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Abstract
Many people suffering from dementia require long-term care that is normally provided by caregivers at home or in residential facilities. The experiences of providing care to dementia patients have a profound influence on their quality of life of the caregivers and the carers face many challenges in providing care to dementia patients. This paper evaluated the challenges faced by the caregivers caring for people with dementia In the United Kingdom and the effects they have on their quality of life.
The study utilized an exploratory review of existing literature. This study found out that the major challenges faced by caregivers are the physical, emotional and psychological strain that affect the health and well-being of the caregivers. Other challenges include social isolation, reduced work opportunities and the financial burden of caring for a person with dementia. These challenges are interrelated, and one challenge can ameliorate another challenge.
Introduction
Dementia is a general term used to describe several syndromes associated with changes in cognitive function due to a variety of some progressive and irreversible disorders in the brain. These brain disorders affect behavior memory, thinking, and the abilities to perform daily tasks. Alzheimer’s disease is the most common type of dementia and represents half of all cases of dementia. Vascular dementia occurs in twenty percent of all dementia and it is caused by problems in the blood supply to the brain cases and Lewy Body dementia, which occurs in twenty percent of all dementia cases. Other forms of dementia occur due to some rare diseases such as Cruetzfeldt-Jacobs disease, Picks disease, Hunting’s Chorea and Parkinson’s disease (Andreas, 2015).
Currently, over 850000 people in the United Kingdom live with dementia and 700000 people care for people with dementia. Some people suffer from mixed forms of dementia that may include Alzheimer’s disease and another type of dementia. Dementia does not have any known cause and cure and death normally occurs in seven to ten years after diagnosis. However, the control of some symptoms of dementia such as depressions, hallucinations, agitations and delusions can be achieved through medications.
Good control of vascular factors like blood pressure and the use of some anti-choline stearate inhibitors reduce disease progression and slow down the loss of cognitive abilities (Alzheimer’s UK, 2015).
Dementia is a disease that most affects old people although in some cases, it might develop at an earlier age. The risk to the development of dementia increases after the age of sixty-five years. Dementia is a serious disease that exalts a very heavy emotional, mental, physical and financial toll on the patient and their immediate families. Dementia is a serious and growing health challenge in the United Kingdom (UK Department of Health, 2012).
In the United Kingdom over 670000 people, live with dementia. The costs of caring for people with dementia to the UK economy are 19 billion pounds a year. Over half a million carers care for people with dementia. Dementia is the tenth largest killer in the United Kingdom accounting for 2.6 percent of all annual deaths. Half of the people with dementia in the United Kingdom do not have a formal dementia diagnosis or contact with specialist dementia services. The rates of diagnosis vary from 39 percent to 7 percent in most areas. People with dementia occupy Twenty five percent of all hospital beds in The United kingdom. Patients with dementia stay for long in the hospital are more likely to be readmitted to the hospital. Two thirds of residents of the residents of care homes have dementia. In the United Kingdom, people with dementia live in care facilities while two thirds of people with dementia live at home (Andreas, 2015).
It is estimated that one in three people with dementia will care for a person with dementia in their lifetime. Dementia has profound effects on a patient and the immediate family. As the disease progresses, the needs of patients increases and carers are the main sources of support for people with dementia. Given the nature of the symptoms and the effects of dementia on a person’s health and behavior, the caregivers of people with dementia face many challenges while caring for patients with dementia (Beatrice& Fiona, 2015). The support systems available for people with dementia are either formal or informal. Informal carers are the most reliable and acceptable forms of support in the United Kingdom. Most families prefer to take care of their people suffering from dementia (Department of Health, 2012)
However since dementia is a long term disease, the long time frame in which the disease lasts hamstrung the efforts of looking into a person with dementia in their households. Informal caregivers also facilitate the linkages with formal providers of treatments such as physicians and community health care workers. Formal and professional caregivers include trained healthcare providers and other professional staff involved in caring for people with dementia. Most people placed in residential homes and nursing care have moderate to severe illnesses and placement into these residential facilities is always a challenging role for many families and person with dementia (Department of Health, 2012).
