Caregiving burden

وَكَانَ يَأۡمُرُ أَهۡلَهُۥ بِٱلصَّلَوٰةِ وَٱلزَّكَوٰةِ وَكَانَ عِندَ رَبِّهِۦ مَرۡضِيࣰّ ا

He commanded his household to pray and give alms, and his Lord was well pleased with him

لَّيۡسَ عَلَى ٱلۡأَعۡمَىٰ حَرَجࣱ وَلَا عَلَى ٱلۡأَعۡرَجِ حَرَجࣱ وَلَا عَلَى ٱلۡمَرِيضِ حَرَجࣱ وَلَا عَلَىٰٓ أَنفُسِكُمۡ أَن تَأۡكُلُواْ مِنۢ بُيُوتِكُمۡ أَوۡ بُيُوتِ ءَابَآئِكُمۡ أَوۡ بُيُوتِ أُمَّهَٰتِكُمۡ أَوۡ بُيُوتِ إِخۡوَٰنِكُمۡ أَوۡ بُيُوتِ أَخَوَٰتِكُمۡ أَوۡ بُيُوتِ أَعۡمَٰمِكُمۡ أَوۡ بُيُوتِ عَمَّٰتِكُمۡ أَوۡ بُيُوتِ أَخۡوَٰلِكُمۡ أَوۡ بُيُوتِ خَٰلَٰتِكُمۡ أَوۡ مَا مَلَكۡتُم مَّفَاتِحَهُۥٓ أَوۡ صَدِيقِكُمۡۚ لَيۡسَ عَلَيۡكُمۡ جُنَاحٌ أَن تَأۡكُلُواْ جَمِيعًا أَوۡ أَشۡتَاتࣰ اۚ فَإِذَا دَخَلۡتُم بُيُوتࣰ ا فَسَلِّمُواْ عَلَىٰٓ أَنفُسِكُمۡ تَحِيَّةࣰ مِّنۡ عِندِ ٱللَّهِ مُبَٰرَكَةࣰ طَيِّبَةࣰۚ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَعۡقِلُونَ

No blame will be attached to the blind, the lame, the sick.Whether you eat in your own houses, or those of your fathers, your mothers, your brothers, your sisters, your paternal uncles, your paternal aunts, your maternal uncles, your maternal aunts, houses you have the keys for, or any of your friends’ houses, you will not be blamed: you will not be blamed whether you eat in company or separately. When you enter any house, greet one another with a greeting of blessing and goodness as enjoined by God. This is how God makes His messages clear to you so that you may understand

وَإِذَا كُنتَ فِيهِمۡ فَأَقَمۡتَ لَهُمُ ٱلصَّلَوٰةَ فَلۡتَقُمۡ طَآئِفَةࣱ مِّنۡهُم مَّعَكَ وَلۡيَأۡخُذُوٓاْ أَسۡلِحَتَهُمۡۖ فَإِذَا سَجَدُواْ فَلۡيَكُونُواْ مِن وَرَآئِكُمۡ وَلۡتَأۡتِ طَآئِفَةٌ أُخۡرَىٰ لَمۡ يُصَلُّواْ فَلۡيُصَلُّواْ مَعَكَ وَلۡيَأۡخُذُواْ حِذۡرَهُمۡ وَأَسۡلِحَتَهُمۡۗ وَدَّ ٱلَّذِينَ كَفَرُواْ لَوۡ تَغۡفُلُونَ عَنۡ أَسۡلِحَتِكُمۡ وَأَمۡتِعَتِكُمۡ فَيَمِيلُونَ عَلَيۡكُم مَّيۡلَةࣰ وَٰحِدَةࣰۚ وَلَا جُنَاحَ عَلَيۡكُمۡ إِن كَانَ بِكُمۡ أَذࣰ ى مِّن مَّطَرٍ أَوۡ كُنتُم مَّرۡضَىٰٓ أَن تَضَعُوٓاْ أَسۡلِحَتَكُمۡۖ وَخُذُواْ حِذۡرَكُمۡۗ إِنَّ ٱللَّهَ أَعَدَّ لِلۡكَٰفِرِينَ عَذَابࣰ ا مُّهِينࣰ ا

When you [Prophet] are with the believers, leading them in prayer, let a group of them stand up in prayer with you, taking their weapons with them, and when they have finished their prostration, let them take up their positions at the back. Then let the other group, who have not yet prayed, pray with you, also on their guard and armed with their weapons: the disbelievers would dearly like you to be heedless of your weapons and baggage, in order for them to take you in a single assault. You will not be blamed if you lay aside your arms when you are overtaken by heavy rain or illness, but be on your guard. Indeed, God has prepared a humiliating punishment for the disbelievers

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ لَا تَقۡرَبُواْ ٱلصَّلَوٰةَ وَأَنتُمۡ سُكَٰرَىٰ حَتَّىٰ تَعۡلَمُواْ مَا تَقُولُونَ وَلَا جُنُبًا إِلَّا عَابِرِي سَبِيلٍ حَتَّىٰ تَغۡتَسِلُواْۚ وَإِن كُنتُم مَّرۡضَىٰٓ أَوۡ عَلَىٰ سَفَرٍ أَوۡ جَآءَ أَحَدࣱ مِّنكُم مِّنَ ٱلۡغَآئِطِ أَوۡ لَٰمَسۡتُمُ ٱلنِّسَآءَ فَلَمۡ تَجِدُواْ مَآءࣰ فَتَيَمَّمُواْ صَعِيدࣰ ا طَيِّبࣰ ا فَٱمۡسَحُواْ بِوُجُوهِكُمۡ وَأَيۡدِيكُمۡۗ إِنَّ ٱللَّهَ كَانَ عَفُوًّا غَفُورًا

