Nas últimas décadas houve o aumento da ocorrência de doenças crônicas no Brasil, dentre elas o Acidente Vascular Encefálico (AVE) se destaca. O AVE frequentemente acarreta perdas funcionais e a dependência por cuidadores. A compreensão da percepção da Qualidade de Vida (QV) e o impacto do AVE sobre os acometidos e seus cuidadores torna-se muito importante, uma vez que se apresenta como um problema de saúde pública no país. Este estudo teve como objetivo avaliar a QV dos indivíduos acometidos por AVE e a de seus cuidadores e também descrever o perfil sociodemográfico e clínico. Tratou-se de um estudo observacional do tipo inquérito transversal, desenvolvido em um município do Triângulo Mineiro envolvendo 83 indivíduos que sofreram um AVE sendo todos assistidos pela Estratégia Saúde da Família (EsSF). Os indivíduos participantes foram separados em 4 grupos, sendo o grupo dos indivíduos com AVE que possuem cuidadores (44), grupo dos indivíduos com AVE sem cuidadores (39), grupo dos cuidadores (44) e um grupo de referência (83) no período de março a maio de 2010. Foi utilizado um questionário contendo dados sociodemográficos e clínicos para os indivíduos com AVE e cuidadores. Para avaliação da QV o instrumento WHOQOL-bref (World Health Organization Quality of Life-bref) foi aplicado à todos os grupos. Para os dois grupos de indivíduos com AVE ainda foi aplicado um instrumento específico denominado SSQOL (Stroke-specific of Quality of Life). Os indivíduos com AVE tinham idade média de 61,93 anos, a maioria do sexo masculino, casados, religião católica, aposentados/pensionistas, baixa renda e responsáveis por ela, baixa escolaridade e 53% possuíam cuidador. Os cuidadores tinham idade média de 49,25 anos, maioria do sexo feminino, filhos (as), casados, religião católica, exerciam outra atividade, baixa renda e escolaridade, longo tempo de cuidado e não tinham dificuldade para o cuidado. O AVE do tipo isquêmico foi o mais encontrado, tempo de diagnóstico de 5 ou mais anos, presença de antecedentes familiares (41%), recidivas (20%) e 51% dos indivíduos possuíam algum grau de dependência. Estavam presentes o tabagismo (54%), etilismo (27%) e a hipertensão arterial (94%). Em relação à QV geral o grupo de AVE com cuidadores apresentou o menor escore. Podemos observar que nos domínios físico, psicológico e meio ambiente o escore médio foi menor para o grupo de AVE com cuidadores. Os maiores escores para estes três domínios foram observados de forma crescente no grupo de AVE sem cuidadores seguido pelo grupo de cuidadores e pelo grupo de referência. No domínio relações sociais observamos que o escore para o grupo de AVE com cuidadores (71,02) foi um pouco maior que o escore médio do grupo de AVE sem cuidadores (70,94). A comparação dos escores em todos os grupos evidenciou que a presença do AVE e o fato de ser cuidador afeta a QV em todos os domínios do WHOQOL-bref. A QV avaliada pelo SSQOL evidenciou que os domínios mais afetados foram o da personalidade, papéis sociais e energia. Ao compararmos os dois grupos com AVE observamos que 6 dos 12 domínios apresentaram diferenças significativas. Esta pesquisa pode ajudar a entender o impacto que o AVE causa na vida dos acometidos e na de seus cuidadores, assim como melhor orientar políticas públicas destinadas a esta população. / There was a raise of chronic diseases occurrence in Brazil in the last decades, among them the stroke detaches itself. The stroke, frequently leads to functional losses and dependency for caregivers. The awareness comprehension of the Quality of Life (QOL) and the stroke impact to the patients and their caregivers become very important, once it shows itself as a healthy problem in the country. This research aimed to evaluate the QOL of patients suffering from strokes and their caregivers and describe the sociodemographic and clinical profile. It was a transversal inquire observational research developed in a city of Triangulo Mineiro involving 83 people who suffered a stroke are all assisted by the Family Health Strategy (EsSF). The participants were separated in 4 different groups: the ones with stroke who had caregivers (44); the ones with stroke without caregivers (39); caregivers group (44) and a reference group (83) from March to May 2010. It was used a questionnaire with the social demographic and clinic dates to the people with stroke and caregivers. To evaluate the QOL it was used the tool WHOQOL-bref (World Health Organization Quality of Life-bref) in all the groups. For both groups with of individuals with stroke has been applied another specific tool called SSQOL (Stroke-specific of Quality of Life). The average age of stroke people was 61,93 years old, most of them male, married, catholic, retired, underpaid and responsible for it, not properly educated and 53% had a caregiver. The caregivers were 49,25 years old, most of them females, daughters and sons, married, catholic, had another activity, underpaid and not properly educated, long care period and had no problems for this activity. The skemical stroke was the most common to be found, 5 or more years of diagnosis time, previous familiar case (41%), repetitions (20%) and 51% 51% of subjects had some degree of dependence. Among them we found, smoking (54%), drinking (27%) and high blood pressure (94%). About general QOL the strokes group with caregivers showed a lower score. We observe that the physical, psychological and environmental domain, the average score was inferior to the strokes groups with caregivers. The highest scores for those three groups were observed increasingly in the strokes group without caregivers followed by caregivers group and the reference group. About the social relation domain, we could see that the strokes group with caregivers score (71,02) was similar the average score from the strokes group without caregivers (70,94). The scores comparison showed that the strokes presence and the fact of being taken care affects QOL in all the domain of the WHOQOL-bref. The QOL evaluated by SSQOL showed the most affected domain were: the personality, social chores and energy. When we compare both groups with stroke we can see that 6 of 12 domains showed significant differences. This research can help o understand the strokes impact in the victims and caregivers lives as well better guidance at public polices for this population.