The Carers of people with dementia provide care to dementia patients for long periods, with the dementia patients needing a great deal of both emotional and physical support from the caregiver. Over 6.5 million people are carers in the United Kingdom and this number is expected to rise in the future. According to Alzheimer’s UK, (2015), there will be a forty percent rise in the number of carers needed by the year 2037 meaning that the population of carers in the United Kingdom will be 9 million people by the year 2037. The population of carers is not static, and every year many millions of people usually take on the responsibilities of caring while at the same time caring ends for millions of others. 2.1 million People become carers every year, and for an equal number, the caring responsibilities for other people end. This means that caring touches the lives of many people in the population.
Three in five people in the population become carers at some stage in their lives. About 1.4 Million people provide one to fifty hours of care per week. The number of care workers caring by more than fifty percent every week has increased. Friends and family make the most of caregivers in the United Kingdom. The Social services and The National Health Service of the United Kingdom rely on the willingness of the carers to provide support, and without their input, the social services would collapse the majority of carers in the United kingdom are of the working age though the number of people aged fifty to sixty four years offer care. Fifty eight percent of carers are women while 48 percent are men.
Carers refer to the people who look for a relative or friend in need of support because of age, illness or some physical disability. The types of care provided by carers in the United Kingdom vary considerably. Ninety three percent of the carers offer support such as the preparation of meals, shopping and laundry. Carers play an important role in all stages of a person with dementia from diagnosis to the management of symptoms and in the final stages of the disease. Fifty seven percent of the carers offer support by helping the person with care with mobility and providing personal care such as dressing, washing, eating and using toilets as well as arranging for coordinated care and medical appointments (Department of Health, 2012).
Carers also provide emotional support, motivation and keep an eye on the person they care for. Most carers care for just one person in the home care settings while others may care for more people especially in residential homes. Due to the demands of caring for the patients with dementia and the progressive nature of the disease, carers face many challenges in the home setting and specialized care units or other care centers. These challenges influence even the life and health of the carers and the patient with dementia.
The purpose of the research study
This study evaluated the challenges faced by the carers of people with dementia in the home setting and other residential facilities and the way these challenges affect their life, health and well being.
Statement of the problem
The role of caring for a person with dementia is a challenging experience for many caregivers. The changes that occur in patients with dementia can be unpredictable and they may pose some significant challenges to the carers. Patients with dementia also require round the clock care and the as the disease progresses, the burden of care for people with dementia increases. Many researchers have linked the process of care giving to some severe effects on the well being and health of caregivers. Understanding the challenges that carers go through is therefore, important since it can help in the designing of interventions and support strategies for carers to make the process of caring for a person with dementia a positive experience for carers.
Literature review
This literature review grew due to the desire to understand the experiences of carers in caring for people with dementia to synthesize the immense amount of information available about caring for people. Caregivers usually go through a process of adjustment, crisis, and adaptations where they try to maintain a balanced functioning using the available resources and their coping mechanisms to meet the stress, the demands and the pressures of caring for a person with dementia. Family, members usually have different perceptions about their ability to cope with the demands of care for dementia patients. The family situation and their experiences of carers are varied (Sarkar, 2015).
Many family care providers view it as a duty to care for their loved ones despite the enormity of the duty of care. Carers make a very vital contribution in the people they care for in society. The personal experiences of providing support and care to people with dementia differ depending on many factors and the individual. The quality and the range of interventions that carers require or find at their locality also vary considerably. The experiences of people caring for patients with dementia have evolved over the years.
According to Ablitt et al., (2009), the way dementia has been conceptualized has significantly changed over the years. In the past, caring for a person with dementia entailed a specific focus on caring emphasizing the burden experienced because of caring like poor physical and mental health. The person suffering from dementia was not included in research since they were viewed in terms of the problems they created to caregivers.
