Family experiences as a caregiver for patients with Parkinson's disease: a qualitative study

There is 'no cure for caregiving': the experience of women caring for husbands living with Parkinson's disease

BACKGROUND

Parkinson's disease is a progressive neurodegenerative disorder. The majority of the nearly 9 million people living with Parkinson's disease are men. As such, caregiving is often assumed by wives as the disease progresses. However, there is little research about the lived experience of wives as they transition to caregivers.

OBJECTIVE

To describe the lived experience of wife caregivers of male spouses living at home with Parkinson's disease.

METHODS

A descriptive phenomenological study. Semi-structured interviews were recorded and transcribed for analysis in Atlas.ti using Colaizzi's method.

RESULTS

Thirteen women, aged 50 to 83 years, were interviewed. Five themes emerged from the analysis, (1) caregiver who? (2) taking it day by day, (3) not sure what to do next, (4) just too much, and (5) caring is your soul's growth, to support the central theme "there is no cure for caregiving."

CONCLUSION

Transitioning from wife to caregiver was a gradual but difficult process. Although the wife caregivers wanted to be part of the health care team, they remained outsiders. Clinicians need to recognize the wives as care coordinators linking medical management with home care. Policy makers need to develop reimbursement models that provide wife caregivers with support groups, education programs, and telemental health services.

Family members' experiences of everyday caregiving for a family member living with Parkinson's disease: a qualitative thematic analysis study

BACKGROUND

In the daily life of individuals living with Parkinson's disease, their loved ones are crucial. Adapting family members to the patient's condition, support in providing care, and psychosocial adaptations is essential.

AIM

To explore family members' perception of everyday caregiving for a family member living with Parkinson's disease and to describe their role in the care and everyday life.

METHODS

In a descriptive, qualitative thematic analysis study, semi-structured interviews were conducted with ten people between the ages of 20 and 70, the closest family members of people living with Parkinson's disease. The analysis of the collected data was carried out using thematic analysis.

RESULTS

We generated the main theme: "Living with a family member with Parkinson's disease", with associated secondary-level sub-themes: "Response", "Change", "Care", and "Support". Family members of individuals living with Parkinson's disease frequently encounter similar life situations. The most notable transformation in their daily lives primarily revolves around adapting to various activities.

CONCLUSIONS

Family members are the ones who most often take on the role of caregiver and provide help to their loved ones. Many of them accept the disease as a part of everyday life and learn to live with it. It is of fundamental importance that we offer family members the necessary support, knowledge, and involvement in holistic treatment and care.

The Effect of Spiritual Orientations and Religious Attitudes on Coping with the Difficulties Encountered by Family Caregivers of People with Parkinson's Disease in Türkiye

This study aimed to determine the effect of spiritual orientations and religious attitudes on coping with the difficulties of family caregivers of people with Parkinson's disease. This descriptive and cross-sectional study was conducted with 113 family caregivers of people with Parkinson's disease who came to be examined in the Neurology outpatient clinic of a Training and Research Hospital in Türkiye between July and September 2023. Data were obtained using a Patient and Family Caregivers Information Form, the Spiritual Orientation Scale (SOS), and the Ok-Religious Attitude Scale (Islam) (ORASI). The mean age of the family caregivers was 55.6 ± 14.2, the SOS total mean score was 89.1 ± 16.2, and the ORASI total score mean was 34.4 ± 4.0. It was determined that 61.1% of the caregivers experienced changes psychologically, 57.5% in their social life, 58.4% in their home life, and 57.5% in their family relationships. A statistically significant relationship was detected between the ORASI of family caregivers who experienced financial and physical distress and the SOS of those who experienced physical and psychological distress (p < 0.05). It was determined that family caregivers of people with Parkinson's disease were affected in many areas physically, socially, and psychologically and that their spiritual orientation and religious attitudes were effective in coping with the problems experienced. Training and support programs are recommended for nurses to develop positive religious attitudes, increase their spiritual orientation and reduce the care burden, taking into account the beliefs and values of family caregivers.

