Effects of Free Time on Quality of Life in Elderly Caregivers


  • Akemi Hirano Department of Adult Nursing, Shubun University, 6 Nikko-cho, Ichinomiya, Aichi 491-0938, Japan
  • Yusuke Suzuki Centre for Community Liaison and Patient Consultations, Nagoya University Hospital, 65 Tsuruma, Showa, Nagoya, Aichi 466-8550, Japan
  • Toshio Hayashi Department of Community and In-Home Nursing, Nagoya University Graduate School of Medicine, School of Health Sciences, Daiko-Minami, Higashi-ku, Nagoya, Aichi 461-8673, Japan
  • Koichiro Ina Department of Internal Medicine, Ina Clinic, 3-111 Hirabari, Tenpaku, Nagoya, Aichi 468-0011, Japan
  • Joji Onishi Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma, Showa, Nagoya, Aichi 466-8550, Japan




Caregivers who contribute to health care of their patients are significantly more likely to experience emotional difficulty, physical difficulty, and financial difficulty, than caregivers who do not contribute. This study aimed to examine the effects of free time on health-related quality of life among elderly caregivers of dementia patients. In the intervention group, caregivers set aside free time every 30 minutes three times a week, while continuing to care for patients. During the free time, caregivers were free to spend time at home and do whatever they wanted. The control group received only usual care. The intervention period was six months. The Vitality subscale score of the SF-36 decreased significantly in the intervention group, despite more than half (57.1%) of participants showing improvements or no change in the rank of this subscale relative to baseline, as assessed by the Wilcoxon signed-rank test (not significant). Caregivers indicated that daily caregiving resulted in an accumulation of physical fatigue, and they continued to have little mental leeway. Caregivers also had difficulty securing free time, which may have hindered improvements to their vitality. There is a need to develop a home-based program that can alleviate caregiver stress and improve their quality of life.


Free time; Dementia; Elderly caregiver; Quality of life


[1] Andrén S, Elmståhl S. The relationship between caregiver burden, caregivers' perceived health and their sense of coherence in caring for elders with dementia. J Clin Nurs. 2008; 17(6):790-799. DOI:https://doi.org/10.1111/j.1365-2702.2007.02066.x. PMID: 18279282

[2] Ervin K, Pallant J, Reid C. Caregiver distress in dementia in rural Victoria. Australas J Ageing. 2015; 34(4):235-240. DOI:https://doi.org/10.1111/ajag.12158. Epub 2014 Nov 25. PMID: 25420414

[3] Covinsky KE, Newcomer R, Fox P, Wood J, Sands L, Dane K, Yaffe K. Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. J Gen Intern Med. 2003;18(12):1006- 1014. DOI:https://doi.org/10.1111/j.1525-1497.2003.30103.x. PMID: 14687259; PMCID: PMC1494966

[4] Alqahtani MS, Alshbriqe AA, Awwadh AA, Alyami TA, Alshomrani MS, Alhazzani A. Prevalence and Risk Factors for Depression among Caregivers of Alzheimer's Disease Patients in Saudi Arabia. Neurol Res Int. 2018; 2018: 2501835, 1-7. DOI:https://doi.org/10.1155/2018/2501835. PMID: 30305962; PMCID: PMC6164206

[5] Givens JL, Mezzacappa C, Heeren T, Yaffe K, Fredman L. Depressive symptoms among dementia caregivers: role of mediating factors. Am J Geriatr Psychiatry. 2014; 22(5): 481-488. DOI:https://doi.org/10.1016/j.jagp.2012.08.010. Epub 2013 Mar 15. PMID: 23567432; PMCID: PMC3710308

[6] Wolff JL, Spillman BC, Freedman VA, Kasper JD. A National Profile of Family and Unpaid Caregivers Who Assist Older Adults With Health Care Activities. JAMA Intern Med. 2016; 176(3): 372-379. DOI:https://doi.org/10.1001/jamainternmed.2015.7664. PMID: 26882031; PMCID: PMC4802361

[7] Livingston G, Barber J, Rapaport P, Knapp M, Griffin M, King D, Livingston D, Mummery C, Walker Z, Hoe J, Sampson EL, Cooper C. Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial. BMJ. 2013; 25; 347:f6276. DOI:https://doi.org/10.1136/bmj.f6276. PMID: 24162942; PMCID: PMC3808082

[8] Charlesworth G, Burnell K, Crellin N, Hoare Z, Hoe J, Knapp M, Russell I, Wenborn J, Woods B, Orrell M. Peer support and reminiscence therapy for people with dementia and their family carers: a factorial pragmatic randomised trial. J Neurol Neurosurg Psychiatry. 2016; 87(11): 1218-1228. DOI:https://doi.org/10.1136/jnnp-2016-313736. Epub 2016 Aug 12. PMID: 27521377; PMCID: PMC5099314