BACKGROUND: Delirium is an “acute change in cognition” prevalent in the elderly population (9). It is a clinical diagnosis which results from complex relationships between patient vulnerability and precipitating medical factors (2,9). Delirium has a complex relationship with dementia and often these two cognitive impairments occur together. While delirium occurrence is exceptionally high in dementia patients, it’s recognition by physicians is unfortunately low (10). Delirium prevalence in dementia patients can be as high as 80% and failure to recognize occurs in as many as 75% of cases (10). Recognition of delirium is important due to its association with poor outcomes and potential for prevention by avoiding precipitating causes. Common poor outcomes associated with delirium include, prolonged cognitive and physical impairment, longer hospital stays, institutionalization and death. With the increasing aging population and the rising cost of healthcare in the United States more attention has been focused on better detection of costly conditions including delirium. Efforts have been made to develop tools for universal screening to aid in the recognition of delirium; however, these are not widely used outside of research. One of the challenges in recognizing delirium is that providers lack knowledge of the patient’s baseline cognitive status, making it difficult to determine whether an acute change has occurred. Caregivers are an untapped resource, holding this key piece of information, in the early recognition of delirium. SPECIFIC AIMS: The goal of this study is to build an argument for the implementation of a training program which would teach caregivers to complete the Family Confusion Assessment method (FAM-CAM) interviews on their loved ones at home in an effort to aid in the early recognition of delirium. This will be accomplished through the followings specific aims. Aim 1: Complete a comprehensive literature review to assess the need for family based screening for delirium. An attempt will be made to identify a gap in the literature for efficient and effective delirium screening and utilization of family caregivers. Aim 2: Data collected in a completed prospective observational study “Family Member Identification of Delirium in the Emergency Department” will be analyzed to assess family caregivers’ role in recognition of delirium, and family caregivers’ receptiveness and interest in a training program. METHODS: The information in this thesis used to build the argument for FAM-CAM training was found through a comprehensive review of published literature on delirium. Resources were found mainly through Pub Med and the Hospital Elder Life Program’s Delirium Bibliography. The study; “Family Member Identification of Delirium in the Emergency Department” enrolled 63 patients for CAM only and 108 Dyads for CAM and FAM-CAM with a total N of 171. RESULTS: Results showed that in 60% of cases of delirium that were recognized by physicians, a caregiver was present and provided information on the patient. Without being made aware of potential benefits of FAM-CAM training, 34% of caregivers reported that training on the instrument would be helpful, and 46% showed interest in participating in the training. Concurrent with current research a high percentage of patients with history of dementia were found to be delirious, further exemplifying the link of risk between these two conditions and identifying caregivers of dementia patients as a good population to implement FAM-CAM training. DISCUSSION: This literature review and accompanying study data suggests that, if implemented, FAM-CAM training could lead to potential future benefits including, reduced delirium associated healthcare cost, improved patient outcomes, and an improved experience for caregivers.

