Psychosocial Adjustment of In-Home Caregivers of Family Members with Dementia and Parkinson's Disease: A Comparative Study

'I wish I had asked for support earlier' - Immigrant family caregivers' experiences of living with a person with dementia

INTRODUCTION

Immigrant family caregivers are increasing worldwide, likewise the number of older people with dementia. Caring for a person with dementia is demanding, with the carer's own life put on hold. Immigrant family caregivers have been less studied. Therefore, the aim of this study was to explore immigrant family caregivers' experiences of living with an older person with dementia.

METHOD

A qualitative approach was chosen, consisting of open-ended interviews analysed using qualitative content analysis. The ethical principles of the Helsinki Declaration were applied in the study, which was duly approved by a regional ethics review board.

RESULTS

The content analysis resulted in three main categories: (i) the diverse roles of a family caregiver; (ii) the impact of language and culture on daily life and (iii) wish for support from society.

CONCLUSIONS

Living with a person with dementia is demanding and burdensome and the consequences of working without any rest may increase social isolation and impair quality of life. Immigrants and country-born family caregivers living with a person with dementia seem to have similar care experiences, but immigrant family caregivers seem to receive help rather late due to a lack of information about the services available, language barriers and to financial reasons. A wish for support earlier on in the caring process was expressed, likewise for care services in the participants' native language. The various Finnish associations and peer support were important sources of information about support services. Together with culturally adjusted care services, these could contribute to better access to care, to quality and to equal care.

Territorial and Gender Differences in the Home Care of Family Members with Dementia

The increasing prevalence of dementia is threatening the capacity of health and social service systems to provide long-term care support at the territorial level. In both rural and urban areas, specific family members (gendered care) are responsible for the daily care of their relatives. The aim of this work is to explore gender and territorial implications in the provision of in-home care by family members. To this end, family caregivers in Navarre, Spain, were administered the Psychosocial Adjustment to Illness Scale (PAIS-SR) and a semi-structured interview. The results show the good psychosocial adjustment of caregivers of relatives with dementia but the negative impacts of caregiving in the domestic, relational, and psychological domains. Moreover, the feminization of psychological distress was found to predominate in rural areas since mainly women are responsible for instrumental and care tasks, while men seek other complementary forms of support. Place of residence (rural vs. urban) was found to exert a strong effect on the respondents’ conception, life experience, and provision of care. Consequently, territorial and gender differences in coping with and adjusting to care require the design of contextualized actions adapted to caregivers’ needs.