Psychosocial stress and coping strategies in spousal caregiving after spinal cord injury

Caregiver Interview as Related to Physical Therapy

The objective of this study is to determine what types of psychosocial issues arise for individuals who render primary care to a PWD on a routine basis, and to determine how these caregivers cope with the stress of their responsibilities. This will involve an interview.

The interview in this study is conducted with a woman who will be known in this study as Karen Hill, a registered nurse and physical therapist and caregiver for the 'Person with Disabilities' at focus in this particular case study. The PWD in this case study is Karen's husband Dale who was ran over by a herd of cattle when administering medication and attaching ear tags to the cattle. Dale was taken to the hospital and due to a mistake at the hospital; ER is now paralyzed from the waist down. Dale has been paralyzed for two years now and Karen quit her job to provide round-the-clock care for her husband. Dale and Karen live in a middle-class home in the country. Karen is experienced working with Social Security issues and has procured the necessary equipment and aids to properly take care of Dale at home. Included in the procurements are a hospital bed, wheelchair, potty-chair, walk-in tub, in addition to having ramps installed on the home's entrances and exits.

Information Required by Caregiver Prior to Assumption of Responsibilities and Where Information Obtained

Karen, with her previous experience as both a RN and physical therapist is luckier than most caregivers in this situation are when those caregivers are family members because Karen knew where and how to obtain the information needed to ensure that proper care would be provided to the PWD in this case study and specifically her husband, Dale Hill.

Greatest Obstacle, Challenges and Rewards Related to Caregiving Role

Karen was asked the questions of what were the greatest obstacles, challenges, and rewards associated with the care-giving role in this specific situation. Karen states that the greatest obstacle has been the ability to accommodate her husband in terms of keeping his mind busy even though his body is limited in terms of daily activities. Karen states that she has been diligent in keeping a schedule insofar as waking Dale at the same time each day, having breakfast a morning wash and taking Dale outside to get fresh air. Another major challenge has been the continuation of the social life of the couple, which was very active prior to Dale's paralysis. This has been critically important according to Karen to ensure that Dale did not sink down into a depression.

Strategies Used by Caregiver to Relieve Stress & Mechanisms Available to Provide Assistance or Respite

Stress is a primary issue that Karen is required to effectively cope with while providing daily care to her husband due to his paralysis. Karen reports that she has a network of friends and family that serve as a support group and that several of her friends respond positively when she needs someone to stay with Dale for an hour or two so that she can take a break from the responsibilities associated with providing care for her husband on a daily basis. As well, Karen's brother-in-law, Robert, is very loyal to assist in bathing Dale four times each week and carries Dale out to lunch twice each week allowing Karen to take short breaks from the responsibility of care provision of the PWD in this particular case study.

Ways in Which Life of Caregiver Changed Due to the Situation

Karen relates that her life was dramatically altered due to providing care for a 'PWD' and this case for her husband after an accident resulted in paralysis. Karen had previously worked two jobs at two different health care facilities and had been highly involved in many aspects of the facilities and their programs. As well, Karen had volunteered for a couple of non-profits in her capacity as a nurse and this resulted in having a very busy and very full schedule. Karen states that she is presently somewhat cut off from the rest of the world due to the encompassing responsibility of providing PWD care for her husband.

Summary and Conclusion

The responsibilities associated with providing care for a PWD individual are a heavy load it is certain. Providing care on a 24-hour per day and 7-day per week basis is not an easy task and is one that leaves individuals tired and often burned out. The individual caregiver must ensure that they have a strategy for combating stress and weariness and as well as depression on the part of the patient and the caregiver themselves due to the constraints and limitations that this type of care giving role places on the caregiver of the PWD.