Magister Artium (Social Work) - MA(SW) / A qualitative study was conducted to explore and describe the factors that hinder parent involvement in the High Five Life Skills Programme for at risk children. Parent involvement remains a challenging phenomenon, which affects not only the child, as an individual, but also the family in society. However, although parenting children is perceived to be an important responsibility, parents do not receive any formal training on how to be good parents. An explorative and descriptive research design was utilised. Data collection was done by means of semi-structured interviews and focus group discussions, with the parents/guardians and children in the High Five Life Skills Programme, as well as the teachers, who refer children to the programme. The method of non-probability sampling, employed in this study was purposive sampling. The sample was selected on the basis of the researcher’s own knowledge, as well as the purpose of the study. Data were analysed using the nine steps proposed by Creswell. The results highlighted six barriers that hindered parent involvement in the High Five Life Skills Programme, namely, Low self-esteem of parents/caregivers and children; Lack of communications between all relevant parties - caregivers, teachers and the facilitators of the High Five Life Skills programme; Lack of role models: Parents’ not being role models as their own negative behaviour hindered their involvement; Lack of an emotional bond between parents and children, coupled with absent fathers; Lack of parents’ parental skills and support networks; and the lack of resources and support with transport to and from meetings, as well as child care for younger siblings. The participants, especially the children, freely expressed themselves, and contributed to the results; thereby assisting the researcher to explore the barriers that hinder parent involvement in the High Five Life Skills Programme. It is anticipated that the results of this current study will form a basis for the High Five Life Skills Programme to develop strategies that respond to the needs of the parents and children involved in the programme.

Nas últimas décadas houve o aumento da ocorrência de doenças crônicas no Brasil, dentre elas o Acidente Vascular Encefálico (AVE) se destaca. O AVE frequentemente acarreta perdas funcionais e a dependência por cuidadores. A compreensão da percepção da Qualidade de Vida (QV) e o impacto do AVE sobre os acometidos e seus cuidadores torna-se muito importante, uma vez que se apresenta como um problema de saúde pública no país. Este estudo teve como objetivo avaliar a QV dos indivíduos acometidos por AVE e a de seus cuidadores e também descrever o perfil sociodemográfico e clínico. Tratou-se de um estudo observacional do tipo inquérito transversal, desenvolvido em um município do Triângulo Mineiro envolvendo 83 indivíduos que sofreram um AVE sendo todos assistidos pela Estratégia Saúde da Família (EsSF). Os indivíduos participantes foram separados em 4 grupos, sendo o grupo dos indivíduos com AVE que possuem cuidadores (44), grupo dos indivíduos com AVE sem cuidadores (39), grupo dos cuidadores (44) e um grupo de referência (83) no período de março a maio de 2010. Foi utilizado um questionário contendo dados sociodemográficos e clínicos para os indivíduos com AVE e cuidadores. Para avaliação da QV o instrumento WHOQOL-bref (World Health Organization Quality of Life-bref) foi aplicado à todos os grupos. Para os dois grupos de indivíduos com AVE ainda foi aplicado um instrumento específico denominado SSQOL (Stroke-specific of Quality of Life). Os indivíduos com AVE tinham idade média de 61,93 anos, a maioria do sexo masculino, casados, religião católica, aposentados/pensionistas, baixa renda e responsáveis por ela, baixa escolaridade e 53% possuíam cuidador. Os cuidadores tinham idade média de 49,25 anos, maioria do sexo feminino, filhos (as), casados, religião católica, exerciam outra atividade, baixa renda e escolaridade, longo tempo de cuidado e não tinham dificuldade para o cuidado. O AVE do tipo isquêmico foi o mais encontrado, tempo de diagnóstico de 5 ou mais anos, presença de antecedentes familiares (41%), recidivas (20%) e 51% dos indivíduos possuíam algum grau de dependência. Estavam presentes o tabagismo (54%), etilismo (27%) e a hipertensão arterial (94%). Em relação à QV geral o grupo de AVE com cuidadores apresentou o menor escore. Podemos observar que nos domínios físico, psicológico e meio ambiente o escore médio foi menor para o grupo de AVE com cuidadores. Os maiores escores para estes três domínios foram observados de forma crescente no grupo de AVE sem cuidadores seguido pelo grupo de cuidadores e pelo grupo de referência. No domínio relações sociais observamos que o escore para o grupo de AVE com cuidadores (71,02) foi um pouco maior que o escore médio do grupo de AVE sem cuidadores (70,94). A comparação dos escores em todos os grupos evidenciou que a presença do AVE e o fato de ser cuidador afeta a QV em todos os domínios do WHOQOL-bref. A QV avaliada pelo SSQOL evidenciou que os domínios mais afetados foram o da personalidade, papéis sociais e energia. Ao compararmos os dois grupos com AVE observamos que 6 dos 12 domínios apresentaram diferenças significativas. Esta pesquisa pode ajudar a entender o impacto que