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

Emotional Lability in MND: Relationship to cognition and psychopathology and impact on caregivers.

Emotional Lability (EL) is a well recognized symptom of cortico-bulbar pathway dysfunction in Motor Neuron Disease/Amyotrophic Lateral Sclerosis (MND/ALS), and is reported to occur in 19-49% of patients. The Emotional Lability Questionnaire (ELQ), is specifically designed to detect EL as reported by MND patients and as observed by their carers. The aims of this study were to 1) validate the Italian version of the ELQ; 2) investigate the relationship between EL and presence of cognitive dysfunction; 3) investigate the relationship between EL and presence of psychopathology. Forty one MND patients, 39 caregivers and respective control groups composed of 39 subjects and 39 partners/friends were tested. The Italian version of the ELQ was found to have good psychometric properties. Seventy-one per cent of patients reported suffering from EL. Correlations were found between bulbar involvement …

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Health among caregivers of children with health problems: findings from a Canadian population-based study.

Objectives: We used population-based data to evaluate whether caring for a child with health problems had implications for caregiver health after we controlled for relevant covariates. Methods: We used data on 9401 children and their caregivers from a population-based Canadian study. We performed analyses to compare 3633 healthy children with 2485 children with health problems. Caregiver health outcomes included chronic conditions, activity limitations, self-reported general health, depressive symptoms, social support, family functioning, and marital satisfaction. Covariates included family (single-parent status, number of children, income adequacy), caregiver (gender, age, education, smoking status, biological relationship to child), and child (age, gender) characteristics. Results: Logistic regression showed that caregivers of children with health problems had more than twice the odds …

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Surrogate decision-makers' perspectives on discussing prognosis in the face of uncertainty.

Rationale: Many physicians are reluctant to discuss a patient's prognosis when there is significant prognostic uncertainty. Objectives: We sought to understand surrogate decision makers' views regarding whether physicians should discuss prognosis in the face of uncertainty. Methods: We conducted semi-structured interviews with 179 surrogates for 142 incapacitated patients at high risk of death in four intensive care units at an academic medical center. The interviews explored surrogates' attitudes about whether physicians should discuss prognosis when they cannot be certain their prognostic estimates are correct. We used constant comparative methods to analyze the transcripts. Validation methods included triangulation by multidisciplinary analysis and member checking. Measurements and main results: Eighty-seven percent (155/179) of surrogates wanted physicians to discuss an uncertain pro…

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The stigma of families with mental illness.

Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma negatively impacts family members and relatives with mental illness. Results: The authors also present strategies to eliminate stigma and discuss implications for the training goals of psychiatrists throughout the text. Conclusion: The authors end this article with recommendations for psychiatry training goals.

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Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress.

This study examined self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their caregivers, and associations between self-efficacy and patient and caregiver adjustment. One hundred and fifty-two patients with early stage lung cancer completed measures of self-efficacy, pain, fatigue, quality of life, depression, and anxiety. Their caregivers completed a measure assessing their self-efficacy for helping the patient manage symptoms and measures of psychological distress and caregiver strain. Analyses indicated that, overall, patients and caregivers were relatively low in self-efficacy for managing pain, symptoms, and function, and that there were significant associations between self-efficacy and adjustment. Patients low in self-efficacy reported significantly higher levels of pain, fatigue, lung cancer symptoms, depression, and anxiety, and significantly…

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Dying with cancer, living well with advanced cancer.

Introduction: There are 1.7 million deaths from cancer in Europe each year and by 2020 the World Health Organisation (WHO) estimates that, globally, more than 15 million people will experience cancer and 10 million will die from it each year. Furthermore, as new therapies are developed, people are living longer with cancer than in the past, and the population with cancer will be older. Materials and methods: We used epidemiologically based needs assessment approaches to estimate the number of people in Europe with symptoms and problems, published data and reviews to appraise treatment options, issues of communication, family care, bereavement and socio-demographic factors affecting care, and a European survey to consider the types of services. In addition, we used systematic literature review data to appraise the effectiveness of services and factors affecting place of death. Results: Th…

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Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment.

Context: Talking about death can be difficult. Without evidence that end-of-life discussions improve patient outcomes, physicians must balance their desire to honor patient autonomy against a concern of inflicting psychological harm. Objective: To determine whether end-of-life discussions with physicians are associated with fewer aggressive interventions. Design, setting, and participants: A US multisite, prospective, longitudinal cohort study of patients with advanced cancer and their informal caregivers (n = 332 dyads), September 2002-February 2008. Patients were followed up from enrollment to death, a median of 4.4 months later. Bereaved caregivers' psychiatric illness and quality of life was assessed a median of 6.5 months later. Main outcome measures: Aggressive medical care (eg, ventilation, resuscitation) and hospice in the final week of life. Secondary outcomes included patients'…

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The coping experiences of carers who live with someone who has schizophrenia.

