[Anticipatory grief in family caregivers of persons with dementia. Psychosocial correlates and impact on caregiver's health: A literature review]

INTRODUCTION

Taking care of a relative with dementia may be linked to negative consequences for the caregiver. One of the processes that can be experienced is anticipatory grief, that is defined as the feelings of pain and loss that appear in the caregiver before the death of the person cared for.

OBJECTIVES

The review aimed to conceptualize anticipatory grief in this population, to study the related psychosocial variables, and to know the repercussions for the health of the caregiver.

METHOD

A systematic search was made under the directives of PRISMA statement in the ProQuest, PubMed, Web of Science (WOS), and Scopus databases, including studies published in the last 10 years (2013-2023).

RESULTS

A total of 160 articles were obtained, 15 being finally selected. It is observed that anticipatory grief is defined as an ambiguous process since it appeared before the death of the sick family member. Being a female caregiver, spouse of a family member with dementia, having a closer relationship with him and/or having an important responsibility in care, are associated with a greater chance of experiencing anticipatory grief. In relation to the person cared for, if he or she is in a severe phase of the disease, is younger, and/or presents problematic behaviours, there is also greater anticipatory grief in the family caregiver. Anticipatory grief has a significant impact on caregivers' physical, psychological, and social health, being associated with greater burden, depressive symptomatology, and social isolation.

CONCLUSIONS

Anticipatory grief turns out to be a relevant concept in the context of dementia, being necessary to include it in intervention programs for this population.

[Guilt and well-being in institutionalized family caregivers of dependent elderly people]

INTRODUCTION AND OBJECTIVE

The experience of family caregivers after nursing home admission has received much less attention, probably because many caregivers experience an initial sense of initial emotional relief. However, for some caregivers nursing home admission is a stressor despite the reduced physical burden of caregiving. Caregiver distress following institutionalization has been related to the new burdens and challenges encountered in the nursing home. Ambivalence and guilt related to the institutionalization decision have been identified as sources of stress. Therefore, this study examined the effect of guilt and well-being on the perceived stress of family caregivers of institutionalized dependent persons.

MATERIALS AND METHODS

Two hundred and one family caregivers of institutionalized persons in a nursing home (La Rioja, Spain) participated. Perceived stress, caregiving guilt and subjective well-being, sociodemographic and caregiving-related variables were assessed. Linear regression analyses and correlations between variables were performed.

RESULTS

Guilt and five dimensions of well-being (anxiety, vitality, self-control and depression, except general health) significantly predicted stress (R²adj=.552 (F (6, 198)=41.71, P<.001)). The effect size was large (95% CI=.461).

CONCLUSIONS

Paying attention to family caregivers' feelings of guilt during institutionalization is important. This will enable the design and implementation of psychosocial interventions that improve caregiver adjustment immediately after institutionalization.

[The effect of family caregiver empowerment interventions on family caregiver capabilities in self-management of type 2 diabetes mellitus in Indonesia]

OBJECTIVE

Empowering family caregivers is one of the strategies to increase the family caregiver's capability in T2DM self-management. The adequate capability of family caregivers in T2DM self-management can improve T2DM management, impacting people's health status with T2DM. This study aimed to examine the effect of family caregiver empowerment intervention on the family caregiver's T2DM self-management capability.

METHODS

This study is an experimental study with a randomized control group pre-test post-test design. The sample size is 60 respondents by simple random sampling, which is divided into two groups randomly. The treatment group (n=30) received 10-session intervention in 10 weeks (six education and training sessions and four mentoring sessions), and the control group (n=30) received standard care. Data were collected using a questionnaire, twice, before and after the intervention (12 weeks after the last intervention session) and analysed descriptively and statistically (One way-ANOVA test, dependent t-test, and independent t-test).

RESULTS

The empowerment intervention significantly increased the family caregiver's T2DM self-management capability, including diet management (t=4.070; p<.001), physical activity management (t=9.493; p<.001), medication management (t=4.021; p<.001), self-monitoring blood glucose levels (t=2.789; p<.001), and foot care skills (t=6.835; p<.001).

CONCLUSION

Family caregiver empowerment interventions can improve the capability of family caregivers in self-management of T2DM, including increasing the capability to manage diet, physical activity, medication, self-monitoring blood glucose levels, and foot care. Nurses can empower family members as family caregivers to improve self-management of T2DM.

[Assessment tools to measure burden in the informal caregiver of patients with dementia]

The complexity of dementia caregiver burden concept has led to a significant number of assessment tests using various approaches. For this reason, a review of these measurementss could be useful for clinical or research purposes.

OBJECTIVE

The objective of the study is to perform an updated review on the tools available, classifying them according to the burden criterion by studying their characteristics and psychometric properties, and providing those most relevant for application.

METHOD

The method applied consisted of a database search -Pubmed, PsycINFO, Embase and Psicodoc (1980-2012).

RESULTS

A total of 31 assessment tools were selected, grouped on the basis of the burden concept evaluated: objective/subjective burden, burden from a multidimensional approach, and as distress associated with patient impairment.

CONCLUSIONS

This study provides a suitable tool for using caregiver burden assessment tools accurately. A marked conclusion is the need to establish agreements in the assessment methods, in order to develop standard knowledge and application to healthcare practice.