o AVE causa na vida dos acometidos e na de seus cuidadores, assim como melhor orientar políticas públicas destinadas a esta população. / There was a raise of chronic diseases occurrence in Brazil in the last decades, among them the stroke detaches itself. The stroke, frequently leads to functional losses and dependency for caregivers. The awareness comprehension of the Quality of Life (QOL) and the stroke impact to the patients and their caregivers become very important, once it shows itself as a healthy problem in the country. This research aimed to evaluate the QOL of patients suffering from strokes and their caregivers and describe the sociodemographic and clinical profile. It was a transversal inquire observational research developed in a city of Triangulo Mineiro involving 83 people who suffered a stroke are all assisted by the Family Health Strategy (EsSF). The participants were separated in 4 different groups: the ones with stroke who had caregivers (44); the ones with stroke without caregivers (39); caregivers group (44) and a reference group (83) from March to May 2010. It was used a questionnaire with the social demographic and clinic dates to the people with stroke and caregivers. To evaluate the QOL it was used the tool WHOQOL-bref (World Health Organization Quality of Life-bref) in all the groups. For both groups with of individuals with stroke has been applied another specific tool called SSQOL (Stroke-specific of Quality of Life). The average age of stroke people was 61,93 years old, most of them male, married, catholic, retired, underpaid and responsible for it, not properly educated and 53% had a caregiver. The caregivers were 49,25 years old, most of them females, daughters and sons, married, catholic, had another activity, underpaid and not properly educated, long care period and had no problems for this activity. The skemical stroke was the most common to be found, 5 or more years of diagnosis time, previous familiar case (41%), repetitions (20%) and 51% 51% of subjects had some degree of dependence. Among them we found, smoking (54%), drinking (27%) and high blood pressure (94%). About general QOL the strokes group with caregivers showed a lower score. We observe that the physical, psychological and environmental domain, the average score was inferior to the strokes groups with caregivers. The highest scores for those three groups were observed increasingly in the strokes group without caregivers followed by caregivers group and the reference group. About the social relation domain, we could see that the strokes group with caregivers score (71,02) was similar the average score from the strokes group without caregivers (70,94). The scores comparison showed that the strokes presence and the fact of being taken care affects QOL in all the domain of the WHOQOL-bref. The QOL evaluated by SSQOL showed the most affected domain were: the personality, social chores and energy. When we compare both groups with stroke we can see that 6 of 12 domains showed significant differences. This research can help o understand the strokes impact in the victims and caregivers lives as well better guidance at public polices for this population.

MSc Occupational Therapy, Faculty of Health Sciences, University of the Witwatersrand, 2009 / An increase in the prevalence of ASD has led to increased demands on service provision. This questionnaire-based, descriptive study aimed to explore service use and experiences of health and education service delivery by caregivers and their children with ASD in Johannesburg. The sample size was 39. Comparisons were drawn between the experiences of the participants accessing the private and public service sectors. Children were diagnosed at an average age of 4 years; 2 years after the first symptoms were noted by their caregivers. Families accessed a mean of 3 institutions and 6 professionals in seeking diagnosis and treatment. No specific referral patterns could be established. Challenges to service access identified by caregivers included: logistical problems, lack of professional knowledge and experience, poor parental coping and insight, and lack of community support. Solutions identified by the caregivers included: marketing, training, better referral procedures, and establishment of educational facilities.

ABSTRACT Stressors that custodial grandmothers face while raising children with disabilities can be more overwhelming compared to stressors experienced by grandmothers of non-disabled children. Strategies and various supports were looked into in order to determine how custodial grandmothers practice self-care so they may experience positive mental health outcomes. A purposive sample of custodial grandmothers was surveyed and the results obtained provided some support on how self-care is and is not practiced in order to manage stress. This study resulted in non-significant findings, which did not support the hypotheses. Additional analysis was used to gauge levels of stress, but could not provide evidence to support the hypotheses. Overall, understanding the challenges custodial grandmothers face while raising disabled children has provided insight to the occurring stressors, practicing of self-care to aid in promotion of positive mental health outcomes, and the need for further research to address this population of people.

