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Sample records for residents family caregivers

  1. Mixed Methods Research of Adult Family Care Home Residents and Informal Caregivers

    ERIC Educational Resources Information Center

    Jeanty, Guy C.; Hibel, James

    2011-01-01

    This article describes a mixed methods approach used to explore the experiences of adult family care home (AFCH) residents and informal caregivers (IC). A rationale is presented for using a mixed methods approach employing the sequential exploratory design with this poorly researched population. The unique challenges attendant to the sampling…

  2. Family Caregivers.

    ERIC Educational Resources Information Center

    Frazier, Billie H.

    This document contains a brief bibliography of peer-reviewed literature, with abstracts, on family caregiving. It is one of 12 bibliographies on aging prepared by the National Agricultural Library for its "Pathfinders" series of publications. Topics covered by the other 11 bibliographies include aging parents, adult children, dementia and…

  3. Use of videophones for distant caregiving: an enriching experience for families and residents in long-term care.

    PubMed

    Demiris, George; Oliver, Debra R Parker; Hensel, Brian; Dickey, Geraldine; Rantz, Marilyn; Skubic, Marjorie

    2008-07-01

    The objective of this study was to explore the role of videophone technology in enhancing the distant caregiving experience of and communication between residents of a long-term care facility and their family members. Ten participants-4 residents of an independent retirement facility and 6 family members-were recruited. A videophone was installed in each resident's apartment, and another was mailed to the remote family member. Participants were asked to conduct a videocall at least once per week for 3 months. Exit interviews assessed general impressions of videophone communication, the relationship between residents and family members, stress, burden, and isolation. Participants were enthusiastic and emphasized a sense of closeness, the inclusion of the resident in family interactions, and reduced feelings of guilt and isolation as key benefits. New models of care are needed to challenge the existing paradigm, which often excludes distant caregivers from the care process. Technology can facilitate this process by bridging geographic distance. PMID:18649824

  4. La CLAve to Increase Psychosis Literacy of Spanish-Speaking Community Residents and Family Caregivers

    PubMed Central

    López, Steven R.; Kopelowicz, Alex; Solano, Susana; del Carmen Lara, Ma.; Foncerrada, Hector; Aguilera, Adrian

    2014-01-01

    The authors developed and tested a 35-min psychoeducational program with the goal of increasing Spanish-speaking persons’ literacy of psychosis. The program uses popular cultural icons derived from music, art, and videos, as well as a mnemonic device—La CLAve (The Clue)—to increase (a) knowledge of psychosis, (b) efficacy beliefs that one can identify psychosis in others, (c) attributions to mental illness, and (d) professional help-seeking. Assessments were conducted before and after administering the program to both community residents (n = 57) and family caregivers of persons with schizophrenia (n = 38). For community residents, the authors observed increases across the 4 domains of symptom knowledge, efficacy beliefs, illness attributions, and recommended help-seeking. For caregivers, increases were observed in symptom knowledge and efficacy beliefs. La CLAve is a conceptually informed psychoeducational tool with a developing empirical base aimed at helping Spanish-speaking Latinos with serious mental illness obtain care in a timely manner. PMID:19634968

  5. Family Caregiver Alliance

    MedlinePlus

    ... A Complex Web: Family Caregiving and Healthcare [Editor's note: This blog was originally posted on the the Atlas of Caregiving website on June ... 2016 Taking Care of SoMEone Else November 14, 2016 Grupo ...

  6. Confidentiality and the family as caregiver.

    PubMed

    Petrila, J P; Sadoff, R L

    1992-02-01

    Many families provide mentally ill relatives with a residence and other support. Although professionals increasingly acknowledge the importance of the supportive role families play, families continue to report that they receive too little information from professionals about the patient, particularly when the family acts as caregiver. The authors suggest that mental health professionals' views about confidentiality may prevent them from providing information to families and urge professionals to rethink the issue of confidentiality and its application to families acting as caregivers. The authors conclude that certain information about a patient can--and should--be shared with families who are in a caregiver role without violating clinical, legal, or ethical principles.

  7. Collecting saliva and measuring salivary cortisol and alpha-amylase in frail community residing older adults via family caregivers.

    PubMed

    Hodgson, Nancy A; Granger, Douglas A

    2013-12-18

    Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

  8. Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

    PubMed Central

    Hodgson, Nancy A.; Granger, Douglas A.

