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caregivers of individuals with AD
Caregivers of Individuals with Alzheimer's Disease
Alzheimer's disease is a terribly debilitating disease that strikes older adults and for which there is no known cure. According to the Institute on Aging, Alzheimer's disease is "an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks." (2012, p.1) Alzheimer's disease is named after Dr. Alois Alzheimer. Dr. Alzheimer is reported to have noted changes in a deceased woman's brain tissues that had passed away with an unusual mental illness, which had symptoms of "memory loss, language problems, and unpredictable behavior." (Institute on Aging, 2012, p.1) Her brain contained abnormal clumps, which are now referred to as amyloid plaques and tangled bundles of fibers now called neurofibrillary tangles, the two main features of Alzheimer's disease. The third feature of Alzheimer's disease is the loss of…
Alzheimer's Disease (2012) Institute on Aging. Retrieved from: http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet
Alzheimer's Disease and Caregiving (2012) Family Caregiving Alliance: National Center on Caregiving. Retrieved from: http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=567
The MetLife Study of Alzheimer's Disease: The Caregiving Experience (2006) MetLife Mature Market Institute® in conjunction with LifePlans, Inc. August 2006. Retrieved from: https://www.metlife.com/assets/cao/mmi/publications/studies/mmi-alzheimers-disease-caregiving-experience-study.pdf
Alzheimer's Disease Caregiving Advisory Group (2009) Convened by the National Alliance for Caregiving and Wyeth & Elan Alliance. 8 Apr 2009. Retrieved from: http://www.caregiving.org/data/AlzhADPilotCaregiverAdBrd.pdf
caregivers of those with dementia through a structure process of information giving. The goal is to determine specifically what information those that care for people with dementia want at the time of diagnosis. It is also necessary to examine the discrepancies between the information that these individuals receive and the information that they actually need to care for the individual in the best way possible. The primary question dealt with in the research is what information that these individuals want and information that they actually receive so that a comparison can be made between the two.
Describing and analyzing the perspectives of caregivers regarding their information needs is the main purpose of this research. Being able to determine what type of information caregivers of those with dementia really need at the time of diagnosis and being able to evaluate the impact of a caregiver education program for dementia on the…
caregivers face when it comes to differentiating between dementia, delirium, and depression due to overlap of depression and delirium in older people. Some symptoms that accompany depression are also pronounced in dementia (Peacock, Hopton, Featherstone & Jill, 2012). These include withdrawal and sleepiness. This overlap creates some problem when it comes to differentiating the two.
Problem in this study and the purpose for which it was commissioned is clearly stated. A causal reading of the introduction will tell you what the entire study is all about and what issues it seeks to address. The first paragraph gives a clear definition of how delirium results and its prevalence in care homes and the fact that it is under-recognized by nurses. It also gives the relationship that exists between dementia and delirium, the confusion that exists between delirium and dementia, and how challenging it is to differentiate between depression, dementia, and delirium.…
Featherstone, I., Hopton, A. & Siddiqi, N. (2010). An Intervention to Reduce Delirium in Care
Homes. Nursing Older People, 22(1), 16-21.
Mitchell, A. & Kakkadasam, V. (2011). Ability of Nurses to Identify Depression in Primary
Care, Secondary Care, and Nursing Homes -- A Meta-Analysis of Routine Clinical
In undertaking a quantitative research study, a researcher seeks to highlight the relationship between two variables, i.e. a dependent and an independent variable. The four kinds of quantitative research designs, according to Burns and Grove (2010), are “descriptive, correlational, quasi-experimental, experimental” designs (p. 34).
Grant, J.S., Weaver, M., Elliott, T.R., Bartolucci, A.A. & Giger, J.N. (2004). Family Caregivers of Stroke Survivors: Characteristics of Caregivers at Risk for Depression. Rehabilitation Psychology, 49(2), 172-179.
The authors in this article make use of a correlational research design. Correlational research, in the words of Burns and Grove (2010), “involves the systematic investigation of relationships between or among variables” (p. 35). In this case, the authors of this particular article make use of statistical analyses to highlight various predictors of stroke survivors’ family caregiver depression risk. In essence, the research piece is largely observational as far as the collection of data is concerned as it…
Burns, N. & Grove, S.K. (2010). Understanding Nursing Research: Building an Evidence-Based Practice (5th ed.). Maryland Heights, MO: Elsevier Health Sciences
Taylor, B.J. (2006). Research in Nursing and Health Care: Evidence for Practice (3rd ed.). Belmont, CA: Cengage Learning
Weil, J. (2017). Research Design in Aging and Social Gerontology: Quantitative, Qualitative, and Mixed Methods. New York, NY: Taylor and Francis.
Caregiver Burnout and Spiritual Growth
The purpose of the "Are you heading for caregiver burnout" inventory by Spencer (2010) is to give the caregiver an opportunity to check in with his or her needs, an act that caregivers seldom take the time to do. Caregivers are often so worried about and involved in addressing the needs of others they forget about their own basic needs for sleep and food. Unfortunately, the cumulative toll of sleep deprivation, inadequate and rushed meals, and the constant 'flight or fight' response induced by the experience of constantly attending to someone with medical needs often takes its toll, even if the caregiver is unaware of this fact.
Taking care of someone for many years is particularly draining physically and mentally. Caregivers may reproach themselves for not being mature in an emotional or spiritual fashion but all human beings have self-actualization needs. They have a…
Spencer, P. (2010). Are you heading for caregiver burnout? Community Table.
Retrieved from: http://communitytable.parade.com/37194/paulaspencersenioreditorcaringcom/quiz-are-you-heading-for-caregiver-burnout/
Caregiver Decision Making for Heart Failure
Reading Research Literature #1
Type your answers to the following questions using complete sentences and correct grammar, spelling, and syntax. Click Save as and save the file with your last name and assignment, e.g.,NR439_RRL1_Smith. Submit to the Reading Research Literature #1 basket in the Dropbox by 11:59 PM MT Sunday at the end of Week 5. The guidelines and grading rubric for this assignment may be found in Doc Sharing.
[replace this text with The following questions pertain to: Sanford, J., Townsend-Rocchicciolli, J., Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55 -- 70.
What is the purpose of this research?
The purpose was to determine how caregivers make decisions for family members with heart failure.
What is the research question (or questions)? This may…
Decision-Making by Caregivers of Family Members with Heart Failure
Describe the population for this study.
The population for this study consisted of people who are family members of those with cardiovascular issues who may develop heart failure or who are currently living with heart failure. The intention was to find out how prepared family members were to deal with worst-case scenarios regarding the patient's care.
How was the sample selected? hat are the strengths and weaknesses of this sampling strategy?
The sample selected for the study was comprised of individuals whose family members have heart failure. The strength of this sampling strategy will be that only impacted people are involved, but the weakness is that these are individuals already aware of their family member's situation and the possibility that they will have to deal with the realities of taking care of their loved one.
ere the subjects in this study…
Sanford, J., Townsend-Rocchicciolli, J., Horigan, A., & Hall, P. (2011). A process of decision-
making by caregivers of family members with heart failure. Research & Theory for Nursing Practice. 25(1). 55-70.
Schwartz, K., Mion, P., Huddock, D., & Litman, G. (2008). Telemonitoring of heart failure patients and their caregivers: a pilot randomized controlled study. Progress in Cardiovascular Nursing. 23(1), 18-26.
Five important issues caregivers should be aware of when working with dementia patients.
dementia is a "progressive and terminal" disease that "you can die from," according to a peer-reviewed article in BMC Medicine (van der Steen, 2013, p. 1). Van der Steen conducted a survey using 372 nursing home patients from 28 nursing facilities in the Netherlands. The initial survey reflected that just 43% of the families understood that "you can die from dementia," but 94% of the physicians responded affirmatively to the statement that "you can die from dementia" (van der Steen).
Many dementia patients do not progress into what is known as "advanced dementia," but they die earlier from "comorbid disease" or "dementia-related health problems," van der Steen explains. Hence, advance care planning (i.e., knowing the facts about dementia and discussing the realities with the patient while he or she can still make decisions) can make palliative…
Alzheimers. (2011). Unusual Behaviour. Retrieved August 30, 2013, from http://www.alzheimers.org.uk .