You who believe, do not come anywhere near the prayer if you are intoxicated, not until you know what you are saying; nor if you are in a state of major ritual impurity- though you may pass through the mosque- not until you have bathed; if you are ill, on a journey, have relieved yourselves, or had intercourse, and cannot find any water, then find some clean sand and wipe your faces and hands with it. God is always ready to pardon and forgive

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِذَا قُمۡتُمۡ إِلَى ٱلصَّلَوٰةِ فَٱغۡسِلُواْ وُجُوهَكُمۡ وَأَيۡدِيَكُمۡ إِلَى ٱلۡمَرَافِقِ وَٱمۡسَحُواْ بِرُءُوسِكُمۡ وَأَرۡجُلَكُمۡ إِلَى ٱلۡكَعۡبَيۡنِۚ وَإِن كُنتُمۡ جُنُبࣰ ا فَٱطَّهَّرُواْۚ وَإِن كُنتُم مَّرۡضَىٰٓ أَوۡ عَلَىٰ سَفَرٍ أَوۡ جَآءَ أَحَدࣱ مِّنكُم مِّنَ ٱلۡغَآئِطِ أَوۡ لَٰمَسۡتُمُ ٱلنِّسَآءَ فَلَمۡ تَجِدُواْ مَآءࣰ فَتَيَمَّمُواْ صَعِيدࣰ ا طَيِّبࣰ ا فَٱمۡسَحُواْ بِوُجُوهِكُمۡ وَأَيۡدِيكُم مِّنۡهُۚ مَا يُرِيدُ ٱللَّهُ لِيَجۡعَلَ عَلَيۡكُم مِّنۡ حَرَجࣲ وَلَٰكِن يُرِيدُ لِيُطَهِّرَكُمۡ وَلِيُتِمَّ نِعۡمَتَهُۥ عَلَيۡكُمۡ لَعَلَّكُمۡ تَشۡكُرُونَ

You who believe, when you are about to pray, wash your faces and your hands up to the elbows, wipe your heads, wash your feet up to the ankles and, if required, wash your whole body. If any of you is sick or on a journey, or has just relieved himself, or had intimate contact with a woman, and can find no water, then take some clean sand and wipe your face and hands with it. God does not wish to place any burden on you: He only wishes to cleanse you and perfect His blessing on you, so that you may be thankful

لَّيۡسَ عَلَى ٱلضُّعَفَآءِ وَلَا عَلَى ٱلۡمَرۡضَىٰ وَلَا عَلَى ٱلَّذِينَ لَا يَجِدُونَ مَا يُنفِقُونَ حَرَجٌ إِذَا نَصَحُواْ لِلَّهِ وَرَسُولِهِۦۚ مَا عَلَى ٱلۡمُحۡسِنِينَ مِن سَبِيلࣲۚ وَٱللَّهُ غَفُورࣱ رَّحِيمࣱ‏

but there is no blame attached to the weak, the sick, and those who have no means to spend, provided they are true to God and His Messenger- there is no reason to reproach those who do good: God is most forgiving and merciful

(No blame is there upon the blind�) [24:61]. Said ibn �Abbas: �When Allah, glorious and exalted is He, revealed (O ye who believe! Squander not your wealth among yourselves in vanity�) [4:29], the Muslims felt vexed to eat with the sick, the old, the blind and the lame. They said: �Food is the best part of one�s wealth, and Allah, exalted is He, has warned against squandering wealth in vanity. The blind cannot see where wholesome food is, the lame cannot compete over food and the sick cannot eat properly�. As a response, Allah, exalted is He, revealed this verse�. Sa�id ibn Jubayr and al-Dahhak said: �The lame and the blind used to feel vexed at eating with healthy people because the latter found them despicable and disliked eating with them. The people of Medina did not allow the blind, lame or sick person to share their food because they considered them dirty. For this reason, Allah, e

(And when thou (O Muhammad) art among them and arrangest (their) worship for them�) [4:102]. The teacher Abu �Uthman al-Za�farani al-Muqri� informed us in the year [4]25> Abu Muhammad �Abd Allah ibn Muhammad ibn �Ali ibn Ziyad al-Suddi in the year 363> Abu Sa�id al-Fadl ibn Muhammad al-Jazari in the Sacred Mosque, Mecca, in 304> �Ali ibn Ziyad al-Lahji> Abu Qurrah Musa ibn Tariq> Sufyan> Mansur> Mujahid> Abu �Ayyash al-Zurraqi who said: �We performed the prayer of Zuhr with the Messenger of Allah, Allah bless him and give him peace, upon which the idolaters exclaimed: �They were in a vulnerable situation, why did we not attack them by surprise?� Then they said: �There shall come another prayer which is more beloved to them than their own fathers, which is the midafternoon (�Asr) prayer�. Gabriel, peace be upon him, then came down with these verses between the Zuhr and the �Asr prayers. (

