Formal and Informal Care: Home Care in the Elderly With Obstructive Sleep Apnea

Formal and Informal Care: Home Care in the Elderly With Obstructive Sleep Apnea

Sagrario Gomez-Cantarino, Patricia Dominguez-Isabel, Blanca Espina-Jerez, Mª Carmen Bouzas-Mosquera, M. Teresa Agullo Ortuño, Maria de las Mercedes de Dios-Aguado, Manuel Carlos Rodrigues Fernandes Chaves
DOI: 10.4018/978-1-7998-3531-8.ch007
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Due to the increase in life expectancy and therefore the prevalence of chronic pathologies, health services have required a change, as well as healthcare. One of these chronic pathologies is obstructive sleep apnea syndrome (OSAS), which is a disorder characterized by an occlusion of the upper airway, an issue that causes an interruption of breathing inducing transient asphyxia. The treatment of this disease is based on continuous positive airway pressure devices (CPAP), but the main caregiver faces problems of adherence to this treatment, causing a deterioration both physically, socially, and psychologically. Therefore, the objective of this present work is to 1) identify the characteristics of OSAS, 2) describe adherence to treatment, and 3) detail the biopsychosocial deterioration of the main caregiver of this pathology in the elderly.
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Caring for the elderly has been a challenge for the health community. Currently, the population’s framework means that health care takes great responsibility in the ageing process in order to address the problems related to this segment of the population (Bielicki, Byskniewicz, Kumor, Korczynski, & Chazan, 2006; Ganga, Thangaraj, & Puppala, 2009; Onen & Onen, 2010; Parra et al. 2015).

Ageing is a progressive and universal process that takes place in every living being, generating a series of changes of a physical, psychological and social type, producing modifications which do not originate from an illness (Leiton, 2016). Even so, there seems to be a tendency of the appearance of diseases when people are in old age, an issue that produces incapacitating diseases or geriatric syndrome, which leads to an impairment in the quality of life and even leads to a decrease in life expectancy at this age (Salech, Jara, & Michea, 2012).

According to the WHO, active ageing is a process that unifies health, safety and participation, with the purpose of increasing the quality of life as they age. In other words, it gives the elderly with an active and healthy life the opportunity to achieve their physical, psychological and social well-being throughout their life trajectory and be able to participate in society by fulfilling their desires, needs and capacities (Ortiz, Aguilera & Hernández, 2016).

The most prevalent chronic processes found in the elderly are related to the cardiovascular system, an example of which is arterial hypertension or ischemic cardiopathy (Cantero, 2011; Jackson & Wenger, 2011). As for the respiratory system, one of the issues we find as a pathology in elderly people is the obstructive sleep apnea syndrome (OSAS), also known as obstructive sleep apnea-hypoapnea syndrome (OSAHS), which is a disorder characterized by an obstruction of the upper airway which is why breathing is interrupted causing a transient asphyxia (Bronc, 2005; Nogueira et al., 2013). We found this pathology as a notable interest due to the high prevalence in the elderly, as well as the clinical characteristics, being very different from young adults (Egía & Cascante, 2007; Gabbay & Lavie, 2012; Launois, Pepín, & Levi, 2007; Naresh & Punjabi, 2008).

This pathology must take into account the family environment and especially the person within this nucleus that is performing as the main caregiver.

Therefore, the magnitude of family care greatly exceeds the time spent on the person suffering from OSA by the informal carer, as opposed to a rather scarce and very reduced time spent by the formal system that is generally institutional (De la Cuesta, 2005; Falque-Madrid, 2014).

Dependent elderly people need to be cared for, a fact that is carried out by both the informal and formal carer. Although it is true that there is a clear question regarding public coverage, which is very basic while the private coverage is mostly unreachable mainly due to its high cost, families are forced to perform this care within their own home. Therefore, the people dedicated to the care of these elderly will be known as informal carers (ICs). (Crespo & López, 2007; Carreño & Chaparro, 2016).

Key Terms in this Chapter

SAOS: A frequent disease and carries certain risks due to possible secondary complications (traffic accidents, cardiovascular disease, etc.). It is easy to diagnose and generally responds positively to treatment.

Nursing: Body of knowledge required to obtain the title of nurse.

Apnea: Transient suspension of breathing.

Drowsiness: A state in which there is a feeling of tiredness, heaviness, sleep, dullness of the senses and clumsiness in the movements.

CPAP: Continuous positive airway pressure and is the treatment of choice in patients with moderate to severe symptomatic apnea. It is equipment used while you sleep that prevents the collapse of the airway.

Therapy: A set of means that are applied to cure or alleviate a person's illness.

Snoring: A rough, severe, hoarse noise produced by breathing while sleeping, due to the vibration of the veil of the palate.

Mask: An object or piece of cloth or paper that is placed over the nose and mouth and fastened with a rubber band or headband to prevent or facilitate the inhalation of certain gases or substances.

Cares: The action of caring (preserving, guarding, conserving, assisting). Care implies helping oneself or another living being, trying to increase their well-being and avoid suffering any harm. It is also possible to care for objects (such as a house) to prevent incidents such as damage and theft from occurring.

Pathology: Part of medicine that studies the anatomical and physiological disorders of diseased tissues and organs, as well as the symptoms and signs through which diseases manifest themselves and the causes that produce them.

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