Congedo, M., Causarano, R.I., Alberti, F., Bonito, V., Borghi, L., Colombi, L., Defanti, A.,
Marcello, N., Porteri, C., Pucci, E., Tarquini, D., Tettamanti, M., Tiezzi, A., Tiraboschi, P.,
and Gasparini, M. (2010). Ethical issues in end of life treatments for patients with dementia. European Journal of Neurology, Vol. 17, 774-779.
d, The Bowen Center). Systems therapy is based on the premise that family members form unconscious or conscious alliances. Triangular relationships in which different people are engaged in conflicts with one another, projections upon other family members, passing negative coping mechanisms from generation to generation are all examples of how family units can behave in a dysfunctional manner. When a member has a certifiable mental illness, these dynamics can be exacerbated. Systems therapy can help all members of the family better understand the negative and positive roles they are playing in a positive fashion.
Using such intense methods as family systems therapy is controversial with schizophrenia, given that it can be difficult for the patient to fully participate in the self-analysis required of conventional 'talk' therapy. However, once the patient's symptoms are bought under control, this is less of a concern. Furthermore, even when the patient is fully symptomatic, the…
Bowen theory. (n.d). The Bowen Center. Retrieved June 14, 2011 at http://www.thebowencenter.org/pages/theory.html
The causes of schizophrenia. (2010). Schizophrenia.com. Retrieved June 14, 2011 at http://www.schizophrenia.com/hypo.php#genes
It is not always easy to keep childcare arrangements running smoothly and problems may arise from time to time. .
In addition to these stresses, familial stresses might occur. For instance, Grandparents and parents may have different views about raising children. Parents' expectations of grandparents may exceed their resources. Grandchildren may not always obey or comply with grandparents' rules. Grandparents may not like the role of strict disciplinarian when discipline is required. Differing opinions regarding discipline may cause friction between the parents and grandparents. These stresses can affect the children and their ability to adjust to the new situation. Familial stresses make the adjustment difficult for everyone. Familial problems are oftentimes difficult to resolve.
As the number of aging grandmothers who are experiencing the adversity stemming from assuming primary parental roles continues to increase, resilience in this population has become an area of academic importance. How well grandmothers cope with…
Early Onset Dementia: Caregivers and Stress
While much research has been conducted on dementia, particularly the supreme focus upon dementia by the National Institute for Health and Clinical Excellence (NICE), there still is a marked dearth of information regarding early onset dementia (Jefferies & Agrawal, 2009). This is no surprise: dementia is generally viewed as a disease of old age. However, overlooking the significance and implications of Young Onset Dementia are dire. Young Onset Dementia (YOD) is defined affects 2.2% of the population under the age of 65 in the United Kingdom. Yet, there's still reason to believe that this number is actually even higher as 2.2% is simply the sum of the referrals to mental health services; it's more than likely that there are large numbers of undiagnosed members of society with this condition.
Generally, those who are undiagnosed, receive informal caregiving delivered by family-members, organisations such as their…
Clare, L., & al., e. (2012). Marital Relationship Quality in Early-Stage Dementia: Perspectives From People With Dementia and Their Spouses. Alzheimer Disease & Associated Disorders, 148-158.
de Vugt, M., & Verhey, F. (2013). The impact of early dementia diagnosis and intervention on informal caregivers. Progress in Neurobiology.
Nyu.edu. (n.d.). What is research design? Retrieved from nyu.edu: http://www.nyu.edu/classes/bkg/methods/005847ch1.pdf
Rosness, A. (2011). Quality of life and depression in carers of patients with early onset dementia. Aging & Mental Health, 299-306.
Ethics of Science and Technology in Maintaining Health / Life in Aged or Terminal Patients -- How Cultural Influences Support or Condemn Their Uses
Science and technology have provided a great deal of assistance in recent years to clinical healthcare professionals when it comes to maintaining / sustaining the lives of very old people. This paper reviews: a) some of the technologies currently being utilized as important components of healthcare services for aged people; b) specifically how those technologies are applied to the care of elderly people; and c) the ethical and social implications vis-a-vis those advanced technologies.
Ethical Challenges in the Care of Seriously Ill Patients
Clearly the development of assisting technologies give doctors and nurses additional tools with which to help aged people continue their lives; but there are serious ethical concerns that have been raised regarding those technologies. In the peer-reviewed journal Pain Medicine the authors discuss…
Kang, H.G., Mahoney, D.F., Hoenig, H., Hirth, V.A., Ponato, P., Hajjar, I., and Lipsitz, L.A.
(2010). In Situ Monitoring of Health in Older Adults: Technologies and Issues. Journal of American Geriatric Society, 58(8), 1579-1586.
Kinney, J.M., and Kart, C.S. (2006). Not Quite a Panacea: Technology to Facilitate Family
Caregiving for Elders with Dementia. Generations, 30(2), 64-66.
I. Statement of the Phenomenon of Interest
1. Is the phenomenon of interest clearly identified?
In the article, Steiner et al., (2009) explained how web-based strategies influence the decisions by stroke survivors to use healthcare services in their first year of recovery. The authors used an experimental design to sample the caregivers and in the investigation of the effects of web-based interventions that the patients sought.
2. Has the researcher identified why the phenomenon requires a qualitative format?
The study undertaking by the researchers was qualitative because it required the collection of data from secondary sources of selected participants and further analysis before conclusions could be drawn.
3. Are the philosophical underpinnings of the research described?
The need to undertake the research was premised on the fact that over 80% of the stroke survivors within the first year after surgery while the remaining 20% percent needed first attention from caregivers.…
Steiner, V., Pierce, L., Windnagel, F., Martincin, K., Pawlak, R., & Salvador, D. (2009). The impact of a web-based caregiver intervention on the reasons stroke survivors use health care services during the first year post-treatment. Topics in Stroke Rehabilitation, 16(2), 122-132
Pierce, L. (2001). Coherence in the urban family caregiver role with African American stroke survivors. Topics in Stroke Rehabilitation, 8(3), 64-72.
Sommer, L., Gies, C., Hefflinger, K., Skrzyniecki, C., Pierce, L. (2016). Problems reported by daughters in caring for parents with stroke. Journal of Women’s Health, Issues & Care, 5(6), 1-5
There are certainly different approaches to the theory of anticipatory mourning. Clearly, one of the major issues within the literature surrounds the communication between the dying person and the caregiver, and both caregiver and patient and those who will be most affected or will mourn their loss. Conventional theory finds that preparing for loss involves experiencing most of the features of grief prior to the demise of the patient; numbness, anger or blame, fear, desperation, and even despair. However, an important difference is that the period of mourning begins before death occurs, and while contact and communication with the dying person is still a viable option. Because of this, there are additional emotions involved; hope, nostalgia, kindness, tenderness, and opportunity for closure (Fulton, 2003). It is this sense of hope, this feeling that there may still be something that can be done for the patient that is the focus of…
Caregiving Statistics. (2010, February). Retrieved from National Family Caregivers Association: http://www.thefamilycaregiver.org/who_are_family_caregivers/care_giving_statstics.cfm
Aliiance, F.C. (2010, September). Selected Caregiver Statistics. Retrieved from:Circlecenterads.info: http://www.circlecenterads.info/documents/FCAPrint_SelectedCaregiv...pdf
Boerner, Schulz and Horowitz. (2004). Positive Aspects of Caregiving and Adaptation to Bereavement. Psychology and Aging, 19(4), 668-75.
Davidson, F. (2002). The Caregiver's Sourcebook. New York: McGraw Hill.
