The impact of caregiving

The increased incidence of chronic illness among the elderly makes long-term care a health concern as the population ages. Little is known about the impact of chronic confusion on the family. This study used a qualitative approach to look at the impact on the caregiving wife of caring for a chronically confused, elderly husband. Six wives whose elderly husbands experienced chronic confusion and who lived alone with their husband were interviewed using the phenomenological method described by Giorgi (1975). The findings indicated that there is a substantial impact when the husband depends on his caregiving wife to remain in the home, especially when the wife is older and experiences chronic illness herself. Overall, these negative effects were congruent with those reported by other researchers, suggesting that the general impact of long-term care is burden. The themes in the caregivers' accounts revolved around three main concerns: the management of the husband's dependency, the maintenance of the family as a unit, and the acceptance of the caregiving situation. Chronic confusion occurred with other chronic illnesses and compounded the husbands' impairments. Interpersonal relations were also adversely affected, and the wives had to learn to take control of the family amidst physical strain and social isolation. The caregiver found that her life came to revolve around the needs of her husband; she derived meaning from fulfilling her perceived duty as a wife. The presence of chronic illness and aging intensified her experience of burden. Despite the costs to her well-being, the wife was devoted to maintaining her husband at home. The caregiving wife needs support to deal with the husband's care and its negative consequences, but her desire to remain as independent as possible appears to conflict with her utilization of outside support. Nursing intervention should be directed toward assisting the caregiver to cope with the husband's care and with its negative effects on her. Nursing education should prepare the practitioner with a broad background in community health nursing, gerontology, and geriatrics to enable her to provide nursing care to these kinds of families. Future nursing research should focus on furthering the understanding of the impact of caregiving as a basis for planning the most helpful interventions to support the caregiver.Applied Science, Faculty ofNursing, School ofGraduat