Abstract This paper discusses that the time and effort, both physical and emotional, required to provide compassionate, timely and appropriate caregiving to another person can assume mammoth proportions, but the hospice approach has been proven to be an invaluable asset for home-based caregivers. The author points out that hospice refers to a concept of care rather than a physical location. The hospice movement's goal is not cure, with all of its aggressive interventions, but palliation of symptoms to help manage the psychological and social difficulties encountered by terminally ill patients, their caregivers and family. The paper stresses that the burdensome, demanding and stressful caregiving responsibilities require that the caregivers take adequate time for themselves to prevent caregivers from engaging in abusive behaviors toward their patient.
From the Paper "In fact, by 2025, it has been estimated that there will be over one billion older people worldwide. This extension in life expectancy to well beyond 80 years of age is the result of better public health measures, improvements in living conditions, and advances in medical care. At the same time, there have been some fundamental changes in the American family that have created a wide range of variations, with numerous permutations of step-children, step-parents and step-grandparents being the norm rather than the exception. No longer is the family unit as cohesive as it was, say, in the middle of the 20th century, so the family members who assume caregiving responsibilities for the elderly may not even be directly related to the individual. Studies have shown that the relationships that exist before an individual requires caregiving tends to dictate what type of relationship will continue to exist, but the fact remains although there is universal agreement that full-time caregiving responsibilities are enormously stressful; some people make better caregivers than others."
A thorough study and research about the phenomenon of abuse of the elderly by family caregivers and the factors implicated in the development and perpetuation of such abuse.
Abstract This research investigates the problem of elder abuse. The research focuses on the identification of the factors underlying the problem.
In the study, both the frequency and the severity of physical and emotional abuse are found to be related positively with the level of stress perceived by caregivers, the cognitive status of the elderly person, the physical status of the elderly person, and the substance abuse status of caregivers. Both the frequency and the severity of financial abuse are also found to be related positively with the level of financial stress characterizing the caregiver-elderly person relationship.
The findings of this study that caregiver stress and substance abuse by caregivers affect the frequency and severity of physical and emotional abuse, and that financial stress affects the frequency and severity of financial abuse are consistent with current theory. The findings that the frequency and severity of elder abuse are related to both the cognitive and physical status of the elderly person for whom care is provided, however, are consistent with some current theory but also are contrary to some current theory. The study concludes that further research is recommended to explore in greater depth the relationship between elder abuse and the physical and mental status of the elderly person for who care is provided in a family environment. Further research also is recommended with respect to developing improved schemes for providing financial assistance for such caring arrangements.
Table of Contents
Introduction
Statement of the Problem
Research Questions
Purpose of the Study
Significance of the Study
Definitions of Terms
Overview of the Remainder of the Study
Review of the Literature
Cognitive Abilities and Development
Stress
Related Research
Conclusions Relative to the Study Problem
Method
Hypotheses
Variables and Operational Definitions
Population and Sample
Instrumentation
Data Analysis
Summary
Results
Results Testing Hypothesis 1
Results Testing Hypothesis 2
Results Testing Hypothesis 3
Results Testing Hypothesis 4
Results Testing Hypothesis 5
Results Testing Hypothesis 6
Results Testing Hypothesis 7
Results Testing Hypothesis 8
Results Testing Hypothesis 9
Results Testing Hypothesis 10
Discussion
Summary of the Results
Discussion and Implications for Current Theory
Recommendations for Further Research
Implications for Professional Practice
References
From the Paper "The increasing awareness that some elderly persons are physically abused and neglected by family members has been accompanied by a widespread assumption about elder abuse: that it is inflicted by well meaning individuals, often the adult children of victims, who are pushed over the edge by the stress of caring for a frail, dependent old person. According to Pillemer & Finkelhor (1989), the falsity of that assumption was revealed by findings that relatively well-functioning elderly people were found to usually be the victims of abuse, which is often inflicted by emotionally disturbed or violent family members. A typical abuser was found to be a person who depends on the victim for money, transportation, housing and household repairs. Elderly victims were no more disabled or dependent on their abusers than were comparison subjects on their relatives. Abusers, however, were much more likely than relatives in the comparison group to have been arrested, hospitalized for a psychiatric disorder, involved in violent behavior outside the family, or limited by a physical problem (Pillemer & Finkelhor, 1989). The generalizations of these findings have been challenged by more recent studies (Saad, Hartman, Kurian, Graham, Wilcock, & Ballard, 1995).