1965, the Older Americans Act (OAA) established precedence for senior care in the United States. The OAA freed federal funding for not only seniors but also their caregivers, providing for such services as transportation and meals support. Since 1965, several adjustments and amendments have been made to the OAA. The most significant of the changes made to the OAA has been the National Family Caregiver Support Program, also known as Title IIIE of the OAA (NAC, 2012). The National Family Caregiver Support Program (NFCSP) was added as an addendum to the OAA in 2000. Of all the amendments to the OAA, the NFCSP is the one that has had the most direct and immediate impact on caregivers of elders -- the family members who care for their aging relatives. Unlike other provisions of the OAA, the NFCSP distinguishes itself by focusing on the caregivers and their needs, thereby initiating a…
Administration on Aging (2014). National family caregiver support program. U.S. Department of Health and Human Services. Retrieved online: http://www.aoa.acl.gov/AoA_Programs/HCLTC/Caregiver/
Administration for Community Living (2014). Administration on aging. Retrieved online: http://www.aoa.acl.gov/AoA_Programs/HCLTC/Caregiver/
Family Caregiver Alliance (2003). New study examines ten states' caregiver programs. Retrieved online: https://www.caregiver.org/new-study-examines-ten-states-caregiver-programs
Feinberg, L.F. & Newman, S.L. (2004). A study of 10 states since passage of the national family caregiver support program. The Gerontologist 44(6): 760-769.
espiratory Care: Scenario
One of the most difficult ethical scenarios which may arise is when a patient is not fully compliant with treatment. In one of the cases I observed, a child had recently been diagnosed with asthma. Unfortunately, the parent was not able to offer the child the ideal environment for coping with his asthma. The parent and child lived in a very dusty environment and it was difficult for the parent to bring the child in for regular checkups. The child was frequently taken to the emergency room because of difficulties in controlling his asthma. There was heavy reliance upon inhaled corticosteroids and other medications primarily intended for short-term use. The parent was also reluctant to allow the child to participate in regular activities such as sports. The child was overweight and this caused a spiral of problems for the child: not being able to participate in normal…
Juniper E.F., Guyatt G.H., Feeny DH, Ferrie P.J., Griffith L.E., & Townsend M. (1996).
Measuring quality of life in the parents of children with asthma. Quality of Life Research,
5: 27 -34.
Providing parent and caregiver training. (2010). AARC. Retrieved from:
Caregivers of Alzheimer's Patients
Community Health Promotion Project Design
As we have discovered in the first part of the study, Alzheimer's is a major health issue for the population of seniors 65 years and older. Alzheimers costs taxpayers and individuals billions of dollars for the provision of care for those who can no longer care for themselves. Alzheimer's is an expensive disease and many times it is the family who must bear much of the expense. We found that the financial strain of caring for someone who has Alzheimer's creates an incredible amount of stress on family members. However, we also found that perhaps even greater than the financial strain, Alzheimer's places in incredible load on the family as they are usually the ones who must care for their family member.
The aggregate for this study consists of family members who must care for other members of the family who…
Belle SH, Czaja SJ, & Schulz R, (2003). "Using a new taxonomy to combine the uncombinable: Integrating results across diverse interventions." Psychology and Aging. 18:396 -- 405
Gitlin LN, Belle SH, & Burgio LD, et al. (2003). "Effect of multicomponent interventions on caregiver burden and depression: The REACH multisite initiative at 6-month follow-up." Psychology and Aging. 2003;18:361 -- 374.
Wisniewski, S., Belle, S. & Marcus, S. et al. (2003). The resources for enhancing old climbers caregiver health (REACH): project design and baseline characteristics. Psychological Aging. 18 (3), 375-384.
Emotional Skillfulness: A Critical eview
This report discusses the 2005 paper by Cordova, Zee, and Warren addresses "Emotional Skillfulness in Marriage: Intimacy as a Mediator of the elationship between Emotional Skillfulness and Marital Satisfaction," from The Journal of Social and Clinical Psychology. The authors tested and verified their hypothesis that the ability to identify and communicate emotions correlated with 'marital adjustment' for both partners in a bonded relationship, and was mediated by 'intimate safety'.
Emotional attitudes of individuals are known to vary, based on a variety of factors, particularly including childhood upbringing and learned emotional patterns (Eckman & Friesen, 1971). Eckman and Friesen go so far as to say that we are born with some emotions. The topic of this work concerns emotional attitudes and understanding between adults in a marital relationship, and the ways in which emotional communication are important, particularly with respect to 'intimate safety', which is defined…
Ekman, P., & Friesen, W.V. (1971). Constants across cultures in the face and emotion. Journal of Personality and Social Psychology, 11, 124-129.
Cordova, J.V., Gee, C.B., Warren, L.Z. (2005) Emotional Skillfulness In Marriage: Intimacy As A Mediator Of The Relationship Between Emotional Skillfulness And Marital Satisfaction. Journal of Social and Clinical Psychology, Vol. 24, No. 2, 2005, pp. 218-235.
articles seem to be saying same thing or do they contradict each other? Is the tone similar in each article, meaning can you tell what the researchers feel about the subject? Do they support the same idea, did they hypothesize similar ideas?
The following are two research essays on the burden of caregivers. The similarities of both essays are that both demonstrate the huge responsibility and unmitigated onus that caregivers carry that consequent in causing them stress and hardship. Differences include the fact that one was carried out on a population in Italy, whilst the other was carried out on a sample in America.
It is striking, too, to note, that although both concluded that caregivers needed more support, the American study recommended ways that individuals could create this for themselves, whilst the Italians-based study placed the responsibility on the community and social work profession. The tone of the articles,…
Sansoni, J et al. (2004) Anxiety and depression in community-dwelling, Italian Alzheimer's disease caregivers, retrieved from International Journal of Nursing Practice: 10: 93-100.
Hayslip, B et al. (2008) Predictors of Alzheimer's disease caregiver depression and burden: what noncaregiving adults can learn from active caregivers. Educational Gerontology, 34: 945-969, 2008
What are the major concepts of Ainsworth's theory?
Ainsworth's attachment theory is rooted in Bowlby's research on the bonds that develop between parent and child. Building on Bowlby's research, Ainsworth conducted a groundbreaking experiment known as the Strange Situation. esults of the Strange Situation experiment revealed three different categories of attachment styles. Ainsworth found secure attachment, ambivalent-insecure attachment, and avoidant-insecure attachment (Cherry, n.d.). Moreover, four categories of attachment style behaviors were observed. These four categories include separation anxiety, which refers to the emotional reaction to the caregiver leaving. The infant's willingness to explore in the caregiver's absence is another feature of attachment. Stranger anxiety refers to how the infant responds to strangers when the primary caregiver is absent. Finally, Ainsworth studied reunion behavior, which was how the child reacted to the return of the caregiver. Using these four parameters of attachment-related behaviors, Ainsworth developed the three primary attachment styles:…
Benoit, D. (2004). Infant-parent attachment. Pediatric Child Health 9(8): 541-545.
Cherry, K. (n.d.). Attachment theory. Retrieved online: http://psychology.about.com/od/loveandattraction/a/attachment01.htm
Fraley, R.C. (n.d.). A Brief Overview of Adult Attachment Theory and Research. Retrieved online: http://internal.psychology.illinois.edu/~rcfraley/attachment.htm
Main, M. & Solomon, J. (1986). Discovery of an insecure-disorganized/disoriented attachment pattern. Affective Development in Infancy. 95(124).
Sanford, J., Townsend-Rocchicciolli, J.,Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55-70.
Describe the population for this study.
participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities. The participant had to be related to the patient with heart failure (HF), provide one activity of daily living, and/or assist the care recipient with two activities of daily living and do this voluntarily.
How was the sample selected? What are the strengths and weaknesses of this sampling strategy?
This was a convenience sample. The participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities and had to meet certain conditions. The strengths are that the researchers know and get precisely what they are looking for (in terms of qualifications of participants). The weaknesses are that…
Sanford, J., Townsend-Rocchicciolli, J., Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55-70.
Describe the data collection procedure.
This was a QUALITATIVE grounded theory study. Unstructured open-ended interviews were conducted in private mutually agreed on locations. Interviewers took notes and interviews were audiotaped. Interviews lasted from 45 minutes to 2 hours
what did the authors say about the reliability and validity of their data collection and analysis?
The authors did not address this point. On the contrary, they point out how their study contributes to previous studies on the topic.
What demographic information was reported?
The caregiver had to be related to the patient with heart failure, provide one activity of daily living, and/or assist the care recipient with two instrumental activities of daily living and not be paid for services. Demographic…
Both of the children were a bit older, so he was not constantly monitoring their every move. Instead, his attention shifted from watching the girl, who was playing with another set of children, and watching his son, who was also playing in a separate area with another group of children. Periodically however, he was texting on his phone. This texting interrupted his watching the children. The girl would go to him for a couple of minutes at a time, but then she would run off with her friends again. The son did not approach his father again once he was playing with the other kids. The father was however, sitting less than ten feet away from the areas where both of his children were playing.
