Nurses need to assess problems related to stress in care giving.

The cost of caring for people with dementia is enormous in monetary and psychological terms. Carers experience emotional, physical and financial stress, depression and poor quality of life. The result may be poor standards of care, neglect or even abuse. To reduce stress, nurses need to better understand individual carer's experience to provide the appropriate support. The diagnosis of dementia leads to many losses and caregivers experience grief, which can be similar to that of bereavement. This is described as 'disenfranchised grief' because it cannot be publicly acknowledged and is not socially supported as happens with death. This study found that the behaviour most strongly associated with burden was aggression, including suspicion, making accusations and talking in a threatening manner. They also found that caregivers with higher income and higher levels of education had lower levels of burden. They suggest that these people developed more effective skills in managing the problems of care and stress. The authors conclude that more intervention is needed to decide how best to support caregivers, and that nurses in the community are in the best position to assess in problems related to stress in care giving.