O you who have faith! Do not approach the prayer when you are intoxicated until you know what you are saying, or defiled-except for travelers on the road-until you have made the full ablution.... Surely God is pardoning, forgiving. Intoxication is drunkenness. Drunkenness is disparate, and the drunkards diverse. One is drunk with the wine of the grape, another with the wine of heedlessness, another with love for this world, another with the frivolity of the soul and self-love. This last is the most difficult, for self-love is the basis of idol-worship, the seed of estrangement, the curtain of ill fortune, and the root of every darkness. If you are martyred a hundred times a day in the path of God you will still be an idol-worshiper if you see yourself in the midst. When will you be the man to want the heart without caprice? When you will have the pain to see the body with contempt? [DS 7

O you who have faith, when you stand for the prayer, wash your faces and your hands up to your elbows.... If you find no water, have recourse to goodly dust. Outward purity has three sections: First is purity after impurity. Second is purity after excretion and sexual activity. Third is purity from the sheddings of the body, such as nails, hair, dirt, and so on. Each of these three sections has an explanation and an explication, and these will be spoken of elsewhere, God willing. Inward purity has three duties: First, purity of the limbs from disobedience, such as back- biting, lying, eating the forbidden, betrayal, and looking at women illicitly. When this purity is gained, the servant is adorned with obedience and reverence. This is the degree of the faith of the pious. Its mark is that the remembrance of the Real is always on their tongue, the fruit of the prom- ise in their heart, th

When you O Muhammad (s) are present among them while you all fear an enemy and you stand to lead them in prayer this type of address is customary in the Qur’ān let a party of them stand with you while another party stand back and let them the party standing with you take their weapons with them. Then when they have performed their prostrations that is when they have prayed let them the other party be behind you on guard until you complete the prayers; thereupon let this party go on guard and let another party who have not prayed come and pray with you taking their precautions and their weapons with them until you have completed the prayers. The Prophet s did this once at Batn Nakhla as reported by the two Shaykhs Bukhārī and Muslim. The disbelievers wish when you have stood up to pray that you should be heedless of your weapons and your baggage that they may descend upon you all at once

O you who believe draw not near to prayer that is do not perform prayer whilst you are inebriated by a drink this was revealed concerning being drunk during the congregational prayer; until you know what you are saying when you have sobered up; nor whilst you are defiled as a result of sexual penetration or ejaculation junuban ‘defiled’ is in the accusative because it is a circumstantial qualifier and may be used to refer to the singular or plural — unless you are traversing crossing a way a route that is unless you are travelling — until you have washed yourselves in which case you may perform prayer a proviso is made for the traveller because a different stipulation applies to him as will follow. It is said that the purpose of this verse is to prohibit the approach to places of prayer that is mosques the exception being if one were merely passing through and not staying. But if you are

حَدَّثَنَا آدَمُ بْنُ أَبِي إِيَاسٍ، حَدَّثَنَا شُعْبَةُ، عَنْ عَدِيِّ بْنِ ثَابِتٍ، قَالَ سَمِعْتُ عَبْدَ اللَّهِ بْنَ يَزِيدَ الأَنْصَارِيَّ، عَنْ أَبِي مَسْعُودٍ الأَنْصَارِيِّ، فَقُلْتُ عَنِ النَّبِيِّ فَقَالَ عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ إِذَا أَنْفَقَ الْمُسْلِمُ نَفَقَةً عَلَى أَهْلِهِ وَهْوَ يَحْتَسِبُهَا، كَانَتْ لَهُ صَدَقَةً ‏"‏‏.‏

Narrated Abu Mas`ud Al-Ansari:The Prophet (ﷺ) said, "When a Muslim spends something on his family intending to receive Allah's reward it is regarded as Sadaqa for him

حَدَّثَنَا إِسْمَاعِيلُ، قَالَ حَدَّثَنِي مَالِكٌ، عَنْ أَبِي الزِّنَادِ، عَنِ الأَعْرَجِ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَالَ ‏ "‏ قَالَ اللَّهُ أَنْفِقْ يَا ابْنَ آدَمَ أُنْفِقْ عَلَيْكَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "Allah said, 'O son of Adam! Spend, and I shall spend on you

حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ‏"‏‏.‏

Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that

حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)

