stroke as a critical life event in the filipino family ... · stroke as a critical life event in...
TRANSCRIPT
stroke as a critical life event in the
Filipino family
Rene D. Somera , Ph.D.
De La Salle University
Manila, Philippines
stroke as a critical life event in the
Filipino family
Rene D. Somera , Ph.D.
De La Salle University
Manila, Philippines
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
The Philippines
METROMANILA
MAP
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
OBJECTIVES
To describe the social and culturaldimensions of stroke as a critical lifeevent among a selected group ofolder persons and their familycaregivers
To gain insights into the patterns of caregiving for older person stroke survivors within Filipino families
OBJECTIVES
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
OBJECTIVES
To provide an assessment of the family and community resources available to older person stroke survivors and their caregivers, as well as the nature and extent of the utilization of these resources
OBJECTIVES
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Study’s Framework
Community /Family Context
Older Person
Stroke Survivor
Rehabilitation/Recovery
COPING
Family Member
Caregiver
Response to Stroke
CARING
Resources
FamIly
CommunIty
STROKE
Older Person
Stroke Survivor
Rehabilitation/Recovery
COPING
Family Member
Caregiver
Response to Stroke
CARING
STROKE
Resources
FamIl
y
C
o
m
m
un
I
t
y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
The study is descriptive and exploratory by design.
It utilized both quantitativeand qualitative approaches.
The quantitative component consisted of a survey while the qualitative component consisted of case studies.
METHODOLOGY
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
The sample populationconsisted of 100 strokesurvivor-caregiver dyads.
The stroke survivors were aged 50 years old and above and had at least one stroke incident in the past year.
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
The respondents names were obtained through:
discharge records of six DOH-
retained hospitals, each having atleast 100-bed capacity, arehabilitation unit and serving a
wide geographical area
referrals from hospital personnel
snowballing \ referrals from
the respondents
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
From the sample, 10 stroke survivor-caregiver dyads were chosen as key informants who underwent a series of in-depth interviews.
Two questionnaires were used in the research: a separate interview schedule for stroke survivors and caregivers.
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
The survey interview was done in two phases:
First visit - done four weeks afterdischarge from the hospital
Second visit - occurred three months after the initial visit
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
For each phase, each of thestroke survivors was made toanswer simultaneously with hisor her caregiver, having anaverage distance of 5-10 metersto minimize discrepancy in theirresponses. Color-codedflashcards and rest periodswere provided to strokesurvivors
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
The qualitative aspect of the studyconsisted of case study analyses
The key informants (KI’s ) werechosen based on the ff. criteria:
M E T H O D O L O G Y
mental alertness
verbal ability
uniqueness of case
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
Three interview guides were utilized for the in-depth interviews: one for the stroke survivor, one for the caregiver, and one home and environment guide.
The in-depth interviews were all recorded on tape, transcribed and finally written into case studies.
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGY
In-depth analysis of the strokeexperience was later onextracted to obtain theimportant lessons that can belearned from the strokeexperience, in terms of copingand caregiving attendant to theillness.