[9] Livingston G, Barber J, Rapaport P, Knapp M, Griffin M, Romeo R, King D, Livingston D, Lewis-Holmes E, Mummery C, Walker Z, Hoe J, Cooper C. START (STrAtegies for RelaTives) study: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manual-based coping strategy programme in promoting the mental health of carers of people with dementia. Health Technol Assess. 2014; 18(61): 1-242. DOI:https://doi.org/10.3310/hta18610. PMID: 25300037; PMCID: PMC4781467

[10] Lai FH, Yan EW, Yu KK, Tsui WS, Chan DT, Yee BK. The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic. Am J Geriatr Psychiatry. 2020; 28(11): 1175-1184. DOI:https://doi.org/10.1016/j.jagp.2020.07.019. Epub 2020 Aug 8. PMID: 32873496; PMCID: PMC7413846

[11] Boots LM, de Vugt ME, van Knippenberg RJ, Kempen GI, Verhey FR. A systematic review of Internet-based supportive interventions for caregivers of patients with dementia. Int J Geriatr Psychiatry. 2014; 29(4): 331-44. DOI:https://doi.org/10.1002/gps.4016. Epub 2013 Aug 20. PMID: 23963684

[12] Ploeg J, Markle-Reid M, Valaitis R, McAiney C, Duggleby W, Bartholomew A, Sherifali D. WebBased Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review. J Med Internet Res. 2017; 19(7): e263. DOI:https://doi.org/10.2196/jmir.7564. PMID: 28754652; PMCID: PMC5554353

[13] Henshaw H, Clark DP, Kang S, Ferguson MA. Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties. J Med Internet Res. 2012; 14(4): e113. DOI:https://doi.org/10.2196/jmir.2036. PMID: 22954484; PMCID: PMC3510684

[14] Stirling C, Leggett S, Lloyd B, Scott J, Blizzard L, Quinn S, Robinson A. Decision aids for respite service choices by carers of people with dementia: development and pilot RCT. BMC Med Inform Decis Mak. 2012; 12:21. DOI:https://doi.org/10.1186/1472-6947-12-21. PMID: 22429384; PMCID: PMC3315425

[15] Leach MJ, Francis A, Ziaian T. Transcendental Meditation for the improvement of health and wellbeing in community-dwelling dementia caregivers [TRANSCENDENT]: a randomised wait-list controlled trial. BMC Complement Altern Med. 2015; 15: 145. DOI:https://doi.org/10.1186/s12906-015-0666-8. PMID: 25952550; PMCID:PMC4429365

[16] Suzukamo Y, Fukuhara S, Green J, Kosinski M, Gandek B, Ware JE. Validation testing of a three-component model of Short Form-36 scores. J Clin Epidemiol 2011; 64: 301-308. DOI:https://doi.org/10.1016/j.jclinepi.2010.04.017

[17] Mohide EA, Pringle DM, Streiner DL, Gilbert JR, Muir G, Tew M. A randomized trial of family caregiver support in the home management of dementia. J Am Geriatr Soc. 1990; 38(4): 446-454. DOI:https://doi.org/10.1111/j.1532-5415.1990.tb03544.x. PMID: 2184186

[18] Kuo LM, Huang HL, Liang J, Kwok YT, Hsu WC, Liu CY, Shyu YL. Trajectories of health-related quality of life among family caregivers of individuals with dementia: A home-based caregiver-training program matters. Geriatr Nurs. 2017; 38(2): 124-132. DOI:https://doi.org/10.1016/j.gerinurse.2016.08.017. Epub 2016 Oct 6. PMID: 27720499

[19] Slatyer S, Aoun SM, Hill KD, Walsh D, Whitty D, Toye C. Caregivers' experiences of a home support program after the hospital discharge of an older family member: a qualitative analysis. BMC Health Serv Res. 2019; 19(1): 220. DOI:https://doi.org/10.1186/s12913-019-4042-0. PMID: 30971236; PMCID: PMC6458630

[20] Lawton MP, Brody EM, Saperstein AR. A controlled study of respite service for caregivers of Alzheimer's patients. Gerontologist. 1989; 29(1): 8-16. DOI:https://doi.org/10.1093/geront/29.1.8. PMID: 2753374


How to Cite

Hirano, A., Suzuki, Y., Hayashi, T., Ina, K., & Onishi, J. (2021). Effects of Free Time on Quality of Life in Elderly Caregivers. Journal of Geriatric Medicine, 3(1), 26–31. https://doi.org/10.30564/jgm.v3i1.2986


Article Type