摘要：Objectives . This study examined the characteristics, activities, and challenges of high-risk informal caregivers. Methods . Telephone interviews were conducted with a nationally representative cross-section of 1002 informal caregivers. Vulnerable caregivers with poor health or a serious health condition were compared with nonvulnerable caregivers. Results . Thirty-six percent of caregivers were vulnerable. Compared with nonvulnerable caregivers, vulnerable caregivers were more likely to have difficulty providing care, to provide higher-intensity care, to report that their physical health had suffered since becoming a caregiver, to be aged 65 years or older, to be married, and to have less than 12 years of education. Conclusions . Reliance on informal caregivers without considering the caregiver's ability to provide care can create a stressful and potentially unsafe environment for the caregiver and the care recipient. An estimated 15 million to 25 million adults in the United States currently provide informal care (i.e., unpaid care) to relatives and friends. 1– 3 Recognition of informal caregivers' contributions was heightened recently by estimates that project the economic value of their services to be $196 billion, 4 a figure that far exceeds national spending for home health care and nursing home care. With ongoing public and private sector efforts to limit postacute and long-term care payments, the health care system's reliance on family caregivers will inevitably intensify. Although informal care can positively affect the physical and psychological well-being of care recipients, its provision often comes at a personal cost to the caregiver. Past studies have shown that caregiving can adversely influence the caregiver's psychological health through added strain, 5 stress, 6, 7 and depression. 8 Moreover, family caregivers are less likely to engage in preventive health behaviors 9– 11 and may even be at increased risk for mortality. 12 However, these effects are not the same for all caregivers. 6, 12– 14 For example, it has been suggested that certain factors such as race, advanced age, employment status, and inadequate social support increase the caregiver's risk for poor health outcomes. 7, 15– 19 Therefore, it appears that the added burden of caregiving may have a more severe impact on the well-being of particular subgroups of caregivers who have predisposing characteristics that place them at “higher risk” for adverse health outcomes. Past studies have rarely focused on high-risk caregivers per se or the nature of their caregiving tasks. The purpose of this study was to examine the characteristics, activities, and challenges of high-risk informal caregivers.