The father in this case was careful in terms of periodically observing what his children were doing and where they were, but he could have…
Associated Press. (2009). Long-lost children rarely turn up. FoxNews. Retrieved 29 April 2013 from www.foxnews.com/story/0,2933,528038,00.html
Invisible Support from Family & Friends
How might symptoms of memory loss, paranoia, and verbal and physical aggression be particularly hard for the caregivers of Alzheimer’s patients?
These symptoms might be hard for the caregiver as he or she is human and they might take it personally especially when it comes to physical and verbal aggression. When the patient with Alzheimer's disease becomes aggressive towards the caregiver, the caregiver might feel overwhelmed, sad, and isolated. These feelings are normal as the situation the caregiver finds him or herself in is what is causing those feelings. Memory loss from the patient might result in the patient not recalling some of the basic things and this might frustrate the caregiver as he or she will have to keep repeating or reminding the patient. Naturally, the caregiver will get frustrated and they might lash out too. However, it is vital that the caregiver…
A driver came to the house and picked Robert up five days a week at 7:30 and brought him home at around 4:00 P.M. The couple received a grant from United ay to fund the service they received from the Respite Center, which cost around $200 per week. The Respite Center had well-thought-out activities designed for seniors with dementia and Alzheimer's, and those activities "helped slow down his Alzheimer's" (Claunch). Those activities include arts and crafts, chair aerobics, games, socializing, breakfast, lunch and a snack, Claunch explains. On many days a special visitor or group comes to entertain the seniors; among those groups are the Gulf Coast omen's Club, the Garden Club, PAS Ministry, gospel groups, line dancers, pianists and sing-along singers.
hen an Alzheimer's patient is stimulated (by being entertained, walking, or engaging in a game of some kind that challenges the mind but does in minimally) the nerve…
Assist Guide Information Services. (2009). Caregiving. Retrieved November 10, 2009,
From http://www.agis.com .
Claunch, Shannon. (2009). Council on Aging: Respite Center Cares for Community.
News Herald. Retrieved November 11, 2009, from http://www.newsherald.com
Adult Daycare for Patients with Alzheimer's Disease
Barriers to Daycare Utilization:
Fortinsky, Richard H., Kulldorff, Martin, Kleppinger, Alison, and Kenyon-Pesce, Lisa. (2009). Dementia care consultation for family caregivers: ollaborative model linking an Alzheimer's association chapter with primary care physicians. Aging & Mental Health, 13(2), 162-170.
The study by Fortinsky et al. (2009) discusses some of the obstacles standing between family caregivers and the admission of their patients to daycare nursing communities. The purpose of the research is to evaluate strategies that might improve the willingness of family caregivers to work with these community services. In a consultation with 84 family caregivers, the study aims to determine what strategies might raise confidence in the capabilities of such services. Additionally, the study seeks to evaluate the responses of primary caregivers to the outcomes produced by this type of intervention. A third objective of the study would be to determine how successfully…
Cantegreil-Kallen, Inge, Turbelin, Clement, Angel, Pierre, Flahault, Aantoine, and Rigaud, Anne-Sophie. (2006). Dementia management in France: Health care and support services in the community. Dementia, 5(3), 317-326.
As study of community-based Alzheimer's support services in France lends greater insight into the obstacles preventing the optimization of care. According to the study by Cantegreil-Kallen (2006) et al., France provides a state-administered network of community-based services available to individuals suffering from Alzheimer's or dementia related to aging. While this federal oversight provides regulatory consistency and quality control, it may also be impeding the fullest possible effectiveness of community-based service contexts. According to the study in question, "Although GPs acknowledged carers' need for emotional support, only minimal levels of other interventions such as day care (12%) and psychotherapeutic interventions (12%) were prescribed. Reasons for under-use included non-availability and carers' reluctance to undergo psychotherapy. Lack of integrated community care services, insufficient information on services, lack of collaboration between health professionals and the frequent absence of a reliable carer were considered the most important barriers to the effective support of people with dementia in primary health care settings." (p. 317)
This confirms the general observation drawn from the preset research that while there are clear benefits to the employment of any form of daycare, community agencies often lack the resources or protocol to ensure that patients are given the best opportunity for the improvement of faculties as well as the improvement of long-term health outcomes.
Group Process and Skill Selection
ecent developments at the medical industry increase the life expectancy. Census reported that 36.3 million Americans were 65 and over in 2004 and 71.5 million Americans will be 65 and over in 2030 (see, census.org). Therefore, the age related diseases and related industry (i.e. eldercare) have been taking an important part of the American society. Taking care of a person with memory loss, dementia and Alzheimer's disease is a demanding task as it requires mental and physical strength. Social supports groups are very helpful to deal with mental and physical distress for Alzheimer's patients' caregivers. In this brief document, a social group session is discussed.
ANALYZING GOUP POCESS AND SKILL SELECTION
Garvin, Gutierrez, and Galinsky (2004) describe the social work groups in which the social workers participate as part of their professional activities either as participants or facilitators. The interaction between social workers and…
Garvin, C.D., Gutierrez, L.M., & Galinsky, M.J., (Eds.). (2004). Handbook of social work with groups. New York: Guilford Publications.
Gitlin L.N., Corcoran M., Winter L., Boyce A., & Hauck W.W. (2001). A randomized, controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia. Gerontologist 41 (1): 4 -- 14.
Mitchell S.L., Teno J.M., & Kiely D.K. ( 2009). The clinical course of advanced dementia." N. Engl J. Med 361 (16): 1529 -- 38.
Molsa P.K., Marttila R.J., & Rinne U.K. (1995). Long-term survival and predictors of mortality in Alzheimer's disease and multi-infarct dementia. ActaNeurol Scand 91 (3): 159 -- 64.
Validating the Effectiveness of Participation in a Time-Sensitive Closed Therapeutic Group for Preschool Aged Children Allegedly Sexually Abused
This paper will review existing research on allegedly sexually abused preschool aged children. The traumatic psychological effects of the abuse including low self-esteem, poor peer relationships, behavior problems, cognitive functioning and physical/mental health will also be evaluated.
The author notes the paucity of available material on sexually abused children. Very little therefore is known of the effectiveness of psychotherapy to assist in the treatment of the problems of this particular group of abused children - a population of 40 selected children with a mean age of 45, with their parents (either father or mother) and/or caregivers attending sessions in another session hall at the same time the children are undergoing therapy.
This proposed study will therefore focus on how mental health services are provided to preschool children with ages ranging between 4…
In a study of the prevalence of elder abuse in the United States, financial difficulties on the part of the abuser did appear to be an important risk factor (Krug, 2002, pp. 130-131).
elationship factors - in the early theoretical models, the level of stress of caregivers was seen as a risk factor that linked elder abuse with care of an elderly relative. While the accepted image of abuse depicts a dependent victim and an overstressed caregiver, there is growing evidence that neither of these factors properly accounts for cases of abuse. Although researchers do not deny the component of stress, they tend now to look at it in a wider context in which the quality of the overall relationship is a causal factor. Today, the belief is that stress may be a contributing factor in cases of abuse but does not by itself account for the entire phenomenon.
Brandl, Bonnie. (2000). Power and Control: Understanding Domestic Abuse in Later Life.
Generations. 24(2), p. 39-45.
Elder Abuse and Neglect. (2009). Retrieved February 11, 2010, from Helpguide.org Web site:
In the film The Savages (Jenkins, 2007) two siblings (Jon and Wendy Savage, the parallel to the Peter Pan characters by the same first name is not hidden) are brought together to care for their aging father who has dementia. Lenny Savage (the father) is the patriarch of the estranged Savage family. Lenny was living in Arizona with his girlfriend, whom we suspect also has dementia, but she abruptly passes away as the film begins. Lenny has had no connection with his children who both live far away on the east coast (Jon in Buffalo; Wendy in New York). Their mother is out of the picture having left their father years before and no one knows where she is. The children, left to their own devices, have grown into isolated, repressed, emotionally-stunted, self-absorbed adults (savages). The film is more about the struggles of the sister and brother to grow…
Alzheimer's Association (2012). http://www.alz.org/about_us_about_us_.asp .
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision. Washington, DC: Author.
de Boer, M.E., Hertogh, C.M.P.M., Droes, R.M., Riphagen, I.I., Jonker, C., & Eefsting J.A. (2007). Suffering from dementia - the patient's perspective: A review of the literature. International Psychogeriatrics, 19(6), 1021-1039.
