Health impact on caregivers of providing informal care to a cognitively impaired older adult: rural versus urban settings.

INTRODUCTION Rural caregivers, compared to urban caregivers, may experience a heavier burden, which could result in poorer health status for these caregivers. Furthermore, caregiving demands may prevent rural caregivers from engaging in healthy behaviours. We investigated potential differences between rural and urban caregivers in the health impact on these caregivers of caring for cognitively impaired individuals. METHODS Two convenience samples of caregivers of older adults with cognitive impairment were obtained from Northern Ontario. The rural sample (n = 20) was taken from a community of < 15,000 inhabitants, the urban sample (n = 17) from a community of 125,000. We obtained demographical information for caregivers and care recipients, and information regarding the level of independence in activities of daily living and frequency of behaviour problems of care recipients, the type and quantity of supports available and used by caregivers, global health indices and a measure of healthy behaviours from caregivers. RESULTS A greater proportion of rural caregivers was non-spousal and employed. Care recipients' characteristics from the 2 groups were similar, except for higher frequencies of behaviour problems among the rural sample. Rural caregivers had access to fewer formal supports but did not report greater burden, poorer health status, or fewer healthy behaviours than urban caregivers. However, for rural caregivers, higher reports of burden were associated with fewer healthy behaviours (r = 0.79, p = 0.001); we found no such association for urban caregivers (r = 0.04, p = 0.861). CONCLUSION Rural caregivers may have special needs regarding the management of behaviour problems in care recipients and in the promotion of healthy behaviours for themselves. Primary health care providers have an important role in ensuring that these needs are met.