Reimagining a Healthcare Ethics for Persons with Parkinson's Disease: Fostering Compassionate Care Through a Culture of Encounter

This paper delves into the potential of Pope Francis' Culture of Encounter (CoE) to establish an ethical foundation that undergirds pastoral and health care for persons with Parkinson's Disease (PD), their family members, and caregivers. To achieve this goal, this paper explores the following key themes: First, an in-depth examination of the documented experiences of persons with PD and their families and caregivers. PD, an ailment deemed incurable by medical experts, profoundly impacts the well-being of patients and significantly influences the lives of their family members and caregivers. Second, Pope Francis' CoE teaches fraternal openness and orients people to acknowledge, appreciate, and love one another. Patterned after Christ's compassion, CoE underscores that no one is useless and expendable. Third, CoE furnishes an ethical framework for pastoral care extended to individuals with PD, their families, and caregivers. According to Pope Francis, CoE's effectiveness and positive outcomes restore people and circumstances to their rightful positions - reinstating the dignity of living.

Spirituality and Spiritual Distress in Parkinson's Disease Caregivers: A Scoping Review

Despite recognition that spiritual concerns contribute to caregiver burden, little is known about spirituality, spiritual well-being, and spiritual distress in Parkinson's disease caregivers. In this scoping review of the literature through October 2022, we searched PubMed, PsychINFO, Embase, and CINAHL. From an initial pool of 328 studies, 14 were included. Caregiver factors (e.g., depression, age) and patient factors (e.g., faith, motor function) affected caregiver spirituality and spiritual well-being. Caregivers experienced loss of meaning, existential guilt, and loneliness, and coped through acquiescence, cultural beliefs, prayer, and gratitude. Future research should focus on the specific spiritual needs of Parkinson's disease caregivers and interventions to address them.

"Embracing The Faith": The Contribution of Islamic Beliefs on the Provision of Care for People with Parkinson's Disease in New Zealand and Indonesia

This study examines the impact of Islamic beliefs on the caregiving practices of individuals diagnosed with Parkinson's disease in Indonesia and New Zealand. The study sample comprised seventeen caregivers who participated in semi-structured interviews which were analysed using the method of inductive thematic analysis. The study delineated three overarching themes: value-driven caregiving, comprehensive care and caregivers strengthened by faith and practice. This study examined the practical applications of the Quran, Hadith and Muslim beliefs in caregiver experiences. Further research is necessary to enhance the support systems for Muslim caregivers in various circumstances, facilitating the advancement of solutions to contemporary social problems.

Factors relating to depressive symptoms of caregivers for older care recipients in Indonesia

Objectives: Family care is a large part of an informal workforce and there are increasing unmet demands for ageing populations, particularly in low and middle-income country settings. This study investigates relationships and care requirements for older care recipients and their caregivers within the household and identifies factors relating to depressive symptoms among caregivers of older persons.Method: Data were derived from the Indonesian Family Life Survey (IFLS Wave 5). Multiple logistic regressions were used for analyses. Outcomes were Center for Epidemiologic Studies Depression Scale (CES-D score ≥10 as having moderate to severe depressive symptoms).Results: Over half of care recipients aged 50 years and over reported requiring intermediate or high-level care intensity. Primary caregivers were most often spouses for older males and adult children for older females. Factors associated with depressive symptoms among caregivers were not working (adjusted odds ratio, AOR 1.86; 95% Confidence Interval 1.19- 2.90), primary school education (AOR 5.01; 1.96-12.8), living in rural area (AOR 1.38; 1.01-1.88), and having multiple older care recipients in the household (AOR 1.98; 1.43-2.75). Having care recipients with medium or high functional limitation levels (AORs 2.27; 1.51-3.42 and 3.36; 2.00-5.63, respectively) and not receiving household co-resident support were associated with caregivers' depressive symptoms (AOR 1.32; 1.01-1.89).Conclusion: To meet the anticipated future demands for elderly care, addressing factors relating to depressive symptoms, especially amongst those not working, low education, living in rural areas could help mitigate adverse effects for caregivers. Caregivers could benefit from the provision of adequate support, including screening for depressive symptoms.

Co-Designing an Integrated Care Network with People Living with Parkinson's Disease: A Heterogeneous Social Network of People, Resources and Technologies

As part of the iCARE-PD project, a multinational and multidisciplinary research endeavour to address complex care in Parkinson's disease, a Canadian case study focused on gaining a better understanding of people living with Parkinson's disease (PwP) experiences with health and medical services, particularly their vision for a sustainable, tailored and integrated care delivery network. The multifaceted nature of the condition means that PwP must continuously adapt and adjust to every aspect of their lives, and progressively rely on support from care partners (CP) and various health care professionals (HCP). To envision the integrated care delivery network from the perspective of PwP, the study consisted of designing scenarios for an integrated care delivery network with patients, their CP and their HCP, as well as identifying key requirements for designing an integrated care delivery network. The results demonstrate that numerous networks interact, representing specific inscriptions, actors and mediators who meet at specific crossing points. This resulted in the creation of a roadmap and toolkit that takes into consideration the unique challenges faced by PwP, and the necessity for an integrated care delivery network that can be personalized and malleable so as to adapt to evolving and changing needs over time.

