Research square · 2025
Associations between Caregiver-Provider Communication Quality and Unmet Care Needs Among Older Adults.
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Liang Jiaming, Samper-Ternent Rafael, Downer Brian, Xie Zhigang
Аннотация
BACKGROUND: Unmet care needs (lack of assistance with daily activities) among older adults are common and linked to adverse health outcomes, greater healthcare utilization, and caregiver burden. While effective patient-provider communication is known to improve care quality, less is understood about the role of caregiver-provider communication, particularly across sociodemographic, health, and caregiving contexts.
METHODS: We conducted a cross-sectional secondary analysis of pooled 2021-2023 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) data, restricted to community-dwelling older adults (65 + years) who received assistance from caregivers due to difficulty with daily activities, and had at least 1 caregiver who communicated with medical providers in the past year. The unit of analysis was the caregiver-older adult pair, with clustering at the older adult level. The outcome was unmet care needs (0, 1, or 2+, across 12 daily activities). The primary predictor was caregiver-reported provider communication quality (range: 3-12). Weighted ordered logistic regression estimated associations between communication quality and unmet care needs, adjusting for older adult and caregiver sociodemographic, health, and caregiving characteristics.
RESULTS: The analytic sample included 1,414 older adults (weighted N = 9.34M) and 1,910 caregivers (weighted N = 21.05M). Half (50.5%) of older adults reported no unmet care needs, 23.5% reported one, and 26.0% reported 2 or more. Higher communication quality was associated with lower odds of greater unmet needs (OR = 0.93, 95%CI: 0.89-0.97). The association was stronger for low-income households (<$30K/year), for adult child caregivers and other relatives compared with spouses, and for caregivers providing < 20 hours or > 40 hours/month of care.
CONCLUSIONS: Improving caregiver-provider communication may be an effective strategy for reducing unmet care needs among older adults with long-term care needs. Targeted efforts might be particularly needed for low-income families and non-spousal caregivers, but strategies must address systemic and logistical barriers to ensure equitable benefit.
METHODS: We conducted a cross-sectional secondary analysis of pooled 2021-2023 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) data, restricted to community-dwelling older adults (65 + years) who received assistance from caregivers due to difficulty with daily activities, and had at least 1 caregiver who communicated with medical providers in the past year. The unit of analysis was the caregiver-older adult pair, with clustering at the older adult level. The outcome was unmet care needs (0, 1, or 2+, across 12 daily activities). The primary predictor was caregiver-reported provider communication quality (range: 3-12). Weighted ordered logistic regression estimated associations between communication quality and unmet care needs, adjusting for older adult and caregiver sociodemographic, health, and caregiving characteristics.
RESULTS: The analytic sample included 1,414 older adults (weighted N = 9.34M) and 1,910 caregivers (weighted N = 21.05M). Half (50.5%) of older adults reported no unmet care needs, 23.5% reported one, and 26.0% reported 2 or more. Higher communication quality was associated with lower odds of greater unmet needs (OR = 0.93, 95%CI: 0.89-0.97). The association was stronger for low-income households (<$30K/year), for adult child caregivers and other relatives compared with spouses, and for caregivers providing < 20 hours or > 40 hours/month of care.
CONCLUSIONS: Improving caregiver-provider communication may be an effective strategy for reducing unmet care needs among older adults with long-term care needs. Targeted efforts might be particularly needed for low-income families and non-spousal caregivers, but strategies must address systemic and logistical barriers to ensure equitable benefit.