Some states have passed laws for mandatory reporting of elder abuse, which means that doctors and social workers must report suspected abuse (Arbetter, 1995). Communities are encouraging neighbors to keep an eye on seniors. Some communities are considering the establishment of shelters similar to those organized for battered women. Some communities also are expanding senior day care services and support services for caregivers (Arbetter, 1995)."
Abstract The writer discusses the ways in which caregiving can be successful or meaningful for those involved with the Alzheimer's patient. The paper argues that the problem is that we live in a society that is not designed to care for an immense aging population with dementia that demands attention seven days a week. Finally, the paper suggests methods for caring for this population.
Table of Contents:
The Problem
Introduction
Statement of the Problem
Purpose of the Study
Importance of the Study
Scope or Delimitation of the Study
Review of the Literature
Introduction
Organization of the Literature Review
Literature Review
Alzheimer's: Causes and Consequences
Causes
Symptoms
Progression
Consequences
Care Options and Financial Considerations
Caregiver Burdens and Non-Medical Admissions
Psychosocial Impact of Alzheimer's Disease
Variables
Impact
Culture
Doing Family Caregiving Well
Coping Strategies
Summary
Conclusion
Implications of the Study
Position of the Author
References
From the Paper "Using neurophysiological methods can also be helpful. For example, using the MRI, measurements of brain atrophy and the hippocampus may help identify dementia development at an early stage. Another problem area that can be measured is hypometabolism in bilateral parietotemporal brain areas. Finally, recent work in biochemistry has identified certain proteins which may be associated with the disease process. These include the A beta 1-42/43 metabolite of the amyloid precursor protein, among others. The authors note that since the mechanism of Alzheimer's is not completely understood, it is important to use many different sources and multiple markers in order to arrive at a good, early diagnosis of Alzheimer's (Almkvist and Winblad, 1999)."
Abstract This paper presents a review of the literature available concerning the relationship between caregivers and the recipients of their care. Particular emphasis is placed on literature that looks at the impact that gender has on the role of the caregiver.
From the Paper "The question of what impact gender has in caregiving and/or the distribution of caregiving tasks among family members when caring for aging parents is a significant one, given the aging of the population and what has been reported as a breakdown in family structure. By far the literature provides information concerning care by the spouse. There is an overwhelming need for studies centered on family members and roles involved in caregiving activities for parents."
Abstract This paper examines how parents and caregivers play a vital role in helping children learn and how it is important for parents and teachers to support children's learning and development, enhance learning through play, and help a child develop confidence and self-worth. It looks at how education innovators, such as Jean Piaget, Robert Owen, Jan Amos Komensky, and Jean Jacques Rousseau, have all had a great impact on education today and discusses how these innovators have impacted the author's belief about how parents and caregivers play a vital role in a child's learning.
From the Paper "Play is one of the main ways in which children learn. Because play is fun, children often become absorbed in what they are doing. It is important for a parent and a caregiver to provide appropriate materials for children to explore. Also, it is important for the parent and caregiver to give the child freedom in what they are exploring, and to facilitate the child. As Piaget stated, ?Discovery learning and supporting the developing interests of the child are two primary instructional techniques. It is recommended that parents and teachers challenge the child's abilities, but NOT present material or information that is too far beyond the child's level.? (http://ship.edu/-cgboeree/piaget.html) The materials provided must be developmentally appropriate for the children. Also, they should meet the children's interests."
Abstract This paper discusses how a person's illness usually spills over to the family and friends who surround them and how, although they may not feel the same type of mental pain as their crippled loved ones, they are also victims. It looks at how these caregivers are weighed down with the many burdens that come with providing for a mentally ill person and examines how to keep them from becoming ill and overwhelmed themselves. These caregivers need information and advice on how to cope with their ill relatives.
