Thailand is an aged society. Caregiving for older people is met within the family.
Therefore, the family is an important source for elder care in Thailand. Around 90%
of older people receive daily care and assistance from children and spouses at home and hospitals. Over 60% of caregivers are adult-child daughters being the primary providers for older persons. (Knodel & Teerawichitchainan 2017.) Adult children supervise older people because they are instructed to respect older persons.
Therefore, older people are recognized and valued by children (Choowattanapakorn et al. 2004). Even though their children get married, at least one child still stays in his/ her home with older people (Choowattanapakorn et al. 2004, Knodel &
Teerawichitchainan 2017). Meanwhile, almost 30% of primary caregivers are spouses. Wives become caregivers for husbands because women live longer than men (Kaakinen et al. 2014). Female caregivers, from childhood, are instilled with the responsibility for caregiving to family members (Tavero et al. 2018).
Older people with multiple chronic illnesses are admitted to different wards of the hospital. Health issues affect everyday life and they become dependants. Thus, family caregivers always give informal care for hospitalized older family members (Dijkstra et al. 2015). Caregiving may be an expression of responsibility to older people based on Thai culture through both natural and dependent caregiving. When older people are observed that they should receive dependent care, dependent caregiving is performed through three crucial processes: mobilizing family members,
performing dependent care, and maintaining continuity of care. After performing dependent care and discovering unpredictable changes, the remobilizing of a family member will be conducted once again because the quality of care for older people is insufficient. (Wongsawang et al. 2013.) The conceptual model of family caregiving for older people in Thai families is presented in Figure 5.
Figure 5. The conceptual model of family caregiving for older people in Thai families.
Source: Wongsawang et al. (2013)
Likewise, in a study by Li et al. (2000) about families and hospitalized elderly patients at one university hospital in the United States, they explained the typology of family care actions, consisting of providing care to elderly patients, working along with the healthcare professionals, and taking care of themselves as follows:
1) Providing care to elderly patients: Family caregivers perform various tasks in providing care of elderly patients as follows:
(a) Being there, which is about staying with the elderly patient all day in the hospital.
(b) Family caregivers maintain linkage, as family caregivers should tell the elderly patient what was happening at home, doing activities based on past experiences during hospitalization, providing reassurance that elderly patients are going to get help, and engaging in religious practices.
(c) The pass way for providing care between home and hospital, family caregivers perform the task of keeping medications and belongings during hospitalization, transferring a patient and belongings to and from the hospital, as well as assisting the patients in adapting to stay in hospital.
(d) Attending to personal care, family caregivers participate in providing care about elderly patient’s daily activities and encouraging elderly patients.
2) Working along with healthcare professionals: Family caregivers exchange information about elderly patients with healthcare professionals, collaborate with healthcare professionals to provide care for elderly patients and participate in the therapeutic process.
3) Taking care of themselves: During family participation in providing care for hospitalized elderly patients, family caregivers may be confronted with various problems. Therefore, they have to find a way to cope with problems and take care of themselves as well.
From the principle of family caregiving for elderly patients, as mentioned above, caring for hospitalized older people is the role of family caregivers. Family caregivers provide care based on past experiences of natural caregiving. When older people are admitted to the hospital, they also participate in providing care for loved ones with care needs and functional limitations (Feinberg & Houser 2012). They work along with healthcare professionals to take better care of hospitalized older people.
Choowattanapakorn et al. (2004) manifested that Thai family members are valuable persons in caregiving for hospitalized older people. Hospitalized older people were able to recover more quickly when family members were involved in taking care of them compared to elderly patients who were supervised by doctors or nurses only.
Meanwhile,caregiving of a hospitalized older person was the intention of the family member who had a sense of filial responsibility. The nurses also believed that caring for the hospitalized older person was family responsibility.
In the hospital, nurses often spend most of their time in checking vital signs, administering medication, collecting medical documents while they give less precedence to other elements of care, for instance, personal hygiene and health education. To manage the gap, the family caregiver needs to participate in providing care for the patient about personal care activities. (Nayeri et al. 2015.) Caring for elderly patients by family members is essential; it can offer more adequate emotional support to elderly patients. Additionally, physicians and the nursing team also need to communicate regularly with family caregivers and provide them with appropriate information involving the condition of the elderly patient. (Bellou & Gerogianni 2014.) Therefore, family-centered care (FCC) is an essential method that involves partnerships between families and healthcare professionals in caring for hospitalized older people (Institute for Patient- and Family-Centered Care 2017).
3.5 PREVIOUS STUDIES OF FAMILY CAREGIVERS IN