• Title/Summary/Keyword: Family of a dementia patient

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The implementation of Smart Care System for Dementia Patients (치매 환자를 위한 스마트 캐어 시스템 구현)

  • Ha, Eun-Sil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3832-3840
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    • 2014
  • The rapidly aging population is also increasing the number of dementia patients rapidly. Studies have revealed the early signs of slowing progress. Therefore, dementia patient safety, continuous care, daily living, and health care are becoming more important. In this paper, a smart home care system using smart phones and Bluetooth communication technology was used to monitor the state of dementia patients of based on the results of grading dementia, health care of the dementia patients at home and provide for the safety of the system using motion sensors and gas leak sensors to respond to various emergency situations, such as fire, gas leak protection, and loitering. Using this system, the patient can stay longer in their home due to the nature of Korean culture before admission, while reducing the family's economical, physical and psychological burden and allowing the consultation of specialists through the system by building a database of individuals and providing professional service and specialty care referral agencies through the link.

Stress and Burn-Out Experience in Caregivers of Patients with Senile Dementia (치매환자 부양자의 스트레스와 소진경험)

  • Son, Gye-Soon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.1 no.1
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    • pp.40-48
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    • 2006
  • Purpose: This study was done to identify the experience of stress and burn-out in caregivers of patients with senile dementia. Method: To evaluate the degree of stress and burn-out in caregivers of patients with senile dementia, 64 caregivers and matched to 64 patients with senile dementia at a Primary Health Care Post in South Kyung Sung Province were selected. The study was carried out from March 6 to March 30, 2001. Data on the degree of dementia in the patients was measured by the MMSE-K (Mini-Mental State Examination-Korea) and caregiver characteristics such as, sex, age, marital status, educational level, job, socioeconomic status, religion, number in family, relationship with patient, duration of care, and chronic disease in caregiver were collected by direct interview with a questionnaire. Results: Of 64 patients with senile dementia, 15.6% were classified as mild dementia (MMSE score 20-24) and 84.4%, as severe dementia. There were no significant characteristics of caregivers associated with the degree of stress and burn-out experience. The degree of burn-out in these caregivers of patients with severe dementia (mean value 94.3) was significantly higher than the 81.4 for those caring for patients with mild dementia (p<0.05). However, the degree of stress was not significantly related with the degree of dementia. The proportion experiencing severe burn-out (above score 4) was 54.7% in the physical domain, 90.6% in the emotional domain, and 73.4% in psychiatric domain, respectively. Conclusion: The above findings suggest that the degree of stress and burn-out experienced by caregivers of patients with senile dementia are high. Also the degree of burn-out experienced by in caregivers of patients with severe dementia was higher than for those caring for patients with mild dementia.

Perception about Shared Decision Making of Family Caregivers of Early Dementia Patients: A Qualitative Content Analysis Study (초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식: 질적 내용분석 연구)

  • Kim, Yun-Jae;Song, Jun-Ah
    • 한국노년학
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    • v.38 no.3
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    • pp.501-519
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    • 2018
  • The purpose of this study was to explore perception about shared decision making of family caregivers of patients with early dementia (PWED). This study was conducted with a sample of 12 family caregivers (mean age = $71.4{\pm}10.4$) of PWED from three dementia safety centers in Seoul. In-depth interviews were done for each participant about shared decision making and data were analyzed using qualitative content analysis. Six categories and 17 sub-categories identified for participants' perception about shared decision making: means to facilitate communication with patients with dementia, means to secure autonomy of patients, opportunity to facilitate treatment, cause of increasing family caregivers' burden, cause of worsening relationship with patients, and option for choices depending on priority change. The findings of this study can provide a knowledge basis for health care professionals and policy makers to understand how family caregivers of PWED think about shared decision making. It would be of great value to develop educational programs and practical guidelines about shared decision making for PWED and their family, which may contribute to respecting PWED's self-determination right as well as reducing burden of their family.

The Study of the Nursing Students Lived Experience of Clinical Practice Nursing of Dementia Patients (간호학생의 치매환자 간호 임상실습 체험 연구)

  • Hwang, Yun- Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.10 no.1
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    • pp.161-171
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    • 2004
  • Purpose: The purpose of the study is to investigate the reality of nursing students lived experience of clinical practice nursing of dementia patients, which will provide the basic research material to enhance the effect of their clinical practice. Method: Van Manens hermeneutic-phenomenological method has been used to analyze the data. Participants consisted of 8 second-year nursing students who did the clinical practice at a dementia unit in C hospital. Data was collected from in-depth face to face interviews. Result: $\ulcorner$being confused by the unfamiliar environment of nursing practice$\lrcorner$, $\ulcorner$being disordered about the patients' duality behaviour$\lrcorner$, $\ulcorner$perceiving necessity to accept patients' behaviors$\lrcorner$,$\ulcorner$feeling personal connections likely to grandmother$\lrcorner$, $\ulcorner$realizing the patients affection of their family$\lrcorner$,$\ulcorner$being frustrated by the patients' hopelessness$\lrcorner$,$\ulcorner$lessening biased view on dementia$\lrcorner$, $\ulcorner$feeling the anxiety about the unsecured future$\lrcorner$, $\ulcorner$realizing the necessity of the gradual and individual care$\lrcorner$,$\ulcorner$understanding the nursing of dementia as comprehensive nursing$\lrcorner$Conclusion: We are able to obtain an in-depth understanding about the nursing students lived experience of clinical practice nursing of dementia patients. Based upon this, there is a need to develop a better nursing intervention in order to enhance the effect of the nursing students clinical practice.