    2013-01-01

    Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations. PMID:24378361

  9. Family Caregiving or Caregiving Alone: Who Helps the Helper?

    ERIC Educational Resources Information Center

    Sims-Gould, Joanie; Martin-Matthews, Anne

    2007-01-01

    This study advances the understanding of family caregiving by examining the relationship between adult children caregivers and their helpers. Specifically, it focuses on examining "who helps whom" and extends analyses beyond the dyadic focus of caregiving in later life. The focus on helping and caregiving addresses the variety of contributions and…

  10. Measuring the Caregiver Burden of Caring for Community-Residing People with Alzheimer’s Disease

    PubMed Central

    Yu, Hongmei; Wang, Xiaocheng; He, Runlian; Liang, Ruifeng; Zhou, Liye

    2015-01-01

    Objectives To assess the direct and indirect effects of patient or caregiver factors on caregiver burden of caring for community-residing people with mild Alzheimer’s disease (AD). Methods We conducted a cross-sectional study of patients diagnosed with AD from two hospitals and three communities in Taiyuan, China and their caregivers. For this survey, 200 patients with mild AD and their caregivers were selected. Caregivers were asked to provide sociodemographic information including age, gender, relationship with the patient, level of education, and number of contact hours per week with the patient. Caregiver burden was assessed using the Caregivers Burden Inventory. The caregivers also completed other measures including the Positive Aspects of Caregiving, the Family Adaptation, Partnership, Growth, Affection, and Resolve, and the Social Support Rating Scale. The patients with AD completed the Montreal Cognitive Assessment; their caregivers completed the Activities of Daily Living Scale and a questionnaire about the patients’ Behavioral and Psychological symptoms of Dementia. The main outcome in this study was caregiver burden. The care receivers’ level of cognitive function, physical function, and behavioral problems were treated as original stress; the primary appraisal variable was measured as the number of hours of caregiving in the previous week reported by the caregiver. Mediator variables included perceived social support, family function, and caregiving experience. Path analysis was used to build the interrelationship among caregiver burden and patient or caregiver factors. Results A lower level of cognitive function in patients (r = −0.28, p<0.001) and longer hours of caregiving (r = 0.17, p = 0.019) were related to increased caregiver burden. Greater social support (r = −0.23, p<0.001), family function (r = −0.17, p = 0.015) and caregiving experience (r = −0.16, p = 0.012) were related to decreased caregiver burden. Social support (r = 0

  11. Nursing support of family caregivers.

    PubMed

    Brackley, M H; Meadows, R F

    1989-01-01

    The relationship between caregiver and elder is a unique one. It cannot be compared to a mother-infant dyad; there is no role reversal. Family caregiving is undertaken out of a sense of filial obligation on the family's part coupled with the needs of the elderly person. The relationship that emerges is based on the dependency of one adult on another and is functional for the family and for society at large. We need families to continue to care for their elderly members at home and families need us to insure their survival. We must constantly be aware that care needs increase over the years, whereas family resources do not. Nursing by its very nature is tied to insuring that families are given the guidance and assistance with which to meet these needs. PMID:2789693

  12. R. I. Caregivers. Caring: A Training Program for Family Caregivers.

    ERIC Educational Resources Information Center

    Rhode Island State Dept. of Elderly Affairs, Providence.

    This document presents a training manual to help caregivers who provide care to older family members and friends at home. The program, which offers a practical approach to caregiving and a realistic view of the aging process, is intended to clarify the problems confronting caregivers of older people, serve as a basic source manual for training…

  13. Family Caregivers: Psychosocial Impacts and Clinical Needs

    ERIC Educational Resources Information Center

    Daire, Andrew P.; Torres, Jennifer; Edwards, Nivischi N.

    2009-01-01

    The authors describe how 3 groups of family caregivers (spouses, daughters, and sons) are affected by the caregiving role. In addition, clinical considerations and interventions for mental health professionals working with these different groups of family caregivers are discussed. A clinical case example is also presented. (Contains 2 tables.)

  14. Family caregiving or caregiving alone: who helps the helper?

    PubMed

    Sims-Gould, Joanie; Martin-Matthews, Anne

    2007-01-01

    This study advances the understanding of family caregiving by examining the relationship between adult children caregivers and their helpers. Specifically, it focuses on examining "who helps whom" and extends analyses beyond the dyadic focus of caregiving in later life. The focus on helping and caregiving addresses the variety of contributions and responsibilities involving not only the caregiver who was the target respondent in this research, but also others identified as helpers in the provision of care. The data for this study are derived from the Work and Eldercare Research group of CARNET: The Canadian Aging Research Network. Secondary analysis of CARNET data focuses on data collected from 250 individuals with significant caregiving responsibilities for at least one older person. Findings extend Kahn & Antonucci's convoys of social support model (1981) and Cantor's model of social care (1991) by disentangling some of the dimensions of helping and caregiving, such as the distinction between direct and assistive help.

