Más contenido relacionado La actualidad más candente (19) Similar a Ch12 caring for the frail elderly rev 11 11 (20) Ch12 caring for the frail elderly rev 11 112. A PROFILE OF CAREGIVING
Approximately ____ million
people needed some assistance with daily
living
Only ___ percent of people aged 65 to 69
need help with activities of daily living.
While ___ percent of those older than 85
needed help
_______ are most likely to provide care to
aging parents. followed by a __________
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3. FAMILY CARE
A PROFILE OF CAREGIVING
Activities of daily living (ADLs): questionnaire is
designed to measure the capability of elderly living
on their own.
Instrumental activities of daily living (IADLs):
keeping track of money, doing light
housework, taking medicine, running errands.
Long-term care: a range of services designed to help
people with chronic conditions compensate for
limitations in their ability to function independently.
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4. GENDER DIFFERENCES
IN CAREGIVING
Primary caregivers: usually women;
Why?
tends to be the daughter who has fewer competing
obligations.
Usually one who is not working or is unmarried – many
daughters take on the caregiving role regardless of their
other responsibilities.
Gender differences in the caregiving experience may
reflect that daughters perform more intimate tasks
for their elderly parents than sons do and that they
spend many more hours providing care.
© 2011 McGraw-Hill Higher Education. All rights reserved.
5. WORK AND
CAREGIVING
__/__ of caregivers are no longer
working, __/__ are employed full-time or part-time.
Since 1970, there has been a substantial increase in paid
employment among women.
Why would Caregivers experience greater job stress and
more work/family conflicts than non-caregivers?
Employer concerns over caregiving
Employers often recognize that caregiving affects the job
performance of caregivers.
© 2011 McGraw-Hill Higher Education. All rights reserved.
6. THE CAREGIVER
BURDEN
The Cost of Being a Caregiver
Many caregivers are additionally stressed by financial
worry associated with paying for home care
services, health care, nursing home care.
Caregiver burden: management of the tasks.
Coping Skills
Caregiver stress: the strain felt by the caregiver.
The degree of stress felt by a caregiver depends partly on the
coping skills she or he may have developed to deal with other
life events, and partly on the kind of social support available.
© 2011 McGraw-Hill Higher Education. All rights reserved.
7. HOW CAREGIVING AFFECTS FAMILY
RELATIONSHIPS
First research on caregiving focused on primary
caregiver in isolation from other family members.
New research suggests that caregiving not only affects
the emotional well-being of the caregiver but
reverberates across other family relationships.
Caregiving can also be a positive influence on the family
relationship by bringing kin together to accomplish a
shared goal.
© 2011 McGraw-Hill Higher Education. All rights reserved.
8. THE EFFECT ON PARENT-CHILD
RELATIONSHIPS
Relationship between the caregiver and an elderly parent
can take many forms.
Mutuality: both mother and daughter describing a
rewarding relationship characterized by joint activities and
minimal conflicts.
Ambivalent: mothers and daughters had relationships
where there were rewards and costs; relationships were
sometimes tense.
Conflicted: few rewards and frequent costs. (“She’s
generous and compassionate to others, but not to me”.)
Stress can increase role reversal. The parent becomes the
dependent one.
© 2011 McGraw-Hill Higher Education. All rights reserved.
9. EFFECT ON SIBLING RELATIONSHIPS
Caregiving can generate tension between primary
caregivers and their siblings.
Why?
One study found that greatest source of stress for women
caring for parent with Alzheimer’s was siblings.
Different types of sibling conflict create different
responses on the part of caregivers.
Disagreements over how to care for a parent may lead to
depression.
© 2011 McGraw-Hill Higher Education. All rights reserved.
10. CARFGIVING EFFECTS ON MARITAL
RELATIONSHIPS
The Bad The Good
© 2011 McGraw-Hill Higher Education. All rights reserved.
11. EFFECT ON MARITAL RELATIONSHIPS
Caregiving can reduce the time husbands and wives have
for each other.
Women may be too worn out from performing
caregiving duties to spend quality time with their
husbands and may worry about whether caregiving
demands are harming their marriage.
The most stressful caregiving situation occurs with
Alzheimer’s disease.
© 2011 McGraw-Hill Higher Education. All rights reserved.
12. EFFECT ON
GRANDCHILDREN
The Bad:
Problems that arise: stress between grandparent
and grandchild, disruption of teen’s social life,
resentment of their mother’s caregiver burden.
Children may have to compete with their
grandparents for their parent’s attention.
Despite such potential strains, several studies
have found that family caregiving may also have
positive consequences for grandchildren.
© 2011 McGraw-Hill Higher Education. All rights reserved.
13. EFFECT ON
GRANDCHILDREN (CONT)
The Good:
Most grandchildren felt the caregiving situation
had a positive influence on family relationships.
Another positive effect: it made the young people
more empathetic toward other adults and their
grandparents.