حَدَّثَنَا مُحَمَّدُ بْنُ بَشَّارٍ، أَخْبَرَنَا يَحْيَى بْنُ سَعِيدٍ، أَخْبَرَنَا بَهْزُ بْنُ حَكِيمٍ، حَدَّثَنِي أَبِي، عَنْ جَدِّي، قَالَ قُلْتُ يَا رَسُولَ اللَّهِ مَنْ أَبَرُّ قَالَ ‏"‏ أُمَّكَ ‏"‏ ‏.‏ قَالَ قُلْتُ ثُمَّ مَنْ قَالَ ‏"‏ أُمَّكَ ‏"‏ ‏.‏ قَالَ قُلْتُ ثُمَّ مَنْ قَالَ ‏"‏ أُمَّكَ ‏"‏ ‏.‏ قَالَ قُلْتُ ثُمَّ مَنْ قَالَ ‏"‏ ثُمَّ أَبَاكَ ثُمَّ الأَقْرَبَ فَالأَقْرَبَ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ أَبِي هُرَيْرَةَ وَعَبْدِ اللَّهِ بْنِ عُمَرَ وَعَائِشَةَ وَأَبِي الدَّرْدَاءِ ‏.‏ قَالَ أَبُو عِيسَى وَبَهْزُ بْنُ حَكِيمٍ هُوَ ابْنُ مُعَاوِيَةَ بْنِ حَيْدَةَ الْقُشَيْرِيُّ ‏.‏ وَهَذَا حَدِيثٌ حَسَنٌ ‏.‏ وَقَدْ تَكَلَّمَ شُعْبَةُ فِي بَهْزِ بْنِ حَكِيمٍ وَهُوَ ثِقَةٌ عِنْدَ أَهْلِ الْحَدِيثِ وَرَوَى عَنْهُ مَعْمَرٌ وَالثَّوْرِيُّ وَحَمَّادُ بْنُ سَلَمَةَ وَغَيْرُ وَاحِدٍ مِنَ الأَئِمَّةِ ‏.‏

Bahz bin Hakim narrated from his father, from his grandfather who said:"I said: 'O Messenger of Allah! Who most deserves(my) reverence?' He said: 'Your mother.'" He said: "I said: 'Then who?' He said: 'Your mother.'" He said: "I said: 'Then who?' He said: 'Your mother.'" He said: "I said: 'Then who?' He said: 'Then your father, then the nearest relatives, then the nearest relatives

حَدَّثَنَا أَحْمَدُ بْنُ مُحَمَّدٍ، أَخْبَرَنَا عَبْدُ اللَّهِ بْنُ الْمُبَارَكِ، عَنِ الْمَسْعُودِيِّ، عَنِ الْوَلِيدِ بْنِ الْعَيْزَارِ، عَنْ أَبِي عَمْرٍو الشَّيْبَانِيِّ، عَنِ ابْنِ مَسْعُودٍ، قَالَ سَأَلْتُ رَسُولَ اللَّهِ صلى الله عليه وسلم فَقُلْتُ يَا رَسُولَ اللَّهِ أَىُّ الأَعْمَالِ أَفْضَلُ قَالَ ‏"‏ الصَّلاَةُ لِمِيقَاتِهَا ‏"‏ ‏.‏ قُلْتُ ثُمَّ مَاذَا يَا رَسُولَ اللَّهِ قَالَ ‏"‏ بِرُّ الْوَالِدَيْنِ ‏"‏ ‏.‏ قُلْتُ ثُمَّ مَاذَا يَا رَسُولَ اللَّهِ قَالَ ‏"‏ الْجِهَادُ فِي سَبِيلِ اللَّهِ ‏"‏ ‏.‏ ثُمَّ سَكَتَ عَنِّي رَسُولُ اللَّهِ صلى الله عليه وسلم وَلَوِ اسْتَزَدْتُهُ لَزَادَنِي ‏.‏ قَالَ أَبُو عِيسَى وَهَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏ رَوَاهُ الشَّيْبَانِيُّ وَشُعْبَةُ وَغَيْرُ وَاحِدٍ عَنِ الْوَلِيدِ بْنِ الْعَيْزَارِ وَقَدْ رُوِيَ هَذَا الْحَدِيثُ مِنْ غَيْرِ وَجْهٍ عَنْ أَبِي عَمْرٍو الشَّيْبَانِيِّ عَنِ ابْنِ مَسْعُودٍ ‏.‏ وَأَبُو عَمْرٍو الشَّيْبَانِيُّ اسْمُهُ سَعْدُ بْنُ إِيَاسٍ ‏.‏

Ibn Mas'ud said:"I asked the Messenger of Allah: 'O Messenger of Allah! Which is the most virtuous of deeds?' He said: 'Salat during its appropriate time.' I said: 'Then what, O Messenger of Allah?' He said: 'Being dutiful to one's parents.' I said: 'Then what, O Messenger of Allah?' He said: 'Jihad in the cause of Allah.' Then the messenger of Allah was silent, and if I had asked him more, he would have told me more

وروي أنه قال صلى الله عليه وسلم عيادة المريض بعد ثلاث فواق ناقة + حديث عيادة المريض فواق ناقة أخرجه ابن أبي الدنيا في كتاب المرض من حديث أنس بإسناد فيه جهالة +

وقال ابن عباس رضي الله عنهما عيادة المريض مرة سنة فما ازدادت فنافلة وقال بعضهم عيادة المريض بعد ثلاث

أما النيل فبحضور الجنائز وعيادة المريض وحضور العيدين وأما حضور الجمعة فلا بد منه

| 7 - كتاب عيادة المريض #

| 1 - باب عيادة المريض

| 15 - باب استحباب الذهاب إلى العيد وعيادة المريض والحج ونحوها من طريق والرجوع من طريق آخر لتكثير مواضع العبادة

Evaluation of a telephone-based support group intervention for female caregivers of community-dwelling individuals with dementia.: Family caregivers, the "second victims" or hidden patients in dementia care, are at risk for social isolation, stress, depression, and mortality. Telephone-based support (telesupport groups) represents a practical, low-burden, low-cost source of emotional support. The present study evaluated the feasibility and effectiveness of professionally led telephone-based support groups for female family caregivers of community-dwelling dementia patients. Recruited through various community sources, 103 f

