Tactful monitoring: how thai caregivers manage their relative with schizophrenia at home.

Approximately 343,680 individuals in Thailand suffering from schizophrenia are cared for at home by relatives, most of whom have a little knowledge of the disease; therefore they're left to develop their own strategies of care. Data were collected by in-depth interviews and observation involving 17 caregivers of relatives diagnosed with schizophrenia. Data were analyzed using the constant-comparative method of grounded theory. Caregivers' chief concern was avoiding psychotic episodes. They do this through a process we call "tactful monitoring," which includes the co-variables "unobtrusive observation" and strategies for calming. Caregivers follow a trajectory that leads them to a state of exhaustion, tired and sad, and fearful about the future care of their loved one. Findings from this study led the authors to conclude that in Thailand, caregivers were able to develop creative ways of tending to their relatives with schizophrenia at home, but not without significant cost to themselves. Limited provision for caregiver education and respite exists. If education and increased respite care were instituted, caregivers could benefit, and patients might avoid expensive inpatient visits.