From the 1990s, the concept of personalized care emerged, numerous studies emerged, and since then the way of caring for a person with dementia changed significantly to considering both the person with dementia and carers and the reciprocal influences of the interaction with the disease. According to Petrus & Wing-Chung, (2005), caring for a person with dementia entails both positive and negative experiences. The changes brought about by dementia require a person and the immediate family caring for somebody with dementia to undergo a process of adjustments, adaptations, and assimilation (Keady et al., 2012).
There is a wide literature available that have studied the impacts of dementia on the relationships between family caregivers and people with dementia. According to Ablitt et al.., (2009), the experiences of giving and receiving care within the family usually occurs in a long standing relationship that in most cases predates the development of dementia and evolves as the disease progresses. Families usually have their own communication styles, boundaries, emotional contentedness and their own patterns of adaptation to changing life events. Sarkar (2005) suggests that dementia presents some psycho social challenges to family relationships. The length and the quality of the relationship between family members influence adjustment and adaptation that occurs with dementia.
Thriving relationships with the family are linked to motivation and meaning in caring for a person with dementia and higher levels of satisfaction with giving care are associated with thriving relationships. In thriving family relationships, there is a higher capacity for managing and negotiating the challenges of dementia and, acknowledging the contribution of every party makes to the relationship and a very strong emotional bond, which make the challenges brought about by dementia, can be separated from the relationship.
In such thriving relationships, there are many support strategies for the continuation of valued activities such as engaging in mutual activities with the person with dementia rather than taking over those roles (La Fontaine et al..., 2013). Zarit et al. (1980) were the first researchers to highlight the burden of the provision of care to dementia patients. Research looking into the impacts of care to dementia patients is now widespread and the possible interventions to reduce the effects of care on carers (Schulz et al., 2000).
Research looking into the impacts of dementia on the pre-existing relationships when it is poor is not common but Lafontaine et al..., (2013), and Ablitt et al., (2009), suggest that a poor relationship among family members leads to disconnectedness and conflicts when caring for a person with dementia. The strategies of managing and experiencing dementia entail the use of less coping strategies and the use of confrontation and deception to manage behavior (Deriers et al., 2010).
Dementia has a profound effect on family relationships and changes opportunities for communication, reciprocity, shared activities, reciprocity. However, love, warmth, affection, and closeness are still possible in family relationships (Ablitt et al., 2009). For married couples caring for their partners, dementia affects opportunities for companionship, shared interests, mutual support and reciprocity and the spouses can experience a sense of isolation and loneliness and loss of intimacy due to change in roles as a consequence of these losses. The shifting of responsibilities within the family due to caring for a person with dementia also entails a complex process of negotiations, which entails managing and negotiating the risks associated with change in abilities and the type of help needed by the person suffering from dementia
According to Alzheimer’s UK, (2015), Caring for a loved one with dementia also affects the relationship with other family members because of the resentment and guilt of one person taking a vast majority of the caring responsibilities. Carers sometimes treat the person they are caring for in a more infantile way because of the impact of the condition on the personality and behavior. Many carers struggle to cope with changed behavior resulting in anger and frustration that sometimes leads to conflicts and violence by the person suffering from dementia.
As dementia progresses, many carers are challenged to deal with aggressive behaviors since it results in a psychologically and physical stress for carers.
The repetitive behaviors of dementia also lead to frustration from carers because they have to repeat themselves and explain things many times. Some erratic behaviors such as problems with drinking and eating are very difficult to deal with since it required some careful monitoring by the carer and occasionally results in conflicts with the person suffering from dementia. However, carers also report some positive outcomes in caring for family members through the strengthening of the bond and the relationship because of the close and intimate relationship shared between them.
According to Alzheimer’s UK, (2015), Caring for a person with dementia, especially in the family environment is a demanding responsibility that is both emotionally and physically exhausting, and this can leave carers with little enthusiasm and energy for anything else. It is hard for carers to leave their carers to pursue personal goals. The guilt of leaving loved ones to pursue personal goals usually overrides the desire to pursue personal goals. Lack of a social life is a major problem for many carers as the responsibilities of caring for the person with dementia is prioritized over own well being. Carers sacrifice their personal life, time and holidays for caring for their loved ones.
