Caregiving Challenges Research Articles

Spirituality, Spiritual Distress and Experiences of Joy, Meaning and Growth Among Parkinson's Disease Caregivers in the United States.

Caregiving challenges of Parkinson's disease can result in loss of faith, meaning, and spiritual distress. The purpose of this study is to describe Parkinson's disease caregivers' perceptions and experiences related to spiritual distress, sources of spiritual and religious support, acts, and experiences of growth, and finding meaning and joy in the midst of spiritual distress. We conducted semi-structured interviews with caregivers of persons with Parkinson's disease (n = 16) and identified five themes: (a) Bearing witness to suffering underlies spiritual distress; (b) Prayers are pleas for "soul help"; (c) Spiritual guidance and support are important; (d) Faith and community are sources of spiritual support; and (e) Joy, meaning, and growth help to transcend spiritual distress. Interventions that target sources of spiritual distress and joy are needed.

Experiences of Migrant Live-in Caregivers in Caring for Patients With Advanced Cancer - A Qualitative Study.

Foreign domestic workers are increasingly hired in Singapore as live-in caregivers for patients with advanced cancer. Language barriers and different cultural backgrounds can make caregiving potentially challenging. This study aims to explore the experiences of migrant live-in caregivers caring for patients with advanced cancer. Semi-structured interviews were conducted to explore: the challenges and needs of migrant live-in caregivers caring for patients with advanced cancer, what enables their cancer caregiving work, and their motivations. Participants were recruited from inpatient oncology wards of an acute tertiary hospital. Inclusion criteria included: (i) migrant live-in caregiver caring for a patient with stage IV solid organ cancer; (ii) age ≥21 years; (iii) conversant in English, Mandarin or Burmese. Twelve female caregivers participated in the study. Their mean age was 35.4 years, 4 were from Indonesia, 3 from Myanmar and 5 from the Philippines. Four main themes emerged: (1) Wide-ranging work responsibilities that could be challenging, (2) Treating and being treated like family, (3) Having access to multiple sources of support and (4) Motivated by being able to provide for their own family of origin. Migrant live-in caregivers face various challenges in cancer caregiving. Having a good relationship with patients, adequate employer and peer support and being able to provide for their family helped to motivate them. Efforts to support them can include formal training, better delineation of job scope and hours, and resources to address psycho-emotional needs. Further research could focus on knowledge gaps for cancer caregiving, psychosocial and post-bereavement needs.

Care Refusal by Older Adults With Dementia Receiving Professional Care: A Scoping Review.

Care refusal behaviors by institutionalized older adults with dementia pose significant challenges for professional caregivers in residential care settings. This scoping review mapped the determinants and effects of care refusal in this population. A systematic search of five databases identified 19 studies published between 2013 and 2023. The findings indicated that personal, relational, environmental, and organizational factors influence care refusal behaviors in institutional settings. Cognitive impairment, communication difficulties, elderspeak, unfamiliar institutional environments, and task-oriented care were key determinants. Care refusal compromised health outcomes, disrupted care provision, and exacerbated neuropsychiatric symptoms in residential care facilities. Terminological inconsistencies and methodological limitations were identified as research gaps. Developing standardized terminology and person-centered strategies represents priority areas for coordinated action across policy, practice, and research to address the impact of refusal behaviors while upholding the rights of institutionalized older adults with dementia.

Exploring the experience of family members caring for a relative with alcohol use disorder: A phenomenological inquiry.

Alcohol use disorder (AUD) is a global concern with negative physical, psychological and social consequences. The ramifications of AUD extend beyond the individual and affect their family caregivers. Yet, the majority of existing research has primarily focused on individuals with AUD and interventions to encourage their abstinence rather than on their support systems. In order to advance a holistic approach, research to address this gap is imperative to understand family caregiver concerns and needs for added support. We conducted a qualitative study using van Manen's hermeneutic phenomenological approach to uncover the meaning of family caregivers' lived experiences and capture the essence of their involvement in caring for a relative with AUD. A purposeful and snowball sample of family members (N = 10) living within the United States participated in a face-to-face or virtual, one-on-one audio-recorded interview and a second meeting for member checking the transcribed data. Participants received a $20.00 gift card as a token for their participation. Six major themes emerged from the description of participants' lived experiences: (1) traversing the peaks and valleys, (2) wandering in the unknown, (3) pointing fingers, (4) weathering the storm, (5) drawing a line and (6) looking back, looking in. Although participants experienced many challenges, they never relinquished and remained committed to their caregiver role. Steadfastly staying with their relatives through crises exemplifies commitment as described by Sister Simone Roach's Theory of Caring. Through the ups and downs, each participant found meaning from the experience, which aligned closely with Starck's Theory of Meaning. This study has implications for nursing practice, public health policy and highlights the need for collaboration to address the existing challenges for family caregivers of relatives with AUD.

