Caregiver Distress
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Percentage of long-stay home care clients whose unpaid caregivers experience distress in a 1-year period.
Numerator
Total number of home care clients who, at the time of their most recent assessment in the given year, have an unpaid caregiver who is experiencing distress as given by assessments with Caregiver status coded as unable to continue in caring activities and/or Primary caregiver status coded as expresses feelings of distress, anger or depression.
Denominator
Total number of long-stay home care clients with a caregiver at the time of their most recent assessment in the given year.
Exclusions
Assessments with "initial assessment" as the reason for the assessment, those conducted fewer than 60 days from the date the case opened to the assessment date or conducted in a hospital setting, assessments of clients younger than 18 years and assessments with a date of assessment that is not the most recent, if a client has more than one assessment in a fiscal year.
Use of Risk Adjustment
Risk Adjustments
Risk adjustment at individual client level (individual covariates) and home care organizational level (direct standardisation). Activities of Daily Living Self-Performance Hierarchy Scale (ADL Hierarchy), Cognitive Performance Scale (CPS), Changes in Health, End-Stage Disease and Signs and Symptoms (CHESS).
Stratifications
Cognitive performance scale score.
Data Attributes
Type of Data Collection
Data Collection Methods
The Resident Assessment Instrument-Home Care (RAI-HC) or the interRAI-Contact Assessment (interRAI-CA), collected by designated assessors, registered healthcare providers. Not all individuals accepted for publicly funded home care services receive a RAI-HC assessment. The HCRS standard expects that a RAI-HC assessment will be carried out on clients admitted to a long-term home care program: it should be completed upon admission to long-term home care and at regular reassessment intervals (usually 6 months to 1 year), or when the client experiences a significant change in clinical status.
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
HCRS based on 2 consecutive quarters (to ensure minimum number of assessments to apply risk adjustment procedures). CIHI is transitioning to the Integrated interRAI Reporting System (IRRS) for long-term care (LTC) and home care data. As a result, CIHI will decommission the previous reporting systems for home care (HCRS and HCRS-CA) by March 2025. Reported at National, Province/Territory level.
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
Canadian Institute for Health Information. Caregiver Distress. Accessed September 28, 2023. www.cihi.ca/en/indicators/caregiver-distress
Canadian Institute for Health Information. Home Care Reporting System — Contact Assessment: Output Specifications, 2021–2022. Ottawa, ON: CIHI; 2021.
www.cihi.ca/sites/default/files/document/hcqi-infosheet-en-web.pdf
Technical Specifications
Restricted access to Resident Assessment Instrument-Home Care (RAI-HC) User's Manual, Canadian version secure.cihi.ca/estore/productSeries.htm?pc=PCC130&gl=1*4124y5*gaODgxMzkxMDI5LjE2OTIxNDg5NDk.ga44X3CK377B*MTY5NjIxNzg4NC44LjEuMTY5NjIxODA5NS4wLjAuMA..&_ga=2.152660921.1203545925.1696217885-881391029.1692148949 Restricted access to Home Care Reporting System (HCRS) Data Submission Specifications Manual secure.cihi.ca/estore/productSeries.htm?pc=PCC305