Cuidando do paciente com provável doença de Alzheimer: o impacto subjetivo da doença no cuidador primário no contexto da pandemia pela Covid-19

Abstract

Introduction: With the population aging, the prevalence of diseases that lead to functional impairment of the elderly increases, generating the need for a caregiver, a role normally performed by a family member, that is, informal. Among the diseases that can even lead to functional disability, we have dementias, the most common being Alzheimer's Disease (AD). The HCoV is responsible for causing the disease COVID-19, being characterized by the WHO, in March 2020, as a pandemic. Thus, social isolation measures were taken, making this care for the elderly with AD even more difficult. Objective: To verify the relationship between the total score of the Caregiver Burden Scale (CBS) and each of its dimensions and the 1) characteristics of caregivers, 2) of the care provided and 3) of the characteristics of the elderly with AD in the context of the COVID-19 pandemic. Method: An analytical cross-sectional study was carried out with 40 primary caregivers of elderly people with probable AD treated at the Centro Especializado de Atenção à Saúde do Idoso (CEASI), in the city of Natal/RN, Brazil, from March 2020 to March 2021. To measure the subjective impact of the disease on the primary caregiver, the CAREGIVER BURDEN SCALE (CBS) was applied, an instrument composed of 22 questions, grouped into five dimensions (General Tension, Isolation, Disappointment, Emotional Involvement, and Environment), with the highest subjective impact the higher the scores. Simple descriptive and inferential analyzes were performed using Student's T-tests and ANOVA, followed by Tukey's test and Pearson's Correlation Coefficient (r), α=0.05. Results: Most caregivers were female (95.0%), with a mean age of 52.85 years and a standard deviation (SD) of 11.23. The sample of patients had a female majority (85.0%), with a mean age of 83.60 years and SD of 7.63. Regarding caregiver characteristics, there was a significant negative correlation only between the Environment dimension and age (p=0.010; -ρ = 0.405). There were significant relationships between the Emotional Involvement dimension and the variables related to the caregiver: marital status (p=0.008), work or study abroad (p=0.042), perform tasks such as helping with hygiene (p=0.044), and dressing (p=0.044). p=0.036); and between the Environment dimension and the time dedicated to the elderly (p=0.009). Regarding patient characteristics, there was a significant negative correlation between the Emotional Involvement dimension and age (p=0.018; ρ= -0.372) and the number of activities involved (p=0.023; ρ= -0.0360). There was a significant relationship between the Isolation dimension and the patient's marital status (p=0.006). Conclusions: In the context of the COVID-19 Pandemic, the subjective impact on the caregiver of elderly people with probable AD was considered relevant. The most affected dimension of CBS was Emotional Engagement younger caregivers, who do not help with hygiene and dressing, with less time of dedication, who work or study abroad, and single/divorced had higher scores in the CBS dimensions. These are also higher when patients are married/stable union, and the younger the patient the lower the number of compromised activities of the same. Such knowledge allows directing interdisciplinary guidelines and strategies in care and therapies, to minimize the difficulties and quality of life of all those involved.