M E T H O D O L O G Y
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGICAL LIMITATIONS
LIMITATIONS
Loss of cases due to:
jincomplete address obtainedfrom hospital dischargerecords
jdeath of respondent
joutright refusal of therespondent
jchange of address of therespondent
juncontrollable factors suchas inclement weather
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGICAL LIMITATIONS
LIMITATIONS
The data collection started withan initial sample of 223 casesculled from hospital dischargerecords of those who wereconfined due to stroke\cerebrovascular accident in sixDOH-retained hospitals. Fivestroke survivor-caregiver dyadswere utilized for pre-testing thequestionnaires.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGICAL LIMITATIONS
LIMITATIONS
Before the first visit:123 cases were
lost
Z deceased………………….. 36
Z outr ight refusal…………… 13
Z change of Address………. 15
Z house was not located….. 43
Z fai led to contact SS/CG… 16
*Total number of cases during
the 1st visit: 100 stroke
survivor-caregiver dyads
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
METHODOLOGICAL LIMITATIONS
LIMITATIONS
Before the second visit: 10
cases were lost
Z d e c e a s e d … … … … … … … … 4
Z outr ight refusal……………. 3
Z change of address\
le f t c i ty……………….. 3
*Total number of cases during the
2nd visit: 90 strokesurvivor-caregiver dyads
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Some selected informants
Aling Tinay, 81 and Mang Pedring, 63
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Some selected informants
Mang Baldo, 67 and Ester, 27
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Some selected informants
Mang Jose, 54 and Aling Desa, 57
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Some selected informants
Mang Inggo, 84 and Aling Lily,42
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Some selected informants
Mara, 27 and Mang Tonio , 64
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Profi le of SS Respondents
15
11
13
11
3
3
3
6
11
8
6
3
2
2
50-54
55-59
60-64
65-69
70-74
75-79
80-85
F e m a l e
Male
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Civil Status of SS Respondents
1
1
50
24
6
15
3
0
Male
FemaleSeparated
Widowed
Married
SingleRESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Ele
me
nta
ryH
igh
Sc
ho
ol
Co
l le
ge
Po
st -
Gra
du
ate
Vo
ca
t io
na
l
26
25
21
12
11
3
1
0
1
0
0
10
20
30
40
50
60
Educational Attainment of SS
Female
Male
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Number of Stroke Incidents
exper ienced by SS
5 8
1 71 9
3 2 1
0
1 0
2 0
3 0
4 0
5 0
6 0
7 0
First Stroke
Second Stroke
Third Stroke
Fourth Stroke
Fifth Stroke
>5 stroke incidentsRESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Relationship of SS to Caregiver
n=100
45
41 2 1 1
25
15
1 1 2 2
0
5
10
15
20
25
30
35
40
45
50SpouseDaughterDaughter-in-lawSonBrotherSisterMotherFatherFather-in-lawOther relativeGrandparentFriendRESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
80
67
30
17
23
0
10
20
30
40
50
60
70
80
Worse Better Remained the
Same
SSs' Perceptions of Financial Situat ion
F i r s t V i s i t
S e c o n d V i s i t
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
SSs' Sources of Financial Support
22
53
46
10 93
11 12
21
38 36
83 3 5
8
0
10
20
30
40
50
60
SpouseSon
Daughte
r
Siblin
g
Oth
er Rela
tive
Friend
Insura
nce Agency
Oth
ers
First Visit Second Visit
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
RESULTS
949798
72
83
66
7679
40
30
0
10
20
30
40
50
60
70
80
90
100
1st Visit
n = 100
2nd Visit
n = 90
SS's Abi l i ty to Meet Basic Needs
Food
Housing
Clothing
Medical Care
Recreation
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
74%78%
83.30%
37.80%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
SSs' Sources of Social Support
Family 74% 83.30%
Other People 78% 37.80%
First Visit Second Visit
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
SSs' Perception of Own
Physical Health Status
2
13
74
24
58
11
44
0
10
20
30
40
50
60
70
80
Poor Fair Good Excellent
First Visit
Second Visit
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Profi le of Caregiver Respondents
2
3
2
1
1
2
2
3
2
14
9
4
4
5
5
10
15
5
6
0
0
0
2
3
14-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-86
Male Female
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Civil Status of CG Respondents
10 107
12
44
62
0
10
20
30
40
50
60
70
80
Single Married Widowed Separated
Female
Male
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
Educational Attainment of CG
37
11
61
7
