**5. Discussion**

The profile of family caregivers was defined in both groups, with the mode being female (72% and 78%). The mean age is close to 63 years, a result similar to other studies [7, 24–26]. Most are married women and daughters who live with their parents, as other studies have shown [7, 27–29].

The mean age of caregivers justifies the higher frequency of retired participants. Most are female, which explains the traditional role of women in the family in western society that is associated with caregiver roles. Caregiver daughters are predominant [26]. The fact of being "married" is in accordance with the characteristics of the Portuguese population [30].

In both groups, the elderly have a mean age of 80.3 years, which corresponds to advanced age. Elderly widows in the CG are twice the number found in the IG, which is explained by the predominance of elderly women in the control group, as the average life expectancy of women is higher than that of men [31].

The elderly caregiver in the IG is more dependent regarding the activities of daily living when compared to the elderly in the CG. In both groups, dependence is at the "highly dependent" level, which means that the caregiver takes responsibility for care to support the ADL [24].

There is a similar level of burden risk between the two client systems, with a predominance of moderate risk [31].

In terms of duration of care, most have been caregivers for one to three years. This value is lower than that found in other studies, in which the care duration was more than five years.

Regarding the "daily hours dedicated to care" in the two client systems, the most frequent category is "more than 10 hours a day," which is identical to what was found in other studies [24, 26].

In the present study, at the same evaluation period (T1) we found statistically significant differences in both groups, specifically in the normal line of defense variables of "total burden" (physiological variable) and "caring expectations" (sociocultural variable). The results obtained for these variables in the intervention group show its disadvantage when compared to the control group, but the data also reveal that the elderly were older in the intervention group and were more dependent regarding the activities of daily living.

During the follow-up (T3) the IG client system showed a better assessment of the "global burden", which varied from intense to moderate, while the burden remained moderate in the CG, considering that this change results from the intervention [31].

Also during the follow-up (T3) the study showed the effect of the nursing intervention on coping strategies with statistically significant differences in the IG client system. The intervention facilitated the process that allowed caregivers to find coping strategies with the available resources, focusing on the most effective ones to meet their needs. The intervention allowed the caregivers in the intervention group to focus on the sources from which they received support, when compared to the CG client system. The results show that in the period after the intervention, the intervention group used coping strategies related to the search for support [31].

The greater dependence regarding the ADL in the IG explains the increase in the time spent by the caregiver, when compared to the CG. These differences are statistically significant. The results confirm that the increased ADL dependence by the elderly increases the time of care provision [32].

*Safety in the Home Care Environment of Families Caring for the Elderly DOI: http://dx.doi.org/10.5772/intechopen.107862*

Due to psychoeducational interventions, caregivers in the intervention group were more empowered, improved social skills, sought support, and disclosed more knowledge of the available resources, which reduces feelings of isolation and stigma [33].

Informal support provided to caregivers declines over time. Nursing guidance is needed to mobilize the community resources and help the system to prevent disruptions and maintain homeostasis [13].

The economic costs of dependent elderly people have increased and the families need help. In the LR at the post-intervention moment (T2), the IG client system increased the percentages of "received support," "payment for received support," "hours of received support," and "home support" in relation to the CG. The increase in these categories occurred over the eight months of the research and is related to the increase in the dependence of the elderly, which has costs associated with care [32].

It is necessary to have policies to support family caregivers. Law N. 100/2019 approves the informal caregiver statute, which regulates the rights and duties of caregivers in Portugal [34].

The health system understands that the family caregiver is a resource, but it is necessary to change the paradigm and understand this is a vulnerable group who needs to be taken care of. The literature refers to the tendency of health professionals to abandon care for less empowered families [34].

At T3, the IG showed the best coping when compared to the CG, with statistically significant differences, which is verified in other studies in which the psychoeducational program was applied [31]. The caregivers must be taught to associate a stressful situation with a coping strategy, making them more effective in the management of difficulties [27].
