Glycemic Control in Elderly Diabetics: A Function of Informal Caregivers' Health Literacy

• Main Author: Ifon, Dora E
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.2016
• Subjects: Aging; Health education
• ISBN: 9781339790336; 1339790335

About 27% Americans ≥ 65 years have Diabetes Mellitus (DM). The complexities of DM care often prompt family members to provide DM care to elderly persons. However, low health literacy of informal caregivers may be a barrier to effective DM care. Unfortunately, about 90 million American adults have low health literacy and some may be caring for an elderly diabetic. The aim of this study was to examine the relationship between caregiver health literacy and DM control in elders with type 2 DM. Using a correlational design, the sample consisted of 88 dyads (veterans and their caregivers) recruited from a health care facility located in the Eastern U.S. Measurements included the REALM instrument for assessment of health literacy, the Katz Basic Activities of Daily Living (ADL) scale to assess the care recipients’ level of dependency, a socio-demographic questionnaire, and the Bayer DCA 2000 point of care A1c instrument to obtain care recipients’ A1c, if the A1c was not documented in the medical records. Data was analyzed with descriptive statistics and logistic regression. Thirty-two percent of caregivers of care recipients with a mean A1c of 7.82 (SD 1.65), aged 78 (SD 8.38), and duration of disease 14.03 years (SD 8.34), were found to have low health literacy. Caregivers’ health literacy significantly influenced care recipients’ A1c. Higher caregivers’ health literacy was associated with lower care recipients’ A1c, X (1, N=88) =3.86, p < .05. Caregivers’ health literacy was significantly associated with educational attainment, x2 [5] = 28.90, p <.000, annual income, x2 [5] = 12.92, p <.05 and race, x2 [2] = 15.40, p <.000. Findings substantiated the importance of assessment of a caregiver’s level of health literacy. Patient care instructions should be provided at the level of the caregiver’s health literacy to facilitate understanding and compliance with instructions. Further research should include studies to elucidate how caregivers with low health literacy process and understand health instructions and longitudinal studies to examine the effect of caregivers’ health literacy on diabetic outcomes of care recipients over time.