Factors That Determine Nursing Home Preference Among Alzheimer Diseases’ Relatives

Yıl 2008, Cilt: 16 Sayı: 2, 11 - 24, 01.06.2008

A. Yılmaz E. Turan

https://doi.org/10.1501/Kriz_0000000273

Öz

Aim; The aim of this study is to determine
factors which predicate nursing home preference
of the Alzheimer diseases’ caregivers.
Material-Method; Sample of the study has
been elected from subjects who had Alzheimer
disease diagnosis and their primary caregiver
relatives, who refered to Ankara University
School of Medicine Psychiatry Department,
Geropsychiatry Policlinic. After constructed
questionnaire and demographic data were collected,
Alzheimer patients were evaluated by
using Mini Mental State Examination (MMSE),
Brief Psychiatric Rating Scale (BPRS), Personal
Self-Maintaining Scale (PSMS) and Geriatric
Depression Scale (GDS), while caregivers were
administrated Maslach Burn-Out Inventory
(MBI), Hamilton Anxiety (HAS) and Hamilton
Depression Scale (HDS). Results; 44 Alzheimer
disease patients and their relatives were
included in the study. 37 caregiver (84%) preferred
nursing their patients at home and 7
(16%) caregiver preferred nursing homes. Caregivers
of Alzheimer patients’ preference of
nursing home is significantly correlated with
cognitive states (MMSE), behavioral and psychological
symptoms (BPRS), personal selfmaintaining
(PSMS), sleep deprivation of
patients and maslach emotional exhaustion
subscale of caregivers (p<0.05). Not any significant
relationship was observed between nursing
home preference and patients’ depression
levels and caregivers’ maslach depersonalization
and personal accomplishment subscale
scores and depression and anxiety levels
(p>0.05). Discussion; Factors which predicate
nursing home preference among caregivers,
cognitive functions, personal self maintaining,
psychological and behavioral symptoms, as a
symptom sleep disorder, and emotional exhaustion
of caregiver were the most saliency factors.
Psychological and behavioral symptoms’ and
sleep deprivations’ being amendable and manegable
factors were important. In previous studies,
it was signified that with appropriate interventions,
caregivers would rather prefer nursing
home later.

