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Sufferings of caregivers of Stroke Patients

By Bushra Ansari

Stroke is one of the leading factors of morbidity and mortality world wide. It is the 3rd most common cause of death in industrialized countries. It is a disease through which one may suffer from long term physical and psycho-social disabilities. Any disease which has long term effect also involved its survivors as well as its caregiver in a long lasting stress. Therefore, the distress of the caregivers can not be ignored. These caregivers come across with more physical, social and financial stress because of anxiety and depression related to disease process as well as disease progression or remission. These caregivers may be of immediate family members, friends or neighbors. To overcome this problem, it is necessary to highlight different physical, social, economical and psychological factors for the sufferings of caregivers, which they face throughout the care giving process.

Physically, caregivers often ignored their own health as well as their pains. They may suffer from body aches, poor general health and obesity. Other factors are headaches, weight loss, heart pounding, low energy of working etc. Due to more time consuming care giving, caregivers ignore their personal checkups, don’t even have time to visit the doctors and disregard their own health concerns. Hence all these factors hamper the care giving abilities and lead to the proactive mortality. If the care is given by the person who is not also in his or her good physical health then it would lead to their fatality.

There are various social factors like age, gender, ethnic group, residential deprivation and living standards etc which may hinder the care giving responsibilities. If the caregiver belongs to elderly group then it would become very difficult for him to take care the patient instead of look after of his or her own health. Similarly, in Pakistani culture, males are more expected to bring the patients in health care facilities as compare to female. So, the gender bias plays a vital role in hindering the care as well as increased the frustration among caregivers. On the other hand, because these caregivers have to take care of the stroke survivors so they get lack of involvement in social gatherings. They don’t have enough time to engage in other activities other than care giving, thus they become socially isolated. Additionally, home caregiver has increase likelihood of suffering from social isolation who may not get training about the care of stroke patient with the group of other caregivers.

While draw attention on economical aspect, the cost of total care and rehabilitation of stroke patients is a very important issue which increase the suffering of caregivers. They continue spending money on the treatment and rehabilitation of their loved ones as well as for their own living expenses. As the severity of this disease is long term, hence care givers are much burdened because of their employment, financial position and residential troubles. This can affect their job-related issues, financial burdens and living standards. As a result, sometimes they become so much frustrated that they may create ignorance or refrain from care during the rehabilitation period of stroke survivors.

Psychologically caregiver’s physical and situational factors lead them to anxiety, depression, frustration and stress and they become very disturbed. Anxiety first appears in spouses as compare to patients themselves because in the initial stages, spouses have to adapt new role immediately. This is the stage where they don’t know much about the care of their loved ones. If they fail, they would become more depressed and frustrated due to not able to fulfilling their responsibilities. As the dependency of the patient increases, difficulty in managing other tasks occurs. 34% to 52% caregivers have suffered from depression during the caring of stroke patients. This also can lead to various symptoms like mood changes, lack of interest or refrain from responsibilities which may appear as emotional outcomes but afterwards they may diminished, as caregiver adapt the life changes.

In my point of view, the care is a multidimensional approach. Besides the stroke sufferers, caregivers also have to take care of other living modalities. In the developed countries, there are various organizations made for caregivers training, but in developing countries especially in Pakistan, there are no proper associations which can support and take care of the needs of caregivers. Hence, there is a need to make organizations for caregivers from which they can learn the basic skills for dealing with their loved ones as well as to overcome their own problems. Now it is the responsibility towards health care professionals to establish training programs which can give training to the basic skills for e.g. Naso-gastric (NG) tube care, feeding through NG tube and catheter care which can save the stroke patients from further complications and lessen the financial burden of repeated hospitalization. Moreover, try to find out the alternatives of feasible care delivery to stroke patients at home in order to reduce the morbidity and mortality of them and also enhance the coping capabilities of the families of stroke patients.
In conclusion, the above mentioned physical, social, economical and psychological factors have imperative impact on the role transition of a person to a caregiver, his or her functioning and responsibilities. The physical perspectives are the determinants which may limit the physical stability of caregivers who are also suffer from their own physical illnesses. Moreover, age, gender, social interactions and job-responsibilities contributes in social point of view on which most of the caregiver may compromise for the early recovery of the patients. Furthermore, psychological aspect is the most important entity under which the physical, social and economical factors are also covered. In psychological perspective, caregivers specially spouses show anxiety and depressive symptoms at the acute stage of stroke. Hence, caregivers should train about the care giving activities, basic skills training so that the progression of the future deviations of their loved ones will become minimized.