scholarly journals Caring for One’s Wife With Dementia—at Home: Older Husbands’ Experiences With Managing Challenges of Everyday Life

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983445
Author(s):  
Linda Rykkje ◽  
Oscar Tranvåg

More than 80,000 Norwegians live with dementia. Most caregivers for people with dementia are spouses, and women outnumber men. Due to an aging population, and women’s higher risk of dementia as well as men’s increased life expectancy, the number of male caregivers will rise. There are some differences in the caregiving roles of men and women. Research suggest that males report lower burden and depression than female caregivers, but some men struggle to adjust to the caregiver role, and men are less likely to access health care services. The aim of this study is to explore the experiences of husbands engaged in caregiving for their home-dwelling spouse with dementia. This knowledge will add to the growing body of research about men in the context of dementia care and may raise gender awareness. The method is qualitative interviews with hermeneutical interpretation. The participants are five husbands recruited from two Hospital Memory Clinics in Norway. The results portray how the husbands managed their everyday challenges, and how they adapted to changes, experiences of loss and bereavement, and how they redefined personal freedom and expanded their responsibilities. Acknowledging the rewards of caregiving, the husbands found their life meaningful and they were thriving in their caregiving role. Health care personnel should recognize and respect the challenging life situation caregiving husbands may experience, calling for personnel to learn from, care for, and collaborate with them, enabling the couple to live a meaningful life together at home as long as possible.

Author(s):  
Astrid Fjell ◽  
Kristin Ådnøy Eriksen ◽  
Monica Hermann ◽  
Anne-Marie Boström ◽  
Seiger Berit Cronfalk

Abstract Aim: The purpose of this study was to investigate how old persons perceived their life to be, how they viewed the ageing process and their need of health care and societal support. Background: The purpose of WHO’s Healthy Ageing strategy and development of age-friendly environments is to support physiological and psychosocial changes in old persons by facilitating basic needs. Interventions to operationalize these needs in older people living at home are often developed from a professional perspective and to a small extent involves the perceptions, experience and expectations of the older persons. Method: This qualitative study has an explorative design using focus group discussions to collect data. In all, 34 persons between 69 and 93 years of age participated in seven group discussions. The interviews were analyzed using inductive manifest content analysis. Findings: The main results suggest that most old persons enjoyed life and wished it to continue for as long as possible. Important was to sustain networks and to feel useful. Unexpected changes were described as threats and the need to use health care services was associated with illness and being dependent. The result is presented in three categories with sub-categories: ‘Embracing life’, ‘Dealing with challenges’ and ‘Considering the future’.


SAGE Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 215824401774490 ◽  
Author(s):  
Linda Rykkje ◽  
Gunhild H. B. Hjorth

The implementation of welfare technology in Norwegian municipals is a governmental priority, but there is little research on transfer of technological solutions into regular health care services. The aim of the project “Safety at home” was to test and evaluate the use of video communication between patients and health care personnel. There were two test periods, with the initial phase focusing on patients with chronic obstructive pulmonary disease (COPD). The second phase focused on patients who most likely would benefit from video communication. Nine patients tested the equipment, and they were interviewed afterward. In addition, nursing personnel evaluated the project through focus group interviews. The results identified that the equipment was user friendly and contributed to the patients’ feelings of safety. However, there were concerns about video calls replacing the “human touch” of home visits. The personnel also experienced that the technological solution had limitations, and new tasks added to their workload. The choice of focusing on COPD patients was considered a disadvantage, and we recommend that future projects should not be restricted by diagnosis and should target the most eligible candidates.


2017 ◽  
Vol 13 (7S_Part_17) ◽  
pp. P832-P832
Author(s):  
Jochen René Thyrian ◽  
Bernhard Michalowsky ◽  
Johannes Hertel ◽  
Markus Wübbeler ◽  
Bernhard Holle ◽  
...  

