Dependence of schizophrenic patients on elderly relatives

Abstract

SYNOPSISAs part of a survey of the need for rehabilitation services in Camberwell, a representative group of 56 unemployed psychiatric patients were selected from the Camberwell Register during 1968; most of these were chronic schizophrenics, and 29, or just over half of them, were living with their parents or siblings. This paper describes a special analysis made by a medical sociologist into the problems of these 29 patients as perceived by their relatives. Assessment of the patient's handicaps and the burden felt by the family showed a dependence on parents of pensionable age which is an obstacle to rehabilitation. Patients were content, but relatives were dissatisfied and experienced considerable financial burden and symptoms of reactive anxiety and depression. The need for special services is emphasized to help the patient towards a more independent existence when the relative dies.

Burden of care in the home: issues for community management

“…Studies have provided consistent evidence that the care-givers of persons with chronic mental illness suffer from a number of significant stresses and moderately high levels of burden (Grad & Sainsbury, 1963;Hoenig & Hamilton, 1966;Stevens, 1972;Faddenef al, 1987;Fisher et al, 1990). The care-giver is usually a relative of the ill person and the care given is invariably continuous.…”

“…In other cases the patient ceases to go out, imposing further limitations on the social life of their partner (Fadden et al, 1987). The patient may contribute very little to household tasks and their contribution may not be welcome because their relative feels that any tasks performed simply add to their own work (Stevens, 1972). Quarrels and tension over domestic responsibilities may lead to an oppressive atmosphere within the home (Gubmanef al, 1987).…”

“…The level of care-giver distress has been related directly to the severity of the relative's psychosis and disturbed behaviour (Gibbons et al, 1984). Worry about what will happen when they die or become too frail to help can affect older care-givers (Stevens, 1972;Corderei al, 1991), and some family members can experience a sense of guilt or feel that they are to blame for their relative's illness (Sargeant, 1993).…”

“…It is not uncommon for parents of an adult with schizophrenia to bail him or her out of debt. When parents as care-givers are elderly and on a pension, this can lead to poverty, social isolation, poor dietary habits, overcrowding (when a schizo phrenic child returns home) and lack of leisure activities (Stevens, 1972).…”

“…About 30% of care-givers were living alone with their ill relative. In a Camberwell survey over 50% of chronic schizophrenics were living with their parents or siblings; in many cases middle-aged single schizophrenics were living with their elderly parents (Stevens, 1972). In three studies from the USA, 80% or more of the known care-givers were parents in their late 50s or 60s (Lefley, 1987).…”