School of Communication Studies, 3745James Madison University, Harrisonburg, VA, USA.
Department of Communication Studies, 26679Hong Kong Baptist University, Kowloon, Hong Kong.
Dementia (London). 2021 Oct;20(7):2278-2293. doi: 10.1177/1471301221990567. Epub 2021 Apr 29.
Family members as informal caregivers are considered the first line of support for people with dementia across the world. In Singapore, caregiving expectations revolve around the cultural expectations of providing care in the home environment. However, studies in Singapore have identified a lack of family support for primary caregivers. Family support has been discussed in the literature as the provision of care for people with dementia, and rarely as a resource for family caregivers.
To understand family support among primary caregivers in Singapore, 24 semi-structured interviews were conducted. Thematic analysis found four themes: excuses for lack of physical support for the caregiver, tensions between cultural expectations of caregiving and the provision of support, unmet emotional support, and lack of awareness of dementia and caregiving needs.
Caregivers rationalized and forgave the absence of physical support but were frustrated when the lack of support impacted people with dementia. This was seen as a lack of fulfilling cultural obligations of caring for elderly parents. The caregivers also felt frustrated with the lack of emotional support provided to them, but these were unspoken between the caregiver and the family members. Insufficient and unhelpful support giving was exacerbated with the perception of family members' limited understanding of the demands of caregiving.
The findings offer four practical suggestions to address unmet support needs. First, public education is needed to enhance general knowledge about the symptoms and progression of dementia. Second, help is needed to address miscommunication about support within the family. Third, the development of guidebooks is needed to help family caregivers communicate with family members about their various support needs. Fourth, the relationship between cultural expectation and caregiving must be understood within the context of modernity and urbanism.
在全球范围内，家庭成员作为非正式照顾者被视为痴呆症患者的首要支持来源。在新加坡，照顾者的期望围绕着在家庭环境中提供照顾的文化期望展开。然而，新加坡的研究已经确定了初级照顾者缺乏家庭支持。家庭支持在文献中被讨论为为痴呆症患者提供的照顾，而很少作为家庭照顾者的资源。
为了了解新加坡初级照顾者的家庭支持情况，进行了 24 次半结构化访谈。主题分析发现了四个主题：缺乏对照顾者身体支持的借口、照顾文化期望与支持提供之间的紧张关系、未满足的情感支持以及对痴呆症和照顾需求的认识不足。
照顾者为缺乏身体支持找借口并原谅，但当缺乏支持影响到痴呆症患者时，他们感到沮丧。这被视为未能履行照顾老年父母的文化义务。照顾者还对他们没有得到的情感支持感到沮丧，但这些情绪在照顾者和家庭成员之间没有被说出来。由于家庭成员对照顾需求的理解有限，认为他们提供的支持不足且无益，因此情况更加恶化。
这些发现为满足未满足的支持需求提供了四条实际建议。首先，需要进行公众教育，以提高对痴呆症症状和进展的一般认识。其次，需要帮助解决家庭内部关于支持的沟通不畅问题。第三，需要编制指南，帮助家庭照顾者与家庭成员就各种支持需求进行沟通。第四，必须在现代性和城市化的背景下理解文化期望与照顾之间的关系。
