CARE OF ELDERLY.   Term Paper ID:23797 Click to get this paper

Essay Subject: Examines care of aged by relatives, significance, stress, generational conflict & role reversal, impact on family, social support, role of nurse.... More...

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Paper Abstract: Examines care of aged by relatives, significance, stress, generational conflict & role reversal, impact on family, social support, role of nurse. Paper Introduction: This paper addresses the care of elderly patients by their relatives and the role reversal that takes place in this care setting. It identifies and discusses the issue of elderly care, the impact of care on family members, social and community resources available to families facing the issue of taking care of elderly patients, and the role of the family nurse practitioner within this caregiving setting. Family members and friends continue to provide the major portion of long-term care of the elderly in society (Burggraf, 1993, p. 25). More than 7 million American households are actively involved in providing care for older adults (Sharlach & Others, 1991, pp. xi-xvi). These households are part of the support for 5 million older Americans who require assistance with day-to-day tasks in order to remain in the community. Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. Nurses who encounter elders in community settings can help initiateproactive planning for elders and their families. Consequently, the population has aged markedly over the pastcentury and will continue to do so well into the next century.Approximately 32 million people are 65 and older, which is about 12.6percent of the total population. Rennebaum,(Eds.). K., & Osterweis, M. Primary health care providers frequently come in contactwith caregivers when a care recipient's health is in question. However, it is a different matter when thehelp others need is both continuous and progressively demanding. New York: Springer. Caregivers to parents, on the other hand, often have siblings who stand inthe same familial relationship to the impaired adult (i.e., parent-child).The siblings of the impaired parent--aunts and uncles to the caregiver--frequently form part of the familial context of caregiving as well.Moreover, many adult children have nuclear families of their own, spousesand children to whom they have responsibilities. Nurse practitioners place emphasis on whythe patient is at risk. The average caregiver receives less informational assistance than neededwith the tasks of caregiving and maintaining a household, and this shortageis not compensated for adequately by the use of an in-home attendant. New York: Academic Press. Perceptions of caregiver needs vary among caregivers. outside of nursing homes)increases as well. Although manyfamily members feel an obligation and desire to care for their elderlyloved ones personally, the large percentage of women working outside thehome and the dissolution of the nuclear family have decreased the number offamily members available to help elders. Husbands and wives are moreinclined to see themselves resorting to institutionalization because oftheir own waning ability to provide care. An increasing number of persons live to the age of infirmity, andfamily members are likely to face difficult decisions about the mostappropriate level of health care for an aged relative. The major categories of mental support are informal, i.e.,provided by family or friends, and formal, i.e., provided by trained peoplewho are paid for their help. Once illness resolves or is stable, counselingabout health promotion and disease prevention helps to maintain thepatient's health. American Nurse, 25(7), 25. Given the significance of work activity in adult life, the impact ofcaregiving on employment must be examined. (1977). The focus of the nurse practitionerrole has changed as nurse practitioner education has changed from a medicalmodel to a nursing model. 267-286). El-Sherif, C. This paper addresses the care of elderly patients by their relativesand the role reversal that takes place in this care setting. Moral obligation, conflicts between caregivingresponsibility and other commitments, difficulties with health carefinancing, the individual's responsibility in planning care, and quality ofcare are major ethical questions that the caregiver encounters. However, given that caregivinghas the inherent capacity to evoke stress, the processes that generatesuccessful adaptation as opposed to generally maladaptive outcomes areoriented toward two areas, namely stress proliferation and stresscontainment. However, these new skills shouldnot replace the responsibilities of the nurse practitioner as a primarycare provider who focuses on prevention, health education, counseling, andcase finding. Dellasega, C. Ashley, J. The actions of other familymembers, however, can affect the balance between the boundaries of care andthe resources available to meet these demands. As the American population continues to age, the number of olderpersons with health impairments and associated dependencies grows.Consequently, the ranks of family caregivers whose assistance enables theirelderly relatives to live in the community (i.e. 154). A product of the demographic agingof the population, especially the rapid growth of the most highly disabledsegment of the elderly population (i.e., those 85 and older), is that theelderly population is becoming increasingly more disabled over time despitebiomedical and public health interventions. Telephone follow-up, reassurance, family counseling, andreferral are all part of the nurse practitioner's role but are hard tocapture. For many people,caregiving is an expression of extreme altruism, where one's own well-beingis sacrificed for the benefit of another. Children are less likely to havean ailing parent institutionalized, for exactly the opposite reason. For childrenhaving to take care of their ailing parents, this area is of primaryconcern. Stephens, J. Mezey, M. It identifiesand discusses the issue of elderly care, the impact of care on familymembers, social and community resources available to families facing theissue of taking care of elderly patients, and the role of the family nursepractitioner within this caregiving setting. 