Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
38 Cards in this Set
- Front
- Back
|
Caregiving
|
1 out 5 in the US is currently an informal caregiver to another adult
Non-paid, little recognition 300 billion annually-If paid 78% of all long term care is provided by caregivers 14% is a combination of caregiver and pd formal caregiver Only 8% receiving care are getting it just from formal care providers |
|
|
What caregivers do
|
Many tasks…depending on the level of the pt they are helping
Starts usually as a distance relationship…just phone support or infrequent visits Evolves into maintaining home environment…cleaning, laundry, grocery shopping, family budget, yard work, transportation Role expands based on how much difficultly the person is having May evolve to toileting, dressing, eating, bathing, other basic care elements Some also become more directly involved with medical treatments…giving meds, injections, changing dressing |
|
|
Who becomes the caregiver
|
Personality factors, family dynamics, quality of the relationship prior
Some people are comfortable with certain aspects of caregiving but not all Incontinence is often a main reason a person is admitted into a nursing home Those who seek alternative care often feel guilty |
|
|
The choice of being a caregiver
|
Acknowledge that not everyone is meant to be a caregiver
Also some of the people who need care may not feel comfortable with their children or family members taking care of them Unwanted caregiving can put a significant strain on the relationship |
|
|
Physical Impact of Caregiving
|
Caregivers suffer from serious, clinically measurable health consequences
Decreased immune system function Greater risk of infection and poorer wound healing Adverse changes to blood pressure Greater risk for developing cardiovascular disease |
|
|
Psychological Wellbeing
|
Clinical depression
Reported increased feelings of stress Lower levels of subjective wellbeing Lower levels of self efficacy |
|
|
Social Impact
|
Decrease in the caregivers own personal time and social interactions
Less time to be with their family, socializing, doing hobbies, inability to take vacations As the pt’s need increases the caregiver may feel they have to be “on call” all the time Alzheimer’s care can equate to 80 hrs a week Leads to a sense of social isolation and less outside help when they could use it the most May feel unworthy or guilty if they do something for themselves |
|
|
Financial Implications
|
May have to quit or reduce the amount of time working
May have to become financially responsible for the care recipient May cause the person to not be able to save for their future |
|
|
Benefits of caregiving
|
May be personally rewarding, boosting their own self esteem
Feel useful and needed Give a more positive attitude toward life Allows for quality time to strengthen the bond of the relationship |
|
|
The care receiver
|
They get to stay in their own home or with family
|
|
|
How can health care professionals support caregivers?
|
Encourage collaboration with the family and fair distribution of duties
Encourage frank and open discussions on a regular basis Let the caregiver know that it is better to ask for help than to exhaust themselves to the point of illness Encourage spending time with the person besides just the caregiving routine Use adult daycare facilities to give a break and allow the pt to socialize as well Caregiver needs to be encouraged to take mini-breaks or vacations HCP need to recognize the contribution the caregivers make Caregivers need to be reassured that the feelings they are experiencing are normal for the situation Should be encouraged to seek out support groups |
|
|
Elder abuse
|
Authorities often do not see it as a crime or cannot differentiate it from age-related illness or disability
8 reports of elder abuse for every 1000 elders Majority occurs at the hands of adult children or spouses Usually occurs as a result of elder dependency and care giver stress. If the caregiver has a negative view towards the elderly this contributes significantly They are not going to get better or be any better if you help them or not Abusers usually have little or poor knowledge of the aging process or illnesses. |
|
|
When Elder abuse was first recognized as a social problem
|
Late 1970s: First recognized as a social problem
Inconsistent and shifting definitions Advisory committee of experts Analyzed and revised definitions Physical abuse Sexual abuse Emotional abuse Financial abuse Abandonment Neglect Self-neglect |
|
|
Physical Abuse
|
The use of physical force that may result in:
Bodily injury Physical pain Impairment Includes physical punishments of any kind |
|
|
Sexual Abuse
|
Non-consensual sexual contact of any kind with an elderly person
|
|
|
Emotional or Psychological Abuse
|
Infliction of:
Anguish Pain Neglect |
|
|
Financial or Material Exploitations
|
The illegal or improper use of an elder’s
Funds Property Assets |
|
|
Abandonment
|
The desertion of an elderly person by a person who had physical custody or otherwise had assumed responsibility for providing care for an elder
|
|
|
Neglect
|
Refusal or failure to fulfill any part of a person’s obligation or duties to an elder
|
|
|
Self-neglect
|
The behaviors of an elderly person than threaten his/her own health and safety
Definition excludes a situation in which a mentally competent older person [understands the consequences of his/her decisions] makes a conscious and voluntary decision to engage in acts that threaten his/her health or safety |
|
|
Reported cases of elder abuse
|