The subjective experience of family caregivers of people living with Parkinson's disease: a meta-ethnography of qualitative literature

BACKGROUND AND AIMS

Parkinson's disease patients (PwPD) rely heavily on their family caregivers. However, there remains uncertainty regarding the subjective experience of the family caregivers of PwPD. This study aims to provide an in-depth summary of the current knowledge about the subjective experiences of family caregivers caring for PwPD, to understand the factors that influence this experience and to provide the evidence for healthcare services.

METHODS

We conducted a systematic review and meta-ethnography using Noblit and Hare's approach. The search strategy used MeSH terms in combination with free-text searching of 10 databases (from their inception until July 2021). Titles and abstracts were reviewed by two reviewers and, for the studies that met the eligibility criteria, full-text articles were obtained. The Critical Appraisal Skills Program (CASP) checklist was employed to assess the quality of studies.

RESULTS

A total of 3318 studies were screened and 29 qualitative studies were included in this review. These studies recorded the experience of 399 participants across 12 countries, most were females. Five themes emerged: (a) feelings related to PD; (b) challenges to family life; (c) external challenges; (d) adjustment and adaptation; (e) external support. We propose a new conceptual model that highlights that the experiences of caregivers for PwPD are dynamic and influenced by a variety of internal and external factors.

CONCLUSION

Our findings illustrate the complex and dynamic experiences of family caregivers for PwPD. It is necessary to explore how the influencing factors can be modified to improve the lived experience of family caregivers.

Women Caring for Husbands Living with Parkinson’s Disease: A Phenomenological Study Protocol

Parkinson’s disease (PD) is an emerging pandemic caused by aging, longevity, and industrialization. Most people diagnosed with PD initially experience mild symptoms, but over time the symptoms become debilitating. Given their intensive care requirement, most married people living with PD receive care from their spouses; most are female caregivers. Because caregiving is hard work with long hours, caregivers experience stress, fatigue, and depression, often leading to exhaustion and burnout. The purpose of this descriptive phenomenological study is to understand the lived experience of women caregivers of husbands living with PD. As part of this study protocol, women caring at home for their husbands diagnosed with PD will be purposely recruited from the Colorado Parkinson Foundation. Semi-structured interviews will be conducted by Zoom© until data saturation is achieved. Colaizzi’s seven-step process will be used to analyze the data in Atlas.ti. Strategies have been incorporated into the study protocol to maximize trustworthiness and to insure methodological rigor. The study will be reported using recommendations from the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research. Findings from this study may guide intervention development to improve the caregiving experience and to inform clinical practice guidelines for health care professionals.

Perceptions and meanings of living with Parkinson's disease: an account of caregivers lived experiences

Purpose: Current study looked into caregiving process of those dealing with family members suffering from Parkinson’s disease, within the changing social milieu in India. It aimed to understand the experiential and existential impact on the lifeworld of caregivers.

Method: Narrative interviews of 10 female caregivers referred by neurologists were gathered. Employing Existential Phenomenological Analysis, the caregiver experiences were understood phenomenologically within an existential framework, six themes were generated.

Results: Themes were – Becoming a caregiver: Undertaking immeasurable and unrelenting responsibilities; Rising patient-hood of one’s family member: pain of losing the person in the patient; Experience of altered temporality: living in pain with the uncertainty and duration of the disease; Encountering meaninglessness: dwindling faith in principles of life; Existing as a “Being For” and not “Being With”: a caregiver’s self-estrangement and blurring of Identity and lastly Self-Preservation through brief moments of respite: coping with caregiving.

Conclusion: The study illuminated how caregiving is experienced by an individual at a process and psychic level by shedding light on the conflicts, concerns and exhaustions endured by them. Adopting an existential approach in healthcare setups can aid in moving closer to felt experiences of these caregivers and in developing integrative and meaningful interventions for enhancing their well-being.