2020 ◽  
Vol 10 (2) ◽  
pp. 1-5
Author(s):  
Sushila Baral ◽  
Sony Pandey ◽  
Rajesh kumar Yadav ◽  
Sudarshan Subedi

Free Health Service is a priority program and a boon to all citizens mostly for the poor and marginalized groups. It is a timely and exemplary program of government but some people have deviation in their normal behaviour as services have been provided free. A descriptive cross-sectional approach was done to assess moral hazard on free health care services by consumers. An interview schedule was used to collect quantitative data and in depth interview with health workers for qualitative data in selected eleven health facilities. The study showed the prevalence of moral hazards of free health care services by the consumers. Two-third (65%) respondents had medicines at home. Around one-third (33%) of respondent had self demanded for the medicines. Two-third (67.6%) doesn't seek for health services during health problems. One-fourth (23.6%) had poster at home for non IEC purpose. Age, education level, travelling time to health facility, occupation, and satisfaction towards services were significantly associated with availability of medicines at home. Age, education level, health workers behaviour were significantly associated with self demand of medicines. Peoples are misutilizing the services as, government bear the burden of cost. There was deviation in the normal behaviour of the peoples due to no registration fees and free drugs availability. Many people like to take medicines and have a notion that there is a pills for every ill as a result they self demand for the medicines and mostly don’t consume full dose which can develop drug resistance. Visit to health facilities to collect medicines at home have increase unnecessary burden to health facilities and also increase in morbidity status. The result can inform developing proper policy and safety measures to drop off moral hazard on free health care services.


Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2526-2542 ◽  
Author(s):  
Despina Laparidou ◽  
Jo Middlemass ◽  
Terence Karran ◽  
A Niroshan Siriwardena

Background There are an estimated 46.8 million people worldwide living with dementia in 2015, being cared for usually by family members or friends (informal caregivers). The challenges faced by informal caregivers often lead to increased levels of stress, burden and risk of care-recipient institutionalisation. Aim The overarching aim of this study was to explore the experiences and perceptions of informal caregivers of people with dementia when interacting with the health care system, and whether the support received acted as a mediator of caregiver stress. The secondary aim was to investigate healthcare professionals’ views and current practice regarding people with dementia and their interactions with informal caregivers. Method We employed a qualitative research design, using focus groups and one face-to-face interview with a purposive sample of informal caregivers and healthcare professionals in Lincolnshire, UK. Data were collected between March and July 2015. We used the stress-process model of stress in caregivers as a theoretical framework. Results We interviewed 18 caregivers and 17 healthcare professionals. Five themes, mapped to the stress-process in caregivers’ model, captured the main challenges faced by caregivers and the type of support they wanted from health care services. Primary stressors included the challenge of diagnosing dementia; caregivers’ needs and expectations of an in-depth knowledge and understanding of dementia from healthcare professionals; and need for carer education. Secondary role strain included lack of support and mismatch of communication and expectations. Caregiver involvement in monitoring care and disease was a potential mediator tool. Conclusions Fragmentation of dementia care services, lack of training for healthcare professionals and the dearth of information for caregivers means health care services are only partially fulfilling a support role. In turn, lack of support may be intensifying caregiver stress leading to worsening in their health and well-being; thus, potentially increasing the risk of institutionalisation of their care-recipient.


Pharmacy ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 138 ◽  
Author(s):  
Ateequr Rahman ◽  
Rubeena Anjum ◽  
Yelena Sahakian

The elderly, whom are vulnerable to the physical, mental and chronic diseases of aging, are the fastest growing segment of the US population. Dementia is of particular concern in this population, and caregivers of people with dementia are subjected to psychological, physical, emotional and functional stress. The purpose of this study was to investigate the impact of caregiving for dementia patients on health care services utilization of caregivers and to examine if caregivers utilize more healthcare services than the control group. The study recruited a total of 143 people in control and non-control groups through non-probability convenience sampling. The control group (non-caregivers) comprised of 71 people, whereas the experimental group (caregivers) consisted of 72 participants. The focus of the study was the health care utilization questionnaire, asking the caregiver about the frequency of specific health care services utilization—including medication use in the last six months, on the scale from 0 to 10. Results were statistically significant for each of the healthcare service utilization when comparing caregivers to the control group. By providing adequate support and assistance in form of support groups, we can alleviate caregivers’ burden and more effectively address the needs of caregivers—thereby reducing the utilization of healthcare services.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Rossinot ◽  
O Marquestaut ◽  
M De Stampa