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Factors Influencing the Caring Burden of Families with Dementia in a Community (지역사회 내 치매환자가족의 돌봄부담감에 미치는 영향요인)

  • Lee, Hye-Kyung;Kim, So-Yul
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1373-1384
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    • 2019
  • This study is a descriptive research to analyze the factors affecting the care burden of dementia patients in the community. The data was collected from 223 dementia patients in the community for 10 days from November 30 to December 9, 2018. The results showed that there was a statistically significant difference in caring burden according to demographic characteristics according to the age group of the main caregivers, the relationship with dementia patients, the duration of caring for dementia patients, and the difficulty of caring for dementia patients. Had a negative correlation with dementia knowledge(r=-.145, p=.030). The factors affecting the care burden of dementia patients were as follows: dementia care period(β=.408, p=.006), difficulty in caring for dementia patients(β=-.307, p=.023), relationship with dementia patients(β=-.299, p=.013), and age group of primary caregivers of dementia patients(β=-.265, p=.007). Therefore, in order to alleviate the burden of caring for dementia patients in the community, a practical and continuous care intervention program is needed

A Study on the Effect of Caregiver Burden on Suicidal Ideation among Caregiver for the Elderly with Dementia (치매노인의 증상정도가 부양자의 자살생각에 미치는 영향에 대한 연구: 부양부담의 매개효과를 중심으로)

  • Kim, JaeYop;Kim, JoonBeom;Jang, DaeYeon;Song, InHan
    • 한국노년학
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    • v.36 no.3
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    • pp.883-903
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    • 2016
  • The purpose of the study is examining the mediation effect of caregiver burden's segmentalized sub factors between dementia caregivers on the relationship between Symptom extent of dementia patients and Suicidal Ideation of dementia caregiver, and suggesting social welfare intervention methods for dementia caregiver The survey is targeted to demented elderly people and caregivers, and currently using medical care institution and day care center in Seoul, Gyeonggi Province and Pusan city. As a result of the survey, 415 cases were collected for the final analysis. In data analysis process, we used SPSS 21.0 for the mediation effect of conversational satisfaction and its significance, and the results are following. First, 21% of the caregivers responded that they had thoughts of suicide in the past year. Second, Symptom extent of dementia patients was positively related to caregiver burden. Third, worse in family relationships, which is sub factors of mediate variable, has partial mediate effect on the model. Based on these outcomes, we suggest the importance and necessity of improved approach about dementia elderly and caregiver between elderly couple as way to reduce caregiver burden and proposed social work-based intervention program for enhancing this.

Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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A Study on a Coping Method of the Family Caregivers of Demented Patients (치매노인 가족부양자의 대처방법에 관한 연구)

  • You, Kwang-Soo
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.648-667
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    • 2002
  • This was a descriptive study designed to identify the level of coping method and its influencing factors on the family caregivers of demented patients, and resolve the family caregivers' level of stress. The data were collected from September 10 to October 10, 2001. Subjects for this study were recruited from four clinics, which were chosen from 15 clinics located in Chunbuk-Do as the study sites because of their cooperation for the study. They were similar in terms of size, the characteristics of the local community. and the population and registration status of the demented patients. The instruments used for the study were as follows: 1. Problematic behaviors of demented patients are measured by the Memory and Behavior Problem Checklist (Zarit, 1980), and the Linguistic Communication Symptoms Questionnaire (Bayles and Tomoeda, 1991) 2. The ability to carry out daily activities was measured using the Barthel Index (1965) and Katz Index (1963), which as well-known ADL assessment methods. 3. Burden was measured using Cost of Care Index by the Kosberg and Cairl (1986). 4. Coping strategy was measured Bell's 18 methods (1977). The data were analyzed using SPSS/PC. The study results were as follows: 1. The total stress score was 2.90 out of a maximum score of 5. The highest score reported was 3.09 on the dimension of restriction of individual and social activities, and the lowest region reported was 2.58 on the dimension of mental and physical health. 2. The total score of the coping method was 2.65 out of a maximum score of 5. The highest score reported was 4.01 on the dimension of thinking that includes an ideation such that it is better than any possible worst case, and the lowest score reported was 1.45 on the dimension of the self-image as a scapegoat. 3. There were significant differences in coping method among the subjects by age (F=2.752 p=0.04), caregiver (F=4.33 p=0.003), care-giving period (F=2.68 p=0.049), and dementia stage (F=2.87 p=0.034). 4. There were highly negative correlations ($\gamma$=-0.301 p=0.000) between problematic behaviors of demented patients and the coping method of their family caregivers. The highest correlation coefficient ($\gamma$=-0.339 p=0.000) was found between aggressive behaviors of the demented patients and the coping method of their family caregivers. 5. There was a low negative correlation ($\gamma$=-0.201 p=0.019) between the ADL of the demented patients and the coping method of their family caregivers. 6. There were highly negative correlations ($\gamma$=-0.213 p=0.005) between stress and the coping method of the family caregivers. The highest correlation was found between financial burden ($\gamma$=-.327 P=.000) and the coping method of the family caregivers. There was no significant correlation among unpleasant aspects of the demented patients, willingness to the demented patients, and the coping method of the family caregivers.

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Evaluation of Visiting Nursing Services for the Vulnerable Family in Urban Community (도시지역 취약가구의 방문간호서비스 평가)

  • Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.15 no.1
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    • pp.56-66
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    • 2004
  • Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

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A Study on the Family Burden of the Mentally Ill in a Rural Area (농촌지역 정신질환자 가족 부담)

  • Lee, Weon-Young;Kim, Jung-Hoe;Nam, Chung-Hyun;Moon, Ok-Ryun;Shin, Young-Jeon
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.400-414
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    • 1999
  • Objectives: This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. Methods : Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. Results : Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of Hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. Conclusions: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.

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