Nursing Dx

Taxonomy II: Role Relationships—Class 1 Caregiving Roles (00061)
[Diagnostic Division: Social Interaction]
Submitted 1992; Nursing Diagnosis Extension and Classification (NDEC) Revision 1998; 2000
Definition: Difficulty in performing caregiver role

Related Factors
CARE RECEIVER HEALTH STATUS
Illness severity/chronicity
Unpredictability of illness course; instability of care receiver’s health
Increasing care needs and dependency
Problem behaviors; psychological or cognitive problems
Addiction or co-dependency of care receiver
CAREGIVING ACTIVITIES
Discharge of family member to home with significant care needs [e.g., premature birth/congenital defect]
Unpredictability of care situation; 24-hour care responsibility; amount/complexity of activities
Ongoing changes in activities; years of caregiving
CAREGIVER HEALTH STATUS
Physical problems; psychological or cognitive problems
Inability to fulfill one’s own or others’ expectations; unrealistic expectations of self
Marginal coping patterns
Addiction or co-dependency
SOCIOECONOMIC
Competing role commitments
Alienation from family, friends, and coworkers; isolation from others
Insufficient recreation

CAREGIVER-CARE RECEIVER RELATIONSHIP
Unrealistic expectations of caregiver by care receiver
History of poor relationship
Mental status of elder inhibits conversation
Presence of abuse or violence
FAMILY PROCESSES
History of marginal family coping/dysfunction
RESOURCES
Inadequate physical environment for providing care (e.g., housing, temperature, safety)
Inadequate equipment for providing care; inadequate transportation
Insufficient finances
Inexperience with caregiving; insufficient time; physical energy; emotional strength; lack of support
Lack of caregiver privacy
Lack of knowledge about or difficulty accessing community resources; inadequate community services (e.g., respite care, recreational resources); assistance and support (formal and informal)
Caregiver is not developmentally ready for caregiver role

Defining Characteristics
SUBJECTIVE
CAREGIVING ACTIVITIES
Apprehension about possible institutionalization of care receiver, the future regarding care receiver’s health and caregiver’s ability to provide care, care receiver’s care if caregiver becomes ill or dies
CAREGIVER HEALTH STATUS—PHYSICAL
Gastrointestinal (GI) upset (e.g., mild stomach cramps, vomiting, diarrhea, recurrent gastric ulcer episodes)

Weight change, rash, headaches, hypertension, cardiovascular disease, diabetes, fatigue
CAREGIVER HEALTH STATUS—EMOTIONAL
Feeling depressed; anger; stress; frustration; increased nervousness
Disturbed sleep
Lack of time to meet personal needs
CAREGIVER HEALTH STATUS—SOCIOECONOMIC
Changes in leisure activities; refuses career advancement
CAREGIVER-CARE RECEIVER RELATIONSHIP
Difficulty watching care receiver go through the illness
Grief/uncertainty regarding changed relationship with care receiver
FAMILY PROCESSES—CAREGIVING ACTIVITIES
Concern about family members
OBJECTIVE
CAREGIVING ACTIVITIES
Difficulty performing/completing required tasks
Preoccupation with care routine
Dysfunctional change in caregiving activities
CAREGIVER HEALTH STATUS—EMOTIONAL
Impatience; increased emotional lability; somatization
Impaired individual coping
CAREGIVER HEALTH STATUS—SOCIOECONOMIC
Low work productivity; withdraws from social life
FAMILY PROCESSES
Family conflict