11.4.13

CAREGIVER BURDEN

Salah seorang teman baik berkeluh kesah. Sudah seminggu ini mertuanya sakit berat yang membuat ia dan suaminya selalu stand by menemani dan merawat. Awalnya biasa saja, namun lama kelamaan dia merasa kelelahan fisik dan mental. Ditambah lagi urusan kantor yang jadi kurang fokus dan anak-anak yang mulai protes karena kuantitas dan kualitas perhatian yang berkurang. Namun, untuk sekali-sekali tidak menemani atau merawat dia juga gak nyaman karena khawatir dipandang egois dan tidak sayang mertua oleh saudara-saudara yang lain.

Jadi ingat kalau dulu pernah menangani (dan mengalami) permasalahan sejenis yang menghasilkan tulisan berikut.

(repost from old notes made in 12 July 2009)

Caregiver burden is the term given to perceived distress of someone who have role as caregiver of others. It is non-direct effect of caring itself where helping and assisting ‘patient’ became burden for the caregiver. This involves multidimensional aspects of physical, psychological, emotional, social and financial. When ignored, eventually it will cause caregiver burnout that can be dangerous to the caregiver physical and mental health, furthermore the ‘patient’ her/himself. Caregiver often allocates emotional, physical and time resources to his/her ‘patient’. The more severe ‘patient’s’ condition is, the larger resources will be allocated. Bigger allocation of resources can cause caregiver has no resources to do other things. As a result, caregiver feel trapped in a task such as caring that ‘patient, especially if caregiver may not quite physically and mentally ready for such of task.

Caregiver in general has two types of distress. First, primary distress from the task of caring. It can be from planning and implementation of treatment, giving great attention to ‘patient’, supervise the planned activities, and overcome ‘patient’’s emotional problems. Second, the secondary distress from other sources. It can be conflict between family members regarding the caregiving activities, economic problems, limited spare time and social activities. Caregiver’s full schedule can lead to reduction time to interact with families and social groups that will change her/his pattern of relationships. Changes in the pattern of this relationship can cause conflict and become another burden for the caregiver.

Caregiver can experience decline in her/his mental and physical health, increased anxiety level, emergence of depression, reduced social life, loss of self-esteem and slowly declining performance. From physical and mental health point of view, somatic complaints arise such as digestive trouble, lack of appetite, headaches, exhaustion, body weight decreased / increased, withdraw from social environment, easy feel offended, insomnia, and increase sarcastic and addicted (cigarettes, alcohol, food, etc.) behavior. Caregiver thinking pattern also stick to a particular perspective in which she/he felt have no time and opportunity to reduce her/his stress level or finding help. The professional that experience caregiver burden can develop a sense of failure that threats her/his self-esteem in professional life. This can lead to the change in attitude and behavior in handling next client. This change can be a work-dissatisfaction, cynical, or rejection toward particular client or too involved with a particular client.

There are several ways to reduce the distress experienced during the process of caring, such as develop a sense of humor, changing perspective about how to help, realizing limitations in helping, allocate time to do leisure activities and also have healthy habits. They also must be conscientious to watch over her/his welfare and learn to recognize burden or burnout symptoms. Some other assistance that can be used are:
  1. Counseling
    Counseling can help caregiver to normalized emotion and make sure that she/he already do the best, provide neutral point of view to stimulate insight in exploring alternatives for treatment process that may help reduce burden, and also help to get out from particular thinking pattern that not helping in solving problem.

  2. Additional education
    Caregiver need more knowledge and skills regarding the cases she/he handle in order to make her/him able to design treatment program that less burden and at the same time increase confidence in helping.

  3. Planning
    Caregiver can set up some strategies to be applied in various situations, therefore she/he may feel more stable to control any situation so that may appear.

  4. Self-care
    Caregiver must be able to set time for her/his personal needs, particularly related to health and social life. Caregiver should have a social group to do fun activities.

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