Spiritual needs of family caregivers in palliative care

ObjectiveThe primary aim of this study is to elucidate the spiritual needs encountered by family members who intricately engage in the progression of illness within the palliative care framework, thus assuming the paramount responsibility of caregiving.MethodsThis study was approved by the Institutional Review Board and Ethics Committee of the University of Health Sciences İzmir Tepecik Training and Research Hospital (17/01/2022–2022/01–16). The research was designed as a prospective study. It was conducted through face-to-face, interactive interviews with family caregivers of patients admitted to the palliative care unit at Tepecik Training and Research Hospital between April 2022 and December 2022. The interviews were performed using a phenomenological approach and structured in a question-and-answer format. Data from twenty family caregivers were analyzed using thematic analysis. The questions were specifically designed to explore the psychological processes, spirituality, conceptions of God, meaning-making, and coping strategies of the family caregivers.ResultsCaregivers experienced various psychological and emotional states progressing through stages of denial, anger, and acceptance. Spirituality emerged as a critical coping mechanism providing strength and meaning amidst caregiving challenges. Caregivers’ perceptions of God varied from loving to punitive, influencing their interpretations of suffering and caregiving roles.ConclusionThis study underscores the importance of integrating spiritual support into palliative care practices. Recognizing and addressing caregivers’ spiritual needs is crucial for enhancing their well-being and improving the quality of palliative care delivery. Training healthcare professionals in spiritual care and implementing targeted interventions can effectively support family caregivers in their caregiving journey.

Caregiving Challenges from Persistent Pain Among Family Caregivers to People with Dementia.

Many family caregivers to people with dementia experience persistent physical pain. Though caregivers' pain is associated with poor caregiving outcomes, there is little research on how pain challenges caregiving to yield poor outcomes. This study developed a typology of caregiving challenges from pain among family caregivers to people with dementia. We conducted semi-structured, in-depth interviews with 25 family caregivers living with persistent pain and caring for people with dementia. We inductively analyzed data via a thematic analysis approach, wherein we identified and categorized caregiving challenges stemming from caregivers' pain. We then analyzed how challenges were related to one another and their consequences for caregiving outcomes. Analysis revealed three interrelated categories of caregiving challenges from living with pain: 1) physical (e.g., difficulty lifting care recipient), 2) psychological/emotional (e.g., worry about future care if their pain condition worsens), and 3) familial/relational (e.g., resentment towards family without pain for not helping with care). Caregivers reported that these challenges compounded one another in ways that made both caregiving and pain management more difficult. Moreover, challenges led to caregivers delaying or skipping care tasks. The nature of challenges and their connection to caregiving outcomes were dependent on various supporting factors, such as whether caregivers reported benefits from their own pain (e.g., greater empathy). The resulting typology informs a conceptual model to guide future translational research on caregivers' pain, including illuminating promising intervention targets of pain self-management programs for family caregivers to people with dementia.

Experiences of Informal Caregivers Caring for Individuals With Chronic Schizophrenia in Asia: A Systematic Review and Meta-Synthesis.