Jenkins, T. (2007). (Jenkins, T. Director & Payne, A. Producer) The savages [Film]. United States, This In That Studios.
McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.
Are there any HIPAA concerns that are evident in this study?
Both caregivers and patients were required to sign informed consent documentation in order to participate in the study. Were any concerns related to HIPAA indicated in the protocol or procedures for conducting the study, those concerns would need to be delineated in the consent documents and explained to the participants. Since caregivers were an integral component to the hospice care and quality of life measures for patients, patient privacy could be maintained just as with any other medical or healthcare services.
What methods were put in place to ensure that the subjects were giving true informed consent?
The inclusion criteria and protocol for participating in the study required that patients and caregivers both be…
McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.
Rosedale, M., & Fu, M.R. (2010). Confronting the unexpected: Temporal, situational, and attributive dimensions of distressing symptom experience for breast cancer survivors. Oncology Nursing Forum, 37(1), 28-33.
Government Regulations and Hospice
Government Regulations Affecting Health Care in Hospice
Regulations Affecting Health Care in Hospice
Impact of rules on Hospice services
This paper focuses on how government regulations impact hospice. The paper starts off with an introduction to the hospice system that was revived by a nurse, Cecily Saunders, who then went on to become a physician, establishing one of the first modern hospices. The concept of total pain is explained in some detail. The body of the paper then includes the studies that have been conducted on patients and caregivers in hospice systems as well as on people who died after they were diagnosed with terminal illness resulting in death in six months following the prognosis. The overall conclusion that can be drawn here is that while in Japan there is a marked need for improving the Day hospice system, the American hospice industry…
American Medical Directors Association. (n.d.). White Paper on Palliative Care And Hospice In Long-Term Care. Retrieved March 10, 2012, from American Medical Directors Association: http://www.amda.com/governance/whitepapers/palliative_care.cfm
Carlson, M.D., Morrison, R.S., Holford, T.R., & Bradley, E.H. (2007). Hospice Care: What Services Do Patients and Their Families Receive? Health Services Research, 42(4), 1672-1690.
Centers for Medicare & Medicaid Services. (2008). Medicare and Medicaid Programs: Hospice Conditions of Participation; Final Rule. Federal Register, 73(109), 32088-32220.
Christakis, N.A., & Escarce, J. j. (1996). Survival of Medicare patients after enrollment In hospice programs . The New England Journal of Medicine, 172-179.
Baronet's second assumption was that a low level of family support and a high level of relationship would also be associated with low feelings of satisfaction (the epistemological assumptions on the part of the caregiver). Results, however, showed that family support played no part neither in determining feelings of satisfaction nor in providing subjective burden resultant from caregiving activates.
Science as a discipline incorporates eight characteristics. hese are: empirical (i.e. evidence-based, hard facts); systematic (i.e. related to or consisting of a system); theoretical (i.e. related to or consisting of a theory); provisional (i.e. temporary until replaced by another theory that makes more sense); public (i.e. he findings of science are not restricted to any specific sector, but are available to the public sector as a whole); objective (i.e. attempting to be corroborated by reality rather than biased and subjective); self-reflective (i.e. aiming to step back and criticize itself); and open-ended…
The empirical and the objective characteristics are obvious in her attempts to connect qualitative emotional factors (i.e. subjective feelings of satisfaction) to 'hard' conditions, and to pronounce association only after scientific association was gauged. The systematic (and similarly theoretical) principle can be demonstrated by Baronet's use of theoretical measures. Each of these measures has, in turn, been formulated on empirical principles, but they consist of particular theories -- or systems -- that posit a means to assessing and gauging certain situations.
Baronet, a.M. (2003). The impact of family relations on caregivers' positive and negative appraisal of their caretaking activities. Family Relations, 52, 137-141
Activities to Reduce Inappopiate Behavios Displayed by Childen With Autism and Othe Developmental Disabilities
The pupose of this dissetation study is to test the effectiveness of an eveyday activities-based potocol (Holm, Santangelo, Fomuth, Bown & Walte, 2000) fo managing challenging and disuptive behavios of 13- to 23-yea-old esidential students (male and female) with Autism who live at Melmak Homes, Inc., of southeasten Pennsylvania, and attend school o adult day pogams. Applied behavio analysis and a focus on eveyday occupations (activities) will be combined duing the intevention phase. Reinfocement will be fo subtask completion and duation of paticipation, NOT fo absence of taget maladaptive o disuptive behavios. Behavio analysts, howeve, will document the fequency/duation of the taget behavios duing each condition. Inteventions will occu daily, Monday though Fiday. A single-subject, multiple-baseline, acoss-subjects design with nine subjects will be used to evaluate change in behavios unde altenating conditions. Data will be analyzed…
references, and favorites)
Child and Family Assets
(Abilities, strengths, skills, accomplishments, and capabilities)
Functional and Meaningful Interactions
(Purposeful interactions; ways interests and assets are used in everyday life)
download Chamberlain Library) the articles uploaded, upload the articles required reading
This is for the "Telemonitoring…" article
The purpose of this research is to determine if it is advantageous to employ electronic home monitoring (EHM) for heart failure patients. Advantageous is determined by whether or not additional costs and hospital visits could be reduced with this technology, and if it could increase the length of time between hospital visits.
The research questions in this study were implicit and stated in the form of three hypotheses. The first questioned whether or not lower costs, emergency room and hospital visits could be achieved with EHM, the second was whether or not quality of life and caregiver mastery could improve while lowering rates of depressive symptoms, and the final one wondered whether or not, the combination of EHM, caregiver mastery and informal social support could decrease the risk of readmission to hospitals.
Longitudinal trajectories for individual participants were used at one level, while a second level included the effects of between-subjects predictors at the higher order. To construct the models, 4,193 observations were used over time, with 3,055 of these conducted ruing community caregiving and 1,148 in the nursing home.
Presentation of Data
Data are presented by means of two figures and three tables. The data appear to be very clearly explicated. The axes in the figures are all clearly marked, and the lines differentiated to indicate the data of concern. The tables clarify the information narrated in the document.
Limitations of Statistical Methods
Limitations include the lack of ethnic diversity in the sample population. Different cultures would respond differently to the burden of care and to counseling intervention. Furthermore, only spouse caregivers were targeted for the research, which limits the application of the data to households where children or other family…
What I found most interesting was the three measurements implemented as a basis for the study. These instruments help greatly towards establishing a sound basis for the study and to implement further statistical analyses of the results. In general, I was impressed with the study and I find it very relevant in a profession where the aim is to reduce suffering.
Gaugler, J.E., Roth, D.L., Haley, W.E., & Mittleman, M.S. (2008). Can counseling and support reduce burden and depressive symptoms in caregivers of people with Alzheimer's disease during the transition to institutionalization? Results from the New York University Caregiver Intervention Study. Journal of American Geriatric Society, 56(3), 421-428
Passion Home Health is a provider of home health care services in Camarillo, CA. The company`s challenge typically revolves around a shortage of care workers given the number of clients. There are two sides to this issue - one is the demand side. That challenge can be addressed in a different ways, but ultimately the goal of management is to have as many clients as possible for the capacity that it has. Thus for this task, the challenge will be on the supply side, for labor. It will be assumed that there will be sufficient demand for whatever the optimal labor configuration is going to be.
Care givers come in a number of different varieties, with different degrees of training. They typically visit the home site of the client. They perform a variety of duties for the client, including sometimes daily chores, for other care givers more of physiotherapy,…
If anything, such a person may have regrets over having wasted too much of life on impersonal achievements and selfish pursuits.
6. Do you agree that in later life men become more nurturing and women more assertive? What do you think are the findings that could support or challenge that observation?
The observation that men tend to become more nurturing, less competitive, less aggressive, and "gentler" in later life and that women tend to become less emotional and more confident or assertive would seem to be substantially true. That is largely attributable to hormonal changes; specifically, aging males tend to produce much less testosterone and post-menopausal females secrete less estrogen in their later years (Pinker, 2002). Naturally, those hormonal changes would be expected to result in various behavioral changes in areas where human behavior (and gender-specific behavior in particular) are products of the secondary sex hormones (Gerrig & Zimbardo, 2008;…
Bearon LB. "Successful Aging: What does the 'good life' look like?" Concepts in Gerontology Vol. 1, No. 3, (Summer 1996).