  15. How Do Family Caregivers of Older People Give Up Caregiving?

    PubMed Central

    Mortazavi, Hamed; Peyrovi, Hamid; Joolaee, Soodabeh

    2015-01-01

    Background Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. Methods A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes (average 52 minutes). Constant comparative analysis was used to analyze the data. Results Three main categories appeared at the end of the analysis: “going out of the road of usual life”, “challenge of meeting older person, family and caregivers care needs”, and “the appearance of inconstancy in the family”. They explained exclusively how family caregivers of old people give up caregiving. Conclusion Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers. PMID:26171407

  16. Caregiving Styles: A Cognitive and Behavioral Typology Associated With Dementia Family Caregiving

    PubMed Central

    Corcoran, Mary A.

    2011-01-01

    Purpose: An increasing number of elderly individuals are diagnosed with Alzheimer’s disease and related disorders (ADRD), many of whom receive daily caregiving from spouse or adult child. Caregiving is a “cultural activity,” and as such it is strongly influenced by sociocultural beliefs about caregiving and how it should be enacted. Understanding this thinking–action process has important implications for future research and service. Reasoned action theory provides empirical evidence that attitudes and beliefs, as they are influenced by the social environment, predict intentions to act. In turn, behavioral intentions can reliably predict behaviors. This grounded theory study describes a typology of caregiving styles relevant to family members of an individual with ADRD, where caregiving style is defined as a culturally based pattern in thinking and action. The goal of this study was to characterize the relationship between caregiver intentions and care strategies. Methods: Study participants included 97 individuals residing in the Washington, DC, area, who provide daily care for a family member with ADRD. Narrative data were collected from each caregiver during three 1-hr interview sessions. A subset of 30 caregiver–care recipient (CR) dyads was videotaped during typical interactions. Results: Four caregiving styles were identified (facilitating, balancing, advocating, and directing), which differ primarily in the intended focus of care and preferred interactions with the CR. Implications: The results provide a foundation for future studies of the relationships between sociocultural context, caregiving styles and strategies, and ensuing outcomes for caregiver–CR dyads. PMID:21335422

  17. Family Caregiver Identity: A Literature Review

    ERIC Educational Resources Information Center

    Eifert, Elise K.; Adams, Rebecca; Dudley, William; Perko, Michael

    2015-01-01

    Background: Despite the multitude of available resources, family caregivers of those with chronic disease continually underutilize support services to cope with the demands of caregiving. Several studies have linked self-identification as a caregiver to the increased likelihood of support service use. Purpose: The present study reviewed the…

  18. Caregiver Burden in Fragile X Families.

    PubMed

    Iosif, Ana-Maria; Sciolla, Andres F; Brahmbhatt, Khyati; Seritan, Andreea L

    2013-02-01

    Complex caregiving issues occur in multigenerational families carrying the fragile X mutation and premutation. The same family members may care for children or siblings with fragile X syndrome (FXS) and for elderly parents with fragile X-associated tremor/ataxia syndrome (FXTAS). Family caregivers experience anxiety, depression, neglect of personal health care needs, employment difficulties, and loss of social support, leading to isolation and further psychiatric consequences. There is growing awareness of caregiver burden with regard to parents of children with FXS, but much less is known about the needs of informal caregivers of patients with FXTAS. In this paper, we review the available literature to date and provide suggestions for further exploration of caregivers' needs. Evidence-based strategies to address these needs are included. Many more research studies exploring caregiver burden in multigenerational fragile X families are needed, as well as studies aimed at investigating interventions and their impact on reduction.

  19. Assessing Impact on Family Caregivers to Alzheimer's Disease Patients.

    ERIC Educational Resources Information Center

    Talkington-Boyer, Shannon; Snyder, Douglas K.

