Cited by 95Dementia and Cognitive Impairment ResearchNursing care and researchGeriatric Care and Nursing Homes

Family caregiver challenges in dementia care in a country with undeveloped dementia services

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Wang, Jing, Xiao, Lily Dongxia, He, Guo‐Ping, De Bellis, Anita·2014·Journal of Advanced Nursing

Abstract

Aims: To examine socially, culturally and politically constructed factors affecting family caregiver practice in dementia care, and to identify possible changes in a country with undeveloped dementia services. Background: In China and many other low‐ and middle‐income countries, social transformations are weakening the family care model, which has an impact on the population with dementia. Exploring the challenges that caregivers face may help the international healthcare community to improve dementia services. Design: A double hermeneutic approach informed by Giddens' Structuration Theory was used. Methods: In‐depth semi‐structured interviews with 23 family caregivers of people with dementia were conducted in 2012. The interviews were audiotaped, transcribed and analysed. Findings: Analyses revealed three consequences of socially constructed factors in dementia care, which constrained caregiver practice. First, caregivers were unable to manage behavioural and psychological symptoms of dementia. Untreated aggressive behaviours caused harm to the person with dementia and endangered the caregiver and the public. Second, the burden on the primary caregiver was evident and caregivers received limited support. Third, there was little coordination between primary and specialist care services for people with dementia. On critical reflection of potential changes that could improve dementia services, caregivers suggested that community nurses have a leading role in coordinating dementia services and supporting caregivers. Conclusion: Relying on family caregivers to care for people with dementia without the prevision of dementia services by the public healthcare system generates negative health outcomes for both care recipients and caregivers. The nursing workforce should be developed to support dementia services.

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  • Carers' knowledge (e.g., health literacy, the patient's care needs) was linked to their experience of carer burden, and use of urgent care after returning home, and contributed to the ways they engaged with information provided at discharge.

    “Carers’ knowledge (e.g., health literacy, the patient’s care needs) was linked to their experience of carer burden, and use of urgent care after returning home, and contributed to the ways they engaged with information provided at discharge [43, 44, 57, 59, 60, 64, 66, 67].”

    From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [57]

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Authors
Wang, J., Xiao, L. D., He, G., & De Bellis, A.
Affiliations
  • Central South University (CN)
  • Flinders University (AU)
  • School of Nursing Central South University Changsha Hunan Province China
  • School of Nursing and Midwifery Flinders University Adelaide South Australia Australia
Corresponding author
Xiao, Lily Dongxia
Venue
Journal of Advanced Nursing
Publisher
Wiley
Published
2013-11-06
Volume
70
Issue
6
Pages
1369-1380
ISSN
  • 0309-2402 (ISSN-L)
  • 1365-2648
OpenAlex
W2052831045
Cited by
95
References
38
Citations by year
2026: 5 · 2025: 9 · 2024: 14 · 2023: 9 · 2022: 15 · 2021: 6 · 2020: 8 · 2019: 9 · 2018: 9 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 4
FWCI
1.65
Type
journal article
Language
en
Open access
Locations
  • Journal of Advanced Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Flinders Academic Commons (Flinders University) (acceptedVersion)
  • Flinders Academic Commons (Flinders University) (submittedVersion)
Funders
  • Flinders/Central South University Collaborative Research Project (01.601.37930)
  • Education Department of Hunan Province (CX2012B084)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
family caregivers, dementia care, caregiver burden, behavioral and psychological symptoms of dementia, dementia services, low- and middle-income countries, China, community nurses, social construction of care, nursing workforce, caregiver support
MeSH terms
Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Aggression, China, Community Health Services, Dementia, Developing Countries, Female, Health Services Accessibility, Humans, Male, Middle Aged, Psychiatric Nursing, Social Support, Caregivers

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