The Structure of Decision-making about the Discharge of Persons with Early Onset Dementia from a Psychiatric Facility among Family Caregivers

Abstract

Objective: Family caregivers of persons with early onset dementia（EOD）experience a dilemma between the dedication to care for their spouse and their own changing future perspectives. The aim of this study is to examine how family caregivers of persons with EOD make decisions about patient discharge from a psychiatric facility.

Method: Participants included seven family caregivers of persons with EOD. We used an interview guide and conducted several semi-structured interviews. The interviews focused on exploring how family life changed after a person with EOD was admitted to a psychiatric facility, worries of the family caregivers related to discharge, and the decisive factor about the discharge for the family caregivers. It was a qualitative descriptive study.

Result: The results identified four categories, “liberated from the limitations by admission to psychiatric facility,” and “I have no choice but to undertake the responsibility of the person with EOD,” was a precondition, and, “realistic judgment of whether home care is appropriate,” “family caregiver’s life and facing the person with EOD”, integrated during admission and return, and decision-making about discharge place. In addition, “awareness of the surrounding environment to encourage the decision” was influenced.

Discussion: Families assessed their own meanings and orientation about older age on being separated from persons with EOD, when they were admitted to a psychiatric facility. Consequently, the families made the decision to get them discharged. Moreover, by recognizing the surrounding environment that encouraged the decisions, it helped in relaxing the heavy responsibility associated with decision-making.