Many researchers agree that physical and emotional stress is a major problem for carers of people with dementia (Alzheimer’s Society, 2012). The duty of providing round the clock care to patients has a major effect on physical and psychological well-being and this is enhanced by the problem of social isolation and the feelings that they are gradually losing their loved ones. The changing and unpredictable, behavior of people with dementia also causes many frustrations and stress, and carers have to adapt constantly their physical and emotional relationships to the needs of people with dementia.
The lack of social connection also affects emotional and physical health. Carers also suffer from poor physical health due to sleep deprivation, carrying out many household chores, like cleaning and laundry and moving and lifting people with dementia, which puts a major strain on the loved one.
The concerns and anxiety about the future and the unpredictable nature of dementia also add some extra psychological strain on carers. The high levels of responsibility carers feel towards their loved ones make many carers ambivalent towards focusing on their own health. Although carers acknowledge that prioritizing the health of their loved ones, when their own health deteriorates, the impacts are always detrimental for the person with dementia and the carers (Sarkar, 2015)
Carers also face some financial implications in caring for their loved ones in different ways. Due to the number of hours spent caring for people with dementia, carers face reduced work opportunities due to lack of flexibility and hence reduced chances of income. Other costs associated with caring for a person with dementia are, medicines and care products, adaptations and equipment, specialist foods and high utility bills like electricity and water.
Carers also faced with long-term uncertainty about significant costs in the future as the condition of their loved ones progresses. It is apparent that caring for a person with dementia puts a very heavy strain on the physical health as well as the psychological health of the person as well and their relationships. Caring for a person with dementia entails an additional sense of loss of loved one coupled with the emotional and physical stress that makes the act of caring for a person with dementia a very emotional experience for carers. An Understanding all the challenges that carers go through is important since it can help in designing of good coping strategies for carers when caring for people with dementia (Ablitt et al..., 2009).
Methods
The study is an exploration review of the existing literature on the impacts of caring for dementia patients on carers. The following databases were searched for articles, Google, PysInfo, Medline, Embase, Pubmed and National Institutes of Health. Print articles and books will also be searched manually in academic libraries. The search items that used were ‘The impact of dementia on carers”, the effects of long term caring on carers for people with dementia.’ and carers and dementia and “the negative effects to carers who care for dementia patients.’ And carers in dementia care’. The articles selected in the manual and the electronic searches were then be reviewed for the relevance to the research questions to ensure only the most relevant articles with the right information are selected for the review.
The researcher reviewed the abstract and the titles of articles and the full texts of the relevant abstracts reviewed in full to ascertain the relevance of the articles. Ten articles w were then selected and reviewed to extract information from the articles useful in answering the research objectives. The criteria used for selection of articles for this study was based on,
1) The population under investigation involves people caring for dementia patients
2) The main variable of the study were the challenges and the effects of caring for dementia to careers
3) The research study was carried out in real world settings where the carers had spent a significant amount of time caring for their loved ones.
Results
Caring for people with dementia is a major life challenge and entails a major emotional, physical, and social burden for carers. Carers experience many emotional problems when caring for people with dementia. The major emotional problem that is often ignored is depression. According to Cummins, (2001), family caregivers who care for a person with dementia have more depressive symptoms compared to non-care givers and the caregivers of people with dementia have more depression compared to carers who care for people with another type of illnesses. The prevalence rate of depressive symptoms for caregivers is in the range of twenty -eight to fifty five percent of all carers (Schulz et al., 2000).
The Stress of carers is an important public health issue because of the negative important role stress plays in caring for a person with dementia. Carers provide assistance in activities such as mobility. Due to these responsibilities, caregivers usually experience poor health, engage in few self-promotional activities and have a lower life satisfaction. The family caregivers with a depressed mood are more likely to have decreased abilities of performing their desirable health maintenance behavior and self-care behaviors.
