Over three decades ago, Tibbit (1983, p. 241) explained the following regarding institutional care of the aged:
Aged persons in our society are neglected and rejected and discriminated against. They are discarded by selfish, callous families and are relegated to loneliness and discomfort which affects their mental and emotional well-being. When they become ill, they are quickly dumped into state hospitals, nursing homes or old-age homes where many of them die from the shock of transfer or from humiliation. Large numbers of them are forced to remain in institutions simply because they have no place to go, and this is largely because their place in the community has been permitted to close in behind them. The children of this generation lack estimable characters and virtue – they make one wonder how it is that while one parent can take care of four children, four children can’t take care of one parent.
Tibbit’s fundamental argument is that the younger generation maintained carelessness, which meant that elderly folk were transferred to care-based institutions where they were isolated, mistreated and lonely. This is a concern that continues to proliferate throughout modern societies. Based on Tibbit’s argument, we will explore what caregiving is, how essential it is to provide the elderly with personal care in a society that has become too busy, and the personal struggles caregivers experience.
What is Caregiving?
Caregiving is the process of caring for sick, elderly, or disabled individuals, specifically those who cannot take care of themselves. Although many families are intentional about providing the best care for relatives who become sick, elderly, or disabled, there is some concern regarding involuntary negligence.
In this case, our modern lifestyles involve many pressures and challenges, such as demanding work schedules, raising children, dedicating time to spend with a spouse, hobbies, and other activities that provide us stress relief. Furthermore, caring for a family member who suffers from Dementia can be extremely stressful because of the “immense psychological and physical burdens” (Aggarwal et al 2003, p. 193).
One of the biggest obstacles, especially when you are unable to cope with caring for a loved one, is that your loved one is resistant to change. This obstacle arises because – according to the National Academies of Sciences, Engineering, and Medicine Journal (2020) – there is a risk that the elderly may feel loneliness, social isolation. These risks are caused by factors such as living alone, the loss of a family or friend, chronic illness, and hearing loss.
As a result, many family members are looking for external caring services. Home care services and caregivers provide relief to family members who are unable to give the attention needed, and it also provides much-needed companionship and friendship to those they care for. Many experienced and compassionate carers are available to take care of a patient in the comfort of the patient’s home. They are available during the day and night, over weekends and public holidays, and some services offer a 24-hour live-in option.
The Impact of Caregiver’s Interventions
Caregivers and home carers can help improve a patient’s quality of life. Their expertise help patients avoid potential loneliness, isolation, even death. In this case, according to Mittelham et al (2006, p. 1594), one way to help patients is through physiological interventions. Physiological interventions include cognitive-behavioural therapy, interpersonal psychotherapy, and problem-solving therapy, which have helped caregivers assist patients to eliminate sending them to institutional care centres. Using physiological interventions also help to increase a caregiver’s knowledge of patient care, which will help improve a patient’s mood, reduce stress and depression levels, and delays nursing home placement (Brodaty et al 2003, p. 657).
To improve the quality of a patient’s life, delayed nursing-home placement should be considered. If a patient is within the comfort of their own home with a carer who understands the patient’s needs, there are long-term benefits such as reduced depression levels. In the case of delayed placement, a study showcased that a 10-day structured caregiver intervention programme delayed nursing-home placement for 7 years without damaging the patient’s psychological health (Brodaty & Gresham 1989).
Struggles of Caregivers
Despite the challenges that patients face when needing care, the people who care for the patient also experience challenges. For example, Moore (2002, p. 32) reported that in a homosexual relationship, the one who cares for the other:
- experiences prejudice and insensitivity when dealing with health services;
- does not receive social and emotional support;
- struggles to take compassionate leave,
- and has trouble with estate planning.
In addition, people from different ethnic groups do not always have access to the use of mental health services (La Fontaine et al 2007). Other factors that may prohibit caregivers from effective caregiving include language barriers and lack of general practitioner knowledge of cultural differences.
Caregivers are significant role-players with regards to patient care. The high levels of burden and psychological morbidity are well documented, as are factors that predict which caregivers are vulnerable to these. Interventions can improve these effects, which can improve the quality of life. The management of the person with Dementia requires a comprehensive that allows the doctors to establish an effective relationship with health care workers and families. This will help target carers who are able to do what is needed for the longevity of the patient.
Tibbit, L.R., 1983. An evaluation of institutional care of the aged in South Africa. South African Medical Journal, 64(7), pp.241-245.
Yeaworth, R.C. and Burke, W.J., 2000. Frontotemporal Dementia: a different kind of Dementia. Archives of Psychiatric Nursing, 14(5), pp. 249-253.
Aggarwal, N., Vass, A.A., Minardi, H.A., Ward, R., Garfield, C. and Cybyk, B., 2003. People with Dementia and their relatives: personal experiences of Alzheimer’s and of the provision of care. Journal of psychiatric and mental health nursing, 10(2), pp. 187-197.
National Academies of Sciences, Engineering, and Medicine, 2020. Social isolation and loneliness in older adults: Opportunities for the health care system. National Academies Press.
Mittelman, M.S., Haley, W.E., Clay, O.J. and Roth, D.L., 2006. Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology, 67(9), pp. 1592-1599.
Brodaty, H., Green, A. and Koschera, A., 2003. Meta‐analysis of psychosocial interventions for caregivers of people with Dementia. Journal of the American Geriatrics Society, 51(5), pp. 657-664.
Brodaty H, Gresham M. “Effect of a training programme to reduce stress in carers of patients with Dementia”. BMJ. 1989 Dec 2;299(6712):1375-9. doi: 10.1136/bmj.299.6712.1375. PMID: 2513967; PMCID: PMC1838247.
Moore, W.R., 2002. Lesbian and gay elders: Connecting care providers through a telephone support group. Journal of Gay & Lesbian Social Services, 14(3), pp.23-41.
La Fontaine, J., Ahuja, J., Bradbury, N.M., Phillips, S. and Oyebode, J.R., 2007. Understanding Dementia amongst people in minority ethnic and cultural groups. Journal of Advanced Nursing, 60(6), pp.605-614.
 According to Yeaworth and Burke (2000, p. 249), dementia is the umbrella term for many different illnesses, such as Vascular Dementia, Alzheimer’s, Parkinson’s disease, and more.