Evaluation of the emotional reactions of caregivers of Alzheimer patients

EVALUATION OF THE EMOTIONAL REACTIONS OF CAREGIVERS OF ALZHEIMER PATIENTS Introduction and Aim: The world population is rapidly aging, leading to an increased prevalence of diseases associated with advanced age. Among these, dementia and Alzheimer's disease, the most common cause of dementia, stand out. The care of individuals with these conditions and the burden on caregivers present a significant public health challenge. Additionally, the nature of Alzheimer's disease inherently induces a sense of 'ambiguous loss' in caregivers due to the continuous losses experienced, initiating a pre-death mourning process. Since there is insufficient research on the pre-death mourning process, it has often been inadequately defined and confused with conditions such as depression. In this context, our study aims to better understand the caregiver's burden, emotional experiences, and the pre-death mourning process, providing more comprehensive and effective solutions. Materials and Methods: Our research is a cross-sectional study involving the primary caregivers, who are unpaid family members, responsible for 257 Alzheimer's patients registered in the Ankara Bilkent City Hospital Home Health Unit. Research data were obtained through a Socio-demographic Data Questionnaire and the Marwit-Meuser Caregiver Pre-death Grief Scale. Statistical Package for the Social Sciences (SPSS) version 25 was used for the statistical analysis of the data, with a significance level set at p<0.05. Results: The average age of the 257 participants included in the study is 54.73. Of the participants, 63.81% are female, 62.65% have a university education or higher, 35.41% are employed, 61.87% are caregivers for their mothers, and 59.53% of the cared individuals have advanced-stage diseases. It was found that 44.75% of the participants have at least one chronic disease, and the average caregiving duration is 6.51 years. The Marwit-Meuser Caregiver Pre-death Grief Scale total score is significantly higher in female participants compared to males (p<0.01). The total score of Marwit-Meuser Caregiver Pre-death Grief Scale is significantly higher in individuals with income less than their expenses compared to those with income equal to expenses (p<0.05). Caregiving duration is statistically significantly longer for primary school graduates compared to high school and university graduates (p<0.01). Conclusion: The burden of caregiving for individuals with dementia/Alzheimer's represents an intensive process both physically and emotionally. Especially, more support programs should be planned for female caregivers. Within the scope of primary healthcare services, caregiving should be personalized, considering the individual needs of caregivers. This thesis aims to emphasize the need for personalized support programs and emotional support to understand and alleviate the challenging experiences of caregivers. Furthermore, Family Medicine and the biopsychosocial approach are considered to play a significant role in this context. Physicians and other healthcare professionals can provide comprehensive health services by being sensitive not only to the patient's needs but also to the caregiver's. In this framework, Family Medicine and the biopsychosocial approach are believed to be a critical factor in supporting caregivers of individuals with Dementia/Alzheimer's, emphasizing the importance of addressing the holistic well-being of both patients and caregivers. Keywords: Alzheimer disease, Care process, Dementia, Family medicine, Healthcare services.