Informal caregivers of individuals with dementia are a great resource for health care systems, and the task is not a very easy one when they are fraught with physical exhaustion and stress. There is a high link between the behavioral problems presented by dementia patients and elevated levels of caregiver stress and depression. The frequency within which disruptive behaviors are manifested by the dementia patient is a string predictor of caregiver stress (Sarkar, 2015). Carers face unpredictable and unfamiliar situations that increase anxiety.
Anna & Andreas, (2015) assert that many carers have different beliefs and concerns over the choice of treatment for people with dementia. There are concerns over the level of treatments that should be provided to people including hydration, nutrition and more palliative approaches for their loved ones. Many carers also struggle with acceptance of the death of their loved ones with some accepting death while others do not accept the possibility that dementia results in the death of their loved ones in a short time.
In situations where carers and their families are not educated to deal with the relative’s condition, carers may also lack knowledge and understanding of dementia. Conflicts and disagreements between families and professionals can also appear to cause difficulties with treatment choices and acceptance of death. Many carers are not able to think about the dying processes and death of their loved one and reluctance to talk about end of life care.
Henry & Marika, (2009), assert that caregivers face many challenges when balancing between care giving and other demands for care like rearing their own child, careers, and their other relationships. The effects of care on carers are diverse and complex. Many related factors ameliorate the way caregivers react and feel in the provision of caring for a person with dementia. According to Pearling et al., four main areas lead to the development of stress in caring for a person with dementia. The first one is the background of the carer such as other life events that may exacerbate stress, the primary stress of the illness like the behavioral and psychological issues of dementia. The secondary role strains like family responsibilities and social life and the intra-psychic strains, which include the personality of the person, competence and the captivity of the carer like feelings of being trapped and work overload.
The provision of care to people with dementia caregivers have a higher risk of suffering from varied health problems such as cardiovascular diseases, low immunity, poor response to vaccines. They also suffer from slow wound healing and suffer from chronic illnesses such as diabetes, arthritis, anemia, ulcers and record more visits to doctors and a higher use of prescription medicines. Dementia caregivers also report low engagement in healthy behaviors such as exercise and have a greater likelihood of suffering from poor sleep patterns, drinking alcohol and smoking. Generally, dementia caregivers have a higher number of physical health problems and worse overall health compared to non-carers. Carers also suffering from poor psychological health are also highly likely to suffer from poor physical health, and a high risk of death (Anna & Andreas, 2015).
Lucinda, (2006) also explains that dementia caregivers also suffer from psychological morbidity that includes anxiety and depression. The levels of psychological distress are significantly higher for caregivers of dementia and the levels of self-efficacy and subjective well being lower for dementia caregivers compared to non-caregivers. Caregivers also tend to sacrifice their own leisure pursuits and their hobbies and restrict the time they have with friends and family.
Many carers reduce or opt out of employment hence lack a social support system that leads to feelings of social isolation. Caring for dementia also has some significant financial effects on caregivers; direct costs include the cost of medications, interventions, and nursing care. There are also hidden costs as most carers are unpaid for the care they give other indirect costs include reduction or loss of employment due to lack of employment. Caregivers find aggression and violence as the most disturbing behavior of patients dealing with dementia. A significant number (15 percent of all dementia patients are aggressive to their carers (Marika & Henry, 2009).
According to Alzheimer’s UK, getting access to appropriate support and help to keep caring for their relatives at home is a major challenge. Although help from medical professionals is available in most cases for dementia patients, the frequency and support from practitioners is sometimes is not sufficient to address all the changing demands of dementia patients. Many carers are sometimes ill prepared to deal with the demands and the needs of dementia patients. Many family carers are task orientated, have little understanding of the disease and do not promote the independence of the person with dementia since they insist on doing all the chores and in most cases, therefore fail to utilize the functional capabilities remaining in dementia patients (Alzheimer’s Society, 2013).
Hirst et al.., (2005), used the British Household Panel survey data between 1991 and 2000 to map the path of individuals while entering and leaving care giving and recorded their distress levels at particular intervals to evaluate the evidence of mental health issues on caregivers. This study revealed that caregivers providing more intense care of more than twenty hours a week had twice the risk of experiencing psychological distress compared to non-caregivers and this effect was particularly greater to women (31) compared to men (22%).
