A Visit-Associated Logistics Framework Describing Challenges Faced by Caregivers of Older Adults

Unpaid family caregivers are assuming increasing levels of care as the healthcare system prioritizes aging in place over institutionalized care. Among their many responsibilities, coordinating in-person clinical visits is a critically important yet understudied area. This logistical aspect of caregiving for older adults is complex as it is influenced by many different medical-psycho-social factors. Presently, there is no existing framework to systematically characterize informal caregiver coordination of in-person medical visit logistics. This represents a key gap in the field and limits our understanding of the caregiving burden more broadly, especially as coordinating medical visits can represent a snapshot of caregiving challenges. To address this gap, we developed a conceptual framework integrating concepts from caregiver stress and burden research, geriatrics, and visit logistics that conceptualizes how visit-related challenges may affect caregiving and attendance of medical appointments. The Visit-Associated Logistics (VAL) framework includes domains of scheduling, preparing for the visit, visit-related time and travel, caregiver independence, routine disruption, and caregiver feelings and impressions. Recognition of what role these domains play-in terms of caregiver burden, visit attendance, and broader health outcomes-will be important in the current healthcare landscape.