Financial Stress on Caregivers of Dementia Patients

Introduction

Alzheimer disease calls for around the clock patient care due to its progressive nature. Such care requires the involvement of the family, friends, as well as the nursing fraternity. Individuals close to the patient spend a lot of time off their work that leads to financial deterioration. Additionally, the family and friends have to raise funds towards the diagnosis and treatment of the patient as well as professional nursing care. Giving care to the elderly and demented individuals is, therefore, a stressful experience that digs deep into the pockets of caregivers.

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Prevalence

Alzheimer Disease (AD), the most significant cause of dementia, is irreversible and deteriorating impairment of the neural system mainly affecting the conscious section of the brain and mainly affects the elderly (Aajami, Kabriaeezadeh & Nikfar, 2019). Typically, AD clinically manifests as a cognitive impairment affecting the behavioural ad psychological functions of the patient leading to dependence. Aajami, Kabriaeezadeh & Nikfar (2019) estimates a population of 46.6 million patients suffering from AD and the figure projects to double in every 20 years. Such enormous figures show the huge demand in finance to cover for patient care. Overly elevated costs lead to significant distress among caregivers.

The cost of giving care to the patients depend on the stage of the disease. Typically, there are three options: productivity loss (IC), direct nonmedical cost (DNMC) and immediate medical cost (DMC) that apply to any stage of the disease. According to a study in Iran, the average DMC for severe and moderate stages of AD are 702 USD and 219 USD respectively, with the expenditure mainly providing for occupational therapy as well as physiotherapy (Aajami, Kabriaeezadeh & Nikfar, 2019). The same study revealed DNMC in severe, mild and moderate stages as 1257, 263 and 641 USD in that order. Majorly, the costs took care of home caring and nursing services. Such figures show a significant amount of money dedicated to AD healthcare concerning the average household income in Iran, that is about 6600 USD. Such costs depict the burden among the family and friends of a dementia patient.

Risk & Protective Factors

Dementia deteriorates the physical and mental capability of the patient leading to their dependency. The dependency of the patient from other well-functioning and economically viable people is possibly the most considerable risk. Such potentially working citizens cannot attend their duties at work hence face the danger of laying off and sucking. Although many caregivers balance work and their responsibility at home, their employment status may highly land in a compromise (Liu, Dokos, Fauth, Lee & Zarit, 2019). If the caregivers remain in their jobs, they may end up performing poorly hence losses at work. Besides, if they do not work, they face more considerable difficulties in catering to other patient needs such as medication. All these situations pose the caregivers at immense financial stress.

The financial status of the society and the general economy also pose a risk in stress development among caregivers. In developed economies, there are profound institutions that offer palliative care, including for dementia patients - nevertheless, the individuals who cannot afford such care struggle to offer even the home-based services. A third of the caregivers have admitted having trouble in their caregiving due to financial constraints (Leszko, 2019). Such indicators prove that taking care of dementia patients is an expensive affair to a lot of people.

Another protective strategy in financial stress among the AD caregivers is the facilitation of out of pocket expenses. Out of pocket expenditures are crucial among the employed in paying expenses such as medical services, equipment, clothing, food, travelling, as well as legal fees among dementia patients (Leszko, 2019).

Consequences

As already noted, most caregivers suffer financial stress in the process of taking care of their loved ones who face dementia. Besides losing numerous working hours, they undergo huge expenses, some accruing up 5531 USD (Leszko, 2019). Such costs are sometimes beyond their means and end up in financial crisis such as debts lasting for a long time.

Such financial constraints have been particularly tough on women who constitute the majority if the caregivers. Studies have indicated the likelihood of poverty and reliance among women who take care of their demented husbands (Cheng, 2017). The financial strains have, therefore contributed to significant caregiver burden. Moreover, given the fact that AD does not have an effective preventive of curable treatment, the disease gets more demoralizing to the caregivers.

Intervention

The AD does not have a therapeutic or preventive drug or therapy. The whole caregiving process is meant to alleviate suffering to the patient. There is a nonetheless dire need for accurate interventions to develop low cost and effective non-pharmaceutical products aimed to improve the quality of life among patients. Additionally, there is a need to reduce financial stress among dementia patient caregivers. One of the measures that may significantly affect financial stress reduction is the need for institutional interventions. Such include the formulation of insurance policy to take care of dementia patients in an attempt to alleviate the struggle among the caregivers.

Conclusion

Financial stress among the caregivers of demented patients is a common problem. The progressive nature of the disease in its neutering the conscious of the patient, it requires close supervision of the patient. In most cases, professional involvement is limited due to high costs in practice. The resultant is families and friends of the patient taking care of their loved ones. Such care often results in less time at work and subsequent poor performance that lead to employee substitution.

Additionally, there are huge costs associated with caring for people with Alzheimer disease. Such expenses summed up are the resultant to immense financial stress. Women who are the majority of the caregivers at home suffer most in their finances, leading to significant deprivation.

References

Aajami, Z., Kebriaeezadeh, A., & Nikfar, S. (2019). The direct and indirect cost of managing Alzheimer's disease in the Islamic Republic of Iran. Iranian Journal of Neurology. doi:10.18502/ijnl.v18i1.940

Lee, S.M., Choi, S., Lim, T., Moon, Y. (2019). Clinical and Demographic Predictors of Adverse Outcomes in Caregivers of Patients with Dementia. Dementia and Neurocognitive Disorder. doi.org/10.12779/dnd.2019.18.1.10

Leszko, M. (2019). The Effectiveness of Psychoeducational and Financial Intervention to Support Caregivers of Individuals With Alzheimer's Disease in Poland. Innovation in Aging, 3(3), 1-9. doi:10.1093/geroni/igz026

Liu, Y., Dokos, M., Fauth, E. B., Lee, Y. G., & Zarit, S. H. (2019). Financial Strain, Employment, and Role Captivity and Overload over Time among Dementia Family Caregivers. The Gerontologist. doi:10.1093/geront/gnz099

The Swedish Council on Technology Assessment in Health Care. (2008). Dementia - Etiology and Epidemiology. A Systematic Review