Birren JE. And Schaie KW. (2006). Handbook of the Psychology of Aging. Burlington,
MA: Elsevier Academic Press.
Gerrig R. And Zimbardo P. (2008). Psychology and Life. New York: Allyn & Bacon.
auspices and with a variety of purposes; this particular study described its secondary purpose as a method for describing decision making and the decision making process undertaken by patients with Heart Failure (HF). Even more importantly for this study was that the study's primary purpose was to determine and describe the process exhibited by the HF patient(s) care givers.
The specific question the study sought to answer was "How do caregivers of family members with HF make decisions" (p. 56).
The study was conducted using a "qualitative design" (p. 58). A qualitative design is normally conducted to gather data on perceptions, thoughts and beliefs concerning any number of subjects. This study was set up to determine the process of making decisions (regarding HF patients) by caregivers and why they made the decisions that they made. Since perceptions, beliefs and thoughts all play a significant role in medical treatment(s), the design…
PCVN; (2012) Progress in Cardiovascular Nursing, accessed on May 18, 2012 at http://www.blackwellpublishing.com/journal.asp?ref=0889-7204
eciprocal relationship can be simply defined as a relationship in which the two parties make an association on the basis of mutual privileges, emotions etc. There are different relationships between people and they influence their emotional development. These reciprocal relationships influence a person's life till the end of time. As far as children are concerned, their learning is mainly dependent on the engagement of family as it is the members of the family that enhance a child's experiences and family well being. Family engagement is responsible for the continuous, mutual and strong association between children and other adult members of the family (Bell and Wolfe, 2004).
When a child is of six months, he/she develops a sense of identity and agency. This whole growth mechanism is responsible for the transformation of his/her infancy-related associative original secondary emotions to the advanced levels. This system is focused on the first stable and…
Bell, M., and Wolfe, C. (2004). "Emotion and Cognition: An Intricately Bound Developmental Process," Child Development, Vol. 75, No. 2, 366 -- 70.
Social-Emotional Development in Young Children. (2012). Michigan.gov. Retrieved August 18, 2013, from http://www.michigan.gov/documents/Social_Emotional_Development_in_Young_Children_Guide_88553_7.pdf
Wilson, R.L. (2003). The Emotional Life of Children. Wagga, NSW: Keon Publications.
Using the COPE Intervention for Family Caregivers to Improve Symptoms of Hospice Homecare Patients: A Clinical Trial
This study was designed to test an intervention for hospice caregivers in order to help them better manage symptoms experienced by patients with cancer. The authors maintain that research indicates caregivers are unable to accurately assess and report the intensity of symptoms and overall quality of life (QOL) of patients with cancer and patients in hospice care.
Three symptoms, pain, dyspnea, and constipation, are commonly are seen in patients with advanced cancer. However, the author's site research that asserts that these symptoms are assessed inadequately and managed poorly in many patients. Pain and dyspnea have been found to create symptom distress, significantly affecting patient QOL.
The authors claim that caregivers must develop the skills needed to function effectively as part of the healthcare team. Building the knowledge base and teaching…
McMillan, S.C. & Small, B.J. (2007, March). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients: A clinical trial. Oncology nursing forum, Vol. 34, Issue 2, 313-321. Retrieved January 20, 2012, from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=3&hid=14&sid=b3e07ee7-388a-4d19-97ef-163b481297fd%40sessionmgr15
Care Case Study
Slide 1 Footnotes
There have been enormous changes due to introduction of various cultural elements in the continuum of care. Before, when people were admitted to assisted living facilities or hospital settings, there were very little cultural elements outside of the majority culture which had sponsored the facility. For example, if a facility was associated with some sort of church or temple, there were elements of that religion present, but there was little alternatives for members of other cultures or religions.
Yet, today, there are now a much wider array of cultural elements available in assisted living homes and hospital facilities. Assisted living programs are regulated on the level of the state.
As such, different states have different types of programs and policies that impact the degree to which cultural characteristics are included or excluded within various assisted living facilities. Some programs encourage cultural elements of patients…
ALFA - Assisted Living Federation of America. (2009). Assisted Living Regulations and Licensing. Retrieved from http://www.alfa.org/State_Regulations_and_Licensing_Informat.asp
Medicare Payment Advisory Commission. (2011). Report to the Congress: Medicare Payment Policy. Retrieved from http://www.medpac.gov/documents/Mar11_EntireReport.pdf
National Caregivers Library. (2012). Independent Living Facilities. Retrieved from http://www.caregiverslibrary.org
Next Step in Care. (2012). Reducing the Stress of Hospitalization for Patients with Dementia and their Family Caregivers: A Guide. Family Caregiver Alliance. Retrieved from http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2449#researchpractice
Motivational Healthcare Techniques
Healthcare Motivational Essay
Most companies would concur that human resources are one of the most -- if not the most -- valuable assets a company has. And what is the healthcare industry besides a (usually) for-profit company? Oftentimes, however, there is an incongruent dichotomy between healthcare management and its employees, or more properly called its caregivers. Hiring, training, and employment policies may sometimes conflict greatly with the company's (hospital's) bottom line, which is profitability, over the ability to maintain high or even average motivation amongst its workers. This paper seeks to explore at least three ways a rapprochement might be met between upper management successfully handling the bottom line -- profit -- and exhorting its agents (employees, or caregivers) to keep their motivation high enough to reach maximum levels for both parties.
The first motivational technique worth noting is one in which a study conducted by S.…
Clark, Paul F., Darlene A. Clark, David V. Day, Dennis G. Shea. (Oct., 2001). Healthcare reform and the workplace experience of nurses: implications for patient care and union organization. Industrial and Labor Relations Review, Vol. 55, No. 1, pp. 133-148.
Gagne, Marylene, and Edward L. Deci. (2005). Self-determination theory and work motivation. Journal of Organizational Behavior, Vol. 26, No. 4, pp 331-362.
Pugh, Douglas S., Joerg Dietz, Jack W. Wiley, Scott M. Brooks. (Nov., 2002). Driving service effectiveness through employee-customer linkages. The Academy of Management Executive., Vol 16, No. 4, pp. 73-84.
The hope appears to be that deinstitutionalization will lead to human services that are more inclusive and that do not marginalize disadvantaged and minority groups in the same way that centralized institutionalized care did. However, this leads me with the question of who is establishing the standards of care for the smaller groups? Are those standards established locally? If not, then how can the standards possibly reflect the concerns of different subgroups in society. On the other hand, if they are established locally, bias and prejudice can still impact the provision of care, and those local biases and prejudices may not be apparent to any non-local oversight agencies.
Australian Institute of Health and Welfare. (2001). Deinstitutionalization: The move towards community-based care. In Australia's Welfare 2001: The Fifth biennial welfare report of the Australian Institute of Health and Welfare (pp.96-139). Canberra: Australian Institute of Health and Welfare.
Fine, M. (Year).…
Australian Institute of Health and Welfare. (2001). Deinstitutionalization: The move towards community-based care. In Australia's Welfare 2001: The Fifth biennial welfare report of the Australian Institute of Health and Welfare (pp.96-139). Canberra: Australian Institute of Health and Welfare.
Fine, M. (Year). Defining and claiming care. In A caring society? Care and the dilemmas of human services in the twenty first century (pp. 26-51). City: Palgrave McMillan.
Litwak, E. (1985). The theoretical bases for primary-group networks and formal organizations in modern industrial society. In Helping the elderly: The complementary roles of informal networks and formal systems (pp.6-30). New York: Guilford.
Mason, J. & Noble-Spruell, C. (1993). Child protection policy in New South Wales: A critical analysis. In Jan Mason (Ed)., Child welfare policy: Critical Australian perspectives (pp.25-36). Sydney: Hale & Iremonger.
Nursing Roles for the Elderly
Nursing professionals play a number of valuable and important roles for members of society. They act as reliable sources of information regarding health issues. They also act as educators and counselors to help patients adjust to changes in their health, treatment and lifestyle. Most importantly, nurses act as caregivers who look after the physical, psychological as well as emotional well-being of their patients. Some of these roles become more essential and pronounced for elderly patients because of their distinct needs as opposed to those experienced by other patient groups.