Remotely delivered information, training and support for informal caregivers of people with dementia.: Background: Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric dis

Comparative efficacy of 11 non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for informal caregivers of people with dementia: A systematic review and network meta-analysis.: Background: In recent years, numerous dementia caregiving interventions for informal caregivers of community-dwelling people with dementia have been developed. However, it remains unclear which non-pharmacological interventions are effective and preferred for their depression and anxiety symptoms, quality of life, and caregiver burden. Objectives: To compare and rank the efficacy of different non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for info

The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis.: Background: Family carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association. Objective: To establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics. Methods: We searched major databases such as PubMed, CINAHL, PsycINFO,

Digital tools for delivery of dementia education for caregivers of persons with dementia: A systematic review and meta-analysis of impact on caregiver distress and depressive symptoms.: Continuing education for dementia has been shown to be beneficial by improving informal caregiver knowledge, dementia care, management, and caregiver physical and mental health. Technology-based dementia education has been noted to have equivalent effects as in-person education, but with the added benefit of asynchronous and/or remote delivery, which increases accessibility. Using Cochrane review methodology, this study systematically reviewed the literature on technology-based dementia educatio

Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis.: There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent sa

Assessment of health-related quality of life among primary caregivers of children with autism spectrum disorders.

The impact of caring for a child with autism on caregivers' health-related quality of life (HRQOL) is not fully understood. The objective of this study was to compare the HRQOL scores of caregivers of children with autism to those of the general US population and to identify the factors that influence HRQOL. Caregivers of children with autism had lower HRQOL scores than the general population. Care recipient level of functional impairment, social support, use of maladaptive coping, and burden influenced caregiver mental HRQOL. Care recipient extent of behavioral problems and social support influenced caregiver physical HRQOL. Findings emphasize the use of multi-pronged intervention approach that incorporates components aimed at improving family functioning, increasing support services, and assisting caregivers in developing healthy coping skills.

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Predictors of quality of life in carers for people with a progressive neurological illness: a longitudinal study.

Purpose: The aim of the present research was to determine the predictors of quality of life (QOL) among carers for people living with a chronic degenerative neurological illness, with comparisons of the differences in significant predictors of QOL between illness groups. Methods: Psychosocial and economic variables were examined among 192 carers for people living at home with motor neurone disease, Huntington's disease, multiple sclerosis, and Parkinson's, over a twelve-month period, to determine their contribution to the prediction of carer QOL. Results: Mood was the only consistent predictor of carer QOL across groups; however, marital relationship satisfaction, social support satisfaction, income, and economic pressure significantly predicted carer QOL for at least one of the illness groups, in addition to mood. Conclusions: The findings highlight the importance of recognising the var…

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Family members of cancer patients: Needs, quality of life and symptoms of anxiety and depression.

Background: Family members of cancer patient's have multiple needs, many of which are not adequately met. Unmet needs may affect psychological distress and quality of life (QOL). The purpose of this study was to assess needs and unmet needs, QOL, symptoms of anxiety and depression, and the relationship between those variables in a large sample of family members of cancer patients in different phases of illness. Material and methods: Of 332 family members invited to participate, 330 accepted and 223 (67%) completed a cross-sectional, descriptive study. Data was collected with the Family Inventory of Needs (FIN), Quality of Life Scale (QOLS) and the Hospital Anxiety and Depression Scale (HADS). Results: Of 20 needs assessed the mean (SD) number of important needs and unmet needs was 16.4 ± 4.3 and 6.2 ± 5.6, respectively. Twelve important needs were unmet in 40-56% of the sample. The mean …

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Developing an individualized treatment plan for patients with schizoaffective disorder: from pharmacotherapy to psychoeducation.

To develop an individualized treatment plan that addresses both psychotic and affective symptoms in patients with schizoaffective disorder, clinicians can take several steps. First, clinicians can confirm the diagnosis. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and in the International Classification of Diseases, Tenth Revision (ICD-10), schizoaffective disorder is defined differently, but, diagnostically, the disorder falls on a spectrum between bipolar disorder and schizophrenia and can be divided into bipolar and depressive types. Next, clinicians can evaluate predictors of outcome. Outcomes can be predicted by previous functioning, number of previous episodes, persistence of psychotic symptoms, and level of cognitive impairment. Then, clinicians can use evidence from clinical trials to guide selection of acute and maintena…

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End-of-life decision making and implementation in recipients of a destination left ventricular assist device.

Background: The use of left ventricular assist devices (LVADs) as destination therapy (DT) is increasing and has proven beneficial in prolonging survival and improving quality of life in select patients with end-stage heart failure. Nonetheless, end-of-life (EOL) issues are inevitable and how to approach them underreported. Methods: Our DT data registry was queried for eligible patients, defined as those individuals who actively participated in EOL decision making. The process from early EOL discussion to palliation and death was reviewed. We recorded the causes leading to EOL discussion, time from EOL decision to withdrawal and from withdrawal to death, and location. Primary caregivers were surveyed to qualify their experience and identify themes relevant to this process. Results: Between 1999 and 2009, 92 DT LVADs were implanted in 69 patients. Twenty patients qualified for inclusion (…

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The nature of youth care tasks in families experiencing chronic illness/disability: development of the Youth Activities of Caregiving Scale (YACS).

