Declining Patient Functioning and Caregiver Burden/Health: The Minnesota Stroke Survey–Quality of Life After Stroke Study

Purpose: Caregivers of stroke patients may adapt to changes in patient functioning over time. If adapta-tion occurs, then caregiver burden and health may be influenced more by worsening in patient functioning than by static levels of functioning. This study examines the relationship between patients ’ baseline and changes in functioning and caregivers ’ sub-jective and objective burden as well as their health. Design and Methods: Only stroke patients who had caregivers were included in this analysis (N=356). Stroke patients (n=281) or their proxies (n = 75) were interviewed within 4 months of hospital discharge and patients ’ medical records were abstracted. The primary caregiver also was interviewed at approximately the same time as the patient or proxy (N = 356). In all but one of the 75 proxy cases, the proxy was the patient’s caregiver. Binomial and ordinal logistic regression models were used. Results: Declining patient neu-rological functioning predicted greater objective burden and subjective burden relating to consequen-ces for caregivers ’ personal lives, but it did not predict caregiver health. Implications: The impact a pa-tient’s stroke has on a caregiver’s personal life and the number of hours spent caring for the patient appear to be a function of the changes of the patient’s status over time rather than a function of a ‘‘snapshot’’ of their functioning at baseline. If these results are confirmed, interventions to protect caregivers may be indicated for stroke patients who continue to decline after hospital discharge