Caregiver role strain

  • Caregiver role strain is a nursing diagnosis that is used a lot in patient care. It has been studied for many years. Terminal illnesses affect patients and their loved ones, particularly primary caregivers, and caregivers themselves really become their own patients when that happens. They have an increased risk of injury and other bad things related to sleeplessness, mental exhaustion, and physical exhaustion from caregiving. They also have less time for social and recreational activities while they are caring for the dying person. Nurses are encouraged to teach caregivers to care for themselves by setting time aside from their caregiving, lessening stress with positive activities, joining support groups, and having someone else help with care when possible, but the teaching and reception probably won’t occur due to time and life issues.

  • Anticipatory, or pre-loss, grief and depression predict if a caregiver will experience complicated grief after the person dies. People who are more likely to experience complicated grief are people who don’t prepare for death, have a very short caregiving period, have less education, have depressive symptoms before caregiving began, are the partner of the person who is dying, and limited social support. Because of this, bereavement support should start before the death occurs to allow for better preparation for end-of-life and to help with social support. Without early intervention, caregivers are unlikely to see beyond the present and may perform little preparation – leading up to the death, 49% of caregivers are not emotionally ready for the death and 35% are not practically ready.

  • After a death, it takes nine to ten months for grief, quality of life, and general health to recover. If this takes a year or more, the griever may potentially have persistent complex grief disorder. This doesn’t affect many people, but those it affects truly suffer. People at greatest risk are those who have little social support during the life crisis, non-supportiveness from social contacts when the death was traumatic, an ambivalent relationship with the deceased, or another life crisis happening at the same time. Signs of PCGD include not being able to talk about the dead, an unwillingness to move or get rid of the stuff belonging to the dead, distancing themselves from loved ones, hurting themselves, being afraid of death, and unbelievable sadness at certain times of the year.