Caregiver Employment Status and Time to Institutionalization of Persons with Dementia

Background - This study was undertaken to examine the association between caregiver employment status and the time to institutionalization of persons with dementia. No study has previously examined this association. Methods - The database of the Canadian Study of Health and Aging was used to obtain data on 326 caregiver/care-recipient dyads. Caregivers were primary, informal carers; care-recipients were diagnosed with dementia and living in the community at baseline. Care-recipients were followed from the date of their baseline screening interview until the date of institutionalization, the date of death before institutionalization, or the date of the 5-year follow-up interview. An accelerated failure time model with a Weibull distribution was used to conduct the survival analysis. Results - During the 5-year follow-up period, 139 care-recipients (45%) were institutionalized; the median time to institutionalization was 1,821 days (95% confidence interval [CI]: 1,539-1,981 days) for the care-recipients of employed caregivers and 1,542 days (95% CI: 1,284-1,653 days) for the care-recipients of unemployed caregivers (p = 0.0634). The adjusted acceleration factor was 1.85 (95% CI: 1.08-3.86), controlling for caregiver thoughts about institutionalizing the care-recipient, caregiver health, and the use of a day center to help provide care. Conclusions - For the care-recipients of employed caregivers, the adjusted time to institutionalization was longer than for the care- recipients of unemployed caregivers.