The risk of experiencing psychological distress increased with an increase of the hours of care giving every week. This study observed a general pattern of psychological stress. In the first year of giving care, there was a rise in cases of distress in the first year, which then stabilized over time and then the cases of distress rose again when care continued for four or more years. Although many caregivers in this survey adjusted to their care giving roles, the risk increased with care giving responsibilities. The time of transiting to care giving was also a time characterized by increased distress. The time it took for caregivers to recover from the psychological distress was five years from the time the care was discontinued. Care giving is independently linked to psychological stress although it is also ameliorated by other factors such as socioeconomic circumstance and income status.
Vitaliano et al., (2003) undertook a meta-analysis of many studies of the impacts of providing care to people with dementia and compared these rates to the general population of older people with those of caregivers. Thy found out that minor and major depression among caregivers was twenty percent compared to eleven percent of the general population. Bond et al., 2003 also observed the process of overcoming distress caused by care giving is also influenced by the reason the care giving ends. If care giving ends due to the death of a spouse, there were deterioration in the mental health of the caregiver. If care needed due to institutionalization of the person with dementia, the mental health of the caregiver significantly improved.
Savage and Bailey, (2004) also reviewed the effects of care giving on the mental health of carers and found out that carers had a less life satisfaction, increased sense of self-worry, stress and psychiatric morbidity among caregivers.
The loss of social contact is also a common challenge for carers. According to Anna & Andreas, (2015), Informal caregivers of old people suffering from dementia usually live constricted lives with little diminishing contacts and friends. The life of many carers usually revolve around the immediate family and the day care facilities, and it is always difficult to visit other people The loss of social connected is one of the major negative impacts of giving care to dementia patients.
Carers have a lower participation in the workforce compared to the general population. According to a study carried out by Arksey et al., (2005) in Britain on the issues that arise when one combines paid employment with care giving found out that there is an inverse relationship between the times spent caring and participating in paid employment. Carers who spent a lot of time giving care spend very little hours on paid work. For women, it is highly likely that they move from full-time employment to part time employment compared to men co-resident caregivers especially family caregivers are more unlikely to be in full-time employment compared to men. Most carers give up paid employment reluctantly to care for loved one.
According to Arksey et al., (2005) many caregivers try to balance between giving care and work through Finding less demanding work, shifting places to places of employment, sifting to self-employment, working very different and odd hours, using lunchtimes and other breaks to provide care, taking some time off paid employments and also utilizing their holiday entitlements in providing care. Dealing with emergencies and crisis is very difficult for many carers to accommodate between the commitments of employment and caring for dementia patients. Paid employment for caregivers has some benefits to carers such as socialization at work alleviating the isolation of caregivers. Making decisions and future career plan is also a challenge for many caregivers because of many unknown factors such as the uncertainties about how much the provision of care will last and the demand of care in the future when the disease progresses.
Caregivers have to make some complex decisions regarding work that require constant review. The caregivers in this survey who worked more than thirty hours per week and care giving were motivated by the need for income, belief in the fact that paid employment is important for well being, health, and the desire to have another identity beyond that of a caregiver. A supportive employer was also important in helping carers stay at their job and the availability of social services that allowed the caregivers to have the chance of working
Caregivers also face the challenge of missed opportunities. The time it takes to provide care means that caregivers have little time for social activity, work, pursuing leisure activities and exercises and the freedoms of choice are also reduced by the provision of care. According to a study carried out by Maclean et al. in 1995 on 24 caregivers caring for people with dementia they found that seventy five percent of the caregivers had lost touch with their friends and more than half of the carers said they had could no longer afford to engage in previously enjoyed hobbies.
According to Lucinda, (2006), carers also face the problem of inadequate support from primary care staff and the social services. The support provided by the social services in England is fragmented, and it is very important for carers to receive this support in terms of information and management of dementia and the provision of the caring role. There are no enough contact points between professionals and carers and varied coverage in terms of availability and content of information provided to carers by professionals. The problem of training of the informal caregivers is also a major challenge for carers in England.
