Skip to main content
SpringerLink
Log in

Pflege von betagten Patienten durch ihre Angehörigen

Soins des patients gériatriques par leur parent

Care of elderly patients by their relatives

  • Published:
Sozial- und Präventivmedizin

Zusammenfassung

Die noch immer wachsende Zahl von geriatrischen Langzeitpatienten einerseits und die oft schwierige Situation der Angehörigen dieser Patienten anderseits fordert neue Betreuungskonzepte. Wir haben die Möglichkeit getestet, Angehörige von geriatrischen Patienten auf der Station mitarbeiten zu lassen.

Von 323 nach dem Stichprobenverfahren gewählten Langzeitpatienten der Basler Spitäler hatten nur 4 (1 %) keine Angehörigen. Von 86% dieser Patienten konnten 343 Angehörige interviewt werden, und 147 (43%) äusserten sich positiv gegenüber der Idee der Mitarbeit. Die Pflegebereitschaft begünstigende Faktoren waren: weibliches Geschlecht, mittlerer sozioökonomischer Status, guter Gesundheitszustand, mittelmässig anspruchsvolle Berufstätigkeit, gute Kontakte zum Patienten vor der Einweisung.

Direkte Mitarbeit auf einer Pilotstation sagten in einer weiteren Erhebung 29 von 196 Angehörigen zu, aus technischen Gründen konnten aber nur fünf ihrer Patienten auf die Pilotstation verlegt werden. Die praktische Erfahrung zeigt, dass Mitarbeit von Angehörigen grundsätzlich möglich ist, im Optimum vielleicht jeder achte Patient einen geeigneten Angehörigen hat und dass sich für die Durchführung vor allem kleinere Pflegeheime eignen würden.

Résumé

Le nombre toujours croissant de patients chroniques gériatriques, d'une part, et la situation souvent difficile de leur entourage, d'autre part, nécessitent l'élaboration de concepts nouveaux de prise en charge. C'est ainsi que nous avons testé la possibilité de faire travailler des parents de patients gériatriques dans les unités de soins.

Parmi 323 patients chroniques tirés au hasard dans les hôpitaux bâlois, seuls 4 (1 %) n'avaient pas de parenté. Nous avons pu, pour 86% de ces patients, interviewer 343 de leurs parents; 147 d'entre eux (43%) se sont exprimés positivement vis-à-vis de l'idée d'une collaboration. Les facteurs favorisants d'un accord à cet égard étaíent le sexe féminin, un statut socio-économique moyen, un bon état de santé, une activité professionnelle moyennement exigeante et de bons contacts avec le patient concerné avant son admission à l'hôpital.

Dans une enquête ultérieure, 29 personnes sur un total de 196 acceptèrent d'envisager un travail pratique mais, pour des raisons techniques, seuls cinq purent s'occuper du patient de leur parenté hébergé dans une unité de soins-pilote. L'expérience pratique montre que, en soi, la collaboration de parents est possible, que, au mieux, un patient sur huit a un parent qui présente les conditions adéquates et que c'est surtout dans des homes (établissements médico-sociaux) de petite dimension qu'un tel système pourrait être mis en œuvre.

Summary

New concepts are needed for the still increasing number of geriatric patients who require long term institutional care and for the often difficult situation of caregiving relatives. We investigated the possibility to integrate relatives of institutionalized patients in the nursing care.

323 geriatric patients were randomly selected and the relatives contacted. Only four (1 %) had no relatives or friends. Of 86% of the patients it was possible to interview 343 relatives or close friends. Of those 147 (43%) were favorably disposed towards a cooperation in the care with the ward staff. Persons willing to cooperate were characterized by female sex, middle class status, good health, not too demanding jobs, and close contacts prior to institutionalisation of their next of kin.

In a second part 29 of 196 relatives were willing to take part in a pilot project. Unfortunately, for technical reasons only five patients could be hospitalized on the experimental ward in the given time. The practical experience demonstrated that relatives can cooperate on a part time basis with the nursing staff in the care of institutionalized geriatric patients. It is estimated that probably 12% of the geriatric patients in institutions have relatives willing and capable to take part in the nursing or other activities on the ward. Smaller nursing facilities appear more suitable than large geriatric clinics for this type of cooperation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Abelin, Th., Schlettwein-Gsell, D., Studer, A. et al., Die sozialmedizinische Lage der Betagten in der Schweiz. Bern. Schriftenreihe ISPM, 1985.

  2. Aronson, M. K., Lipkowitz, R., Senile Dementia, Alzheimer's Type: The Family and the Health Care Delivery System. J. Amer. Ger. Soc.29, 568–571 (1981).

    Google Scholar 

  3. Atchley, R. C., Miller, S. J., Older People and Their Families. Ann. Review Gerontol. Geriatrics1, 337–369 (1980).

    Google Scholar 

  4. Barnes, R. F., Raskind, M. A., Scott, M., Murphy, C., Problems of Families Caring for Alzheimer Patients: Use of a Support Group. J. Am. Ger. Soc.29, 80–85 (1981).

