Caregiver Stress When Caring for Family Members Diagnosed with Dementia: Application of Tsai’s Middle-Range Theory of Caregiver Stress

Michelle Obama, BSN, RN; Jennifer Lopez, BSN, RN; Jackie Chan, BSN, RN; Lady Gaga, BSN, RNJulie Elting, EdD, RN, CNE

Practice Problem● 11 million + home caregivers in US –

Relatives with limited choices● Recipients: old age, impaired mobility, &

dementia – ? path of decreasing function● Caregivers: resentment, lack of social

support, financial strain, physical stress & decline in health

● Dilemma/guilt of continuing home care or placing in institution

Theory of Caregiver Stress● Identify risk factors for stress and depression

during caregiving● Assessment to develop interventions

Literature Review● Populations: Grandmothers caring for

granddaughters with HIV; African American daughters caring for aging parents; parents of kids w/chronic feeding problems; partners w/ dementia

● complex relationship between caregiver & recipient; women and African Americans higher risk; assessment tools

● Interventions: Address financial demands, provide social interventions and emotional support; respite care; increase mastery & decrease self-judgment; perceive events as manageable; increase coping strategies

Application of Theory to Practice ProblemAssessment (Use Caregiver Stress Assessment Questionnaire)● Input: care needs of recipient w/dementia (physical,

psychological, & emotional); Caregiver’s life – financial needs, other roles, family responsibility, health. Need demographic info, explore relationship b/w caregiver & recipient.

● Control Process: Physical and perceptions/beliefs of caregiver- adaptive responses to the Input factors – may lead to depression

● Output: Caregiver – physical function, self-esteem/role mastery, role enjoyment, & marital satisfaction

● Interventions: Weekly telehealth case management, In-home care assistance, respite care and adult day facility programs, support groups, volunteer services, government/community assistance; Increase family support, social opportunities

URL Example paper Application of Theory to Practice