Represent the “tip of the iceberg”
Difficult to study because of Difficulty obtaining reliable information from both the victims and the perpetrators Victim’s fear of social stigma or reprisal Societal ageism Lack of knowledge of the victims as far as where to turn for help Lack of information and intervention protocols for treatment professionals |
|
|
Abuse and neglect
|
Physical violence, chronic verbal aggression and neglect present among a small segment of the elderly population
Approximately 5 million 65+ yo are abused annually 84% never reported Self neglect most often ( 37%); Caregiver neglect (20.4%); Financial exploitation (14.7%) Oldest Old most vulnerable |
|
|
Who are the perpetrators
|
90%: Family members
spouses [58%] or adult children [24%] Most likely to be abused by the person with whom the elder lives Non-family caregivers Nursing home staff Nurses aids: have the least training and most client contact [mostly likely perpetrator Less overt forms of abuse Subtle indignities Insensitivities Overuse of medications Others Financial abuse Acquaintances who try to separate the elders from their money and/or other resources Those in a position of trust include Persons with a formal financial relationship Bankers, accountants All of whom are obliged to serve the best interests of the elder and to avoid conflict of interest and self-dealing |
|
|
Financial Abuse
|
Others
Financial abuse Acquaintances who try to separate the elders from their money and/or other resources Those in a position of trust include Persons with a formal financial relationship Bankers, accountants All of whom are obliged to serve the best interests of the elder and to avoid conflict of interest and self-dealing |
|
|
Telemarketing Fraud
|
Significant and growing problem
Estimated over $40 billion annually Elderly may be a target of schemes because they are: Easily accessible Often at home More likely to be socially isolated Lacking someone with whom to discuss things More likely to suffer from cognitive impairment More trusting Less likely to recognize and report fraud |
|
|
The Self as Perpetrator
|
Self-neglect: Inability to perform essential self-care activities
Gambling: marketing to elderly Free transportation Cheap meals Social activities |
|
|
Risk factors for abuse
|
Female
80+ Dementing illness of care receiver Abusing caregiver |
|
|
Theories and Concepts
|
Situational stress model
Transgenerational violence Double-directional violence Psychopathology or perpetrator Social exchange theory |
|
|
Situational Stress Model
|
Abuse results when over-burdened caregivers suffering from overwhelming stress related to caregiving take out frustrations on care receiver
Empirical evidence has not supported this |
|
|
Transgenerational Violence
|
Violent behavior is learned within the family is transmitted from one generation to the next
Little evidence to support this |
|
|
Double-directional Violence
|
Caregiver and care receiver are both abusive
Especially occurs with demented patients |
|
|
Psychopathology of the perpetrator
|
Problem behaviors related to abuse
Mental disorders Substance abuse Dependency on care receiver Wolf & Pillemer, 1989 ~ 2/3 of perpetrators of physical abuse were dependent on their victims |
|
|
Social Exchange Theory
|
Idea of reciprocity or a fair distribution of rewards within relationships
Elder may feel devalued due to ageism and have lower social status implying less attractive partner in relationship or even a burden Must provide higher levels of compensation as part of exchange bargain |
|
|
Empirical Evidence: Caregiver characteristics
|
Substance abuse
Cognitive impairment Lack of caregiving experience Economic difficulties Abused as a child Stress Social isolation Blaming others Lacking empathy Hypercritical attitude Lack understanding Unrealistic expectations Financial dependency Other family or marital conflicts Reluctant to give care |
|
|
Empirical Evidence: Victim characteristics
|
Older
Female Dependent Alcohol abuser Socially isolated History of past abuse Marital or family conflicts Difficult behavior Demanding Unappreciative Unrealistic expectations |
|
|
Elder Abuse Policy
|
No National policy
Each states legislates its own policies on what constitutes abuse and how and by whom it is to be addressed 42 states have mandatory reporting whenever there is evidence of abuse |
|
|
Intervention
|
Approach is similar to child abuse
Mandatory reporting by professionals If professional report suspected abuse are they violating privacy or confidentiality? How serious do the signs have to be to prompt reporting people against their will? What happens if the accusations turn out to be false? Could reporting abuse only make it worse? Educating professionals about potentially abusive situations Educating the public about normal aging processes Helping families develop and nurture informal support systems Linking families with support groups Teaching families stress-management techniques Arranging comprehensive care resources Providing counseling for troubled families Encouraging the use of respite care and day care Informing families about resources for meals, transportation, in-home care Utilizing the long-term-care ombudsman program to address quality of life issues in long-term care Encouraging caregivers to pursue individual interest for self-care |
|
|
Protective Placement
|
Similar to child abuse cases but it punishes the victim and counters the victims right to self-determination
Often results is nursing home placement while leaving perpetrator free May lead to lack of reporting or denial in intervention |
