Association of family/friend caregiver involvement in care with assisted living residents’ depressive symptoms

AbstractObjective Assisted Living (AL) facilities are crucial care settings for older adults, with family and friends playing a significant role in resident care. However, the impact of caregiver involvement on the mental health of older adults in AL is often overlooked in research. This study explored the association of lower hours of caregiver help (vs >median), unfavorable caregiving situation (i.e., caregiver facing challenges) (vs favourable), and caregiver unwillingness to increase emotional support (vs willingness) with the prevalence of depressive symptoms (Resident Assessment Instrument – Home Care RAI-HC Depression Rating Scale score of ≥3) among older adults in AL. Methods This repeated cross-sectional study utilized data from the RAI-HC, collected from residents in 249 publicly funded AL homes in Alberta, Canada, between January 1, 2018, and December 31, 2021. We analyzed the most recent records of residents ≥65 years in each quarter (43,643 assessments). We used modified Poisson regression for analysis, adjusting for repeated measures, pandemic impact, and resident and facility characteristics. Results The prevalence of depressive symptoms ranged from 15.9% to 22.4% from before the pandemic to the late pandemic period. Lower hours of caregiver help were associated with a lower risk of depressive symptoms, while an unfavourable caregiving situation, or caregivers unwilling to increase help were associated with a higher risk of depressive symptoms. Conclusions The findings emphasize that certain characteristics of caregiving context are linked to the risk of depressive symptoms in AL residents. It emphasizes the need for targeted strategies, including addressing caregiver burden where possible, to enhance caregiver involvement in AL.