Abstract Background Public health policies tend to generalize the use of Hospital-At-Home (HAH) to answer the growing will of patients to be treated or to die at home. HAH is a model of care that provides acute-level services in the patient’s home with the interventions of variety of health care professionals. Relatives participate also in the interventions by helping for sick patients at home, but we lack data on the care of patients and caregivers in HAH. The aim of this study was to make an inventory of the experiences of patients and family caregivers in HAH. Methods The research was qualitative using nineteen semi-directed interviews from nine patients and ten caregivers of one care unit of Greater Paris University Hospitals’ HAH, and the grounded theory was used to analyze the transcripts. Caregivers were also asked, after the interview, to fill in the Zarit Burden Inventory. Results HAH remained mostly unknown for patients and caregivers before the admission proposition and the outlook of being admitted in HAH was perceived as positive, for both of them. Caregivers had a versatile role throughout HAH, leading to situations of suffering, but also had sources of support. The return home was considered satisfactory by both caregivers and patients, related to the quality of care and increased morale despite HAH’s organizational constraints. We noted an impact of HAH on the relationship between the patient and the caregiver(s), but caused by multiple factors: the fact that the care takes places at home, its consequences but also the disease itself. Conclusions HAH strongly involved the patient’s caregiver(s) all along the process. HAH’s development necessitates to associate both patients and caregivers and to take into account their needs at every step. This study highlights the need to better assess the ability of the caregiver to cope with his or her relative in HAH with acute and subacute care at home. Key messages Health care services need to take into account family caregivers. Hospital at home services should be developped worldwide.


2020 ◽  
Author(s):  
Jochen René Thyrian ◽  
Friederike Kracht ◽  
Angela Nikelski ◽  
Melanie Boekholt ◽  
Fanny Schumacher-Schönert ◽  
...  

Abstract Background: The outbreak of the Corona virus is a challenge for health care systems worldwide. Elderly people with comorbidities are at a higher risk and the different levels of government in Germany reacted jointly to the challenge with social distancing and a lockdown. Little empirical evidence exists about the psychosocial situation of elderly people during this time. Thus, the aim of this study is to analyze a) knowledge about, and feelings related to the Corona-pandemic. Describe b) loneliness, depression and anxiety, and, c) the perceived, immediate impact of the lockdown on frequency of social contacts and quality of health care provision of people with cognitive impairment during social distancing and lockdown in the primary care system and daily living at home in Germany. Methods: This analysis is based on data from standardized telephone interviews in a convenience sample of n=141 people with known cognitive impairment in the primary care setting. Participants were recruited from currently running interventional trials. Therefore, data on e.g. cognitive and psychological status prior to the pandemic was available. Attitudes, knowledge about and perceived personal impact of the pandemic, social support, loneliness, anxiety, depression, frequency of social activities due to the pandemic and perceived impact of the pandemic on health care services were assessed during the time of lockdown. Results: The vast majority of participants consider themselves sufficiently informed about Corona (85%) and most think that the measures taken are appropriate (64%). A total of 11% shows one main symptom of a depression according to DSM-V. The frequency of depressive symptoms has not increased between the time before pandemic and lockdown in almost all participants. The sample shows minimal (65.0%) or low levels of anxiety (25%). The prevalence of loneliness is 10%. On average seven activities have decreased in frequency due to the pandemic. Social activities related to meeting people, dancing or birthday visits have decreased significantly. Talking with friends by phone and activities like gardening have increased. Utilization of health care services like day clinics, relief services and prescribed therapies are reported to have worsened due to the pandemic. Also visits to general practitioners decreased. Discussion: The study shows a limited impact of the pandemic on psychological variables including depression, anxiety and loneliness in the short-term. People are well informed but not especially concerned about themselves or others. There is a decrease in social activities as expected, in line with the restrictions imposed. The impact on health care provision is prominent. There is a need for longitudinal studies to assess longer-term effects of the pandemic and social distancing on elderly people with cognitive impairment living at home and their caregivers. There is also a need for qualitative, in-depth studies to further interpret the results. In general, elderly people in the setting under examination and with the limitations of this specific study seem to compensate restrictions during the time of lockdown in Germany rather well.


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