The purpose of this study was to develop an empirically derived multi-item scale of care tasks performed by young people in the context of family illness/disability: the Youth Activities of Caregiving Scale (YACS). A total of 135 youngsters aged 10-24 years with an ill/disabled family member completed questionnaires. Factor analyses performed on the YACS yielded four factors, instrumental care, social/emotional care, personal/intimate care and domestic/household care, accounting for 57.78% of the variance. The internal reliabilities of all factors ranged from 0.74 to 0.92. Higher scores on the YACS related to higher youth age and several caregiving context variables (i.e. household type [single or dual-parent household], relationship with care-recipient and perceived choice in caregiving). Higher scores on the YACS also related to care-recipient illness/disability variables (onset, funct…

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Disease trajectories and ACT/RCPCH categories in paediatric palliative care.

The objective of this study was to provide a preliminary description of trajectories of life-limiting conditions (LLCs) using qualitative experiential data. Semi-structured interviews were conducted with families of children with LLCs, selected to encompass all Association for Children's Palliative Care (ACT)/Royal College of Paediatrics and Child Health (RCPCH) categories, using a schedule developed from focus groups of professionals. Thirty out of 76 families agreed to participate. Four of these were unsuitable. In nine out of 26 families, their child had died. In eight out of the 26, two individuals were interviewed. Twenty-four mothers, nine fathers, one sibling and two foster-carers were interviewed in total. The interview schedule was developed from data from four themed focus groups, comprising 25 professionals from 14 backgrounds. Thirty-four milestones in five phases were identi…

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Surgical "buy-in": the contractual relationship between surgeons and patients that influences decisions regarding life-supporting therapy.

Objective: There is a general consensus by intensivists and nonsurgical providers that surgeons hesitate to withdraw life-sustaining therapy on their operative patients despite a patient's or surrogate's request to do so. The objective of this study was to examine the culture and practice of surgeons to assess attitudes and concerns regarding advance directives for their patients who have high-risk surgical procedures. Design: A qualitative investigation using one-on-one, in-person interviews with open-ended questions about the use of advance directives during perioperative planning. Consensus coding was performed using a grounded theory approach. Data accrual continued until theoretical saturation was achieved. Modeling identified themes and trends, ensuring maximal fit and faithful data representation. Setting: Surgical practices in Madison and Milwaukee, WI. Subjects: Physicians invol…

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Distinguishing symptoms of grief and depression in a cohort of advanced cancer patients.

Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer patients. Grief was measured using symptoms from the patient version of the Inventory of Complicated Grief-Revised (ICG-R) and symptoms of depression were assessed using the Structured Clinical Interview for DSM-IV (SCID). A factor analysis revealed that symptoms of patient grief formed a coherent factor that was distinct from a depression factor. Patient grief "caseness" (defined as being in the top 10% of the distribution of grief scores), but not major depressive disorder, was uniquely associated with the wish to die (odds ratio [OR] 10.13 [0.1…

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Factors that explain the poorer mental health of caregivers: Results from a community survey of older Australians.

Objectives: To contrast the level of anxiety and depression reported by older Australians providing assistance to someone who is ill, disabled or elderly with that of non-caregivers; and to identify secondary stressors and mediating factors which explain caregivers' poorer mental health. Method: Analysis of data from wave 2 of the PATH Through Life Study, a community survey of 2,222 adults aged 64-69 years conducted in Canberra and Queanbeyan, Australia. Mental health was assessed using the Goldberg depression and anxiety scales. Analyses focused on those who identified themselves as a primary carer and/or reported providing care for more than 5 hours per week. Analyses evaluated whether the association between caregiver status and mental health was mediated by financial factors, role strain, physical health, and social support and conflict with family and friends after adjusting for dem…

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Exploring posttraumatic growth in children impacted by Hurricane Katrina: correlates of the phenomenon and developmental considerations.

This study explored posttraumatic growth (PTG), positive change resulting from struggling with trauma, among 7- to 10-year-olds impacted by Hurricane Katrina. Analyses focused on child self-system functioning and cognitive processes, and the caregiving context, in predicting PTG at 2 time points (Time 1 n = 66, Time 2 n = 51). Findings suggest that rumination, both negative, distressing thoughts and constructive, repetitive thinking, plays an important role in PTG. Hypotheses regarding future expectations and perceived competence were not fully supported, and, unexpectedly, coping competency beliefs, realistic control attributions, and perceived caregiver warmth did not contribute to PTG models. With 1 exception (positive reframing coping advice), caregiver-reported variables did not relate to PTG; no caregiver variable reached significance in final models. Relevant theory, developmental…

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[Greek nannies in Rome?].