38Elementary
High School
College Level
College Graduate
Post-Graduate
VocationalRESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
RESULTS
32
14 14 14
67
32
3 31
01
0
5
10
15
20
25
30
35
Bi r th Order o f CG Respondents
1
2
3
4
5
6
7
8
9
10
11
12
13
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
43
31
3
12
13 3 2 2
0
5
10
15
20
25
30
35
40
45
50
Spouse
Daughter
Daughter - in- law
Son
Brother
Sister
Mother
Grandchi ld
Fr iend
Relationship of CG to SS
RESULTS
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTSSELECTED CAREGIVING SITUATIONS
CONSIDERED AS HASSLES BY C G s, 1st visit
Si tuat ion
1 . Extra expenses incurreddue to careg iv ing
4 8 %
2. SSs ’ hea l th dec l ined 4 4 %
3. Superv i s ing SS in do ingt h i n g s
3 9 %
4. He lp ing SS in persona l caren e e d s
3 1 %
5 . R e c e i v e d n o h e l p f r o mfami ly & f r i ends
2 7 %RESULTS
Note: computed by giving a score of one for every
situation with entry of very distressing (code 4);
includes caregivers with total score of at least 5 out
of perfect score of 8.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
SELECTED CAREGIVING SITUATIONSCONSIDERED AS HASSLES BY C G s, 2nd VISIT
S i t u a t i o n S e c o n d V i s i t
1 . S S s ’ h e a l t h d e c l i n e d 4 0 %
2 . S S s ’ u n r e s p o n s i v e n e s s 2 1 %
3 . S u p e r v i s i n g S S i nd o i n g t h i n g s
1 8 . 9 %
4 . R e c e i v e d n o h e l p f r o mf a m i l y o r f r i e n d s
E x t r a e x p e n s e s d u e t oc a r e g i v i n g
1 4 . 4 %
1 4 . 4 %
5 . S S s ’ c o n f u s i o n 6 . 7 %
RESULTS
Note: computed by giving a score of one for every
situation with entry of very distressing (code 4);
includes caregivers with total score of at least 5 out
of perfect score of 8.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
CAREGIVING SITUATIONS CONSIDEREDAS BURDEN BY CAREGIVERS,
1st & 2nd VISITSSituation F irst Second Visit Visit
Taking care of SS
when not feeling well 17% 4.4%
It’s hard on me emotionally 5% 0%
It caused my health to get worse 6% 0%
Care costs more than I can afford 38% 11.1%
I have to give him constant attention 37% 3.3%
SS gets confused 25% 5.6%
SS embarrasses me or others 22% 0%
SS lapses into senility 10% 2.2%
SS becomes upset & yells at me 22% 5.6%
RESULTS
Note: computed by giving a score of one for everysituation with entry of great deal(code 4); includes
caregivers with total score of at least 5 out of a
perfect score of 9.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
COMMONLY USED COPING STRATEGIESEMPLOYED BY CAREGIVERS
First Visit
1. “not blaming others” 95%
2. “hoping that things will get better” 94%
3. “not taking tensions out on others” 93%
Second Visit
1. “not blaming others” 97.8%
“not taking tensions out on others” 97.8%
2. “not getting mad” 95.6%
3. “trust in the Lord” 93.3%
“withdraw from the situation” 93.3%
RESULTS
Note: computed by giving a score of one for everysituation where the caregiver can cope well;
includes caregivers with total score of at least 18 out
of a perfect score of 34.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
C A R E G I V I N G H A S S L E S , C A R E G I V I N G B U R D E N
& C O P I N G I N D E X A M O N G C A R E G I V E R S ,
1st&2nd VISITS
Caregiv ingAspects
F irs tVis i t
S e c o n dVisi t
Z -va lues
Hass l e 1 2 0 % 2 . 2 % 4 . 1 7 * *
B u r d e n 1 1 0 % 1 . 1 % 2 . 8 0 * *
C o p i n g 2 5 1 % 67.8% -2 .45**
**-p<0.01
RESULTS
Note: 1 - gives no. of caregivers who f inds
providing care very distressing
2 - includes caregivers who can cope well
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
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RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RESULTS
RESULTS
7064 64 62
52
33
0
10
20
30
40
50
60
70
Services Avai led by SS, F i rst V is i t
Help in personalcare
Learning arm or legexercises
Help in dealing withemotions
Hospital aftercare
Help withprescriptions
Help with financialplanning
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
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RESULTS
RESULTS
93.3
65.668.9
81.1
42.2
0
10
20
30
40
50
60
70
80
90
100
Services Avai led by SS, Second Vis i t
Help in personalcare
Finding/organizingservices SS needs
Hospital aftercare
Help withprescriptions
Help with financialplanning
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
SUMMARY OF RESULTS
Majority of the SS have low educational
attainment which has profoundimplications on their awareness aboutstroke and factors which may
predispose them to the i l lness.
