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Die Belastung pflegender Angehöriger bei Demenz

Enstehungsbedingungen und Interventionsmöglichkeiten

Carer burden in dementia

Origins and intervention

Zusammenfassung

Die Versorgung Demenzkranker in der häuslichen Umgebung ist mit einer sehr hohen Belastung für die pflegenden Angehörigen verbunden. Zu den wesentlichen Stressfaktoren zählen einerseits unveränderliche Kontextbedingungen wie Geschlecht, Verwandtschaftsverhältnis oder Ausprägung der Krankheitssymptome, andererseits aber auch der Wandel der persönlichen Beziehung, der individuelle Stil der Problembewältigung, die verfügbare Unterstützung sowie die Einstellung gegenüber der Pflegesituation. Die Mehrzahl der bisherigen Interventionen für pflegende Angehörige Demenzkranker hat den Schwerpunkt auf Wissensvermittlung und Verbesserung der Problemlösefähigkeit gelegt, aber den emotionalen Anteilen der Angehörigenbelastung nicht genügend Aufmerksamkeit gewidmet. Der Nutzen von Entlastungsprogrammen für pflegende Angehörige ist in zahlreichen kontrollierten Studien untersucht worden. Sie zeigen, dass die stärksten Wirkungen mit intensiven, langdauernden, individuell abgestimmten und alltagsnahen Interventionen zu erzielen sind. Aus diesen Erkenntnissen und Erfahrungen werden die Umrisse einer psychologisch begründeten verhaltenstherapeutischen Intervention für pflegende Angehörige Demenzkranker abgeleitet.

Summary

Caring for a demented elderly indiviudal in the home is associated with a high burden on care-providing family members. Factors contributing to this burden include invariable context conditions such as gender, type of relationship and severity of symptoms as well as role change, coping style, available support and appraisal of the caring role. Most interventions for family carers have focused on providing dementia-related information and problem solving skills but have placed less emphasis on the emotional facets of the burden. Controlled studies evaluating the efficacy of support programs for family carers suggest that the greatest benefits can be achieved by interventions which are intensive, long-term, individually tailored and targeted to the everyday context. From these findings and experiences the outline of a psychologically based behavioral intervention for family carers of dementia patients is derived.

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Kurz, A., Wilz, G. Die Belastung pflegender Angehöriger bei Demenz. Nervenarzt 82, 336–342 (2011). https://doi.org/10.1007/s00115-010-3108-3

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Schlüsselwörter

  • Demenz
  • Familienangehörige
  • Lebensqualität
  • Versorgung
  • Verhaltenstherapie

Keywords

  • Dementia
  • Family carers
  • Quality of Life
  • Intervention
  • Behavioral therapy