    1994-01-01

    Examined impact of caregiving among 110 caregivers to aging family member with Alzheimer's disease. Family caregivers' appraisals along dimensions of subjective burden, negative impact, caregiving satisfaction, and caregiver mastery were correlated with extent of memory and behavior problems of patient and caregivers' coping style, locus of…

  20. Caregiving as a Family Network Event.

    ERIC Educational Resources Information Center

    Mellins, Claude A.; And Others

    Caregiving studies often focus on the impaired elder who is the care receiver and the one family member who is perceived as the primary caregiver. Such studies fail to consider all members of the family, whether or not they are involved in providing care. This study was conducted to explore the effects of an elder's health-related dependency on…

  1. Adopting the Caregiver Role: A Family Legacy.

    ERIC Educational Resources Information Center

    Piercy, Kathleen W.; Chapman, Jeffery G.

    2001-01-01

    A qualitative study was done to investigate how adult children become caregivers to older parents with functional impairments and what roles their own children adopt in their family's care arrangement. Interviews revealed five influences on children and grandchildren's adoption of caregiver roles: expectations; family rules; religious training;…

  2. Making Choices: A within-Family Study of Caregiver Selection

    ERIC Educational Resources Information Center

    Pillemer, Karl; Suitor, J. Jill

    2006-01-01

    Purpose: This article reports on a within-family study to identify factors that lead mothers to expect that a particular child will serve in the role of primary caregiver. Design and Methods: Data for this study were collected by in-person interviews with a representative sample of 566 mothers between the ages of 65 and 75 years residing in the…

  3. Family caregivers and limitations in social activities.

    PubMed

    Miller, B; Montgomery, A

    1990-03-01

    Constriction of social and personal activities is one of the most frequently noted consequences of caring for a frail elder. This study analyzed the correlates of perceived limitations in social activities using data from a national sample of the frail elderly and their caregivers. Two research issues were addressed: 1) What differences in demographic, family, and caregiving attributes are associated with variation in perceived restricted social activities? and, 2) How does the process influencing restriction of social activities vary by family relationship of the caregiver? Higher levels of elder dependency and task demands were characteristic of those who reported social limitations, and daughters and wives were more likely to report such limitations than sons and husbands. Subjective assessment of time and task demands, however, were more important influences than objective caregiving activities for all family caregivers. PMID:2180010

  4. Family caregivers and limitations in social activities.

    PubMed

    Miller, B; Montgomery, A

    1990-03-01

    Constriction of social and personal activities is one of the most frequently noted consequences of caring for a frail elder. This study analyzed the correlates of perceived limitations in social activities using data from a national sample of the frail elderly and their caregivers. Two research issues were addressed: 1) What differences in demographic, family, and caregiving attributes are associated with variation in perceived restricted social activities? and, 2) How does the process influencing restriction of social activities vary by family relationship of the caregiver? Higher levels of elder dependency and task demands were characteristic of those who reported social limitations, and daughters and wives were more likely to report such limitations than sons and husbands. Subjective assessment of time and task demands, however, were more important influences than objective caregiving activities for all family caregivers.

  5. Family medical leave as a resilience resource for family caregivers.

    PubMed

    Swanke, Jayme; Zeman, Laura Dreuth

    2009-01-01

    Case managers mobilize family networks to care for patients. Family medical leave can be a resource for case managers who seek to enhance resilience among family caregivers. The Family Medical Leave Act, passed in 1993, was the first U.S. policy to regulate employee leaves from work for family care purposes (29 CFR 825.102). This policy offers family caregivers increased flexibility and equality. Current and emerging policies also can reduce financial strain. The discussion examines how case managers can integrate family medical leave into best-practice models to support patients and family caregivers.

  6. Family Caregivers and Consumer Health Information Technology.

    PubMed

    Wolff, Jennifer L; Darer, Jonathan D; Larsen, Kevin L

    2016-01-01

    Health information technology has been embraced as a strategy to facilitate patients' access to their health information and engagement in care. However, not all patients are able to access, or are capable of using, a computer or mobile device. Although family caregivers assist individuals with some of the most challenging and costly health needs, their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of engaging family caregivers through the use of consumer-oriented health information technology. We compile existing evidence to make the case that involving family caregivers in health information technology as desired by patients is technically feasible and consistent with the principles of patient-centered and family-centered care. We discuss how more explicit and purposeful engagement of family caregivers in health information technology could advance clinical quality and patient safety by increasing the transparency, accuracy, and comprehensiveness of patient health information across settings of care. Finally, we describe how clarifying and executing patients' desires to involve family members or friends through health information technology would provide family caregivers greater legitimacy, convenience, and timeliness in health system interactions, and facilitate stronger partnerships between patients, family caregivers, and health care professionals.

