El impacto de la demencia del anciano sobre su cuidador y factores de la carga asociada al hecho de cuidar

Introduction: The high prevalence and chronic evolution of dementia are responsible for a major social, financial and human cost. Family members are the first-line caregivers for demented elderly patients living at home in our country. Giving care to a demented patient has an important impact on the mood, quality-of-life and physical and psychological health of family aids. The purpose of this study wes to explore the barden of caring for home-based patients with dementia in our community and to examine the characteristics of theirprimary caregivers. Material and methods: In order to determine the factors that exhaust caregivers, a cross sectional survey was done among a sample of demented patients and their caregivers who were admitted at the USP San Carlos Hospital (Murcia) during a period of 6 months. The study employed a self-recording questioneaire form which collected different data included in four sections: A/Sociodemographic data of the patient. B/Sociodemographic data of the family primary caregiver. C/Carers' opinions, attitudes and emotional responses of relatives of patients with dementia. D/Strain level of care provider. It was measured by means of the 13-items Caregiver Burden Scale. A logistic regression analysis was performed to identify caregiver characteristics and to examine the effects of different factors associated with caregiver strain. The power of that association wes measured by the odds-ratio. Results: A total of 80 patients (20 men, 60 women, average age 82.4 years) and their 80 informel caregivers (27% men, 73% women) were included. The selection of the prime caregiver wes "considered natural" in 48 cases (60%) and chosen after a consensus or agreement between the potential caregivers in 28 cases (35%). About the problems perceived by the caregivers, the main one is the physical effort for 43%. Also, confrontations among the relatives (25%) and the loosing of the own time (23%) are described as serious inconveniences of caring. For the future, 93% of the participants thinks that the economic charge will be unsupportable and they expressed the need for more institutional help. The largest part of carers in this study recognised th at they would be "liberated" by the die of the patient, but the factors analysed (such as age, sex or patient functional status) were not related to this variable. Aggressive life-sustaining treatments are better accepted for their relatives than for themselves. Average score of CBS was 9.28. According to this scale, 75% of caregivers were found under high or even extremely high level of stress (CBS > 7). Level of perceived burden correlated significantly with the physical and mental deterioration of the patient. Conclusions: Our results reproduce previous findings and suggest that females (wife or daughter) are typically found to be the primary caregiver when a family member falis ill. The mejority of caregivers presented a high level of stress, correlated wilh patient's health problems. The results document the great need for services among families and the need for enhancement of quality of care and negotiated partnership between families and professionals.