By Hilary Gibson, Staff Writer
There are many
different theories regarding the emotional impact experienced by
caregivers when placing a loved one, especially one who is
living with dementia, into a long-term care facility. Some
people feel that this may alleviate the stress experienced by a
family member caring for someone with cognitive memory
impairment, however, others worry that there may actually be a
significant increase in the feelings of guilt when transferring
someone into a long-term care facility. In a recent, multi-site
study published in the prestigious Journal of the American
Medical Association (JAMA), there has been strong evidence
showing that the latter may be true, with caregivers suffering
additional emotional trauma following the decision to place the
person they care for into a facility.
Results of this
four year study come from comprehensive analysis and data collected
by the University of Alabama at Birmingham, documenting the negative
emotions that caregivers experienced during the transition of their
loved one from home to a long-term care facility. The study also
included an analysis of the decision-making process leading to
facility placement, what kind of visitation or contact took place
between the relatives after the placement, and the impact on the
health of the caregivers following such placement.
Among the 180
caregivers who took part in the study, symptoms of depression and
anxiety stayed as high in these individuals as it had been when
their charge was still living at home with them. The reason for this
may be because there is no sense of closure or relief when someone
is placed outside the home, as is experienced when a loved one
passes away. To the contrary, there appeared to be an increase of
distress and depression among these caregivers. Also, facing new
challenges such as having to make frequent and possibly quite
distant trips to a long-term care facility, along with a significant
decrease in control over the care that is being provided, can make
such a transfer very difficult for everyone. Caregivers also feel
guilt over witnessing the quick and steady decline in the cognitive
and functional abilities of someone who is placed into a facility,
and frequently blame themselves for this decline because of having
placed their loved one outside the home.
The data collected
on caregivers who were married to the person they were caring for
showed an even higher increase of depression before and after
placing their spouse into a facility. Once placement into a facility
happened, more than half of the caregivers still performed some sort
of physical care for their loved one during their visits. One of the
most interesting findings of this study shows that caregivers who
report experiencing a greater amount of burden were more likely to
place their loved one into a long-term care facility, while
caregivers who reported that their caregiving experience made them
feel important were less likely to place a person into a facility.
The authors of this
study came to the conclusion that caregivers really need to begin to
receive help before, as well as after, a loved one has been placed
into long-term care. Preparation for the mental and emotional
well-being of the caregiver during this transition should include
medical attention for depression and anxiety, along with support
from family and friends. Some of the ways in which a caregiver can
try to ease their guilt is by realizing that they are doing the best
they can, and should it come to the point where a loved one needs to
be placed into a facility, it doesn’t mean you have failed as a
caregiver. There are certain conditions that you just don’t have any
power over, and while the early forms of dementia may be manageable
at home, it can be quite different with the onset of more severe
symptoms. Most of the time, when dementia or Alzheimer’s is at its
zenith, it really isn’t safe for you or your loved one not to have
managed care and help around-the-clock. As hard as it may be, try to
look beyond the present situation and realize that it won’t last
forever - your loved one won’t suffer forever, and nor will you.
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