From the Paper "Caregivers also suffer from subjective burdens, or emotional issues because they are having problems with their coping skills: They have feelings of guilt, remorse, anguish, stress, self-blame, depression, anger and grief. The providers feel badly about not doing enough, remorse at the changes occurring, anxiety and fear about the future, and frustration about the many ways that this illness has changed their family members? lives. Caregivers often have to put their own plans on hold, which can lead to feelings of anger and resentment. On top of this is the disruption of social activities due to the stigmatism associated with mental illness."
Abstract This paper discusses abuse in general, with a focus on abuse of the elderly. The paper examines the relation between the stress levels of the caregivers and the abuse of the patients. The paper defines elder abuse and presents a profile of the elder abuse victim. Factors contributing to abuse are explored and the relevant statistics are provided.
Outline
Introduction
Emergence and Social Construction of Family Violence
Domestic Violence
Child Abuse
Animal Abuse
Elder Abuse
Statistics Regarding Elder Abuse
Laws and Legislation
Elder Caregiver Stress
The Future: Prevention or Eradication of Elder Abuse
From the Paper "While many believe domestic abuse to be a relatively new problem, in fact, it was widely recognized as a problem in U.S. society as early as the beginnings of the temperance movement that began in about 1880. Indeed, it is arguable that the issue of familial stress was also a factor in that early recognition, as well as that recognition preceded the temperance movement's rise. The Woman's Christian Temperance Union was the foremost proponent of morality in many arenas during that time, and often presented its agenda concerning morality, temperance and aesthetics in drama. "The Little Captain," a temperance melodrama, was one such that "focused most exclusively on the social and familial effects of alcohol by explicitly detailing family violence. WCTU editors expected its unrelentingly miserable content to be so unappealing to youth that it could act only as a deterrent. The 'fallen' character in the melodrama, James Grey, was a father of four young children who was ruined by alcohol and destroyed his family in the process" (Parker, 1999)."
Abstract This paper examines factors regarding selecting care for one's elderly parents - the balance of work and caregiving; choosing an agency or home; guardianship; involvement of other family members and finally the stress factor. The paper also looks at one theory about caregiving known as the exchange theory.
From the Paper "Some of these changes will come through health care reform. Granted, Medicare and Medicaid help a lot with parent caregiving, but they do not go far enough. One perfect example is the situation of immigrant elderly parents. Parent caregiving for immigrant parents is utterly non-existent on the federal and state government agendas, and this creates a situation in which elderly Americans' health deteriorates because minor conditions are exacerbated via missed doctor visits and checkups.
It is simply too expensive to care for an immigrant elderly parent in this country, and the resulting health care decisions are often highly inefficient, not to mention destructive for the parents' health too.
Some provisions must be made for caring for these elderly immigrant parents who cannot live on their own and support themselves.
These changes will not solve the problems of parent caregiving in America; they will, however, make it easier for the adult children to exercise their reciprocal roles and ensure their parents longer, happier, healthier lives."
Tags: health, care, aging, agency, stress, guardianship
A research proposal to study the design and development of effective intervention programs to encourage foster-parent/caregiver and child relationship attachment.
Abstract This paper explains that the objective of this research proposal is to design a research initiative to apply the attachment theory foster-parent/caregiver and child relationships through means of an observational study or survey/questionnaire. The author seeks to understand why the attachment between the parent/caregiver/foster parent and the child is so important to the development of the child as presented in attachment theory. The paper presents a literature review, which supports these findings and highlights the significance of activities of continuity of the child in foster care.
Table of Contents:
Introduction
Background of the Study
Statement of Problem
Purpose of the Study
Rationale
Research Questions
Limitations
Definitions of Terms
Organization of the Remainder of the Study
Literature Review
Findings
Recommendations for Research
Methodology
Research Design
Instrumentation and Data Collection/Analysis
Population/Sample for Data
From the Paper "Caltabiano and Thorpe relate that in order to understand these attachment models from the adult relationship perspective research has relied on interviews or self-reporting methods to learn in this area. The 'Adult Attachment Interview' was reported in the work of George, Kaplan & Main (1984) in research that conducted an in-depth exploration into the nature of the adult individual's childhood relationships to their caregiver. Another method utilized in this are of study is the self-report instrument known as the 'Attachment Style Questionnaire' (ASQ) as noted in the work of Feeney, Noller & Harahan (1994)."