In Roman society, parents often entrusted their newborn to a wet nurse, usually a slave or a lower-class freeborn woman, who normally lived with them. It was advised to choose with care the right person, as milk is not a neutral bodily substance but transmits many properties, physical and moral. Soranus devotes an entire chapter to the meticulous inspection of the nurse's milk and temper. The nurse's character must be checked as thoroughly as her physical health. The mind of the newborn, compared with wax, is from the start and forever impressed positively or negatively. Mnesitheus and others even advise choosing a woman resembling physically the mother, or a handsome person; Favorinus and others reject violently the recourse to wet nursing as immoral; submitting the child to the pernicious influence of a foreign non-kin person implies the destruction of family ties. Wet nurses had to fo…

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Treatment choices for fevers in children under-five years in a rural Ghanaian district.

Background: Health care demand studies help to examine the behaviour of individuals and households during illnesses. Few of existing health care demand studies examine the choice of treatment services for childhood illnesses. Besides, in their analyses, many of the existing studies compare alternative treatment options to a single option, usually self-medication. This study aims at examining the factors that influence the choices that caregivers of children under-five years make regarding treatment of fevers due to malaria and pneumonia in a rural setting. The study also examines how the choice of alternative treatment options compare with each other. Methods: The study uses data from a 2006 household socio-economic survey and health and demographic surveillance covering caregivers of 529 children under-five years of age in the Dangme West District and applies a multinomial probit techni…

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In their own words: patients and families define high-quality palliative care in the intensive care unit.

Objective: Although the majority of hospital deaths occur in the intensive care unit and virtually all critically ill patients and their families have palliative needs, we know little about how patients and families, the most important "stakeholders," define high-quality intensive care unit palliative care. We conducted this study to obtain their views on important domains of this care. Design: Qualitative study using focus groups facilitated by a single physician. Setting: A 20-bed general intensive care unit in a 382-bed community hospital in Oklahoma; 24-bed medical-surgical intensive care unit in a 377-bed tertiary, university hospital in urban California; and eight-bed medical intensive care unit in a 311-bed Veterans' Affairs hospital in a northeastern city. Patients: Randomly-selected patients with intensive care unit length of stay >=5 days in 2007 to 2008 who survived the intens…

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Psychosocial challenges and protective influences for socio-emotional coping of HIV+ adolescents in South Africa: a qualitative investigation.

Introduction: While the roll-out of antiretroviral therapy in South Africa should lead to a reduction in mother to child transmission, mortality and orphaning, it will also be accompanied by a large number of children entering adolescence and adulthood with a chronic infectious disease. Adolescence is a particularly vulnerable period for HIV-infected people in relation to mental health problems and engagement in high-risk behaviours, including non-compliance with medical treatment. The goal of this qualitative study was to develop an understanding of the psychosocial challenges as well as protective influences promoting socio-emotional coping in HIV+ adolescents in order to inform mental health promotion and HIV prevention programming for this population in South Africa. Method: In-depth qualitative interviews were conducted with HIV+ adolescents (25) and caregivers of HIV+ children (15)…

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Daily experiences among mothers of adolescents and adults with autism spectrum disorder.

In the present study, 96 co-residing mothers of adolescents and adults with an autism spectrum disorder (ASD) participated in an 8-day diary study and reported on their daily experiences. In comparison with a nationally representative sample of mothers of children without disabilities, mothers of adolescent and adult children with ASD spent significantly more time providing childcare and doing chores, and less time in leisure activities. Fatigue, arguments, avoided arguments, and stressful events were also more common among mothers of individuals with ASD. However, mothers of individuals with ASD reported similar levels of positive interactions and volunteerism as the comparison group. Daily experiences were subsequently related to well-being in both groups. These findings highlight the need for family support services.

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Spousal perceptions of marital stress and support among grandparent caregivers: variations by life stage.

Few studies have examined how raising grandchildren influences the marital relationship of grandparent caregivers although half of such caregivers are married. This study used national survey data from Midlife Development in the United States (MIDUS) to contrast perceptions of spousal support and strain for grandparents who had recently provided care for grandchildren along with their own young children (n=16), and grandparents who had recently cared for grandchildren only (n=96). Results revealed an interaction between caregivers' sex and family situation with grandmother caregivers who were raising both their own minor children and grandchildren reporting less spousal support than grandfathers in the same situation. Differences on the spousal strain dimension were not significant. Grandmother caregivers occupying 2 caregiving roles appear to have a unique experience with caring for gra…

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The experiences of carers in Taiwanese culture who have long-term schizophrenia in their families: a phenomenological study.

Schizophrenia is a severe illness with little hope of recovery and requires long-term care. The purpose of this study was to explore the experiences of carers who live with someone with long-term schizophrenia, within the cultural context of Taiwan. The study was conducted in a community setting in central Taiwan. A qualitative phenomenological approach was used to explore the experiences of carers. Purposive sampling was used by selecting the carers who were close relatives of the clients, had lived with the clients for at least 1 year and bore most of the responsibilities. Semi-structured face-to-face interviews were conducted to collect the data and narratives were analysed using Colaizzi's (1978) seven-step method. Data saturation was achieved after interviewing 10 carers. Three themes and eight sub-themes were identified: burdens of caring (helping clients' illness, lack of professi…

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Caregiver depression is associated with a low sense of coherence and health-related quality of life.