12-15). Most caregivers consult other family members about the decision tocease in-home care for an ailing parent. The time andenergies of caregivers come to be consumed by this single enveloping role.Absorption into caregiving, of course, is often at the expense of theactivities and relationships across which people's lives have previouslybeen spread. The majority of caregivers receive help from outsidesources, i.e., community outreach programs, parochial assistance programs,or family nursing home programs. Financialconsiderations and ethical conflicts provoke further caregiving concerns. With this help, families may be better prepared tomake informed decisions before a crisis occurs. (1991). The degenerative and irreversible course of old age,and its varied symptoms, typically results in family caregivers becomingincreasingly engulfed by the needs of the impaired relatives. Nevertheless, these responsibilities and skills are invaluable inassisting families that are put in a caregiving position to betterunderstand their caregiving role, as well as to assist in counseling whenso needed. Many caregivers are also forced to alter theiremployment status to accommodate caregiving. Nurse practitioners--Where do theybelong within the organizational structure of the acute care setting?Nurse Practitioner, 2 (1), 62-65. Nurse practitioners are learning to perform proceduresthat were previously the sole domain of physicians, such as bone marrowaspirations and chest tube insertions. Lexington, MA: Lexington Books. Although placement of an elderly relative in a nursing home may seemlike an ideal option for relieving the burden of caregiving, family membersoften experience grief and turmoil over this choice (Townsend, 199 ).Several quantitative studies indicated that placement was an extremelystressful event for family members (Dellasega, 1991). Theyperceive their younger age as a advantage in handling an ailing parent. Understandably, overwhelming circumstances may also result inisolation, a sense of being invisible in the larger society, and aconviction that no one "out there" understands or cares about the pain andsuffering that goes with the caregiving. None of the instrumentalsupport measures is significantly correlated with sentiments of emotionalsupport. Sharlach, A. Coping with these stress factors focuses upon two types of resources,social assets in the form of social support and personal assets in the formof a sense of mastery or self-efficacy. One of the major reasons for the institutionalization of patients hasbeen cited as caregiver burnout. Studies have found thatcaregiving employees are forced to reduce their work hours, rearrange theirwork schedules, miss meetings and training opportunities, forgo promotions,take leaves of absence, and make other changes in their work routines andcareers in order to accommodate their caregiving responsibilities.Caregivers protect their families and jobs at the expense of personal timeand socialization. The problem ofrole reversal is involved, i.e., parent/child versus child/parent,resulting in caregivers frequently reporting physical health problems andemotional distress as consequences of providing informal care for anelderly loved one. Caregiving stress among community caregiversfor the elderly: Does institutionalization make a difference? Social isolation, lack of privacy,and inadequate rest are commonalities of the round-the-clockresponsibilities, often contributing to unhealthy family dynamics. Journal ofCommunity Health Nursing, 8(4), 197-2 5. Stress and coping in later-life families (pp. 4 -43). Because primary caregivers carry most of the burden of providingcare, their ability and willingness to continue to do so establishesboundaries on the duration of in-home care. Nurses involved in senior centers or similarcommunity facilities need to develop classes about long-term care planningand decision making. The extent of stress proliferation and the degree of stresscontainment explain why the well-being of some people is put at extremerisk by caregiving, whereas other people seemingly are able to survive withlittle apparent damage to themselves. Melillo, K. This includes the existence of socialrelations, networks, and support which is the functional content of socialrelations. L. Nurses can have impact when families assumecaregiver role. In M. Family members whotake on the challenge of caregiving do so at a great personal cost.Caregivers frequently report physical health problems and emotionaldistress as consequences of providing informal care for an elderly lovedone. F., & Schneider, E. These center around health, finances, ethical conflicts,family dynamics, and employment. 5). Symptoms of nonspecific psychologicaldistress--depression, anxiety, and anger--as well as poor health, fatigue,or difficulty lifting the patient all contribute in the decision makingprocess to have a person institutionalized. Stress proliferation relates to the encroachment of care-relatedstress into areas of life previously insulated from hardship. (1995, January). Demographic trends portend concomitantincreases in the number of elderly persons with chronic disease,disability, and dependence upon others for assistance with activities ofdaily living. 62). Nurse Practitioner, 2 (5), 4 -43. However, the primary caregivers do not act within a social vacuum.Instead, most caregiver-patient pairs are embedded within larger familysystems. D., & McGivern, D. D., & Futrell, M. Family nurse practitioners can play an important part in thecaregiving of elderly family members. Family caregivers have serious unanswered ethical questions as wellas concerns about the duty of other family members and of society to theelderly person. Hobfall, & D. These householdsare part of the support for 5 million older Americans who requireassistance with day-to-day tasks in order to remain in the community. As a result of advances in public health and medical technology,people are likely to live appreciably longer than their parentalgeneration. 