comparison with working carers not forced to reduce working hours, non-working carers experienced higher levels of caregiver burden and depression, however these results were not confirmed in the adjusted model. Other factors also emerged as important including weekly hours of care, the cared-for older individual’s ADL/IADL scores and informal support network.

Conclusions

Given the positive effect of labour force participation on health of informal caregivers of older people with AD, policy makers should promote their employment avoiding their forced reduction of working hours, while also putting measures in place to decrease the intensity of informal care provision.

Keywords:

• Alzheimer’s disease
• informal caregivers
• physical and mental health
• working carers
• work restrictions

Acknowledgments

This paper was prepared on behalf of the UP-TECH multidisciplinary research group. Social workers: Diletta Baldassarri, Luigina Bitti, Aurora Carosi, Maila Sabbatini, Elisabetta Paolasini, Tania Fiori, Cinzia Fronzi, Simona Giacchetta, Valeria Giacomini, Laura Giovagnoli, Giuli Lattanzi, Anna Maria Manca, Ida Marinelli, Valeria Pigini, Marina Pignotti, Maria Chiara Proietti, Antonia Quarticelli, Martina Rovedi, Letizia Tasso, and Valentina Valeri. Nurses: Andrea Antonioli, Mariella Barabucci, Mara Bassani, Paola Bollettini, M. Cristina Bruttapasta, Carla Buccolini, Rosa Carangella, Franca Carboni, Daniela Ceccolini, Patrizia D’Incecco, Mariangela Di Felice, Lara Dini, Giordano Gioia, Giuseppe Di Prima, Giancarlo Giusepponi, Cesarina Lanciotti, Alessia Loffreda, Oriana Luciani, Laura Mariani, Francesco Mastrorilli, Roberto Moroni, Izabela Piatkowska, Roberta Rucoli, Giampaola Scoccia, Nives Teodori, and Tiziana Tonelli. Physicians: Rossano Angeloni, Rosa Anna Bratti, Giuseppe Bonafede, Severino Lorenzetti, Cristina Paci, Giovanna Picciotti, Donella Pezzola, Vincenzo Rea, Vittorio Scialè, Mario Signorino, Francesca Sorvillo, and Pia Francesca Tomassini. Psychologists: Alessia Ciccola and Loena Cionfrini. Social services managers: Daniela Alessandrini, Antonio De Santis, Brunetta Formica, Giuliano Tacchi, Silvia Tortorelli. Marche Regional Authority: Gemma Marchegiani, Giovanni Pozzari, and Giovanni Santarelli. General Practitioners: Dario Bartolucci. UP-TECH scientific committee: Giorgio Caraffa, Filippo Cavallo, Lucia Di Furia, Antonio Lacetera, Claudio M. Maffei, Lamberto Manzoli and Demetrio Postacchini. IRCCS INRCA working group: Roberta Bevilacqua, Anna Rita Bonfigli, Franco Bonfranceschi, Silvia Bustacchini, Marina Capasso, Laura Cassetta, Patrizia Civerchia, Federica Demma, Mirko Di Rosa, Gianluca Furneri, Cinzia Giuli, Marzio Marcellini, Paolo Marinelli, Maria Gabriella Melchiorre, Maria Elena Moraca, Andrea Principi, Cristina Rocchetti, Liana Spazzafumo and Daniela Vincitorio. Virtual counter for technologies: Krystian Bartulewicz, Paolo Olivetti and Lorena Rossi.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

The UP-TECH study was funded by the Marche Region through the National Fund for Dependency Care managed by the Italian Ministry of Welfare. This study was partially supported by Ricerca Corrente funding from Italian Ministry of Health to IRCCS INRCA. The funders play no role in the design of the study, in the collection, analysis and interpretation of data, or in the decision to submit the manuscript for publication. This article/publication is based upon work from COST Action IS1409 supported by COST (European Cooperation in Science and Technology).