    Google Scholar 

  5. Blessed, G., Wilson, I. D., The Contemporary Natural History of Mental Disorder in Old Age. Brit. J. Psychiat.141, 59–67 (1982).

    PubMed  Google Scholar 

  6. Brody, S. J., Poulshock, S. W., Masciocchi, C. F., The Family Caring Unit: A Major Consideration in the Long-term Support System. The Gerontologist18, 556–561 (1978).

    PubMed  Google Scholar 

  7. Butler, R. N., Epidemiology of Aging. NIH Publ. 80969 (1980).

  8. Campbell, A. J., McCosh, L. M., Allan, B. C., Dementia in Old Age and the Need for Services. Age-Ageing12, 11–16 (1983).

    PubMed  Google Scholar 

  9. Christie, A. B., Changing Patterns in Mental Illness in the Elderly. Brit. J. Psychiat.140, 154–159 (1982).

    PubMed  Google Scholar 

  10. Clarke, M. G., Williams, A. J., Jones, P. A., A Psychogeriatric Survey of Old People's Home. Brit. Med. J.283, 1307–1310 (1981).

    Google Scholar 

  11. Crossmann, L., London, C., Barry, C., Older Women Caring for Disables Spouses: A Model of Supportive Services. The Gerontologist21, 464–470 (1981).

    PubMed  Google Scholar 

  12. De Beauvoir, S., Das Alter. Rowohlt, Reinbeck (1972).

    Google Scholar 

  13. Ericsson-Persson, B., Galvan, S., Norberg, A., Bexell, G., Care of Senile Demented Patients in the Final Stage of the Disease as Experienced by Their Close Relatives. J. Clin. Exp. Gerontol.6, 17–26 (1984).

    Google Scholar 

  14. Fengler, A. P., Goodrich, N., Wives of Elderly Disabled Men: The Hidden Patient. The Gerontologist19, 175–183 (1979).

    PubMed  Google Scholar 

  15. Fries, J. F., Crapo, L. M., Vitality and Aging. Implications of the Rectangular Curve. Freeman, San Fransisco (1981).

    Google Scholar 

  16. Gilhooly, M. L., The Impact of Care-Giving and Care-Givers: Factors Associated with the Psychological Well-Being of People Supporting a Dementing Relative in the Community. Br. J. Med. Psychol.57, 35–44 (1984).

    PubMed  Google Scholar 

  17. Gilleard, C. J., Boyd, W. D., Watt, G., Problems in Caring for the Elderly Mentally Infirm at Home. Arch. Gerontol. Geriatr.1, 151–158 (1982).

    PubMed  Google Scholar 

  18. Gutman, D., Observations on Culture and Mental Health in Later Life. In Birren, J. E., Sloan, R. B., (eds), Handbook of Mental Health and Aging, Englewood Cliffs N. Y. Prentice Hall (1980).

    Google Scholar 

  19. Hagnell, O., Lanke, J., Rorsman, B., Oejesjö, L., Does the Incidence of Age Psychosis Decrease? A prospective, Longitudinal Study of a Complete Population Investigated During the 25-Year Period 1947–1972: The Lundby-Study. Neuropsychobiology7, 201–211 (1981).

    PubMed  Google Scholar 

  20. Harford, M. E., Parsons, R., Groups of Relatives of Dependent Older Adults. The Gerontologist22, 394–398 (1982).

    PubMed  Google Scholar 

  21. Haycox, J. A., Late Care of Demented Patient. N. Engl. J. Med.303, 165–166 (1980).

    PubMed  Google Scholar 

  22. Hayter, J., Helping Families of Patients with Alzheimer's Disease. J. Gerontol. Nursing8, 81–86 (1982).

    Google Scholar 

  23. Huber, F., Stähelin, H. B., Bloch, F., Pflege von chronischkranken geriatrischen Patienten durch Mitarbeit von Angehörigen. Z. Gerontol.17, 205–208 (1984).

    PubMed  Google Scholar 

  24. Hunt, L. B., The Elderly in Hospital: Recent Trends in Use of Medical Resources. Brit. med. J.4, 83–85 (1973), Suppl. 1.

    PubMed  Google Scholar 

  25. Ikegami, N., Institutionalized and the Non-Institutionalized Elderly. Soc. Sci. Med.16, 2001–2008 (1982).

    PubMed  Google Scholar 

  26. Isaacs, B., Livingstone, M., Nevil, Y., Survival of the Unfittest — A Study of Geriatric Patients in Glasgow. Routledge & Kegan, London (1972).

    Google Scholar 

  27. Johnson, C. L., Johnson, F. A.: A Micro-Analysis of «Senility»: The Responses of the Family and the Health Professionnals. Culture, Medicine and Psychiatry7, 77–96 (1983).