Aims and objectives: The purpose of this study was to understand the coping experiences of carers living with a schizophrenic family member. Our research may be a valuable reference for mental health professionals seeking to improve the quality of care for people with schizophrenia and their carers. Design: We employed a qualitative descriptive phenomenological research methodology to understand the coping experiences of carers living with a schizophrenic family member. Methods: Purposive sampling and in-depth, face-to-face interviews were used to collect data. When data saturation was reached, the sample size comprised 10 carers (five men and five women). The interview focused on the carer's coping experience. During the process of data collection and data analyis we established epoches (bracketing) and returned to the reality of the carers' experience to keep the data objective. Narrat…

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An exploratory study of spiritual care at the end of life.

Purpose: Although spiritual care is a core element of palliative care, it remains unclear how this care is perceived and delivered at the end of life. We explored how clinicians and other health care workers understand and view spiritual care provided to dying patients and their family members. Methods: Our study was based on qualitative research using key informant interviews and editing analysis with 12 clinicians and other health care workers nominated as spiritual caregivers by dying patients and their family members. Results: Being present was a predominant theme, marked by physical proximity and intentionality, or the deliberate ideation and purposeful action of providing care that went beyond medical treatment. Opening eyes was the process by which caregivers became aware of their patient's life course and the individualized experience of their patient's current illness. Participa…

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Acute stress in parents of children newly diagnosed with cancer.

Objective: Acute Stress Disorder (ASD) and subclinical symptoms of acute stress (SAS) may be a useful framework for understanding the psychological reactions of mothers and fathers of children newly diagnosed with a pediatric malignancy. Patients and methods: Mothers (N = 129) and fathers (N = 72) of 138 children newly diagnosed with cancer completed questionnaires assessing acute distress, anxiety, and family functioning. Demographic data were also gathered. Inclusion criteria were: a confirmed diagnosis of a pediatric malignancy in a child under the age of 18 years without prior chronic or life threatening illness and fluency in English or Spanish. Results: Descriptive statistics and multiple linear regressions were used to examine predictors of SAS. Fifty-one percent (N = 66) of mothers and 40% (N = 29) of fathers met DSM-IV diagnostic criteria for ASD. The majority of the sample repo…

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Expressed emotion in eating disorders assessed via self-report: an examination of factors associated with expressed emotion in carers of people with anorexia nervosa in comparison to control families.

Objective: High expressed emotion (EE) has been linked to outcome in anorexia nervosa (AN). Traditional interview measures of EE require considerable resources. The aim was to compare EE, measured with a self report tool, in parents of people with AN (carers; N = 151) with that of parents of healthy people (controls; N = 93), and to explore factors associated with EE. Method: A cross-sectional design was used to assess EE (Family Questionnaire) and psychological distress (Hospital Anxiety and Depression Scale). Results: Over 60% (96/151) of carers showed high emotional over-involvement (EOI) compared with 3% (3/93) of controls, whereas 47% (71/151) of carers showed high criticism (CC) compared with 15% (14/93) of controls. The most significant variable related to CC was "negative/difficult behaviors," and anxiety, for EOI. Conclusion: The FQ was sensitive both to CC and EOI. Intervention…

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Early childhood aetiology of mental health problems: a longitudinal population-based study.

Background: Mental health problems comprise an international public health issue affecting up to 20% of children and show considerable stability. We aimed to identify child, parenting, and family predictors from infancy in the development of externalising and internalising behaviour problems by age 3 years. Methods: Design Longitudinal, population-based survey completed by primary caregivers when children were 7, 12, 18, 24 and 36 months old. Participants 733 children sequentially recruited at 6-7 months from routine well-child appointments (August-September 2004) across six socio-economically and culturally diverse government areas in Victoria, Australia; 589 (80%) retained at 3 years. Measures 7 months: sociodemographic characteristics, maternal mental health (Depression Anxiety Stress Scale (DASS)), substance misuse, home violence, social isolation, infant temperament; 12 months: part…

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ALS patients and caregivers communication preferences and information seeking behaviour.

