SOCW 6204 Week 3 Caregiver Burden Assessment Example

What the Discharge Would Ask of Her Daughter: A Caregiver Burden Assessment Using Pearlin's Stress Process Model to Rate Each New Care Task by Whether She Could Do It and When, Weigh the Strains It Would Add and Record What She Agreed To, Declined and Conditioned

Student Name

Walden University

SOCW 6204: Medical Social Work I

Instructor Name

Month Day, Year

What the Discharge Would Ask of Her Daughter: A Caregiver Burden Assessment Using Pearlin's Stress Process Model to Rate Each New Care Task by Whether She Could Do It and When, Weigh the Strains It Would Add and Record What She Agreed To, Declined and Conditioned

Her Situation in Her Own Framing

Nadège, 51, is the daughter of Mrs. Augustin, whose assessment appears in Week 2. She works rotating shifts as a dispatcher for the city transit authority, two weeks of days followed by two weeks of evenings, and lives 20 minutes from her mother with her two teenage children. Her brother in Florida sends money each month but cannot help in person. She described her position this way: "I'm the one who's here. I want to help her. But I can't be in two places at once, and I can't lose this job."

The Framework

Pearlin et al. (1990) treated caregiver stress as a process with several parts: who the caregiver is and the context she lives in, the stressors that come straight from the care itself, the strains that spread from caregiving into work and family, the resources that soften both, and what all of it does to her health. The model is useful here because it separates what Mrs. Augustin's care would require from what those demands would do to the rest of Nadège's life.

Primary Stressors: The Care Tasks

The pattern is clear. Nadège can take on most tasks, but only at certain times, and she cannot provide overnight supervision during her evening-shift weeks. Overnight is when her mother fell.

Table 1

Care Tasks a Discharge Home Would Create, Rated by Capacity and Timing

Ratings come from Nadège's own account in a 40-minute meeting on hospital day three, with her mother's permission.

Secondary Strains

Three strains would follow. First, work: Nadège would lose overtime she relies on, about $600 a month, and has used most of her leave. Second, her own household: her children are 15 and 17, and she worries that more time at her mother's will strain her relationship with them. Third, family: she feels her brother's financial help, though welcome, leaves the daily work to her, and the two have argued about it.

Mediators

Her mother's cousin in the building checks on her most days and could help with meals. Nadège's church community, which is also her mother's, has helped before. She has a supervisor she describes as understanding. These resources would soften the burden but cannot cover nights.

Screening Result

The Caregiver Strain Index, developed by Robinson (1983) with caregivers of patients recently hospitalized for hip surgery and heart conditions, was completed as a supporting screen. Nadège answered yes to 6 of 13 items, including that caregiving would be inconvenient, physically straining and confining, and that it would require work adjustments. Robinson suggested that seven or more positive responses indicate a high level of strain, so her score sits just below that level. Her own words suggest the strain would rise quickly if overnight care were added. Schulz and Sherwood (2008) note that caregiving can affect caregivers' physical and mental health, and that the effects depend partly on how demanding the care is and what support caregivers have.

Willingness

Nadège agreed to manage her mother's medications, to provide transport on her days off and to help with bathing during day-shift weeks. She declined to provide overnight care, saying she could not without risking her job. She attached two conditions to any plan for her mother to go home: that some form of overnight help or monitoring be arranged, and that her mother agree to use a medical alert device. These answers, together with the therapy team's assessment of her mother's mobility, will guide the discharge recommendation.

What the Assessment Means for the Plan

Taken together, the assessment shows a caregiver who is willing and capable during the day and unavailable at night, with strain close to the level the screen treats as high. A discharge plan that assumes she can do more than she agreed to would raise that strain and put both women at risk. The plan should therefore build on what she offered, arrange overnight coverage from another source, and check on her strain again two weeks after any discharge, since caregiving demands often grow once the first weeks at home are over.

References

Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583-594. https://doi.org/10.1093/geront/30.5.583

Robinson, B. C. (1983). Validation of a Caregiver Strain Index. Journal of Gerontology, 38(3), 344-348. https://doi.org/10.1093/geronj/38.3.344

Schulz, R., & Sherwood, P. R. (2008). Physical and mental health effects of family caregiving. American Journal of Nursing, 108(9 Suppl.), 23-27. https://doi.org/10.1097/01.NAJ.0000336406.45248.4c