25). This has been both a course of financial considerationsand a reflection in the current state of caregiving. For spousal caregivers, these systems typically include theiradult children, their own siblings, and the siblings of the care recipient. A guide for assessingcaregiver needs: Determining a health history database for familycaregivers. New York: Teachers College. Inaddition, in most younger families, where both husband and wife arebreadwinners, income also plays an important role in caring for an elderlyparent at home, since the presence of resources is reflected in easing someof the burdens of care, such as the use of an attendant (Aneshensel,Pearlin, Mullan, Zarit, & Whitlatch, 1995, pp. 153-155). For most people, assisting others when their needs are limited andtransient is relatively easy. For example, nursespracticing in physicians' offices can begin discussions with an elder aboutthe elder's wishes if his or her current level of physical or mentalfunctioning should decline. Morethan 7 million American households are actively involved in providing carefor older adults (Sharlach & Others, 1991, pp. The strain of caregiving experience may exacerbateexisting problems among family members. The literatureidentifies common themes of concern to families (Melillo & Futrell, 1995,May, pp. Although functional loss and disability are not necessaryconsequences of the aging process, both tend to increase with age as aresult of underlying chronic disease. Caregivers in this respectare as often the hidden patients, in that they are at risk for serioushealth problems. Family members and friends continue to provide the major portion oflongterm care to the elderly in society. Washington, DC:Academic Health Centers. Profiles in caregiving. The roles of physicianassistants and nurse practitioners in primary care. However, with respect to the socialsupport received by the typical caregiver, two dimensions warrant emphasis. The length of timeneeded for a caregiver to accept the change in the elder's ability to liveindependently varies with each situation. Home care for an ill elder isalso more complex than in previous years because the very old often havemultiple problems affecting their functional abilities. Some caregivers have graduallyadjusted to the idea during hone care prior to the placement, while, forothers, recent health decline and hospitalization of the elder marked thefirst time that they were forced to think about a placement. The potential impact of these concernsmust be considered when examining the health of caregivers and caretakers.One of the most pressing concerns within the context of adult/eldercaretaking relates to declining physical and mental health of thecaregiven, and the stress it places on the caregiver. References Aneshensel, C., Pearlin, L., Mullan, J., Zarit, S., & Whitlatch, C.(1995). (1995, May). Advanced technical skills are part of this new role for nurses inadvanced practice. (1993). However, family members who takecare of their elderly parents do so at great personal cost. A. Clawson, D. The minority of caregivers receive help fromfamily members, i.e., sons, brothers, sisters, or friends, although adiverse group of other relatives may help regularly (e.g., in-laws andnieces/nephews). (199 ). (1993). xi-xvi). Onthe other hand, despite this unmet need, caregivers generally feel caredfor and connected to their friends and relatives. The second area entails the regulation or control of the impactof numerous care-related stressors, largely through various material andpsychological resources, called stress containment (Mezey & McGivern, 1993,p. Inaddition, family relationships and dynamics may be altered by caregivingresponsibilities. Townsend, A. Over the past 25 years, nurse practitionereducation has moved from continuing education in medical schools tograduate level education in the colleges and universities. (1991). Burggraf, V. Nurses, nurse practitioners.Evolution to advanced practice. Since the196 s, deinstitutionalization of aging parents by their children has been aprogessive trend. (1993). Crowther, S. Hospitals, paternalism, and the role of thenurse. Nursing care for families that experience problems with the rolereversal of child/adult or adult/parent situation are often left bereft.However, family nurse practitioners can play an important role in absorbingthe conflict that is inevitable between caregiver and care recipient.Primary care within nursing is the academic discipline of nursing, and itmust be considered the dominant force of the discipline itself (Ashley,1977). Curriculumcontent now includes nursing theory, and the focus is the management ofthe patient's needs rather than the disease, as in the medical model (El-Sherif, 1995, January, p. Family members and friends continue to provide the major portion oflong-term care of the elderly in society (Burggraf, 1993, p. In general terms, social support refers to the satisfaction of aperson's interaction with others. E., Lowe, B. The nurse practitioner's role and work setting are also changing.Traditionally, the nurse practitioner has provided primary care incommunity health clinics, private offices, or outpatient settings.However, because hospitals have become cost-conscious in an environmentwhere health care needs and services are increasing, nurse practitionersare moving into the hospital setting (Clawson & Osterweis, 1993, pp. In addition, they talk tofriends, professionals, or both. Clearly, therefore, this sentiment is fostered by factors otherthan the direct help received with instrumental tasks of caregiving.Support may be derived from the mere presence of other family (Aneshenselet al, 1995, p. Nursing home care and family caregivers'stress. For example, tasks thatbecome too physically demanding, such as lifting and moving the patient,might be taken over by hiring outside help, such as a physician assistant,or registered nurse. Elder careand the workforce: Blueprint for action. New York: Hemisphere.----------------------- 13 If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.