Nurses as Caregivers for the Elderly
The most important role of nursing professionals is that of a caregiver or care provider. Nurses provide care to patients at the hospital as well as at home in the capacity of private nurses. They help patients in the administering of medical treatment and in following the lifestyle changes recommended…
This could make it easier for everyone to deal with critical challenges and prevent the situation from becoming worse. (Medina, 2006) (Leddy, 1998)
However, because the son is engaging a confrontational attitude, means that these issues are becoming very complicated based upon the way he is acting. These elements are showing how new tactics must be utilized that will exercise health care professionals' power and control over the situation. The defining variables for this component are the primary caregiver does not want to cooperate and understand what is happening. This supports the answer to the assessment question by illustrating what options they have available, in dealing with these kinds of challenges over the long-term. (Medina, 2006) (Leddy, 1998)
egulation and Conflict
The basic regulations allow the caregiver to make decision concerning the treatment options the patient is receiving. According to the AAPS, the patient and the caregiver have a number…
Patient's Bill of Rights. (2013). AAPS. Retrieved from: http://www.aapsonline.org/patients/billrts.htm
Cohen, E. (2005). Nursing Case Management. St. Louis, MO: Mosby.
Leddy, S. (1998). Conceptual Basis of Professional Nursing. Philadelphia, PA: Lippencott.
Levine, C. (2004). The Cultures of Care Giving. Baltimore, MD: John Hopkins University Press.
Alzheimer Healthy Community
PLANNED, PERSONALIZED CARE
Alzheimer's Healthy Community
Dog-Assisted Therapy for Older People with Dementia
A review of nine studies on the subject produced loose conclusions on the value of this type of therapy (Perkins et al., 2008). They, however, established a trend, indicating increased social behavior and decreased agitation when dogs were in the company of the respondents. This improvement in social behavior was unrelated with the severity of the respondents' dementia. Six of the 9 studies were conducted in the U.S.A., 2 in Japan and 1 in Australia on 28 respondents, all with a diagnosis of Alzheimer's disease or dementia (Perkins et al.).
The behavioral and psychological symptoms of this ailment not only cause the afflicted individuals much pain but also put them at risk of physical harm (Perkins et al., 2008). Animal-assisted therapy, on the other hand, has shown positive effects over pro-social behavior and the…
Cevizci, S. et al. (2013). Animal-assisted therapy and activities in Alzheimer's Disease.
Chapter 12. "Understanding Alzheimer's Disease," InTech:Canakkale Onsekiz Mart
Hung, J, (2012). A study on the establishment and evaluation of adult day care service centers. Vol. 6 # 5, Global Journal of Business Research: Chao-yang University of Technology.
Iecovich, E. And Biderman, A. (2013). Attendance in adult day care centers of cognitively intact older persons: reasons for use and nonuse. Journal of Applied Gerontology:
The following questions pertain to:
McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.
What is the purpose of this research?
The purpose of this research was to describe the unexpected and distressing symptom experiences that women may have after undergoing breast cancer treatment, with the goal of enhancing follow-up care through practitioner education and an increase of the knowledge base.
What is the research question (or questions)? This may be implicit or explicit.
What symptoms may be experienced after breast cancer treatment that contribute to symptom distress and psychological stress that are may be temporal, situational, or attributive -- and that may be ameliorated during follow-up care?
What theories, frameworks, models or concepts may have influenced the researchers' choice of a research design?
The qualitative approach stems from a phenomenological philosophical background…
Leaning does not only imply facts, but continual and fluid evolution of the brain. This is the identical process that the brain takes when improving itself and reducing aging. If the brain continues to receive stimuli and appropriate chemicals for energy, then it follows tat there will be increased brain function and activity. If the voltage, just as in a battery, becomes stronger, then activity increases. As the brain is continually stimulated, more building materials are produced that allow information to become part of our experience. Interestingly, the variety and frequency of certain exercise programs, in fact, "teach" the body at different rates. Using different intensities of movement, concerns of overeating, weight regulation, quality of life, and especially depression are mitigated (Douglas, 2009).
Finally, the healthcare and other market modifiers will need to change and evolve as the population ages. The global baby bust will change financial markets, investing, products,…
Aging Statistics. (2010, June 30). Retrieved from Administrator on Aging - U.S. Health & Human Services: http://www.aoa.gov/aoaroot/aging_statistics/index.aspx
Does Population Aging Affect Financial Markets? (2012). National Bureau of Economic Research. Retrieved from: http://www.nber.org/bah/winter05/w10851.html
Dynamics of Population Aging in the Modern World. (2002, January). Retrieved from Longevity-Science.org: http://longevity-science.org/Population_Aging.htm
Family Caregivers: The Issues They Face Are Everyone's Concern. (2010). Capella University,
Living Environment Options
Guide: Variables Having an Impact on the Options of Individuals with egard to Living Environments
Older adults require supportive and enabling environments. In addition to being safe and empowering, the said environments must also help in the elimination of ageism. It should be noted that in a way, the well-being of older adults is affected by their immediate living environments (Healy and Link, 2011). In this guide, a living environment will be used as a generic term indicating not only the physical place of residence but also the existing support networks in place.
Insurance and Financial esources
To begin with, it is important to note that insurance does have a significant impact on the choice of living environments. For instance, while some health insurance programs cover most of the costs incurred in an assisted living facility, some plans do not have such provisions. As Wallace (2007) points…
Cress, C.J. (2007). Handbook of Geriatric Care Management (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
Healy, L.M. & Link, R.J. (2011). Handbook of International Social Work: Human Rights, Development, and the Global Profession. Oxford: Oxford University Press.
Johnson, T.F. (Ed.). (1999). Handbook on Ethical Issues in Aging. Westport, CT: Greenwood Publishing Group.
Rosenfeld, J.A. (Ed.). (2009). Handbook of Women's Health (2nd ed.). Cambridge: Cambridge University Press.
Grandparents as Caregivers
An Introduction to the Skipped Generation
Families in the late 20th and early 20th century are not the same as they were prior to World War II and even up into the 1960s. The idea of marriage is both a social and religious contract that is sanctioned by society as a valid contract and event. Depending on the particular society and culture, marriage combines the institution of family with intimate and sexual relationships, and the idea of the unit growing from this union. Traditionally, marriage has been with a man and a woman with the potential of having children, thus creating kinship ties to extended families. Historically, this was also an economic unit; families joined forces with land or property, or even joined nations together. Over the past few decades, though, marriage has weakened as the prime social institution of family life. There are a number of…
Collins, W. (2011). A Strengths-Based Support Group to Empower African-American Grandmothers Raising Grandchildren. Social Work and Christianity. 38 (4): 456-66.
Goodman, C., et al. (2008). The Health of Grandmothers Raising Grandchildren: Does the Quality of Family Relationships Matter? Families, Systems and Health. 26 (4): 417-30.
Lipscomb, R. (2005). The Challenges of African-American Grandparents Raising Their Children. Race, Gender and Class. 12 (2): 163-77.
Strom, P., Strom, R. (2011). Grandparent Education: Raising Grandchildren. Educational Gerontology. 37 (1): 910-23.
We don't really know everything a newborn infant is capable of, but we know that mother and infant relate to each other within the first few minutes of life (Klaus, 1998). When we think of infancy, in my opinion we have to keep in mind that we cannot observe brain activity. The baby that can reach for a toy at seven months was learning things all along that brought him or her to that point. So I believe infancy to be a crucial part of child development.
If this is true, then the role of the caregiver is crucial. We know that babies are cared for in different ways by members of different cultures. In the United States, a mother is likely to place the baby in some kind of stroller and push the child in front of her. However in some African and Asian cultures, the mothers carry…
Gonzalez-Mena, Janet. 1997. "The cultural context of infant caregiving. Childhood Education, Sept. 22.
Klaus, Marshall. 1998. "Mother and Infant: Early Emotional Ties." Pediatrics 102:5, November.
Mogilner, Celly. 1995. "Maternal social and physical contact: links to early infant attachment behaviors." Journal of Genetic Psychology, December.
Small, Meredith F. 1997. "Making connections (adult-infant connections) (1997). American Scientist, November.
Digestive Disorder: Diverticulitis
The patient is a 37-year-old female with a family history of colorectal cancer mandating regular colonoscopies before the age of 40. The patient's diverticulosis was discovered during a routine colonoscopy at age 35. She was asymptomatic for 2 years, but developed diverticulitis at age 37. When she began experiencing significant pain her lower left abdominal area, she suspected diverticulitis, called her gastroenterologist who referred her to the emergency room for a cat scan, which confirmed the diagnosis, and then given a course of antibiotics, which resolved the issue.