In Asia, many caregivers are culturally obliged to assume the role of taking care of individuals experiencing chronic schizophrenia, even as they grapple with stigma and compassion fatigue. Despite the significance of this phenomenon, the collective experiences of Asian caregivers remain poorly understood. To synthesise qualitative evidence on the experiences of informal caregivers when caring for individuals with chronic schizophrenia in Asia. A search was conducted on seven databases for studies published between 2013 and 2023. The included studies were appraised using the Critical Appraisal Skills Program tool. Data extraction was based on the Joanna Briggs Institute (JBI) Qualitative Extraction Form. The data synthesis was based on the framework by Sandelowski and Barroso. Our review included the experiences of 1345 informal caregivers from 57 included studies. The analysis yielded the overarching theme of 'Navigating Challenges, Forging Resilience'. Three themes were identified: (i) challenges in caregiving, (ii) lack of support and (iii) coping and resilience. Our findings highlighted the Asian caregivers' stressors, particularly cultural and traditional factors, a facet often overlooked in the literature. Mental healthcare practitioners must provide caregivers with comprehensive information. Anticipatory guidance is essential during the initial stages of the diagnosis. To negate geographical limitations, caregiver-training sessions can be pre-recorded and posted to online platforms. Finally, cultural and spiritual beliefs can be integrated into the treatment plans for individuals with schizophrenia in the community. Within the institutional setting, mental healthcare practitioners are encouraged to provide caregivers with comprehensible information or training in person and through written or online platforms, which can transcend geographical limitations. Anticipatory guidance is essential, especially during the initial stages of the diagnosis, when confusion and uncertainties are prevalent. Periodic home visits by mental healthcare practitioners can help ease caregivers' concerns and enhance their caregiving confidence. Finally, cultural and spiritual beliefs should be integrated into the treatment plans for individuals with schizophrenia in the community as it promotes cultural acceptability, encourages referrals to appropriate institutions and reduces the stigma of mental healthcare.

Experiences of family caregivers of children living with thalassaemia-major in Karachi: a phenomenological study

IntroductionThalassaemiamajor, a global health burden, presents a growing challenge in Pakistan’s strained healthcare system. This study explores how caregivers of children with beta-thalassaemia major navigate healthcare services, aiming to identify facilitators and barriers to accessing optimal care.MethodsA qualitative interpretative phenomenological approach was employed. In-depth interviews with 18 purposively sampled caregivers from Karachi thalassaemia centres were conducted. Thematic analysis using a combined inductive-deductive approach identified themes within the interview data.ResultThe study revealed significant challenges for caregivers at individual, interpersonal and organisational levels. Lack of awareness about carrier states, limited disease knowledge, financial constraints and concerns about the child’s future emerged as primary hurdles. Parents felt helpless due to the absence of emotional and social support for their children’s treatment. Obstacles such as complicated registration processes at thalassaemia-care centres, high costs of chelating agents and blood unavailability were major barriers to seeking care and caregiving. Additionally, the study highlighted the absence of guidelines for thalassaemia-carrier detection among mothers during antenatal care.ConclusionThe study emphasised the importance of implementing premarital screening programmes due to the lack of knowledge about the disease and carrier state. To prevent the disease, it is crucial to include thalassaemia-carrier detection for mothers in antenatal guidelines and provide counselling at the primary level. Additionally, caregivers encountered treatment accessibility issues, prompting the establishment of a satellite thalassaemia centre linked to a top-tier tertiary care hospital in the public sector. This initiative addressed treatment challenges and improved overall care for patients with thalassaemia and their caregivers.

Validity and Reliability of the Korean Version of the Caregiver Burden Questionnaire for Family Caregivers of Hemodialysis Patients

AimThis study aimed to adapt and validate the Korean version of the Caregiver Burden Questionnaire for Family Caregivers of Hemodialysis Patients, originally developed by Hejazi et al. in 2022, to ensure its applicability and validity in Korea. MethodsUsing both online and offline approaches, this study included 230 family caregivers. Data analysis was performed with SPSS AMOS version 29.0 using the Korean version of the Caregiver Burden Questionnaire for Family Caregivers of Hemodialysis Patients and the Korean version of the Zarit Burden Interview as the primary instruments. ResultsThe findings confirmed the high content validity of the questionnaire (scale-level content validity index = .99), and confirmatory factor analysis established its construct validity. Convergent validity was confirmed with average variance extracted values ranging from .43 to .87, and composite reliability scores ranging from .80 to .91. A significant positive correlation with the Korean version of the Zarit Burden Interview (r = .81) demonstrated concurrent validity. The tool consists of 21 items across four factors on a 5-point Likert scale, exhibiting excellent internal consistency (Cronbach's α = .91) and good test-retest reliability (intraclass correlation coefficient = .79). ConclusionsThis study validated a reliable instrument for assessing caregiver burden in families of hemodialysis patients in Korea. This tool accurately measures caregiver challenges and has the potential to enhance societal health and welfare.

