Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Canada.
Innovation in Seniors Care Research Unit, Faculty of Nursing, University of Alberta, Edmonton, Canada.
Dementia (London). 2020 Nov;19(8):2601-2620. doi: 10.1177/1471301219834423. Epub 2019 Mar 6.
Family caregiving is considered a social transition as changes in the health of the care recipient create a process of transition for the caregiver when they are more vulnerable to threats to their own health. Family and friend caregivers take on many responsibilities and experience high levels of burden when caring for community-dwelling older adults living with dementia and multiple chronic conditions. However, little is known about the changes they experience in their caring roles or how they cope with these changes. This qualitative descriptive study was part of a larger mixed methods randomized controlled trial evaluating a web-based caregiver support toolkit. Multiple semi-structured phone interviews were conducted with caregivers of older adults with dementia and multiple chronic conditions. Content analysis was used to generate thematic descriptions. Six themes were generated and grouped into two categories. Significant changes experienced by caregivers are described by the following themes: 'everything falls on you - all of the responsibilities,' 'too many feelings' and 'no time for me.' The themes describing how caregivers coped with these changes include: seeking support, self-caring, and adapting their caregiving approach. Study results indicate that caregivers of older adults with dementia and multiple chronic conditions experienced many changes in their caregiving journey resulting in increasing complexity as they tended to the care recipients' declining health and well-being. These caregivers used several creative strategies to cope with these changes. Health care providers should consider both the caregiver and care recipient as clients in the circle of care, and facilitate their linkage with health and community support services to help address the increasing complexity of care needs.
家庭护理被认为是一种社会过渡，因为护理接受者健康状况的变化会给护理者带来过渡过程，使他们更容易受到自身健康威胁。当家庭和朋友护理者照顾居住在社区的患有痴呆症和多种慢性病的老年人时，他们承担着许多责任，并承受着很高的负担。然而，人们对他们在护理角色中经历的变化知之甚少，也不知道他们如何应对这些变化。这项定性描述性研究是一项更大的混合方法随机对照试验的一部分，该试验评估了一种基于网络的护理人员支持工具包。对患有痴呆症和多种慢性病的老年人的护理者进行了多次半结构化电话访谈。采用内容分析法生成主题描述。生成了六个主题，并分为两类。护理者经历的重大变化由以下主题描述：“所有的责任都落在你身上”、“太多的情绪”和“没有时间留给自己”。描述护理者如何应对这些变化的主题包括：寻求支持、自我护理和调整他们的护理方法。研究结果表明，患有痴呆症和多种慢性病的老年人的护理者在他们的护理之旅中经历了许多变化，随着他们照顾接受者健康状况和幸福感的下降，护理变得越来越复杂。这些护理者使用了几种创造性的策略来应对这些变化。医疗保健提供者应该将护理者和护理接受者视为护理圈中的客户，并促进他们与健康和社区支持服务的联系，以帮助满足不断增加的护理需求的复杂性。
