Deciding to institutionalize: why do family members cease caregiving at home?

The primary purpose of this secondary analysis was to identify common themes from the statements of caregivers who ultimately decided to institutionalize their relative with Alzheimer or Parkinson disease. Content analysis of transcripts from caregivers (n=11) who institutionalized their relative during their participation in a caregiver intervention study was performed. Two categories identified from the caregivers' stories were anticipating the inevitable and reaching the limit. The results of the descriptive analysis indicated that 3 to 4 months before institutionalization, caregivers discussed knowing that they would not be able to continue caring for their relative. The most frequent reasons for institutionalization were serious health events. The incidental finding that there were more institutionalizations in the Alzheimer disease participant group than in the Parkinson disease group may indicate that caregiving is more difficult for caregivers in Alzheimer disease than in Parkinson disease. This analysis contributes new and important information about the time interval between caregivers' anticipation of the need for alternative care arrangements and the subsequent placement in formal care. Nurses and other healthcare providers should be alert to the fact that when caregivers express anticipation of the need for change in care arrangements, it may be a signal for immediate assessment and referral to appropriate resources for assistance.