Disagreement in preference for residential care between family caregivers and elders is greater among cognitively impaired elders group than cognitively intact elders group

Objectives: This study examined the predictive factors of preference for residential care in cognitively intact and impaired elders and their family caregivers. It was hypothesized that disagreement in preference for residential care between the elders and their caregivers was greater in the cognitively impaired. Methods: A cross-sectional survey was conducted during June 2007 to March 2008 in Hong Kong, and 707 community-dwelling elders aged 65 and above and 705 family caregivers were interviewed. Cognitively impaired elders were over-sampled to give reliable estimates for that sub-group. A structural questionnaire was used to collect data on preference for residential care and potential factors. Logistic regression was used to identify the predictors. Results: More cognitively impaired elder-caregiver dyads (37.4%) had disagreement in preference for residential care than cognitively intact elder-caregiver dyads (20.5%) (p < .001). From the elders' perspective, less preference for residential care was associated with cognitive impairment, whereas greater preference was associated with depression (for cognitively intact elders), more usage of community service and functional impairment. From the caregivers' perspective, greater preference for residential care was associated with greater caregiver burden, or care-recipients having cognitive or functional impairment, or more usage of community services. Conclusions: Cognitively intact elders were more likely to indicate preference for residential care than cognitively impaired elders. Elders, both cognitively intact and impaired, were less likely than their caregivers to indicate preference for residential care. Disagreement in preference for residential care between the elders and their caregivers was larger for the cognitively impaired group than the cognitively intact group. Copyright (C) 2009 John Wiley & Sons, Ltd.