Mental health nurses’ support to caregivers of older adults with severe mental illness: a qualitative study

Abstract

BackgroundLiterature has shown the serious impact of severe mental illness on the daily life of caregivers. We studied reported caregiver support practices by mental health nurses for use in the development of a nursing intervention. We aimed to explore current caregiver support practices by mental health nurses.MethodsTwenty-one participants completed semi-structured interviews, and 17 participants attended two focus groups. All interviews were audio-taped, transcribed and coded for qualitative analysis.ResultsThe diversity in caregiver support could best be described by three prototypes: the tolerator, the preventer and the concerner, representing three approaches of involvement with caregivers. At one end of the spectrum are mental health nurses (MHN) who are essentially only concerned with the wellbeing of the care recipient and see the caregiver as a potential impediment in reaching the client’s goals. We call these the tolerators. At the other end of the spectrum are the MHNs who see the caregiver and the care recipient as inextricably connected with each other. In these cases the MHN directs her/his intervention towards both the informal caregiver and the care recipient. We call these the concerners. In the middle position are MHNs who realize that caregivers are important agents in the achievement of the client’s goals, and therefore consider preventing them from becoming overburdened as an important goal. We call these the preventers.ConclusionsBased on the extent to which the MHNs believe that the informal caregiver plays a necessary role in the client’s support system, and the degree to which they feel responsible for the caregiver’s wellbeing, three MHN prototypes can be distinguished. These prototypes determine how the nurses’ vision directs their understanding of their role and responsibilities and the content of their behaviour. This implies that a change in behaviour needs to be preceded by a change in vision. Therefore, promoting family support cannot be achieved by one-size-fits-all-programmes.

Professionals' understanding of their responsibilities in the collaboration with family caregivers of older persons with mental health problems in Norway

“…Our analysis illustrated that the professionals' role in the collaboration with family caregivers varied considerably, a result which is in line with findings of international studies (van de Bovenkamp & Trappenburg, 2012; Zegwaard et al., 2015). Variations in involvement may be a reflection of professionals' sensitivity and adaptation to differences in the older person's and family caregiver's needs in different contexts.…”

Unmet care needs, care provision and patient satisfaction in patients with a late life depression: a cross-sectional study

“…However, the risk is that these (older) informal caregivers become overburdened. It is therefore important that professional caregivers also pay attention to the care burden and capacity of the informal caregivers, particularly if the treatment is of long duration (Ho, Chan, Woo, Chong, & Sham, 2009;Lin & Wu, 2011;Zegwaard, Aartsen, Grypdonck, & Cuijpers, 2015).…”

Relatives’ experiences of an equine-assisted intervention for people with psychotic disorders

“…Relatives often spend a large amount of time caring for their diagnosed family members (Brain et al, 2018 ; Flyckt et al, 2013 ). Relatives’ experiences are an important source of knowledge (Zegwaard et al, 2015 ) and mental health services should be based on a holistic view of both the patient and their relatives (Svensson et al, 2020 ). Interventions that allow relatives to be involved may also improve social functioning and the emotional ability of people with a psychotic disorder (McFarlane, 2016 & Pharoah et al, 2010 ).…”