The Experiences of Treatment Burden in People with Parkinson's Disease and Their Caregivers: A Systematic Review of Qualitative Studies

BackgroundHigh treatment burden is associated with poor adherence, wasted resources, poor quality of life and poor health outcomes. Identifying factors that impact treatment burden in Parkinson's disease can offer insights into strategies to mitigate them.ObjectiveTo explore the experiences of treatment burden among people with Parkinson's disease (PwP) and their caregivers.MethodsA systematic review of studies published from year 2006 was conducted. Qualitative and mixed-method studies with a qualitative component that relate to usual care in Parkinson's disease were included. Quantitative studies and grey literature were excluded. Data synthesis was conducted using framework synthesis.Results1757 articles were screened, and 39 articles included. Understanding treatment burden in PwP and caregivers was not the primary aim in any of the included studies. The main issues of treatment burden in Parkinson's disease are: 1) work and challenges of taking medication; 2) healthcare provider obstacles including lack of patient-centered care, poor patient-provider relationships, lack of care coordination, inflexible organizational structures, lack of access to services and issues in care home or hospital settings; and 3) learning about health and challenges with information provision. The treatment burden led to physical and mental exhaustion of self-care and limitations on the role and social activities of PwP and caregivers.Conclusion:There are potential strategies to improve the treatment burden in Parkinson's disease at an individual level such as patient-centered approach to care, and at system level by improving access and care coordination between services. Future research is needed to determine the modifiable factors of treatment burden in Parkinson's disease.

Living with Long Term Conditions from the Perspective of Family Caregivers. A Scoping Review and Narrative Synthesis

(1) Background: When living with one or more long term conditions (LTCs), both the patient and the family experience the impact of the condition at different levels. The family's needs and perceptions should be considered in the process of caring for people with LTCs. The aim of this review is to understand "the process of living with LTCs" from a family perspective. (2) Methods: A scoping review and narrative synthesis were conducted using a systematic methodology in MEDLINE, CINAHL, Web of Science and PsycINFO, in English and Spanish, including evidence from 2018. (3) Results: A total of 28 articles were included in the review. Acceptance, coping, self-management, integration, and adjustment were key attributes in the process of living with LTCs from the perspective of family caregivers that interrelated in a dynamic way through different mechanisms: being aware of the changing situation, personal networks, information and education, personal conditions, attitude to life and communication. (4) Conclusions: The five attributes that comprise living with LTCs from the perspective of the family caregiver are closely connected of to those of patients living with LTCs; however, self-management and integration have a different meaning and application.

Counterpunching to improve the health of people with Parkinson's disease

BACKGROUND

Boxing programs designed specifically for people with Parkinson's disease (PD) can be beneficial in improving the physical, mental, and functional health of persons with PD.

PURPOSE

This study examined the effect of a boxing program, Rock Steady Boxing (RSB), on the health of people with PD from both the boxers' and their caregivers' perspectives as well as evaluated balance, quality of life (QoL), and depressive symptoms after 12 weeks of RSB.

METHODS

A mixed methods, one-group experimental design with focus groups were embedded within an intervention study. Six boxers completed baseline and 12-week postassessments.

RESULTS

The majority of boxers maintained or improved scores for balance, QoL, and reduced depressive symptoms. Findings indicate physical and mental benefits of RSB among persons with PD and this was further validated by qualitative data from boxers and caregivers, along with quantitative data of boxers. Caregivers and boxers reported that boxers' ability to perform activities of daily living (ADLs) improved and is supported by quantitative improvements in the Parkinson's disease Questionnaire-39 ADL subscale. All boxers reported reduced stigma, and caregivers and boxers valued the opportunity to work out in an environment free of stigma, a finding not previously reported.

CONCLUSIONS

It is important for nurse practitioners to recognize exercise benefits for people with PD and recommend the program to patients and include caregivers in their overall assessment of health and wellness.

IMPLICATIONS FOR PRACTICE

Nurse practitioners and other health practitioners may consider recommending a boxing program, such as RSB, for their PD patients as a sole or supplemental exercise program.

Self-care needs and practices for the older adult caregiver: An integrative review

Older adult caregivers experience health risks due to the demands of the role, higher prevalence of chronic illness, the aging process, and insufficient time for self-care. Using Whittermore and Knafl's methodology, an integrative review was conducted to explore the self-care needs and practices of older adult caregivers. The terms self-care, caregiver, informal caregiver, carer, family carer, and older adult were used to search the CINAHL, PsychINFO and SocIndex databases and obtain studies published in English between 2010 and 2020. Non-research articles, reviews, mean age of subjects < 50 years, studies focused on formal caregivers were excluded. Fifteen articles met inclusion criteria. Physical activity, stress management, social support, and support resources were identified as self-care needs. Self-care practices included self-advocacy, coping strategies, prioritizing of self, legacy building, and activism. Further exploration is required on how to best support older adult caregivers in fulfilling their caregiving role while promoting their own health.