There are also few support groups for carers in the United Kingdom. Counseling and support services for carers in England received by a minority of carers. Counseling is important in reducing the caregiver stresses and reduces the carer stresses. The lack of sufficient respite care services and short breaks from caring including in-home respite services and institutional respite services and mixed carer support, are available but vary in amount, source, and availability. These services are important in reducing carers stress levels and the health, offer psychological comfort as well as increases the level of satisfaction among carers.
Discussion
From the synthesis of the results of there are recurrent themes in the research studies about the challenges faced by caregivers caring for people with dementia. The major challenges that face caregivers in caring for people with dementia are the effects on psychological health and caregiver burden. Many studies linked care giving to the development of depression, depressive symptoms and stress (Vitalizo et al..., 2003: Bond et al..., 2003; Savage & Bailey, 2004: Shah & Waado, 2015). The demands of caring for a person with dementia are a major care burden for carers, and the need to provide care and the unpredictable behaviors of caring for people with dementia makes the duty of caring for these patients a cause of stress for many caregivers.
Caregivers also experience the challenge of poor physical health such as physical exhaustion. Most carers of people with dementia prioritize the needs of the person with dementia and in the process neglecting their own health (Cummins, 2001: Andreas, 2015). The demanding nature of caring for a person with dementia means that caregivers have little time and opportunities for engaging in positive health environments like exercises.
Caring for a person with dementia is also linked to poor social and family relationships for caregivers due to the limited times for participation. Carers of people with dementia also deal with the huge financial implications of dementia disease. The direct costs associated with dementia include the cost of medications and treatments and specialized care. The indirect costs caregivers incur when caring for people with dementia are the loss of income opportunities by the carer due to limited time available for work. Most informal carers in the United Kingdom are not paid to care for their loved ones with dementia as they feel they have a duty to care for their loved ones.
The lack of sufficient support from health practitioners and social care also adds to the challenges of caring for a person with dementia. Insufficient support and training of care providers sometimes makes the responsibilities of caring for a person with dementia a challenging experience since they may not know how to deal with some challenging behaviors of dementia like sudden behavioral changes. Social isolation and loneliness are also some serious challenges facing carers of people with dementia. Carers of people with dementia have little time to engage in other activities besides caring for people with dementia. The process of caring for people with dementia has a profound impact on the social, emotional, psychological, mental and physical health of the carers.
Limitations of the study
The major limitation of the study is that it is an exploration study of the available literature and has utilized a number of already available studies. The results of the study are therefore, limited to the results obtained from the previous studies and there is a need for expanding the research to include longitudinal studies using a bigger sample size and duration of time to add credibility to the results. The sampling procedure also used a simple selection criterion of relevance to the research objective and therefore, some significantly important research studies may have been left out in the sampling procedures. Further longitudinal studies should be carried out while attempting to reduce the effects of these limitations.
Summary and conclusions
This paper sought to evaluate the challenges faced by cares of people with dementia in The United Kingdom. From this synthesis, it is apparent that Caring for a person with dementia is a challenging and strenuous job for the caregivers. The results obtained from this study agree with the findings of the literature review that link the process of caring for a person with dementia to causing physiological and mental health problems to carers. This study reveals that caregiver’s quality of life is heavily impacted by the caring experiences and the challenges associated with caring. The results show that there is a significant relationship between poor emotional, mental and the physical health of caregivers caring for people with dementia. There is also a link between poor mental health and social isolation, of caregivers.
The financial impacts of caring for a person with dementia also contribute to poor mental health for caregivers. Lack of sufficient support and training for caregivers in dealing with dementia patients is a major challenge that has some negative impacts on the life of family caregivers and the patients. The findings of this study has some significant implications since it can help researchers in studying and carrying out research for the improvement of the quality of life of care givers. The information in this study can also help in designing interventions and support programs for caregivers to people with dementia to reduce the impacts the caring experience has on the life and the health of caregivers.
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