Prevalence and Predictors of Caregiver Distress in Six European Communities: Data From the IBenC Study, Using interRAI-Home Care Assessments.

Home care organisations were chosen for diversity of location, size, management or payment, not to represent each country, so the sample may not reflect all home care clients. Except in Iceland, representativeness was uncertain. In Italy, baseline data were documented retrospectively 6 months later, which may have overestimated disability levels. In the Netherlands, cognitive impairment was very low, likely because cognitive impairment was a common reason for refusing participation. The analysis was cross-sectional, so it cannot show that any client characteristic caused caregiver distress. Caregiver distress was identified from three closely related interRAI-HC items recorded by the assessor, not from a separate caregiver report. Information about caregiver characteristics was lacking, which limits understanding of why distress varied. Of the sample, 388 clients had no informal caregiver and were excluded, so the results apply only to clients with an informal caregiver.

Two authors are part of the interRAI collaborative network of researchers and practitioners. The other authors declared no potential conflicts of interest.

Do not conclude that increasing formal home-care hours will reduce caregiver distress. In Finland, Iceland and the Netherlands, more formal care hours were associated with higher distress, and the study cannot show cause and effect.