Abstract This paper examines the pros and cons of hiring a domestic caregiver and shows how people contradict themselves when choosing help.
From the Paper "Julia Wrigley, author of Other People's Children, and her assistants controlled 177 concentrated, tape-recorded interviews. 76 interviews were with caregivers, 79 were with employers, and 22 with coordinators of agencies who specialize in domestic employment (p.x). The purpose of these interviews, to assess private childcare assortments as viewed by the domestic caregiver as well as the employers. The observations and sentiments formed by the different array of individuals tends to contradict itself, while some people have positive views of domestic caregivers, others resent placing their child or children under the care of incompetent caregivers. Yet, even those who realize the trials and tribulations of domestic caregivers, they may also apprehend the indubitable soundness of live-in caregivers. One such contradiction is that of employers who are more likely to hire subordinate caregivers because they are less expensive; however, they would prefer a better-educated caregiver that articulates English well."
Abstract A number of studies have been conducted over the past decade that provide insights into the type of emotional problems that can occur in the caregivers. There is also research that is done to determine the means by which the emotional turmoil can be reduced if not eliminated. This paper offers example of both types of studies. Although any type of illness can be used, a number of these articles use the emotional problems resulting from having a parent who is suffering from Alzheimer's disease. It explains that this illness can be very similar to dementia that often afflicts the elderly.
From the Paper "Increasing numbers of the babyboomer generation are having to take care of their aging parents in addition to other responsibilities, such as sending their children to college and working full time to pay for rising expenses. The degree of stress that occurs regardless when caring for someone who is ill, is aggravated because of emotions including guilt that one is not doing enough, fear that a loved one is suffering, sadness that a life is coming to an end and depression from frustration and exhaustion. Resources are another difficulty. In many cases, the older children do not even live in the same area as their aging parent and have to find services that are at a premium and vary considerably from one place to the next. Or, if living near one another, considerable time is required to run errands, go to and from the doctors, and respond to phone calls at all time day and night. It takes its emotional toll upon the strongest of individuals. Until recently, discussion of care giving focused on the recipients of care. However, increasingly specialists are addressing the needs of relatives and other informal caregivers."
Abstract This research examines differences in physical and mental health status between minority-group grandparents raising grandchildren and those who are not involved in this care-giving role. The discussion builds on earlier studies of grandparent caregivers, using a national data set, but it is unique in that it explores the physical and mental health of the growing sub-population of minority-group grandparents who are raising grandchildren.
Table of Contents:
Introduction
Review of the Literature
Methods
Results
Discussion
Implications for Research and Practice
Conclusion
From the Paper "Minority caregivers will be significantly more likely than their non care-giving peers to have limitations in four of the five activities of daily living (ADL) investigated . Caregivers will have more problems moving around inside the house and doing day-to-day tasks. The levels of limitation will be quite substantial, with 29 percent of caregivers reporting "a lot of limitation" climbing a flight of stairs and two of five caregivers indicating that they will have a lot of limitation walking six blocks. Approximately two-thirds of caregivers will have at least one limitation, and the mean number of limitations will too. No significant differences will be found between Minority caregivers and non-caregivers with respect to self-reported health status or with their reported ability to bathe, dress, and provide other personal care."
Abstract This paper defines a caregiver, both primary and secondary caregivers, as anyone who is able and willing to carry out the numerous tasks associated with managing an Alzheimer and Dementia Disease (AD) patient and specifically describes California caregivers, spouses, adult sons and daughters. Latino caregivers and men and women caregivers. The author points out that, although there is a wealth of research into caregiving by women, there is relatively little literature about caregiving by men because the overwhelming of number caregivers for AD patients are women. The paper concludes that sons as caregivers have generally assumed their role voluntarily rather than as a cultural expectation as is the case with daughters; men have been shown to keep their caregiving role a secret from their workplace: Society has not yet granted sons equality in this arena. Six tables.
Table of Contents
Introduction
Statement of the Problem
Need for the Study
Goals of the Study
Limitations of the Study
Delimitations of the Study
Objectives of the Study
Operational Definitions
Literature Review
What is Dementia?
