Mary V Seeman1. 1. Professor Emerita in the Department of Psychiatry at the University of Toronto in Canada.
Abstract
OBJECTIVE: The purpose of this paper is to explore a literature gap--sibling involvement in the care and support of people with schizophrenia, and to make recommendations for filling the gap. METHOD: The method used was observation and documentation of clinical notes over a ten-year period in an outpatient clinic for women with schizophrenia. Illustrative examples were selected from approximately 200 entries dealing with sibling relationships. FINDINGS: Siblings constitute an important segment of the social network of persons with schizophrenia, although they do not usually take an active part in their brother or sister's care until parents are no longer able to cope alone. The role of primary caregiver appears to be a stressful one for siblings. The closest sibling bonds were those between sisters, and in most cases, the eldest girl in the family assumed the caregiver role. This depended, however, on the family's means, values, and cultural traditions, as well as on the personal attributes and life circumstances of the siblings. Financial, human, and social capital were critical determinants of sibling involvement. Sharing responsibilities and negotiating the distribution of required caretaking tasks was often the most effective way of dealing with the burden of care giving. CONCLUSION: Although some clinical recommendations can be made, specificities that distinguish this population and the effectiveness of sibling caregiving need to be further researched.
OBJECTIVE: The purpose of this paper is to explore a literature gap--sibling involvement in the care and support of people with schizophrenia, and to make recommendations for filling the gap. METHOD: The method used was observation and documentation of clinical notes over a ten-year period in an outpatient clinic for women with schizophrenia. Illustrative examples were selected from approximately 200 entries dealing with sibling relationships. FINDINGS: Siblings constitute an important segment of the social network of persons with schizophrenia, although they do not usually take an active part in their brother or sister's care until parents are no longer able to cope alone. The role of primary caregiver appears to be a stressful one for siblings. The closest sibling bonds were those between sisters, and in most cases, the eldest girl in the family assumed the caregiver role. This depended, however, on the family's means, values, and cultural traditions, as well as on the personal attributes and life circumstances of the siblings. Financial, human, and social capital were critical determinants of sibling involvement. Sharing responsibilities and negotiating the distribution of required caretaking tasks was often the most effective way of dealing with the burden of care giving. CONCLUSION: Although some clinical recommendations can be made, specificities that distinguish this population and the effectiveness of sibling caregiving need to be further researched.