The adolescents repeatedly described feeling
closer to their mothers, who were nearly always
primary caregivers.
© 2011 McGraw-Hill Higher Education. All rights reserved.
14. HOME AND COMMUNITY-BASED SERVICES
Home and community-based services: most common
are:
Case management is provided by a social worker who
assists frail elderly people and their families in obtaining
the medical, social, and personal services needed.
© 2011 McGraw-Hill Higher Education. All rights reserved.
15. INSTITUTIONAL CARE
Nursing homes: the long-term care
option of last resort.
Why is it the last resort?
More than ___ percent of Americans who turned
65 in 1990 will spend some time in a nursing
home.
© 2011 McGraw-Hill Higher Education. All rights reserved.
16. THE NURSING HOME INDUSTRY
People who reach age 65 have 40% chance of entering a
nursing home at some point during their lives.
Problems:
Although many nursing homes provide adequate and, in
some cases, exceptional care, poor-quality care is a
continuing problem.
Among the problems documented were untrained
staff, poor health care, unsanitary conditions, poor
food, and unenforced safety regulations.
© 2011 McGraw-Hill Higher Education. All rights reserved.
17. STAFF TURNOVER IN LONG-TERM CARE
High turnover leads to _____ care, placing the
most vulnerable population group at risk of
__________, falls, and inadequate _______.
© 2011 McGraw-Hill Higher Education. All rights reserved.
18. PROBLEMS IN ADJUSTING TO A NURSING
HOME
People who live independently in a community find the
transition to institutional life difficult.
People sometimes wept recalling a cherished piece of
furniture or a comforting daily routine.
Older Hispanics or other immigrants who enter nursing
homes face unique obstacles in adjusting to
institutionalization, including language and cultural
differences.
© 2011 McGraw-Hill Higher Education. All rights reserved.
19. PATIENT ABUSE IN
NURSING HOMES
Patient abuse very/not very common;
may be ______ or ________
High turnover and high absenteeism among
staff creates situations that provoke abuse.
Aides may use _________s to control
patients, pinch or slap them.
© 2011 McGraw-Hill Higher Education. All rights reserved.
20. PATIENT ABUSE IN NURSING
HOMES (CONT)
More often abuse is more subtle and
psychological.
Federal government and states have established
vigilant rules in an attempt to protect patients.
Greatest protection against abuse in nursing homes
is presence of an “Ombudsman program”.
Serve as watchdogs, monitor the quality of care
in nursing homes by investigating complaints
by families and residents against facilities.
© 2011 McGraw-Hill Higher Education. All rights reserved.
21. FAMILIES OF THE INSTITUTIONALIZED
ELDERLY
Caregiver stress often does not end after an aging parent
or spouse is admitted to a nursing home.
Constant conflict with the staff adds to the stress, as
caregivers who formerly attended to every need of their
loved ones now find they are at the mercy of strangers.
Highest levels of stress and depression occur among
caregivers of patients with severe behavioral problems
and memory loss.
© 2011 McGraw-Hill Higher Education. All rights reserved.
22. NEXT WEEK
Review for the final exam
Student Learning Outcomes Quiz review
Student Presentations
© 2011 McGraw-Hill Higher Education. All rights reserved.
Notas del editor A.A Profile of CaregivingAccording to the General Accounting Office, approximately 12 million people needed some assistance with daily living in 1995. Only 9 percent of people aged 65 to 69 need help with activities of daily living (ADLs), while 43 percent of those older than 85 needed help. Children are most likely to provide care to aging parents, followed by a spouse. Caregiving generally lasts from five to seven years. Home and community-based services: most common are: Personal care, such as bathing, dressing, feeding, and grooming.Housekeeping, including meal preparation and planning, grocery shopping, transportation to medical services, bill paying.Case management is provided by a social worker who assists frail elderly people and their families in obtaining the medical, social, and personal services needed. High turnover leads to poor care, placing the most vulnerable population group at risk of bedsores, falls, and inadequate diet. Patient abuse very/not very common; may be verbal or physicalHigh turnover and high absenteeism among staff creates situations that provoke abuse. Aides may use restraints to control patients, pinch or slap them. More often abuse is more subtle and psychological.Federal government and states have established vigilant rules in an attempt to protect patients.Greatest protection against abuse in nursing homes is presence of an “Ombudsman program”.Serve as watchdogs, monitor the quality of care in nursing homes by investigating complaints by families and residents against facilities. Patient abuse very/not very common; may be verbal or physicalHigh turnover and high absenteeism among staff creates situations that provoke abuse. Aides may use restraints to control patients, pinch or slap them. More often abuse is more subtle and psychological.Federal government and states have established vigilant rules in an attempt to protect patients.Greatest protection against abuse in nursing homes is presence of an “Ombudsman program”.Serve as watchdogs, monitor the quality of care in nursing homes by investigating complaints by families and residents against facilities.