Caregiver exposure to critical events and distress in home-based palliative care in Germany a cross-sectional study using the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) scale

Abstract

BackgroundLay family caregivers of patients receiving palliative care often confront stressful situations in the care of their loved ones. This is particularly true for families in the home-based palliative care settings, where the family caregivers are responsible for a substantial amount of the patient’s care. Yet, to our knowledge, no study to date has examined the family caregivers’ exposure to critical events and distress with home-based palliative care has been reported from Germany. Therefore, we attempt to assess family caregiver exposure to the dying patient’s critical health events and relate that to the caregiver’s own psychological distress to examine associations with general health within a home-based palliative care situation in Germany.MethodsA cross-sectional study was conducted among 106 family caregivers with home-based palliative care in the Federal State of North Rhine Westphalia, Germany. We administered the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale. Descriptive statistics and linear regression models relating general health (SF-36) were used to analyze the data.ResultsThe frequency of the caregiver’s exposure, or witness of, critical health events of the patient ranged from 95.2% “pain/discomfort” to 20.8% “family caregiver thought patient was dead”. The highest distress scores assessing fear and helpfulness were associated with “family caregiver felt patient had enough’” and “family caregiver thought patient was dead”. Linear regression analyses revealed significant inverse associations between SCARED critical health event exposure frequency (beta = .408, p = .025) and total score (beta = .377, p = .007) with general health in family caregivers.ConclusionsFamily caregivers with home-based palliative care in Germany frequently experience exposure to a large number of critical health events in caring for their family members who are terminally ill. These exposures are associated with the family caregiver’s degree of fear and helplessness and are associated with their worse general health. Thus the SCARED Scale, which is brief and easy to administer, appears able to identify these potentially upsetting critical health events among family caregivers of palliative care patients receiving care at home. Because it identified commonly encountered critical events in these patients and related them to adverse general health of family caregivers, the SCARED may add to clinically useful screens to identify family caregivers who may be struggling.

Musculoskeletal disorders of older adults: an integrative literature review

“…Sixteen articles (4)(5)(6)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) address issues related to harms to the physical health of caregivers, highlighting the illness, the impairment, the regions of the body most affected and the main symptoms resulting from the sum of the feeling experienced by caregivers of older adults.…”

“…Among the musculoskeletal disorders most evident in caregivers of older adults due to care, the presence of pain is highlighted (4,6,(10)(11)18,21) in body segments (4,7,(11)(12)(13)(14)16,18) , mainly in the spine, upper and lower limbs, with moderate to intense pain intensity (6,14,17) , characterized by being persistent and uncomfortable. Other authors point to the presence of chronic musculoskeletal diseases in caregivers (4)(5)15) , such as arthritis, osteoarthritis, and osteoporosis.…”

Assessment of the Kempe Family Stress Inventory in self-care post-restrain schizophrenia

“…The family revealed that post-restrain schizophrenia had a desire to take a bath and did not want to take a bath. The relationship between the general tendency to avoid actions in problem situations and the tendency to seek social transfer to overcome stress [12,15,18]. Assertive behavior was also found to correlate with the tendency to be involved in substitution activities.…”

“…This activity can be realized through the provision of counseling services and health care workers always control families and clients. Multiply family empowerment in managing the various burdens faced by families who care for post-mental disorders [18][19][20]. The need for self-care elimination in schizophrenia post-restrain helps fulfill the need for self-elimination care in schizophrenia post-restrain.…”

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