S U M M A R Y O FRESULTS
SS respondents have low
socio -economic status, are at risk forvarious il lnesses as well as for socialisolation as a consequence of i l lness.
There were more male SS respondents
which may be attributed to theirlifestyles.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
SUMMARY OF RESULTS
S U M M A R Y O FRESULTS
Majority of the stroke survivors are
dependent on their families forfinancial support.
Majority of the SS experienced
stroke for the first time.
Most of the SS were parents who have
to perform their parental roles even ifthey are stil l on the period of recovery.
Most of the SS perceived their
situation to be worse for both the first and the second visits.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
SUMMARY OF RESULTS
S U M M A R Y O FRESULTS
Support from the family significantly
increased during the second visit;support from other people considerablydeclined.
Medical care was not well provided
to the stroke survivors, as perceived by the SSs, themselves.
Support is more apparent during the
first visit after the stroke occurred.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
SUMMARY OF RESULTS
The caregivers in the study were mostly
females; mostly immediate familymembers and were mostly the eldestchildren.
S U M M A R Y O FRESULTS
Increase in the number of stroke survivors
who are able to perform instrumental activities of daily living was significant and implied an improvement in the
over-all health status of the SS.
The majority of the SS expected additional
support on both visits; the need for psychosocial and economic support is more apparent during the first visit.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
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OBJECTIVES
SUMMARY OF RESULTS
S U M M A R Y O FRESULTS
The C G s were more highly educated
than the SSs; their level of awarenessabout stroke, however, did not differmuch from that of the SSs.
The decline in the SSs’ health was
what the C G s found as the mostdistressing by the second visit.
Financial constraints associated with
caregiving was what the C G s foundas the most distressing aspect ofcaregiving during the first visit.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
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S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
SUMMARY OF RESULTS
The cost of health care which is more
than what the CGs could afford is themost commonly encountered burden forboth visits.
S U M M A R Y O FRESULTS
The nature of health services available in
the community is virtually unknown to almost all of the respondents.
There was an increase in the number of
C G s who are able to cope well by the second visit, as revealed by the coping index.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
SUMMARY OF RESULTS
Community health services are not
availed of by the majority of therespondents.
S U M M A R Y O FRESULTS
Information about the existence of
community services and the involvement of family CGs in community efforts is virtually non-existent.
Reasons cited for not avail ing community
health services are inadequacy ofservices particularly those that wouldaddress the SSs’ rehabilitation needs,
lack of equipment and trained personnel.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RECOMMENDATIONS
RECOM
MENDATION
More systematic and efficient record-keeping in government hospitals
Consistency in patient profile information
The institution of a computerized data base management system in the Records Division of government hospitals, as a long range goal
Research
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
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RECOMMENDATIONS
RECOM
MENDATION
The need for a longitudinal studythat would further investigate the patterns of post-stroke management in the home
A study over a longer periodof time, preferably from one totwo years after the stroke,would yield richer insightsinto the dynamic processes ofstroke rehabilitation, bothfrom the perspective ofpatients and caregivers.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
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LIMITATIONS
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RECOMMENDATIONS
RECOM
MENDATION
The use of controlled comparison in a future study
This would clarify whetherthere is a significantdifference in perceivedburden between two groupsof users and non-users ofservices available in thecommunity
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
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LIMITATIONS
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RECOMMENDATIONS
RECOM
MENDATION
This would generate comparisons in illness management within the Filipino home setting.
