Challenges Experienced By Caregivers of Family Members With a Mental Illness in a Rural Community

Purpose:

In South Africa, as in countries such as the United Kingdom (Rugkåsa, Canvin, Sinclair, Sulman & Burns, 2014) and the United States of America (Harvey, Burns, Fiander, Huxley, Manley & Fahy, 2002), due to deinstitutionalization of persons with mental illness, family members became the primary caregivers. The care provided is extraordinary, uncompensated care that is physically, emotionally, socially and financially demanding. The lack of support of the caregiver is often the key determinant of whether the care recipient can remain at home or must again be institutionalized (Blum & Sherman, 2010). The caregivers of these mentally ill persons balance caregiving with other demands such as child rearing and securing the family’s livelihood. Reliance upon poorly prepared caregivers for day-to-day symptom management and other health related risks compromises the quality of life of mentally ill persons and contributes to increased levels of caregiver burden and emotional distress (Washington, Meadows, Elliott & Koopman, 2011). Caregivers have to balance their caregiving with other demands, and are often not able to take the mentally ill family member back to the clinic for their follow up visits to obtain their medication. As a result the mentally ill person relapses and is then readmitted to the psychiatric hospital.

Although research has been conducted globally on the challenges caregivers experience in taking care of mentally ill persons at home (Monyaluoe, Mvandaba, du Plessis, & Koen 2014; Papastavrou, Charalambous, Tsangaris & Karayiannis, 2010), little is known about the challenges these caregivers in the selected community, experience in taking care of their mentally ill family members. The purpose of this presentation is to present the findings of a research study that explored and described the challenges caregivers experience in caring for a mentally ill family member in a selected rural community in Limpopo, South Africa. 

Methods:

A qualitative descriptive design was used to conduct the study. Thirteen caregivers of family members with a mental illness in a rural community were selected purposively. Data was collected with semi-structured interviews, informal observations and field notes. The semi-structured interviews were conducted either at the caregivers’ homes or at the local clinic. Interviews were transcribed verbatim and the data was analysed in accordance with Tesch’s method of open coding.

Results:

Three themes were identified: Effects on family as a unit, burdensome responsibility on caregivers, and resources in the community. The main findings of the research included: caregivers over-burdened by day-to-day care of family member; caregivers are socially isolated due to care giving responsibilities and stigma attached to mental illness; financial strain, escalated feelings of hopelessness and being a failure; caregivers experienced increased emotional strain as a result of aggressive behaviour and substance abuse of mentally ill family member; caregivers suffered due to a lack of professional support, social support, and community resources.

Conclusion:

The objective of exploring the challenges caregivers experience in caring for a mentally ill family member in a selected rural community in Limpopo, South Africa was met and recommendations were formulated to assist psychiatric nursing practitioners in supporting these caregivers.