Anahtar Kelimeler

Alzheimer disease, caregiver, nursing home

Alzheimer Hastalarının Yakınlarında Bakımevi Tercihini Belirleyen Faktörler

Öz

Anahtar Kelimeler

Alzheimer hastalığı, bakım veren, bakımevi

Kaynakça

• Almberg B, Grafström M, Winblad B (1997) Major Strain and Coping Strategies As Reported by Family Members who Care for Aged Demented Relatives. Journal of Advenced Nursing, 26: 683-691.
• Aydemir Ö, Köroğlu E (ed) (2000) Kısa Psikiyatrik Değerlendirme Ölçeği (BPRS). Psikiyatride Kullanılan Klinik Ölçekler, Hekimler Yayın Birliği, 43-45.
• Balla S, Simoncini M, Giacometti I, Magnano A, Leotta D, Pernigotti LM.(2007) The Daily Center Care on Impact of Family Burden. Arch Gerontol Geriatr. Suppl. 1; 55–59.
• Barusch AS, Spaid WM (1989) Gender Differences in Caregiving: Why Do Wives Report Greater Burden?. Gerontologist, 29(5): 667-676.
• Billig N (2000) Üçüncü Bahar / Yaşlılık ve Bilgelik, 1. Basım, (Çev. Ed. Ç. Yazgan) Evrim Yayınevi, İstanbul, s.229-286.
• Brody EM, Dempsey NP, Pruchno RA (1990) Mental Health of Sons and Daughters of the Institutionalized Aged. Gerontologist, 30(2): 212-219.
• Butler RN, Collins KS, Meier DE ve ark (1995) Older Women’s Health: Clinical Care in the Postmenopausal Years. Geriatrics, 50(6): 33-41.
• Czobor P, Volavka J (1996) Dimensions of the Brief Psychiatric Rating Scale: An Examination of Stability During Haloperidol Treatment. Comprehensive Psychiatry, 37(3): 205-215.
• Duygun T (2001) Zihinsel Engelli ve Sağlıklı Çocuk Annelerinde Stres Belirtileri Stresle Başaçıkma Tarzları ve Algılanan Sosyal Desteğin Tükenmişlik Düzeyine Olan Etkisi. Yüksek Lisans Tezi, Ankara.
• Ergin C (1996) Maslach Tükenmişlik Ölçeğinin Türkiye Sağlık Personeli Normları. 3 P Dergisi, 4(1): 28-33.
• Fitting M, Rabins P, Lucas MJ ve ark (1986) Caregivers For Dementia Patients: A Comparison of Husbands and Wives. Gerontologist, 26(3): 248-252.
• Garity J (2006) Caring for A Family Member with Alzheimer's Disease: Coping with Caregiver Burden Post-Nursing Home Placement. J Gerontol Nurs. Jun;32(6):39-48.
• Gaugler JE, Roth DL, Haley WE, Mittelman MS (2008) Can Counseling and Support Reduce Burden and Depressive Symptoms in Caregivers of People with Alzheimer’s Disease During the Transition to Institutionalization? Results from the New York University Caregiver Intervention Study. J Am Geriatr Soc 56:421–428.
• Grafström AB, Winblad B (1997) Caring for A Demented Elderly Person – Burden and Burn-out Among Caregiving Relatives. Journal of Advenced Nursing, 25: 109-116.
• Grafström M, Fratiglioni L, Sandman PO, Winblad B (1992) Health and Social Consequences for Relatives of Demented and Non-Demented Elderly A Population Based Study. Journal of Clinical Epidemiology, 45(8): 861-870.
• Güngen C, Ertan T, Eker E (2002) Standardize Mini Mental Test’in Türk Toplumunda Hafif Demans Tanısında Geçerlik ve Güvenilirliği. Turk Psikiyatri Dergisi, 13(4): 273-281.
• Harper S, Lund DA (1990) Wives, Husbands and Daughters Caring for Institutionalized and Noninstitutionalized Dementia Patients: Toward A Model of Caregiver Burden. Int’L. Journal of Aging and Human Development, 30(4):241-262.
• Hirono N, Tsukamoto N, Inoue M, Moriwaki Y, Mori E (2002) Predictors of Long-Term Institutionalization in Patients with Alzheimer's Disease: Role of Caregiver Burden. No To Shinkei. Sep;54(9):812-8.
• Kiyo SKD (1995) A Study on Health and Caregiving Status of the Elderly Over Age 75 Living in Urban Tokyo-Social Services and Caregiving For the Bedridden and Senile Elderly. 21: 14-24.
• Lawton MP, Brody EM (1969) Assessment of Older People, Self-Maintaining and Instrumental Activitiesod Daily Living. Gerontologist, 9: 176-186.
• Maral I, Aslan S, İlhan MN, Yıldırım A, Candansayar S, Bumin MA (2001) Depresyon Yaygınlığı ve Risk Etkenleri: Huzurevinde ve Evde Yaşayan Yaşlılarda Karşılaştırmalı Bir Çalışma. Türk Psikiyatri Dergisi, 12(4): 251-259.
• Matsuda O, Hasebe N, İkehara K, Futatsuya M, Akahane N (1997) Longitudinal Study of the Mental Health of Caregivers Caring for Elderly Patients with Dementia: Effect of Institutional Placement on Mental Health. Psychiatry and Clinical Neurosciences, 51: 289-293.
• Mintzer JE, Mirski FD, Hoering KS (2000) Behavioral and Psychological Signs and Symptoms of Dementia: A Practicing Psychiatrist’s Viewpoint. Dialogues in clinical neuroscience, 2(2): 139-155.
• Michel JP, Zekry D, Mulligan R, Giacobini E, Gold G (2001) Economic Considerations of Alzheimer’s Disease and Related Disorders. Aging (Milano). 13:255- 260.
• Mittelman MS, Haley WE, Clay OJ et all (2006) Improving Caregiver Well-Being Delays Nursing Home Placement of Patients with Alzheimer Disease. Neurology. Nov 14; 67(9): 1592-9.
• Mittelman MS, Roth DL, Clay OJ et all (2007) Preserving Health of Alzheimer Caregivers: Impact of A Spouse Caregiver Intervention. Am J Geriatr Psychiatry. Sep; 15(9): 780-9.
• Noji A, Iado S, Murashima S ve ark (1995) A Study on Health and Caregiving Status of the Elderly Over Age 75 Living in Urban Tokyo-Social Services and Caregiving for the Bedridden and Senile Elderly. Seiroka Kango Daigaku Kiyo, 21:14-24.
• Pfeifer E (1995) Institutional Placement for Patients with Alzheimer’s Disease. How to Help Families with A Difficult Decision. Postgrad Med, 97(1): 125-126.
• Sağduyu A (1997) Türkçe Geriatrik Depresyon Ölçeği. 8(1).
• Smith GE, Kokmen E, O’Brien PC (2000) Risk Factors for Nursing Home Placement in A Population- Based Dementia Cohort. J Am Geriatr Soc. 48:519- 525.
• Sorias O (1998) Psikiyatrik Derecelendirme Ölçekleri. Psikiyatri Temel Kitabı, Hekimler Yayın Birliği, 1.Cilt: 81-93.
• Soykan A (1992) Şizofreni ve Şizoafektif Bozukluklarda Akut ve İzleme Dönemi Anti-psikotik Tedaviye Yanıtın Değerlendirilmesi: Negatif ve Pozitif belirtiler. Uzmanlık Tezi, Ankara.
• Street JS, Clark WS, Kadam DL, Mitan SJ, Juliar BE, Feldman PD, Breier A (2001) Long-Term Efficacy of Olanzapine in the Control of Psychotic and Behavioral Symptoms in Nursing Home Patients with Alzheimer’s Dementia. International Journal of Geriatric Psychiatry, 16: 562-570.
• Şahin EM, Yalçın BM (2003) Huzurevinde veya Kendi Evlerinde Yaşayan Yaşlılarda Depresyon Sık- lıklarının Karşılaştırılması. Geriatri, 6(1): 10-13.
• Yaffe K, Fox P, Newcomer R, Sands L, Lindquist K, Dane K, Covinsky KE (2002) Patient and Caregiver Characteristics and Nursing Home Placement in Patients With Dementia JAMA. 287: 2090-2097.
• Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1982) Development and Validation of A Geriatric Depression Screening Scale: A Preliminary Report. J Psychiatr Res. 17(1): 37-49.