Deciding to Seek Help among Family Members Caring for Veterans with Diabetes Mellitus and Co-morbid Illnesses.

摘要

Studies suggest that strict control of diabetes is dangerous for older adults with chronic illnesses. Since Veterans have a higher prevalence of diabetes and other chronic ailments, caregivers need a better understanding of how restrictive diabetes control may be detrimental. Furthermore, the critical role of caregivers in the management of diabetes supports the need to understand how they experience the help-seeking process. In order to develop effective programs and policies, researchers must understand what triggers caregivers to seek help. At this time, limited understanding exists on how help-seeking takes place among caregivers of Veterans.;This study utilized Grounded Theory and interviewed caregivers (N=25) of Veterans who were diabetic with other co-morbid illnesses. The recruitment of caregivers took place at the West Los Angeles Veterans Administration (VA). A semi-structured interview was used to understand the help-seeking process. The transcripts were analyzed to develop a theoretical model.;The study findings suggests that help-seeking is a complex phenomenon. Two themes emerged: (1) Knowing what you do not know and (2) Help means different things to different people. The first theme suggests that caregivers provide care to Veterans until they reach a crisis point in which their resources (instrumental and financial), physical and mental well-being are compromised. Therefore, caregivers experience a multitude of factors before they come to realize "what they don't know". The type of assistance the caregiver needs (informational, instrumental, emotional, spiritual or financial support) depends on how it is defined by the caregiver---"help means different things to different people". Help-seeking, therefore, occurs based on what kind of assistance the caregiver needs. The study also shows that informal and formal networks are critical in facilitating the help-seeking process and provides insights into to two different types of caregivers (proactive and overwhelmed, passive and overwhelmed).;This study provides a foundation for understanding the help-seeking process of caregivers of Veterans and suggests that the VA needs to bring forth policy changes to reduce the risk for hypoglycemia and caregiving burden. Furthermore, the study findings can be used to develop social work interventions and encourage future research on understanding the phenomenon of help-seeking among caregivers.