The purpose of this research was to explore the gender differences in caregiver burden in Alzheimer’s patients in the Inland Empire. Currently, there are more than half a million Californians who live with Alzheimer’s disease (Ross, Brennan, Nazareno, & Fox, 2009) and this number is expected to double over the next few years. Due to an increase in the older population and the rise of informal caregivers, the study provided insight as to how males and females perceive caregiver burden and how each gender responds to caregiver burden. This exploratory study utilized a quantitative research design through the use of questionnaires which measured caregiver burden through the use of the Zarit Burden Interview. A total of 38 participants were recruited through support groups at the Inland Caregiver Resource Center. Though findings did not suggest a gender difference in caregiver burden, they did indicate that there was a relationship between ethnicity and gender in relation to the caregiver and care receiver relationship. Implications for social work practice include assessment for and aid in the development of gender appropriate resources for informal caregivers of Alzheimer’s patients.

Individuals diagnosed with 22q11.2 deletion syndrome (22q) have many barriers and quality of life issues associated with the condition. Without an obvious anomaly, affected individuals may live years without a proper diagnosis. The purpose of this qualitative case study research was to explore perceptions of caregivers of individuals with 22q. Uncertainty in illness theory was used as it describes the inability to find answers with unpredictable medical issues. The central research question focused on at how challenges associated with a 22q diagnosis are addressed. Interviews were conducted with 10 caregivers. Guided by the uncertainty in illness theory, data analysis was conducted by coding through NVivo to find themes. Themes identified included, but were not limited to: (a) age and symptoms at diagnosis; (b) usage of the internet for answers; (c) future transition uncertainties; and (d) lack of provider knowledge. Five out of 10 participants had a child with a known heart condition at birth, which led to a 22q diagnosis. Five out ten individuals with 22q were diagnosed at a later age following a manifestation of other serious conditions. A greater index of suspicion could have led to a more timely diagnosis of 22q. All individuals expressed the desire for a more prompt and thorough diagnosis. The positive implications for social change include influencing physicians and policy makers through education and implemented policies that can lead to more timely diagnoses and treatment for better health outcomes. This social change can influence the target population through scholarly publications in medical journals. It may also be influenced through policy proposals influencing early detection screenings at birth. The addition of caregiver advocates may also bring about change within the 22q community.

Lacking a healthy attachment to a caregiver and having in-utero methamphetamine exposure have been linked to a variety of cognitive delays, developmental delays, and mental health issues throughout a person's lifespan. It is unknown if there is a relationship between in-utero methamphetamine exposure and the ability to build a healthy attachment to a caregiver. The purpose of this generic qualitative study was to improve understanding of the perceptions of caregivers about attachment efforts for foster children under the age of 3, who have had in-utero methamphetamine exposure. This study was guided by attachment theory. Purposeful sampling was used to select 7 participants who had provided care to foster children with in-utero methamphetamine exposure within the last year. Data were collected through the use of semistructured interviews, which were conducted in-person, audiotaped, and then transcribed. Data was analyzed through text searches of themes, axial coding, and repetitive words. Trustworthiness was obtained through member checking and generating a rich description of the participants' experiences. The findings revealed that many of the participants feel that these children do not respond to their efforts to build a healthy attachment to them. They also felt that the foster children did not process stimuli, such as touch, in the same way as other children; that the foster children found such interactions to be aversive. The findings of this study have the potential to impact social change by assisting therapists, caseworkers, and foster parents better understand the needs of foster children and to create a foundation for interventions to better serve foster children with in-utero methamphetamine exposure.