Experiences of caregivers of patients with traumatic brain injury during hospitalization in western China: A qualitative study

ABSTRACT Family members frequently provide both physical and emotional support to patients. Previous studies have focused primarily on the experiences of patients with traumatic brain injury (TBI) and their caregivers during home care and the transition from hospital care to the community, with less emphasis on their experiences during acute hospital care immediately after TBI. This study aimed to explore the experiences of caregivers of patients with TBI during acute hospitalizations. A qualitative descriptive study using individual semistructured interviews was conducted at the trauma center of a tertiary hospital in western China. A purposive sample of 21 caregivers of patients with TBI were recruited. The interviews were conducted face to face in the inpatient ward from July to September 2023. Conventional content analysis was used to conduct the framework analysis. The experiences of caregivers were identified within three key themes: TBI consequences in patients (physical impairments, psychological distress, and cognitive dysfunctions), challenges of caregivers (physiological/emotional/economic burdens, conflicts, and concerns regarding recovery), and needs of caregivers (health information, medical services, and recovery expectations). This study highlights the experiences of caregivers of patients with TBI during hospital stays in western China. The challenges faced by caregivers and the needs of caregivers are multidimensional. Appropriate support should be provided to alleviate the burden of caregiving.

Caregiver burden, attachment and cognitive emotion among the family caregivers of severe mental illness patients

BackgroundSerious mental illness (SMI) is a debilitating medical condition that causes stress and challenges for the family caregivers (FCs) of affected patients, increasing their caregiver burden (CB). This situation can activate attachment styles (AS) and trigger negative emotions, further contributing to CB. Given that AS and cognitive-emotional regulation (CER) can affect the CB of FCs of patients with SMI, the aim of this study was to evaluate the relationship between CB with AS, and CER among the FCs.MethodsThis cross-sectional descriptive-correlational study was carried out in May–November 2022. Participants were 278 FCs of patients with SMI consecutively recruited from Roozbeh leading psychiatric hospital, Tehran, Iran. Data were collected using a patients’ demographic and clinical characteristics questionnaire, an FCs’ demographic characteristics questionnaire, the Attachment Style Questionnaire, the Cognitive Emotion Regulation Questionnaire, and the Burden Scale for Family Caregivers, and were analyzed using the SPSS software (v. 16.0).ResultsCB had significant inverse relationship with secure AS (r = − 0.262) and significant positive relationship with fearful AS (r = 0.194) and dismissive AS (r = 0.242) (P < 0.01). Moreover, CB had significant inverse relationship with adaptive CER strategies and significant positive relationship with maladaptive CER strategies (P < 0.001). Regression analysis also showed that CB had significant relationship with secure AS and catastrophizing, rumination, self-blame, and positive refocusing CER strategies (P < 0.05).ConclusionThis study concludes that AS and CER can impact CB. There is a negative relationship between secure AS and CB, as well as between adaptive CER strategies and CB. Conversely, there is a positive relationship between avoidant AS and increased CB, as well as between maladaptive CER strategies and CB. It is recommended to adopt strategies that promote the use of secure AS and adaptive CER among the FCs of patients with SMI.

Changes in care provision to older parents during COVID-19 and the well-being of adult children: The moderating roles of the child-parent relationship and pandemic-related measures

Objective: The study addresses the associations between changes in care provision to older parents since the pandemic and worsened depression and anxiety in adult children. It also explores whether pandemic-related control measures and child-parent relationships moderated these associations. Background: Changes in informal care during the pandemic, such as increased or decreased caregiving frequency, may have affected caregivers’ psychological well-being. Limited research exists on how stressors and resources shape the well-being of adult children caregivers. Method: Data from 740 respondents in the first SHARE Corona Survey (SCS) who provided care for their parents during the pandemic were analyzed. Changes in depression and anxiety were assessed using data from SCS and pre-pandemic Wave. Logistic regression analyses were conducted, with added interactions between the moderators - pandemic measures and child-parent relationship characteristics - and changes in care frequency. Results: Increased caregiving frequency during the pandemic was associated with worsened depression. Stricter pandemic measures intensified this effect but also reduced the likelihood of anxiety for those who provided care less often. A higher quality of relationship with the mother in childhood was marginally associated with lower depression among those increasing caregiving but worsened depression for those decreasing it. Conclusion: To address post-pandemic caregiving challenges, efforts should focus on reducing caregiver stress and considering the enduring influence of early child-parent relationships.

