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Dementia and Caregiving
Types: alzheimers, vascualar (strokes), lowy body, mixed dem, parkinson, FTD, Creutzfield, normal press hydo
Group of symptoms: memory, language (aphasia-lang/ anomia- objects), visuospatial skills (apraxia-motor), caculations, exectuive funcitions (planning, organ, abstrac, seq), personality, behavior
Warning signs: memory loss, difficulty performing tasks, lang prob, disorientation, poor judgement, abstact thinkn prob, misplacing things, change in mood/behav, change in personality, loss of inititave
ambiguity in dememting illness: result of brain damange/death, persisitant, progressive diseasse, lucidity
ambiguous loss: psychologiclly absent, inability to participate in family life, changes in role, family and friends fade away
difficutlties with family: isolation (loss of social connection, preoccupation with illness) depletion of resources (physical, emotional, fincancial)
Types of support: availability (size of network, density, freq of contact, reciprocity), instrumental (daily living needs, phyical help) emotiional, informational
Models of social support: hierarchical-compensatory (spouse to children), task-specificity, funcional-speciificity of relationship, convoy
negative effects of caregiving: depression, anxiety, phyicial morbity, psycholicial morbiity
- positive effects of cargiving: flexibility, slowing life down, bonding, letting go of unimprotant things, reasons not to do something, duty/ companionship, rewarding, providing quality of life, enjoyment, importnat, loves persn
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Caregiving
- Stress: the tension between an event or situation and the perceived ability to cope or adapt to it has been developed to explore the effect on family functioning
- Two types: demands/ resources and types of illness
Rolland's Illness Typology: rather than focusing on medical typology, it describes illness challenges which are disorganizing to family systems
Phases of Caregiving: prediagonostic (type of onset, intervention/confirmation, gathering v polarization), diagnosis (trauma/crisis, organzing v disengagement, family gathering), role changes (losses, restructuring v denial, change in roles), chronic caregiving (engulment /exhaustiion, respite, family support, education), shared care (boundary maintenance, collaboration v ambilaence v avoidance, collarboartive care), long term care (marginalization of family caregiving, engagement v conflict v disengagement, planniing "family expertise"), end of life (amvivalence, relief v guilt v conflict, family gathering and life review)
- Hills ABC-X Model
- A factor: demands, phsycal, mental, emotional (situation, whats going on)
- B factor: resources (that are present-money, support system, time)
- C factor: perceptions (how do they feel about whats going on
- X factor: outcome, physical and mental health outcomes, level of disorganization of families (role changes, conflict)
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Guest Speaker:
resources: family/ friends
perceptions: she wanted to be the one taken care of, thought it was too much, help is okay, involved/support grp/ edu others
outcome: not interested in dating, support groups of friends, engaged/ active
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Caregiving/Losses
Types of family involvement: disengaged (hands off), consultant (phone call), competitive (not give up role), cooperative (ideal, mix), depenent (don't know what to do)
what do families contribute to long term care: legitimacy, stability, intimacy, past and future, generational diversity
29% of US pop providing care to someone who is ill, disabled, or aged, 65.7 million
caregivers of adults are now older, that were thier counterparts in 2004, average is now 49years
more women than men are caregivers: an estimated 66% of caregivers are female
average age of caregiver is 48, 51% is between the ages of 18-49
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Readings: Taking care of Alzheimers....
women as "keepers of Kin"- taking care of elderly is seen as a women's job
Women often dealt with the day-to-day duties such as bathing, feeding and assisting with going to the bathroom, while male caretakers are more likely to handle finances, fix things around the house or run errands.
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Readings: Caregiving and Ambiguous Loss
main problem is not the illness itself, but the ambiguity and uncertainty it causes
cognitive impairment
Tips for coping: name your problem, practice both and thinking, Know your “family” and community information and support systems, Continue—but revise—family holidays, celebrations and rituals, revise family roles, be aware of family rules, Understand that anger and guilt are normal, but avoid harmful actions, imagine something new to hope for, check your own health
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Readings: Married her friend, living with a monster
Marital problems arise partly because changes can be subtle and difficult to detect early on in the disease.
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