To evaluate information preferences and information seeking behaviour in ALS patients and caregivers. Sixty ALS patients and caregivers couples were interviewed using a structured questionnaire about the content of diagnosis communication and their information seeking behaviour. The patients (35 men and 25 women) had a mean age of 63.4 years (SD 9.5). The caregivers (21 men and 39 women) had a mean age of 53.3 years (SD 14.9). The overall satisfaction with bad news communication and the impression that the physician had understood their feelings were higher amongst patients. Both parties indicated that the most important aspects to be informed were current researches, disease-modifying therapies and ALS outcome. Approximately 55% of patients and 83.3% of caregivers searched for information from sources outside the healthcare system. The most frequently checked source was internet, althou…

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Living in a world of our own: the experience of parents who have a child with autism.

In this article, we discuss findings of a hermeneutic phenomenological study that sought to describe the experiences of parents who have a child with autism. Qualitative interviews were conducted with parents from 16 families of children with autism residing in a western Canadian province. "Living in a world of our own" emerged as the essence of the parents' experiences. In "living in a world of our own," parents described a world of isolation. Three themes representing the essential challenging elements of the parents' experiences included vigilant parenting, sustaining the self and family, and fighting all the way. Although much is known about the fundamental importance of support to parents of children with chronic conditions and/or disabilities, findings from this study indicate that knowledge has not been adequately transferred to the care of children with autism.

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Antecedents and sequelae of sudden parental death in offspring and surviving caregivers.

Objectives: To examine the psychiatric antecedents that put parents at risk for early death, and the psychological sequelae of bereavement in offspring and caregivers. Design: A population-based study. Setting: Bereaved families were recruited through the coroner's records and by advertisement. Control families were recruited by random-digit dialing and advertisement. Participants: Families with biological offspring from 7 to 25 years of age in which 1 parent died of suicide, accident, or sudden natural death were included (n = 140). Controls (n = 99) had 2 living parents and their biological offspring and had no death of a first-degree relative within the past 2 years. Main outcome measures: Lifetime psychiatric history for deceased parents (probands) and new-onset psychiatric disorders, self-reported symptoms, and functional status in offspring and surviving caregivers. Results: Bipola…

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Quality of life of couples dealing with cancer: dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers.

Background and purpose: Although evidence suggests that survivors and spousal caregivers tend to experience somewhat similar levels of distress and that the survivor's distress affects his/her own quality of life, the degree to which each person's distress has an independent effect on their partner's quality of life is unknown. Thus, this study aimed to examine the dyadic effects of psychological distress on the quality of life of couples dealing with cancer. Methods: A total of 168 married survivor-caregiver dyads participating in the American Cancer Society's Study of Cancer Survivors-I and Quality of Life Survey for Caregivers provided complete data for study variables. Participating survivors were diagnosed with either breast or prostate cancer approximately 2 years prior to participating in the study. Results: Using the Actor Partner Interdependence Model, results revealed that alth…

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Fostering futures: a preventive intervention program for school-age children in foster care.

Children in foster care have social and emotional problems at rates three to ten times higher than those found in the general population. During the elementary school years (i.e. 5-12 years), research indicates that disruptive behavior in children in care can negatively impact social, emotional and academic development, as well as placement stability. Evidenced-based interventions to improve children's behavior and reduce parenting stress are necessary. This pilot study augmented an existing evidenced-based intervention (i.e. the Incredible Years) developed for birth families for use with foster caregivers. Results from 18 families indicate that foster caregiver-reported conduct symptoms were significantly lower for children whose families participated in the treatment group. A similar trend was found for the overall externalizing behavior. No significant changes were identified in paren…

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The health of caregivers for children with disabilities: caregiver perspectives.

Background: There are an estimated 5.9 million children with severe disabilities in the USA, and most of them are cared for at home by their parents and families. Indirect evidence suggests that poor caregiver health may contribute to recurrent hospitalizations and out-of-home placements for children with chronic conditions and disabilities. Greater knowledge of caregiver health-related needs would allow for the improvement of existing services and the development of new strategies to sustain caregivers in their vital roles. This study explores caregiver perspectives of the health implications of long-term informal caregiving for children with disabilities. Methods: Forty parents/caregivers of children with disabilities residing in urban, suburban and rural regions of Utah completed questionnaires and participated in focus groups that explored their feelings regarding their current physi…

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Depressive symptoms, omega-6:omega-3 fatty acids, and inflammation in older adults.

Objective: To address how interactions between polyunsaturated fatty acid (PUFA) levels and depressive symptoms were related to proinflammatory cytokine synthesis. Depression and stress promote proinflammatory cytokine production. Dietary intakes of omega-3 (n-3) and omega-6 (n-6) PUFAs also influence inflammation; high n-6:n-3 ratios enhance proinflammatory cytokine production, although n-3 has anti-inflammatory properties. Methods: Blood samples from 43 older adults (mean age = 66.67 years, SD = 10.09) provided data on PUFAs and tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-6 soluble receptor (sIL-6r). Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. Results: Depressive symptoms and n-6:n-3 ratios worked together to enhance proinflammatory cytokines beyond the contribution provided by either variable alone, with substantial v…

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Predictors of care-giver stress in families of preschool-aged children with developmental disabilities.

