DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20214307

Homecare: a strategy to ease the burden of Family Care Givers of clients with mental disorders: an overview

Suja Chungathil Mathew, Thereza Mathias

Abstract


Mental disorders are the second leading cause of disease burden in terms of Years Lived with Disability (YLDs) and the sixth leading cause of Disability-Adjusted Life-Years (DALYs) in the world in 2017. Mental disorders can lead to extreme physical, psychological, social and financial burden among the caregivers. Family is a basic unit of caring for the mentally ill. Empowering the family caregivers on caring their mentally ill client at home is an effective strategy in rehabilitation as the mental health facilities are limited in India. Home based care is known to reduce burden among the caregivers. Homecare includes various components that help in caring and managing clients with Activities of Daily Living (ADL), supervision and administration of medication, recreation and leisure activity, stress management, regular follow up with mental health professional, social skill training, management of psychiatric emergencies, management of potentially harmful behaviours such as suicide and anger management. The outcome of the home care of mentally ill   depends on the willingness and cooperation of the family and continuous support and monitoring by the mental health team. It is cost-effective and implies the shift of responsibility not only on the hospital but on the family caregivers and the health professionals in the community.


Keywords


Home care, Burden, Family care givers, Mental disorders

Full Text:

PDF

References


India State-Level Disease Burden Initiative Mental Disorders Collaborators. The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990-2017. Lancet Psychiatry. 2020;7(2):148-61.

Sidana A. Community psychiatry in India: Where we stand?. J Mental Health Hum Behav. 2018;23:4-11.

Demyttenaere K, Bruffaerts R, Villa J, Gasquet I, Kovess V, Lepine JP, et al. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004;291(21):2581-90

Dhawan A, Pattanayak RD. Community-based addiction psychiatry. In: Chavan BS, Gupta N, Arun P, Sidana A, Jadhav S, eds. Community Mental Health in India. 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2012: 195-204.

Klug G, Gallunder M, Hermann G, Singer M, Schulter G. Effectiveness of multidisciplinary psychiatric home treatment for elderly patients with mental illness: a systematic review of empirical studies. BMC Psychiatry. 2019;19(1):382.

Ravi S, Goud BR, Archana M, Pius TM, Pal A, John V, et al. Burden among caregivers of mentally-ill patients: A rural community – Based study community medicine. Int J Res Dev Health. 2013;1:29-34.

Lasebikan VO, Ayinde OO. Family Burden in Caregivers of Schizophrenia Patients: Prevalence and Socio-demographic Correlates. Indian J Psychol Med. 2013;35(1):60-6.

Burns T, Catty J, Watt H, Wright C, Knapp M, Henderson J. International differences in home treatment for mental health problems. Results of a systematic review. Br J Psychiatry. 2002;181:375-82.

Akbari M, Alavi M, Irajpour A, Maghsoudi J. Challenges of Family Caregivers of Patients with Mental Disorders in Iran: A Narrative Review. Iran J Nurs Midwifery Res. 2018;23(5):329-37.

Thara R, Henrietta M, Joseph A, Rajkumar S, Eaton WW. Ten-year course of schizophrenia--the Madras longitudinal study. Acta Psychiatr Scand. 1994;90(5):329-36.

Walke SC, Chandrasekaran V, Mayya SS. Caregiver Burden among Caregivers of Mentally Ill Individuals and Their Coping Mechanisms. J Neurosci Rural Pract. 2018;9(2):180-5.

Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet. 2007;370(9590):859-77.

Katz AR. Noncommunicable diseases: global health priority or market opportunity? An illustration of the World Health Organization at its worst and at its best. Int J Health Serv. 2013;43(3):437-58.

Kessler RC, Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc. 2009;18(1):23-33.

Casado R, Frías-Osuna A, Palomino-Moral PA, Ruzafa-Martínez M, Ramos-Morcillo AJ. Social support and subjective burden in caregivers of adults and older adults: A meta-analysis. PLoS One. 2018;13(1):0189874.

Ampalam P, Gunturu S, Padma V. A comparative study of caregiver burden in psychiatric illness and chronic medical illness. Indian J Psychiatry. 2012;54(3):239-43.

Souza ALR, Guimarães RA, Vilela D, Assis RM, Oliveira LM, Souza MR, et al. Factors associated with the burden of family caregivers of patients with mental disorders: a cross-sectional study. BMC Psychiatry. 2017;17(1):353.

Santos GD, Forlenza OV, Ladeira RB, Aprahamian I, Almeida JG, Lafer B, et al. Caregiver burden in older adults with bipolar disorder: relationship to functionality and neuropsychiatric symptoms. Psychogeriatrics. 2017;17(5):317-23.

Parabiaghi A, Lasalvia A, Bonetto C, Cristofalo D, Marrella G, Tansella M, et al. Predictors of changes in caregiving burden in people with schizophrenia: a 3-year follow-up study in a community mental health service. Acta Psychiatr Scand Suppl. 2007;(437):66-76.