    Google Scholar 

  28. Klusmann, D., Lüders, I., Bruder, J., Lauter, H., Die Betreuung kranker alter Menschen im Mehrgenerationenhaushalt — Zwischenergebnisse eines laufenden Forschungsprojekts. Arbeitsbericht — Sonderforschungsbereich 115, Deutsche Forschungsgemeinschaft, Univ. Hamburg.

  29. Lalive d'Epinay, Chr., Christen, E., Coenen-Huther, J. et al. (GUGRISPA), Vieillesse, Ed. Georgi, Saint-Saphorin (1983).

    Google Scholar 

  30. MacLennan, W. J., Isles, F. E., McDougall, S., Keddie, E., Medical and Social Factors influencing Admission to Residential Care. Brit. Med. J.288, 701–703 (1984).

    Google Scholar 

  31. Maddox, G. L., Mutual Help Groups for Caregivers in the Management of Senile Dementia: A Research Agenda. Modern Aging Research5, 339–352 (1984).

    Google Scholar 

  32. Nationales Komitee Schweiz für die UNO-Weltkonferenz 1982 über das Altern»: Schweizerischer Landesbericht zuhanden der UNO-Weltkonferenz über das Altern. Pro Senectute Zürich (1982).

  33. Parmelee, P. A., Spouse Versus Other Family Caregivers: Psychological Impact on Impaired Aged. Am. J. Community Psychol.11, 337–349 (1983).

    PubMed  Google Scholar 

  34. Rothstein, U., The Role of Relatives in the Care of Aged Patients in a Hospital Setting. Symposium des European Social Research Committee der Int. Gerontol. Gesellschaft, Ystad, Schweden (1977).

  35. Rosenzweig, N., Some Differences between Elderly People who Use Community Resources and Those who Do not. J. Am. Geriatr. Soc.23, 224–233 (1975).

    PubMed  Google Scholar 

  36. Sanford, J. R. A., Tolerance of Debility in Elderly Dependants by Supporters at Home: Its Significance for Hospital Practice. Brit. med. J.3, 471–473 (1975).

    PubMed  Google Scholar 

  37. Schlettwein-Gsell, D., Bass, B., Social Needs of the Relatives of Old People, p. 79–83 in Family Life in Old Age, Dooghe G., Helander J. (eds), Martinus Nijhoff, Den Haag (1979).

    Google Scholar 

  38. Schneider, E. L., Brody, J. A., Aging, Natural Death and the Compression of Morbidity: An Other View, N. Engl. J. Med.309, 854–856 (1983).

    PubMed  Google Scholar 

  39. Shanas, E., Social Myth as a Hypothesis: The Case of Familiy Relations of Old People. Gerontologist19, 3–9 (1979).

    PubMed  Google Scholar 

  40. Sheldon, F., Supporting the Supporters: Working with the Relatives of Patients with Dementia. Age and Ageing11, 184–188 (1982).

    PubMed  Google Scholar 

  41. Shuval, J. T., Fleischman, R., Shmueli, A., Informal Support for the Elderly: Social Networks in a Jerusalem Neighbourhood. Brookdale Inst. Gerontol. (1982).

  42. Smith, K. F., Bengtson, V. L., Positive Consequences of Institutionalisation: Solidarity Between Elderly Parents and Their Middle Aged Children. The Gerontologist19, 438–447 (1979).

    PubMed  Google Scholar 

  43. Smyer, M. A., The Differential Usage of Services by Impaired Elderly. J. Gerontol.35, 249–255 (1980).

    PubMed  Google Scholar 

  44. Stähelin, H. B., Pflege von chronischkranken, geriatrischen Patienten durch Mitarbeit von Angehörigen. Soz. Präv. Med.26, 63 (1981).

    Google Scholar 

  45. Stähelin, H. B., Bloch, F., Jeker, Ch., Der Beitrag der Familie bei der Pflege chronischkranker Betagter. Soz. Präv. Med.28, 286–291 (1983).

    Google Scholar 

  46. VESKA. Medizinische Statistik 1983. VESKA Aarau (1984).

  47. York, J. L., Calsyn, R. J., Family Involvment in Nursing Homes. The Gerontologist17, 500–505 (1977.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medizinisch-Geriatrische Kliniken Felix Platter Spital und Kantonsspital Basel, Schweiz

    H. B. Stähelin, F. BlocH, D. Schlettwein-Gsell, Ch. Jeker, M. Bächi & M. Zierath

  2. Stiftung für Experimentelle Alternsforschung, Basel

    D. Schlettwein-Gsell

  3. HCP Health Care Planning Ltd., Basel

    M. Bächi

Authors
  1. H. B. Stähelin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. BlocH
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Schlettwein-Gsell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ch. Jeker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Bächi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Zierath
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stähelin, H.B., BlocH, F., Schlettwein-Gsell, D. et al. Pflege von betagten Patienten durch ihre Angehörigen. Soz Präventivmed 30, 290–311 (1985). https://doi.org/10.1007/BF02078300

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02078300

Search

Navigation