Objectives: The main objective is to examine the sense of coherence (SOC) of spouse caregivers. The aim was further investigate the association of SOC, health-related quality of life (HRQoL), depressive symptoms, distress and how severity of Alzheimer's disease (AD) affects SOC. Method: 17O patient-spouse caregiver dyads in which the patient has recently diagnosed mild AD. Caregivers completed SOC scale (SOC-29), HRQoL (15D), Beck depression and general health questionnaire scale. The assessment of AD-related symptoms was made using mini mental state examination, clinical dementia rating, neuropsychiatric inventory and functional performance using activities of daily living (ADCS-ADL) scale. Results: Male caregivers' SOC was significantly higher than female caregivers. The main predictor for low SOC was depression, with 37% of spousal caregivers reporting depressive symptoms. Women repor…

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Resilience in children of parents with mental illness: relations between mental health literacy, social connectedness and coping, and both adjustment and caregiving.

This study investigated the relationships between resilience factors (mental health literacy, social connectedness, coping strategies) frequently targeted in interventions, and both adjustment (depressive symptomatology, life satisfaction, prosocial behaviour, emotional/behavioural difficulties) and caregiving outcomes in children (12 - 17 years) of a parent with mental illness. Forty-four participants completed questionnaires. Correlations showed weak support for the predicted beneficial associations of mental health literacy with caregiving and adjustment, stronger support for the beneficial relationships between social connectedness and adjustment, and strong support for the adverse links of disengagement and involuntary coping strategies with adjustment and caregiving. Findings suggest that some resilience factors have a differential impact on adjustment and caregiving, and support t…

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Mental health outcomes of family members of Oregonians who request physician aid in dying.

Oregon legalized physician aid in dying over 10 years ago but little is known about the effects of this choice on family members' mental health. We surveyed 95 family members of decedent Oregonians who had explicitly requested aid in dying, including 59 whose loved one received a lethal prescription and 36 whose loved one died by lethal ingestion. For comparison purposes, family members of Oregonians who died of cancer or amyotrophic lateral sclerosis also were surveyed. A mean of 14 months after death, 11% of family members whose loved one requested aid in dying had major depressive disorder, 2% had prolonged grief, and 38% had received mental health care. Among those whose family member requested aid in dying, whether or not the patient accessed a lethal prescription had no influence on subsequent depression, grief, or mental health services use; however, family members of Oregonians w…

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Understanding advance care planning as a process of health behavior change.

Objectives: To explore whether models of health behavior change can help to inform interventions for advance care planning (ACP). Design: Qualitative cross-sectional study. Setting: Community. Participants: Sixty-three community-dwelling persons aged 65 and older and 30 caregivers with experience as surrogate decision-makers. Measurements: In focus groups conducted separately with older persons and caregivers, participants were asked to discuss ways they had planned for future declines in health and why they had or had not engaged in such planning. Transcripts were analyzed using grounded theory. Results: Four themes illustrated the potential of applying models of health behavior change to improve ACP. (1) Participants demonstrated variable readiness to engage in ACP and could be in different stages of readiness for different components of ACP, including consideration of treatment goals,…

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Preventive care for adolescents: few get visits and fewer get services.

Objective: Professional guidelines for adolescents recommend annual preventive visits with screening and anticipatory guidance for health-related behaviors. The objective of this study was to examine receipt of preventive services, including disparities in services received, by using a nationally representative sample of adolescents. Methods: Using data from the 2001-2004 Medical Expenditure Panel Survey (ages 10-17; N = 8464), we examined receipt of preventive care visits and several measures of the content of care, based on caregiver's reports, among adolescents who received a preventive care visit during the past 12 months. Content of care outcomes included physical parameters measurement (height, weight, and blood pressure); receipt of anticipatory guidance (dental care, seat belts, helmets, exercise, healthy eating, and secondhand smoke exposure); and, for 12- to 17-year-olds, wheth…

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Life after survival: long-term daily functioning and quality of life after an out-of-hospital cardiac arrest.

Background: Information about long-term consequences of cardiac arrest is sparse. Because the survival rate is expected to increase, better knowledge of long-term functioning and quality of survival is essential. Objectives: To determine the level of functioning of out-of-hospital cardiac arrest survivors 1-6 years later, and to evaluate the predictive value of medical variables on long-term functioning. Methods: A retrospective cohort study including 63 survivors of an out-of-hospital cardiac arrest, admitted to a Dutch University hospital between 2001 and 2006. Participants received a questionnaire by post. Primary outcome measures were: participation in society (Community Integration Questionnaire) and quality of life (SF-36). Secondary outcome measures were: physical, cognitive and emotional impairment, daily functioning and caregiver strain. Statistical analyses included multiple re…

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Mental health, treatment preferences, advance care planning, location, and quality of death in advanced cancer patients with dependent children.

Background: Clinicians observe that advanced cancer patients with dependent children agonize over the impact their death will have on their children. The objective of this study was to determine empirically whether advanced cancer patients with and without dependent children differ in treatment preferences, mental health, and end-of-life (EOL) outcomes. Methods: Coping with Cancer is a National Cancer Institute/National Institute of Mental Health-funded, multi-institutional, prospective cohort study of 668 patients with advanced cancer. Patients with and without dependent children were compared on rates of psychiatric disorders, advance care planning (ACP), EOL care, quality of their last week of life, and location of death. Results: In adjusted analyses, patients with advanced cancer who had dependent children were more likely to meet panic disorder criteria (adjusted odds ratio [AOR], …

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