Health Literacy and Heart Failure Management in Patient-Caregiver Dyads

• The health literacy of caregivers affects patient self-care in heart failure.
• The patient-caregiver dyad should be targeted to improve patient outcomes.
• Health literacy should be measured in both patients and caregivers in the elderly.
• Task-oriented health literacy measures are useful in heart failure management.

BackgroundOlder adults with heart failure (HF) often need caregivers to assist with care, yet little is known about the health literacy of both patients and their caregivers. The objective of this study was to assess health literacy and the relationship between health literacy and HF self-care in HF patient-caregiver dyads.Methods and ResultsSeventeen patient-caregiver dyads were recruited. Dyads completed a measure of HF self-care and 2 measures of health literacy: 3 validated questions and a nutrition label reading task. Patients were older than caregivers and the majority of both patients and caregivers were female. Caregivers had higher health literacy by both the health literacy questions (P = .001) and label-reading measure (P = .001). All caregivers had adequate health literacy as assessed by the 3 questions, but 29% had inadequate health literacy according to the label-reading task. Caregivers and patients scored adequately in HF maintenance but inadequately in management and confidence domains.ConclusionsCaregivers had better health literacy than patients; however, the task-oriented label-reading measure revealed poorer health literacy than the self-report measure. Measures of health literacy that reflect day to day tasks may be more illuminating than the 3 questions.