"Diverticulitis develops when feces become trapped in pouches (diverticula) that have formed along the wall of the large intestine. This allows bacteria to grow and cause an infection or inflammation and pressure that may lead to a small perforation or tear in the wall of the intestine. Peritonitis, an infection of the lining of the abdominal…
Davis B.R. & Matthews, J.B. (2006). Diverticular disease of the colon. In M. Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 855-859. Philadelphia: Saunders Elsevier.
Maconi, G., Barbara, G., Bosetti, C., Cuomo, R., & Annibale, B. (2011). Treatment of diverticular disease of the colon and prevention of acute diverticulitis: A systematic review. Dis. Colon Rectum, 54(10), 1326-38.
Martin, S.T., & Stocchi, L. (2011). New and emerging treatments for the prevention of recurrent diverticulitis. Clin. Exp. Gastroenterol., 4, 203-212.
Unlu, C., Daniels, L., Vrouenraets, B.C., & Boermeester, M.A. (2011). A systematic review of high-fibre dietary therapy in diverticular disease. Int. J. Colorectal Dis. doi: 10.1007/s00384-011-1308-3. Retrieved from: http://dx.doi.org/10.1007/s00384-011-1308-3
Sexuality and Severe Brain Injury
The ethical issue in this case study is the fact that Mr. Z decides to have sexual intercourse with his wife Mrs. Z who is brain damaged. Her current state does not allow her to make any valid and sober decision. The action by Mr. Z is unethical since for one to have sex they should give consent, this is however not possible for Mrs. Z since she is unable to speak. This is a clear indication that she is not able to participate in even basic decision making leave alone giving consent to sexual intercourse. The severe mental disability leaves Mrs. Z incapable of giving any valid consent to intercourse. The act of having sexual intercourse with a an individual without her direct consent is quite unethical since Mr. Z is engaging in intercourse with someone who has not given consent even…
Syracuse University. (1998). An Ethical Decision-Making Model. Retrieved June 25, 2014 from http://soe.syr.edu/academic/counseling_and_human_services/modules/Common_Ethical_Issues/ethical_decision_making_model.aspx
Rainbow, C. (2009). Descriptions of Ethical Theories and Principles. Retrieved June 25, 2014 from http://www.bio.davidson.edu/people/kabernd/indep/carainbow/theories.htm
society that has a much higher percentage of older adults than any previous generation. Still, older adults are often marginalized and rarely interact with younger people, many believing "old people" have nothing to offer. The modern environment is faced with a number of problems that directly relate to aging. A number of methods to reduce the effects of time are thought to be new and innovative, when often; it is many tried and true methods that are the most efficacious. This is as important for medical specialists, geriatric caregivers, and even family caregivers -- those in the trenches who are faced with the daunting and daily tasks of helping to care for our aged. They know that using physical activity to bolster biological reactions is one of these methods that work -- and now science has proven that certain chemicals are released when one is active, amused or happy that…
Costanza, R., et al. (2008). An Integrative Approach to Quality of Life Measurement,
Research and Policy. Sapiens Journal. 1 (1). Cited in:
Johannson, M., et al., (2006). Living with Incurable Cancer at the End of Life -- Patients'
Broken Heart Syndrome
Cardiovascular Case Study
Broken heart syndrome, otherwise called stress or Takotsubo cardiomyopathy (TTC), represents an adverse physiological response to an acute psychological or physical stressor (Derrick, 2009). The death of a loved one or experiencing a physically traumatic event, represent two examples of life stressors that can cause this reversible form of cardiomyopathy. Although effective treatment is available, the seriousness of the condition is such that it explains how a person can literally die of a broken heart.
An estimated 1.2 million people suffered from an myocardial infarction (MI) in 2007 and approximately 1% (Derrick, 2009, p. 50) to 2% (Wittstein, 2012, p. 2) of MI events was probably due to TTC. Women are far more susceptible to TTC than men and represent approximately 89% of all cases (Derrick, 2009, p. 50). This gender bias shifts the estimated prevalence of TTC among female MI patients…
American Heart Association, American Stroke Association. (2011). Women & cardiovascular disease: Statistical fact sheet 2012 update. Heart.org. Retrieved 4 Feb. 2012 from http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319576.pdf
Derrick, Dawn. (2009). The "broken heart syndrome": Understanding Takotsubo cardiomyopathy. Critical Care Nurse, 29, 49-57.
Fitzgerald, Helen. (2000). Helping a grieving parent: Working through Grief. AmericanHospice.org. Retrieved 4 Feb. 2012 from http://www.americanhospice.org/index.php?option=com_content&task=view&id=84&Itemid=8
Liao, Joshua. (2011). Takotsubo: Octopus trap. Journal of Medical Humanities. Published ahead of print online Aug. 9. Retrieved 4 Feb. 2012 from http://www.springerlink.com/content/ak0776051x43w701/
As people age, there are three main types of cognitive changes that can impair or alter cognitive functioning: mild cognitive impairment (MCI), Alzheimer's, and Parkinson's. All of these syndromes are more severe than the normal decline that is expected with aging, though they do not all reach the severity of dementia. Dementia refers to the "the loss of cognitive functioning- thinking, remembering, and reasoning- and behavior abilities, to such an extent that it interferes with a person's daily life and activities" (NIH, 2013). While there are some similarities between these three conditions, there are also significant differences between the three syndromes. These differences can impact treatment options and also help predict impact on the patient and the family.
MCI is an intermediate stage, which features a more significant cognitive decline than that expected with normal aging, but is not as severe as full-blown dementia. "It can involve problems…
Mayo Clinic Staff. (2012, August 21). Mild Cognitive Impairment. Retrieved October 21, 2013
from Mayo Clinic website: http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553
National Institutes on Health. (2013, October 17). Alzheimer's Fact Sheet. Retrieved October
21, 2013 from the National Institute on Aging website: http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet
Mr. H case study
What is the client's most prominent presenting issues (that is, what seems to take priority as being wrong)?
Mr. H has shown a sharp decline in cognitive functioning. He has quit his job without warning and without consulting with his spouse (who is economically as well as emotionally affected by this decision), has shown difficulty remembering basic tasks and words that a man of his education and background should be able to retrieve easily, and is exhibiting signs of disorientation. Despite being an accomplished outdoorsman he has gotten lost while hiking; has difficulty reading; and although he was a science teacher has difficulty doing basic math. He also has trouble performing basic acts of self-care and memory exercises.
Q2. What else do you feel you need to know (or, what might be some areas you may ask about in order to determine what…
Alzheimer's disease: Treatment and drugs. (2013). Mayo Clinic. Retrieved from:
Diagnostic criteria for dementia of the Alzheimer's type. (2013). BehaveNet. Retrieved from:
Child Play Time Naturalistic Observation
Describe the setting and why you chose it.
The naturalistic observation approach is performed in a pre-school environment. The reason being that the environment allows the experiment to focus on the possibility of behavior of a child to be influenced by environmental factors or conditions, giving a comprehensive depiction of what occurs in classrooms in the case of preschool children. The following study gives a unique observational design and approach which allows numerous observations on a child for the purpose of examining the trends of behaviors both within and across classroom event settings and the manner in which they relate to a given child's gender and also basic tutor conducts (Leslie M. Booren, Jason T. Downer, & Virginia E. Vitiello, 2012).
Discuss the age, gender, ethnicity and overall physical description of the child?
The observation was performed on a child of pre-school age, around five…
African-American people from a qualitative perspective. The literature review will provide a brief background on African-American people and leading health problems they face along with a brief inclusion of census data to create a general picture of health from the perspective of an African-American person. One African-American man was interviewed. His answers provide a means of generating a construct that will be used to draw conclusions for nursing practice and standard of care development.
African-American People: Literature Review
A website called: 'Dimensions of Culture', examines cultural patterns existent in many African-American communities. Those that recently immigrated from Africa show an even different culture compared to African-Americans that have lived in the United States for generations. One common cultural pattern experienced by African-Americans is the 'Black' Experience, which is diverse, representing a wide array of skin tones and backgrounds. The next is the social structure. The social structure often takes on…