Dealing with Depression in Family Caregivers
Main Article Content
Abstract
Aims and objectives: By reporting the use of therapeutic nursing interventions to facilitate the process of change in a depressive elderly caregiver, this paper seeks to underline the importance of fitting interventions to individual clients.
Background: In assisting families of chronic illness sufferers, it must be remembered that the perceptions and functions of both clients and families are determined by family members, and that changes, if any, are made by those clients and families, rather than by nurses. However, nurses do play an important role in facilitating the process of change.
Design: This is a case report.
Methods: A case study of a depressive elderly caregiver is used to examine the use of therapeutic nursing interventions to facilitate the process of change with problem analysis, case conceptualisation and specific skills employed documented.
Results: The change from one therapeutic approach (Cognitive-behavioural therapy) to another (Narrative Therapy) facilitates enlisting the caregiver’s unique strengths, resources and competence to overcome the difficulties and challenges identified during the process of change. In dealing with depression in family caregivers, nurses should not only be flexible but also remain sceptical in using different approaches, with heightened awareness of the client’s circumstances.
Article Details
Copyright (c) 2017 Hui-Choi WH.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Choi-Kwon S, Kim HS, Kwon SU, Kim JS. Factors affecting the burden on caregivers of stroke survivors in South Korea. Archives of Physical Medicine & Rehabilitation. 2005; 86: 1043-1048. Ref.: https://goo.gl/DnH5pW
Plank A, Mazzoni V, Cavada L. Becoming a caregiver: New family carers' experience during the transition from hospital to home. J Clin Nurs. 2012; 21: 2072-2082. Ref.: https://goo.gl/VHP8R8
Northouse L, Williams AL, Given B, McCorkle R. Psychosocial care for family caregivers of patients with cancer. J Clin Oncol. 2012; 30: 1227-1234. Ref: https://goo.gl/zysY9F
Williams AL, McCorkle R. Cancer family caregivers during the palliative, hospice and bereavement phases: A review of the descriptive psychosocial literature. Palliative Support Care. 2011; 9: 315-325. Ref: https://goo.gl/zg9Nge
Brereton L, Carroll C, Barnston S. Interventions for adult family carers of people who have had a stroke: A systematic review. Clinical Rehabilitation. 2007; 21: 867-884. Ref: https://goo.gl/mTIhzq
Schoenmakers B, Buntinx F, De Lepeleire J. Supporting the dementia family caregiver: The effect of home care intervention on general well-being. Aging & Mental Health. 2010; 14: 44-56. Ref: https://goo.gl/A0K4Rr
Van Heugten C, Visser-Meily A, Post M, Lindeman E. Care for careers of stroke patients: Evidence-based clinical practice guidelines. Journal of Rehabilitation Medicine. 2006; 38: 153-158. Ref: https://goo.gl/AAE65x
Wright LM, Levac AM. The non-existence of non-compliant families: The influence of Humberto Maturana. Journal of Advanced Nursing. 1992; 17: 913-917. Ref: https://goo.gl/7XmvwH
Wright LM, Watson WL, Bell Beliefs JM. The heart of healing in families and illness. 2001; 35. Ref: https://goo.gl/z8op4b
Wright LM, Leahey M. Nurses and families. A guide to assessment and intervention. Philadelphia, F.A Davis. 2005. Ref: https://goo.gl/uAdG3t
Shyu YIL, Kuo LM, Chen MC, Sien-Tsong C. A clinical trial of an individualised intervention programme for family caregivers of older stroke victims in Taiwan. Journal of Clinical Nursing. 2010; 19: 1675-1685. Ref: https://goo.gl/rhYjLR
Bell JM, Wright LM. Research on family interventions, In Families and health: A systemic approach in nursing care. 2007.
Radloff LS. A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977; 1: 385-401. Ref: https://goo.gl/9RSD86
Chappell NL, Kusch K. The gendered nature of filial piety-A study among Chinese Canadians. J Cross Cult Gerontol. 2007; 22: 29-45. Ref: https://goo.gl/0JLh63
Beck AT, Brad AA. Depression: Causes and treatment. University of Pennsylvania Press. 1967. Ref: https://goo.gl/tjKbvS
Chan CLF, Chui EWT. Association between cultural factors and the caregiving burden for Chinese spousal caregivers of frail elderly in Hong Kong. Aging & Mental Health. 2011; 15: 500-509. Ref: https://goo.gl/9t0UO8
White M, Epston D. Narrative means to therapeutic ends 1st Edition.
Gergen KJ, Gergen M. Social Construction: Entering the Dialogue Taos Institute Publications. 2004. Ref.: https://goo.gl/7DcTJy
Hadjistavropoulos T, Taylor S, Tuokko H, Beattie BL. Neumpsychological deficits.caregivers perception of deficits and caregiver burden. J Am Geriatr Soc. 1994; 42: 308-314. Ref: https://goo.gl/Akpp3w
Zimmerman JL, DickersonVC. Using narrative metaphor: Implications for theory and clinical practice. Fam Process. 1994; 33: 233-245. Ref: https://goo.gl/Nld7oU
Roth DL, Perkins M, Wadley VG, Temple E M, Haley WE. Family caregiving and emotional strain: Associations with quality of life in a large national sample of middle-aged and older adults. Quality of Life Research. 2009; 18: 679-688. Ref: https://goo.gl/JEPhKR
Thomson P, Molloyb GJ, Chung ML. The effects of perceived social support on quality of life in patients awaiting coronary artery bypass grafting and their partners: Testing dyadic dynamics using the Actor-Partner Interdependence Model. Psychology, Health & Medicine. 2012; 17: 35-46. Ref.: https://goo.gl/C51RD5
Bakas T, Clark PC, Kelly-Hayes M, King RB, Lutz BJ, et al. Evidence for stroke family caregiver and dyad interventions: A statement for healthcare professionals from the American Heart Association and American Stroke Association. Stroke. 2014; 45: 2836-2852. Ref: https://goo.gl/PvPteU
National Academies of Sciences Engineering and Medicine. Families caring for an aging America. 2016.
Eaton J, McCay L, Semrau M, Chatterjee S, Baingana F, et al. Scale up of services for mental health in low-income and middle-income countries. Lancet. 2011; 378: 1592-1603. Ref: https://goo.gl/4uFDgb
Bauer M, Fitzgerald L, Haesler E, Manfrin M. Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence. J Clin Nurs. 2009; 18: 2539-2546. Ref: https://goo.gl/ODs58I