Caregivers in Crisis: Moving a Relative with Alzheimer's to Assisted Living

Abstract

The experience of moving a relative with Alzheimer's disease (AD) to an assisted living facility (ALF) was examined in this secondary data analysts of 20 interviews with family caregivers. Crisis theory was used as guiding framework for the analysis. Findings indicate that all elements of a crisis were evident among caregivers in the process of moving their relative to an ALF. Dangerous behaviors resulting from the relative's cognitive decline led to caregiver fear and anxiety, which served as crisis precipitants. Perceived lack of family support in conjunction with physical and psychological exhaustion were crisis mediators. These factors, along with the caregiver's failed attempts to keep their relative at home, caused the crisis process to move toward the outcome of ALF placement. A better understanding of the crises that surround placement issues will assist nurses in planning interventions for the growing number of families faced with this issue.

Reviewing the definition of crisis in dementia care

“…Behavioural and psychological symptoms of dementia were identified as a stressor leading to crisis situations [7,27,28,31,32,37]. Communication between the informal caregiver and the general practitioner was cited as important to general practitioner management [22,28,34].…”

“…• caregiver illness possibly leading to death [7,12,13,17,19,26,29,31,38] institutionalization, [7,17,26]…”

“…The authors advocated the need for clearer communication and better cooperation between caregivers and the general practitioner although it is unclear what this entails [34]. Case management or help from a nurse may also improve communication between the general practitioner and the informal caregiver [7,30,39]. …”

Specific psychological and behavioral symptoms of depression in patients with dementia

“…Behavioral and psychological symptoms of dementia (BPSD) impair quality of life in patients and those around them (Rabins et al, 1999) and are the principal reason for admission to nursing homes (Liken, 2001;Gaugler et al, 2009).…”

rôle des aidants familiaux en fonction de différents milieux de vie des personnes âgées en perte d'autonomie :

“…Cette conclusion est toujours soutenue par la majorité des auteurs (Almberg, Grafstrom et Krichbaum et Winblad, 2000a;Butcher et al, 2001;Gaugjer, Leitsch, Zarit et Pearlin, 2000). À ce sujet, Liken (2001a) souligne que le placement d'un parent en institution est une source de stress importante. connaissances professionnelles, est sujette à des confrontations (Brooke, 1989;Keefe et Fancey, 2000;Litwak, 1985).…”