Representing the Needs of Rural Caregivers of People Living with Alzheimer’s Disease and Related Dementias through User Personas

Abstract Background and Objectives Rural caregivers of people living with Alzheimer’s disease and related dementias (ADRD) face unique caregiving challenges. Current interventions do not address many of the systemic barriers experienced by rural ADRD caregivers, including barriers related to geography, healthcare services access, and financial insecurity. The objective of this study was to gain a deeper understanding of rural ADRD caregivers’ needs, strengths, and strategies in obtaining caregiving support, and to represent these attributes in the form of personas that can be used to design interventions for rural ADRD caregivers. Research Design and Methods In this qualitative user-centered design study, we conducted semi-structured interviews with self-identified caregivers of people living with ADRD in rural areas. Interview data was copied to a virtual whiteboard, and affinity diagramming was used to confirm a priori attributes and yield inductive attributes relevant to rural ADRD caregivers. Attributes were assigned to personas, which were then validated through team-based discussion, consultation with a study advisory board, and review by rural caregivers and community partners. Results Analyses of N=19 interviews yielded seven inductive attributes relevant to rural ADRD caregivers of persons living with ADRD and five distinct personas: Capable Christine, Connected Connie, Isolated Irene, Learning Larry, and Discerning Dan. Personas differed on inductive attributes including financial security, subjective rurality, attitudes, connectedness, and information behavior, including preferences for traditional versus technology-based information seeking. Discussion and Implications The personas identified in the present study can be used as tools to represent and efficiently communicate the intersection and interaction of attributes relevant to designing interventions and technologies to meet the support needs of rural ADRD caregivers.

Challenges for Family Caregivers of Persons With Mild Cognitive Impairment: A Qualitative Longitudinal Study.

Family caregivers of persons with mild cognitive impairment attempt to understand the behavioural and functional changes exhibited by their relative. However, how caregivers respond to initial changes and changes over time has not been explored. The purpose of this qualitative study was to explore the experience of family caregivers responding to changes in their relative's memory, behaviours, and physical functions over 2 years. Eleven family caregivers of a relative with mild cognitive impairment were purposively recruited from neurological clinics in Taiwan. Face-to-face semi-structured interviews were conducted within 6-months of referral; three follow-ups were conducted at 6-month intervals. Content analysis of 41 transcribed audio-recorded interviews revealed the longitudinal changes in their relative with cognitive impairment was made caregiving challenging. Three themes described the challenges: (1) Changes related to their relative's cognitive impairment, which included increases in mood fluctuations, erratic behaviours, and reductions in physical abilities; (2) changes in their relative's comorbidities, which included adapting to new symptoms and treatments for a chronic disease, monitoring medication adherence and drug interactions; and (3) changes in caregiver burden, which increased levels of stress, uncertainty, and anxiety resulting in greater role strain. Caregiving became more challenging with time, especially caregivers whose relative developed dementia during the study period. These findings offer insight into the trajectory of the experience of family caregivers attempting to understand changes in cognition, behaviours, and physical functions for their relative with mild cognitive impairment over 2 years, which could help mental healthcare providers develop support services to reduce caregiver role strain.

A Narrative Review of the Clinical, Humanistic, and Economic Value of Pembrolizumab-Based Immunotherapy for the Treatment of Breast and Gynecologic Cancers.

Breast and gynecologic cancers are common across the world and are associated with substantial societal and economic burden. Pembrolizumab was among the first immune checkpoint inhibitors targeting programmed cell death protein1 to be approved for the treatment of patients with triple-negative breast cancer, cervical cancer, and endometrial cancer. Recent clinical trials have established pembrolizumab regimens as a standard of care treatment for these tumor types. Clinical data are further supported by patient-reported outcome, cost-effectiveness, and real-world evidence. Pembrolizumab monotherapy and combination regimens do not negatively influence health-related quality of life and are cost-effective relative to comparators. Ongoing phase3 studies with pembrolizumab will expand the current understanding of its use in breast and gynecologic cancers. Several of these studies are in patients with early-stage disease with the hope of curing patients. The main objective of this review is to summarize the clinical, humanistic, and economic value of pembrolizumab in these settings and to describe the future challenges for patients, caregivers, clinicians, and payers.

Family caregivers of children with cystic fibrosis: supportive care needs – scoping review

BackgroundCystic fibrosis (CF) in children requires complex and time-consuming daily care, presenting significant challenges for families and caregivers. Family caregivers caring for children with CF report diverse and complex needs.ObjectiveThis...