Replication of the study in the context of other illnesses that require long-term care
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
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MENDATION
S U M M A R Y O F RESULTS
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RECOMMENDATIONS
RECOM
MENDATION
Program
The existing programs in the Department of Health’s Non-Communicable Disease Control Service (NCDCS) - Cardiovascular, Health Care Program for Older Persons (HCPOP), and Community-Based Rehabilitation Program (CBRP) must be strengthened further, giving due consideration to these recommendations, as follows:
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
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LIMITATIONS
M E T H O D O L O G Y
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RECOMMENDATIONS
RECOM
MENDATION
Close coordination with hospital
personnel in the identification of stroke survivors and families who could be beneficiaries of CBRP services.
This process should begin
immediately during the patient’s hospital stay . Since this study util ized DOH-retained hospitals as
contact points, this is where the collaborative l inkage should begin.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
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LIMITATIONS
M E T H O D O L O G Y
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RECOMMENDATIONS
The link is important for CBRPimplementors , for purposes ofmonitoring and evaluation ofpatients’ progress. Moreover, it iscrucial for caregivers to have asense of support for thecaregiving role in the criticaltransition point between thehospital and the home.
RECOM
MENDATION
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
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RECOMMENDATIONS
RECOM
MENDATION
Partnerships with family members of disabled persons (such as stroke survivors)
The family caregiver, in particular, must be included in CBRP’s training of trainers on basic rehabilitation services, in addition to other identified volunteers from the community.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
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RECOMMENDATIONS
RECOM
MENDATION
Establishment of a pool of community volunteers who could serve as proxy caregivers
Periodic relief for caregivers from CBRP community volunteers could reduce caregiving strain considerably.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RECOMMENDATIONS
RECOM
MENDATION
Formation of social support networks within the community for stroke survivors
A caregiver support group can be a strain reliever for family caregivers.
Interaction of these two groupscould spell a betterunderstanding of theirrespective situations.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
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RECOMMENDATIONS
RECOM
MENDATION
IEC campaign within thecommunity regarding healthpromotion in general and disabilityprevention in particular
Mechanisms for a continuous andregular evaluation of the demandfor rehabilitation services shouldbe instituted
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RECOMMENDATIONS
RECOM
MENDATION
The design of 30-second radio and television spot advertisements should be an effective strategy for better audience retention.
Media campaign activities on the prevention and causes of disability (particularly stroke) with a national audience
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RECOMMENDATIONS
RECOM
MENDATION
W iden the geographical coverage area of CBRP services in order to reach the clientele it seeks to serve
Link with community health centers
Health services offered by thehealth center should beexpanded to include rehabilitationhealth services and manned bytrained personnel to deliver theservices needed by its targetclientele.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RECOMMENDATIONS
RECOM
MENDATION
Policy
A national subsidized home care program for Persons With Disabilities (PWDs)
This subsidy moreover wouldencourage families to take careof their disabled elderly memberby providing them resources fortheir basic needs - proper diet,medicines, some capital forincome-generating projects, andsome means to make themparticipate in community activities.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RECOMMENDATIONS
RECOM
MENDATION
Strengthen and broaden rehabilitationand health services for disabledpersons through:
Lobbying for the passage of legislation that would provide for the inclusion of temporary
and long-term support of families with disabled members, particularly the elderly.
Reimbursement for home care of P W D s, particularly lay caregivers
of disabled persons, may be the significant centerpiece of this
legislation.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
RECOMMENDATIONS
RECOM
MENDATION
Development of awareness programs for local officials, community leaders and families to consolidate and reinforce their role in facilitating the improvement of health rehabilitation services within the community context.
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Making the study resultsuseful and practical
what every family caregiver of
older persons should know
A Primer
English version
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
Making the study resultsuseful and practical
mga dapat malaman ng tagapagkalinga
sa mga nakatatandangkapamilya
Isang Praymer
Tagalog version
g i v e r sg i v e r s
O ld e rO ld e rp e r s o n sp e r s o n s
a n d t h e i ra n d t h e i r
c a r ec a r e
R E C O M
MENDATION
S U M M A R Y O F RESULTS
RESULTS
LIMITATIONS
M E T H O D O L O G Y
OBJECTIVES
stroke as a critical life event in theFilipino family