Batista CF, Bandeira M, Oliveira DR. Factors associated with the overburden of male and female caregivers of psychiatric patients. Cien Saude Colet. 2015;20(9):2857-66.

Li J, Lambert CE, Lambert VA. Predictors of family caregivers' burden and quality of life when providing care for a family member with schizophrenia in the People's Republic of China. Nurs Health Sci. 2007;9(3):192-8.

Fekadu W, Mihiretu A, Craig TKJ, Fekadu A. Multidimensional impact of severe mental illness on family members: systematic review. BMJ Open. 2019;9(12):32391.

Sawatzky JE, Kerry S. Impact of caregiving: listening to the voice of informal caregivers. J Psychiatr Ment Health Nurs. 2003;10(3):277-86.

Schulz R, Sherwood PR. Physical and mental health effects of family caregiving. Am J Nurs. 2008;108(9):23-7.

Azman A, Jamir Singh PS, Sulaiman J. The mentally ill and their impact on family caregivers: A qualitative case study. Int Social Work. 2019;62(1):461-71.

Philip S, Chaturvedi SK. Musings on Task Shifting in Mental Health. J Psychosoc Rehabil Ment Health. 2018;5:103-7.

Lund C, Alem A, Schneider M, Hanlon C, Ahrens J, Bandawe C, Bass J, et al. Generating evidence to narrow the treatment gap for mental disorders in sub-Saharan Africa: rationale, overview and methods of AFFIRM. Epidemiol Psychiatr Sci. 2015;24(3):233-40.

Biegel DE, Song L, Milligan SE. A comparative analysis of family caregivers' perceived relationships with mental health professionals. Psychiatr Serv. 1995;46(5):477-82.

Harris M, Greaves F, Gunn L, Patterson S, Greenfield G, Car J, et al. Multidisciplinary integration in the context of integrated care - results from the North West London Integrated Care Pilot. Int J Integr Care. 2013;13:41.

Rosen MA, Granados D, Dietz AS, Benishek LE, Thompson D, Pronovost PJ, et al. Teamwork in healthcare: Key discoveries enabling safer, high-quality care. Am Psychol. 2018;73(4):433-50.

Sharma DB, Gupta V, Saxena K, Shah UM, Singh US. Role of Faith healers: A barrier or a support system to medical care- a cross sectional study. J Family Med Prim Care. 2020;9(8):4298-304.

Mlinac ME, Feng MC. Assessment of Activities of Daily Living, Self-Care, and Independence. Arch Clin Neuropsychol. 2016;31(6):506-16.

Stentzel U, Berg N, Schulze LN, Schwaneberg T, Radicke F, Langosch JM, et al. Predictors of medication adherence among patients with severe psychiatric disorders: findings from the baseline assessment of a randomized controlled trial (Tecla). BMC Psychiatry. 2018;18(1):155.

Farooq S, Naeem F. Tackling nonadherence in psychiatric disorders: current opinion. Neuropsychiatr Dis Treat. 2014;10:1069-77.

Patten SB, Williams JV, Lavorato DH, Bulloch AG. Recreational physical activity ameliorates some of the negative impact of major depression on health-related quality of life. Front Psychiatry. 2013;4:22.

Varvogli L, Darviri C. Stress Management Techniques: evidence-based procedures that reduce stress and promote health. Health Sci J. 2011;5(2):74-89.

Joynt KE, Jha AK. Thirty-day readmissions--truth and consequences. N Engl J Med. 2012;366(15):1366-9.

Liberman RP, Kopelowicz A. Recovery from schizophrenia: a concept in search of research. Psychiatr Serv. 2005;56(6):735-42.

Saurman E, Lyle D, Kirby S, Roberts R. Use of a mental health emergency care-rural access programme in emergency departments. J Telemed Telecare. 2014;20(6):324-9.

Vecchio N, Davies D, Rohde N. The effect of inadequate access to healthcare services on emergency room visits. A comparison between physical and mental health conditions. PLoS One. 2018;13(8):e0202559.

Van KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE. The interpersonal theory of suicide. Psychol Rev. 2010;117(2):575-600.

Devi YS, Konnur R. Effectiveness of standardized psycho-education for primary caregivers of patients in Tertiary Care Hospital. Indian J Psy Nsg. 2018;15:46-52.

Saha S, Chauhan A, Buch B, Makwana S, Vikar S, Kotwani P, et al. Psychosocial rehabilitation of people living with mental illness: Lessons learned from community-based psychiatric rehabilitation centres in Gujarat. J Family Med Prim Care. 2020;9(2):892-7.

Molu NG, Ozkan B, Icel S. Quality of life for chronic psychiatric illnesses and home care. Pak J Med Sci. 2016;32(2):511-5.

Gowda M, Gajera G, Srinivasa P, Ameen S. Discharge planning and Mental Healthcare Act 2017. Indian J Psychiatry. 2019;61(4):706-9.