Background: This study examined the predictors, mediators and moderators of parent stress in families of preschool-aged children with developmental disability. Method: One hundred and five mothers of preschool-aged children with developmental disability completed assessment measures addressing the key variables. Results: Analyses demonstrated that the difficulty parents experienced in completing specific care- giving tasks, behaviour problems during these care-giving tasks, and level of child disability, respectively, were significant predictors of level of parent stress. In addition, parents' cognitive appraisal of care-giving responsibilities had a mediating effect on the relationship between the child's level of disability and parent stress. Mothers' level of social support had a moderating effect on the relationship between key independent variables and level of parent stress. Conclu…

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Accelerated telomere erosion is associated with a declining immune function of caregivers of Alzheimer's disease patients.

Caregivers of Alzheimer's disease patients endure chronic stress associated with a decline of immune function. To assess the psychological and immunological changes of caregivers, we compared depressive symptoms, PBMC composition, in vitro activation-induced proliferation and cytokine production, and telomere length and telomerase activity of 82 individuals (41 caregivers and 41 age- and gender-matched controls). We found depressive symptoms were significantly higher in caregivers than in controls (p < 0.001). Correspondingly, caregivers had significantly lower T cell proliferation but higher production of immune-regulatory cytokines (TNF-alpha and IL-10) than controls in response to stimulation in vitro. We examined the impact of these changes on cellular replicative lifespan and found that caregivers had significantly shorter telomere lengths in PBMC than controls (6.2 and 6.4 kb, resp…

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The challenge of patients' unmet palliative care needs in the final stages of chronic illness.

Background: There is consensus in the literature that the end of life care for patients with chronic illness is suboptimal, but research on the specific needs of this population is limited. Aim: This study aimed to use a mixed methodology and case study approach to explore the palliative care needs of patients with a non-cancer diagnosis from the perspectives of the patient, their significant other and the clinical team responsible for their care. Patients (n = 18) had a diagnosis of either end-stage heart failure, renal failure or respiratory disease. Methods: The Short Form 36 and Hospital and Anxiety and Depression Questionnaire were completed by all patients. Unstructured interviews were (n = 35) were conducted separately with each patient and then their significant other. These were followed by a focus group discussion (n = 18) with the multiprofessional clinical team. Quantitative …

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The effects of acculturation on asthma burden in a community sample of Mexican American schoolchildren.

Objectives: We sought to determine whether low acculturation among Mexican American caregivers protects their children against asthma. Methods: Data were obtained from an observational study of urban pediatric asthma. Dependent variables were children's diagnosed asthma and total (diagnosed plus possible) asthma. Regression models were controlled for caregivers' level of acculturation, education, marital status, depression, life stress, and social support and children's insurance. Results: Caregivers' level of acculturation was associated with children's diagnosed asthma (P = .025) and total asthma (P = .078) in bivariate analyses. In multivariate models, protective effects of caregivers' level of acculturation were mediated by the other covariates. Independent predictors of increased diagnosed asthma included caregivers' life stress (odds ratio [OR] = 1.12, P= .005) and children's insur…

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Who will care for the grandparents? Exploring relationships between grandparents and grandchildren.

Adult children are often identified as primary caregivers for their older adult parents; however, in a growing number of cases, the adult child does not become the caregiver. Evidence of this includes the growing social phenomenon of grandparents raising their grandchildren. In this qualitative research project, the long-term caregiving relationship between grandparents and grandchildren living in grandparent-headed households was explored through interviews with three grandparent-grandchild dyads. The ongoing relationship in the dyads did not seem to mimic a parent-child relationship or a grandparent-grandchild relationship, but instead a third kind of relationship that requires further exploration.

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Daily living with distress and enrichment: the moral experience of families with ventilator-assisted children at home.

Objective: The growing shift toward home care services assumes that "being home is good" and that this is the most desirable option. Although ethical issues in medical decision-making have been examined in numerous contexts, home care decisions for technology-dependent children and the moral dilemmas that this population confronts remain virtually unknown. This study explored the moral dimension of family experience through detailed accounts of life with a child who requires assisted ventilation at home. This study involved an examination of moral phenomena inherent in (1) the individual experiences of the ventilator-assisted child, siblings, and parents and (2) everyday family life as a whole. Methods: A qualitative method based on Richard Zaner's interpretive framework was selected for this study. The population of interest for this study was the families of children who are supported …

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