The Role of Caregivers in the Stroke Patients Recovery: A Mixed Methodology Study Focusing on Caregiver Challenges and Patient Outcomes

The Role of Caregivers in the Stroke Patients Recovery: A Mixed Methodology Study Focusing on Caregiver Challenges and Patient Outcomes

Exploring experiences of mothers of children with thalassemia major in Indonesia: A descriptive phenomenological study.

Thalassemia is a hereditary blood disorder that poses significant challenges for affected children and their families. Caregivers, particularly mothers, often experience difficulties in managing their child's condition. Understanding their current experience is crucial for improving care and support. This study aimed to explore the experiences of mothers caring for children with thalassemia in Banten, Indonesia. A qualitative descriptive approach was employed, involving semi-structured in-depth interviews with eleven mothers of children diagnosed with thalassemia. Data were collected from April to May 2023. The interviews were audio recorded, and the data were analyzed verbatim using Colaizzi's method to identify key themes related to the experiences. Three themes were developed: 1) Perception of thalassemia as a genetic condition, 2) Emotional, logistical, and practical caregiving challenges, and 3) Support received by mothers in caring for children with thalassemia. The findings highlight the multifaceted challenges faced by mothers of children with thalassemia and emphasize the need for improved communication, emotional support, and care coordination from nurses and healthcare providers. Future research should focus on expanding support systems and exploring effective interventions to enhance the quality of life for families navigating the complexities of chronic illness.

“It’s a delicate dance”: How informal caregivers experience the role and responsibilities of supporting someone living with a lower-grade glioma

Abstract Background People with lower-grade gliomas (LGG) often require long-term support with a condition that causes substantial symptom burden and is likely to progress. Partners, family, and friends often become informal caregivers (IC), but the types of support they provide, and their experiences of this, have not been well investigated. We aimed to understand how ICs experience the role and responsibilities of supporting people with LGG. Methods This descriptive qualitative study used semistructured interviews to explore the role and responsibilities of a purposive sample of ICs across the United Kingdom, who currently, or in the past 5 years, support(ed) someone with an LGG. Interviews were audio-recorded and transcribed, and an inductive thematic analysis was conducted. Results Nineteen ICs were interviewed (mean age 54.6 years; 5 males/14 females). While most participants spoke about “Being a ‘carer’,” the level of care provided varied. Participants conveyed their experiences with “Adjusting for cognitive difficulties,” “Emotional protection,” “Supporting participation in daily life,” and “Healthcare advocacy.” ICs often felt “abandoned” by healthcare services to provide required care themselves, and reported experiences with “Balancing the challenges of caregiving,” including conflict with work/childcare. Issues around “Maintaining the care recipient’s independence” were interwoven throughout. Conclusions ICs of people with LGG provide wide-ranging support to help manage the consequences of the illness. Consideration of ways to help ICs with the challenges of fulfilling this role, particularly, balancing support provision without inhibiting the care recipient’s independence, could help improve outcomes for ICs and people with LGG.

The Development of a Family Support Program for Caregivers of Hemodialysis Patients

Family caregivers of hemodialysis patients have a heavy burden based on negative experiences, long-term care hours, total physical dependence of patients, comorbid health conditions, and financial stress treatment procedures. This study design is a mixed method followed by 114 participants in the quantitative phase and eight participants in the qualitative phase. The research instrument used Zarit Burden, a demographic profile form, semi-structured interview questions, and a recorder. Data analysis used ANOVA, t-test, and thematic analysis. The results showed that most participants were 51 to 60 years old, patients' wives, college graduates, had a monthly income below ph10,000.00 and had cared for patients for 20 to 24 hours. Participants have experienced high physical and financial burdens and loss of control over life, as well as very high emotional and social burdens. Significant differences were found in the levels of emotional, social, and financial burdens when grouped by education level. Monthly income affects the level of social and financial burdens. Physical exhaustion, emotional suffering, limited social life, role conflict, financial poverty, and fear of the future are the themes of challenges in caregiving. Participants coped with their challenges by seeking help and sleep, emotional adjustment, acceptance, maintaining friendships, resisting the urge to participate in social activities, utilizing family resources, seeking financial support from politicians and government agencies, and borrowing money. The proposed stress relief support program has the potential to be an intervention to enable family care with various forms and levels of caregiving burden.