What is Alzheimer's Disease?
Research on Alzheimer's and related Dementia
Who is a Caregiver?
Differences between Primary and Secondary Caregivers Profile of California Caregivers The Role Theory
Spouses as Caregivers Adult Children as Caregivers Women as Caregivers Men as Caregivers The Differences between Men and Women as Caregivers Caregivers' burdens
Caregiving Outcomes
Research Methodology
Results and Discussion
Findings
Discussion
Summary and Conclusion
Support Groups and Other Resources for Caregivers
From the Paper "Dementia is a word most people think they can define. Classically trained individuals will suggest it is simply the state of being "out of one's mind," based on the Latin roots of the word. But it is, these days, a state of being that is highly technically described, and a diagnosis of dementia-Alzheimer's or any other variety-is generally arrived at by batteries of tests. Functioning in regard to the material tested is assessed; those deviating too far from the norm are likely to be classified as suffering dementia. Lucas notes (1995) that "Clinical assessment has lagged behind research in memory disorders," but it is believed now that memory is regarded as a heterogeneous entity which is comprised of distinct systems; for example, long-term vs. short-term memory, and encoding vs. retrieval memory, and several other pairs of related brain functions. Memory, Lucas suggests, is at the root of a definition of dementia, and he explains a wide variety of memory types in locating dementia."
Abstract The advancements in medical facilities have considerably increased life expectancy of Americans and, consequently, there is a surge in the aged population. Caring for the increasing "aging population" has become an important issue in the health care field. This paper discusses some of the important aspects of caring for the old and the effects on the caregivers in a detailed manner. There are a lot of practical problems associated with old age caring. The paper discusses the financial burden, health impact, and time constraints on the caregiver.
Paper Outline
Introduction
Aging and Society's Outlook
Emotional Stress in Caregiving Caregiving, Employment and Financial Aspects
Conclusion
Bibliography
From the Paper "Another aspect that is attendant with the caregiving is the time and attention that the task demands. A survey conducted revealed that around 7% of informal caregivers had to quit their jobs, being unable to divide their time between caregiving and work. Even if they continue in their present jobs there is an observed fall in their productivity because of their constant preoccupation with the caring task. ?The aggregate costs of caregiving to US businesses in lost productivity are at least $11.4 billion per year,? [Salvatore J. Giorgianni]. About two out of five caregivers responded that the number of hours that they worked has been greatly reduced. About 40% of the caregivers had to take unpaid leave of absence of around 17 days a year, which reflects as 8% of their yearly work time. [Marc A. Cohen] In many cases, looking after seriously disabled and chronically ill elders would necessitate fulltime care. Quitting jobs added to the already mounting financial burden."
Abstract Pain management is an issue which has come a long way in the last few decades, especially when viewed in the setting of pain management in the terminally ill population. It is widely held that many effective pain management therapies are available, yet many patients still undergo severe pain at the end of life due to a lack of knowledge surrounding the effective use of pain control methods on the part of physicians and caregivers alike. Patients and caregivers in this study are provided with pain management education, both on what is to be expected and what can be done. Patients and caregivers are surveyed both before and after the education and the level of pain management is assessed to see if greater knowledge surrounding therapeutics and expected outcomes can improve patients' subjective perception of pain control and ultimately terminally ill patient comfort.
From the Paper "In the last forty years, amazing progress has been made in the management of patients at the end of life. Patients who are at the end of life often rely on caregivers for support, both emotionally and literally, surrounding concerns about the process of dying. Caregivers are often left to make decisions on how to manage panoply of symptoms including things like breathlessness, physical and mental incapacity, and most of all the effective management of physical pain. The last four decades have shown the medical profession much about how to address these issues with appropriate palliative management, yet often times these issues are not adequately addressed by the caregiver, either because of lack of knowledge or lack of resources. When these issues remain unattended, they often lead to increased anxiety, depression and physical and mental stress, both for the ill patient and for the home care giver. What is the best practical approach to the management of pain in the home care of terminally ill patients? How can these patients be adequately assessed for current and future palliative needs? How are medications chosen? How is an adequate dose determined? And how can the home caregiver ensure all these criteria are met, and the patient made as comfortable as possible."