本研究目的係為探索中年未婚女性畢業照顧者之生活經驗，以瞭解其生活調適情形與對未來生活的規劃，促使社會工作者對畢業照顧者有更深層的認識，並作為未來擬定處遇計畫及支持性福利措施或方案的參考。本研究採用質性研究中的深度訪談法，以立意取樣選取8位符合研究條件（照顧失能家人之時間至少需達1年以上；且被照顧者已逝世，照顧者脫離照顧身份時間已達6個月以上）之受訪者。主要研究結果分述如下： 一、成為「畢業照顧者」的心情包含：卸下重擔的輕鬆感、感傷自己孤獨一人、慢慢釋放的壓力等三種類型，因應受訪者的照顧年資、畢業年限、被照顧者的自我意識是否清楚，以及自身適應能力等差異，呈現出迥然不同的情緒反應。 二、中年未婚女性畢業照顧者之生活重心移轉情形，依「程度」劃分出：頓失生活重心、摸索生活重心、重拾生活重心等三類，並將「場域」劃分為：職場工作、志工、社交與休閒娛樂等。呈現出畢業照顧者的生活重心由「逝者」漸轉移至「生者」，進而開始重視自身需求的情形。現階段遇到的挑戰包含：（1）不易重返職場；（2）孤獨與寂寞；（3）處理內心解不開的結。 三、對於老年生活的規劃，研究結果指出：（1）理想居住型態有二，以與單身未婚的朋友共居為主，進住養老院為輔；（2）為降低個人在晚年生活的風險，體認保健、保險與儲蓄的重要性。（3）作好面對死亡的準備，包括預立遺囑、遺產分配、接受安寧療護的意願釐清，以及身後歸屬與處理方式等。本研究彙集了受訪者分享「當照顧已成往事」的心得，有感於畢業照顧者淬鍊過後的人生智慧益發顯得寶貴，本研究歸納出：重拾原有的夢想和興趣、把握當下與志工生活，以及注重生命品質等三項重點作分享。 根據研究結果進一步討論發現：（1）中年未婚女性畢業照顧者面臨喪親時的調適方式與一般人相去不遠，相異之處在於照顧工作帶給她們身體、心靈、社交活動上的影響，導致畢業照顧者容易出現「筋骨酸痛」、「失落又解脫的矛盾心情」與「不易重返職場」等特殊需求，進而需要「職能治療與復健」、「專業心理諮商」以及「提供友善政策以支持重返職場」等專業服務或福利政策；（2）畢業照顧者因提前接觸老年與臨終生活，彷彿替自己預習了老年生活與死亡的課程，這種經驗將有助於自身面對老年生活的態度與適應；（3）中年單身者擔憂未來失去生活自理能力後的照顧問題，我們必須正視此一中高齡單身族群的照顧議題，文末並依結果分析提出對社工實務、政策與未來研究之建議。 / The purpose of this study was to explore the life experience that former caregivers which were unmarried middle-aged female, to understand the life adjusting and future planning, and to promote social workers to get deeper understanding for the former caregivers in order to help draft the action plans and supporting welfare measures or projects. This research employed qualitative methods. The researcher conducted semi-structural interview with eight former caregivers individually, and collected in-depth data. 8 interviewees who conform to research conditions (time of taking care of disabled family members is at least more than 1 year; if care receiver passed away, the time that caregiver loses care-giving status has been more than 6 months) are selected by purposive sampling. The study findings after data analyzed are listed below： First, the feelings of became former caregivers were three types： The relaxation of unloading the heavy responsibility, loneliness and strain was slow down. Research results demonstrate totally different emotional responses according to differences, including interviewee’s care-giving seniority, years of graduation, whether care receiver’s self awareness is clear or not, and self adaption ability. Second, As for middle-aged single female former caregiver’s life center shift condition, it can be divided according to “level”: three kinds including losing life center, exploring life center, and regaining life center. In addition, it can also be divided according to “field”: workplace, volunteer, social and leisure entertainment. The conditions that former caregiver’s life center gradually shifts from “dead” to “living”, and begins to attach importance to self requirements are demonstrated. The challenges in current stage include:（1）Not easy to go back to workplace,（2）solitude and loneliness, and（3）dealing with the untied knot in heart. Third, Concerning the planning of old age life, research results indicate that:（1） There are two ideal living styles, which is mainly living together with single friend supplemented with living in House for the Aged,（2）in order to reduce individual risk in old age life, and realize the importance of health care, insurance, and saving.（3） Prepare for facing death, including living will, estate distribution, clarification of willingness to accept hospice care, after-death ownership and disposal method. This study summarizes interviewees’ experiences of sharing “when care giving has become bygones”. Realizing that former caregiver’s life wisdom is valuable, it is summarized in this study: Sharing the three points including regaining the original dream and interest, seizing the moment and volunteer life, and focusing on life quality. Based on the findings of this research, the researcher finds three points：（1）middle-aged single female former caregiver’s adjustment method when facing bereavement is quite similar to general people. The difference is the effect of care giving work on their body, mind, and social activity, which easily induces former caregiver’s special requirements including “aching muscles”, “ambivalence of loss and relief”, and “not easy to go back to workplace”, and then professional service or welfare policy including “occupational therapy and rehabilitation”, “professional psychological counseling” and “providing friendly policy to support going back to workplace” are required.（2）Former caregivers contacts old age and death life earlier, so it is just like to preview the lesson of old age life and death for themselves. This kind of experience will be helpful for the attitude and adjustment of facing old age life.（3）Middle-aged single people worry about the care giving problem when they lose life providing ability in the future, and we must face the care giving issue of this elderly single group. The outcome could be the suggestions for the social work practice, social policy and future research.