El sentido del cuidado y las estrategias de afrontamiento en cuidadores de mayores con demencia

Abstract

Although recent research begins to include concepts such as satisfaction or quality of life, studies have focused on the negative consequences of caring for a dependent elderly. We consider that different aspects such as the experiencing of satisfaction within the caregiving role, the caregiving quality of life and the finding of meaning, can coexist with burden, anxiety and depression. Furthermore, we postulate the importance of the coping strategies and the search for meaning in relation to the consequences the caring has on the primary caregiver. Also, given the scarcity of researches addressing the impact that institutionalization has on the family caregiver; we intend to explore the process of institutionalization. Participants were 140 elderly caregivers, 77 caregivers in community, 63 in nursing homes, 79 were caring for seniors with dementia and 61 were caring for seniors without dementia. We assess the primary caregiver¿s characteristics, evaluating variables related to mental and emotional health as well as their quality of life and satisfaction. The instruments used are the scale of Zarit burden interview, HAD, GDS, HDRS, EQ-5D and Lawton satisfaction scale. In addition, we have evaluated the institutionalization process and its consequences, as well as the consequences of dementia regarding the caregivers¿ mental health and quality of life. Finally, we assess the meaning and coping strategies as well as their connection to the caregivers mental health and quality of life, as well as to the institutionalization and dementia. The findings suggests that the care of a dependent elderly is on one hand a chronic stressor that disturbs the caregivers mental health, but on the other hand it offers rewarding aspects, being the characteristic of the situation more strongly related with the mental state of the caregiver and the positive outcomes of the caregiving, finding on them, no consequences of the elderly dementia. As for the decision to institutionalize, it appears related to the ¿no choice freedom¿ of the primary caregiver, experiencing burden and dissatisfaction within the caregiving role. The findings also suggest that care doesn¿t conclude after placing the relative in a nursing homes, although there is a change regarding the stressors affecting the caregiver, being important the establishment of an appropriate cooperation between the caring staff and the elderly¿s families in order to improve the caregivers¿ mental health and quality of life. The outcomes also suggest that the finding of meaning increases satisfaction and reduces the degree of burden.