  7. The Relationship between Mastery and Depression among Japanese Family Caregivers

    ERIC Educational Resources Information Center

    Schreiner, Andrea S.; Morimoto, Tomoko

    2003-01-01

    The present study examined the relationship between caregiver mastery and depressive symptoms among family stroke caregivers in western Japan (N = 100). Family caregivers were identified from a sample of rehabilitation hospitals; participation rate was 100 percent for all eligible caregivers. Care-givers with high mastery were found to have…

  8. Perceptions of familial caregivers of elder adults.

    PubMed

    Sayles-Cross, S

    1993-01-01

    This study investigated perceptions of 139 familial caregivers of elder adults to answer the question "Is there a significant relationship between appraisal, social distance and the cost of caring for an elder family member?" The cost of caring was analyzed in five dimensions (personal-social restrictions, physical-emotional health, value, care recipient as provocateur and economic cost). Caregivers reported concern for their well-being, feelings of disgust/anger, high social distance and coping by accepting and holding back. Not only were significant relationships found, but caregivers emerged as an at-risk population.

  9. Aging family caregivers: policies and practices.

    PubMed

    Heller, Tamar; Caldwell, Joe; Factor, Alan

    2007-01-01

    This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving, (3) support needs of families, (4) family support policies and practices, and (5) recommendations for a research and policy agenda. Research examining outcomes of life-long caregiving has shown that most families adapt well to having a family member with disabilities. However, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to have a negative impact on maternal employment and family income as mothers often give up or cut back on employment to care for a child with developmental disabilities, who is more likely to continue living in the family home throughout adulthood than other adult children. Federal and state initiatives are addressing issues of family support through both the developmental disabilities and aging service systems.

  10. Family Caregivers in Cancer (PDQ®)—Patient Version

    Cancer.gov

    Expert-reviewed information summary about the challenges faced by family caregivers of cancer patients. This summary focuses on typical caregiver roles and concerns, and helpful interventions for caregivers.

  11. Family Caregiver Research and the HIPAA Factor

    ERIC Educational Resources Information Center

    Albert, Steven M.; Levine, Carol

    2005-01-01

    Research in family caregiving recently has become more challenging because of the strict protection of privacy mandated in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. We ask when should Institutional Review Boards (IRBs) follow HIPAA rules to the letter and when might they use the waiver option? What is the appropriate…

  12. Dementia: The Experience of Family Caregivers.

    ERIC Educational Resources Information Center

    Chenoweth, Barbara; Spencer, Beth

    1986-01-01

    Caregivers of family members with dementia of the Alzheimer's type were surveyed for their experiences with early symptoms, obtaining a diagnosis, home care, and institutionalization. At each stage in the process of providing care there are new and different stresses that can be ameliorated by appropriate professional assistance. (Author)

  13. Typical and atypical dementia family caregivers: systematic and objective comparisons.

    PubMed

    Nichols, Linda O; Martindale-Adams, Jennifer; Burns, Robert; Graney, Marshall J; Zuber, Jeffrey

    2011-01-01

    This systematic, objective comparison of typical (spouse, children) and atypical (in-law, sibling, nephew/niece, grandchild) dementia family caregivers examined demographic, caregiving and clinical variables. Analysis was of 1476 caregivers, of whom 125 were atypical, from the Resources for Enhancing Alzheimer's Caregivers Health (REACH I and II) studies. Based on statistical and clinical significance, there were large effects for demographics but no large effects among caregivers or care recipients on clinical and caregiving variables. Non-spouse family members were more likely to be caring for women and unmarried individuals. Grandchildren and nieces/nephews provided care for older care recipients. For care recipients who are unmarried, older, or women, fewer care possibilities may be available; consequently family members other than spouse or children may become their caregivers. Once an individual becomes a caregiver, the clinical experience of dementia caregiving is similar across caregiver types. These findings have implications for clinical care and public policy. PMID:21391405

  14. Typical and Atypical Dementia Family Caregivers: Systematic and Objective Comparisons

    ERIC Educational Resources Information Center

    Nichols, Linda O.; Martindale-Adams, Jennifer; Burns, Robert; Graney, Marshall J.; Zuber, Jeffrey

    2011-01-01

    This systematic, objective comparison of typical (spouse, children) and atypical (in-law, sibling, nephew/niece, grandchild) dementia family caregivers examined demographic, caregiving and clinical variables. Analysis was of 1,476 caregivers, of whom 125 were atypical, from the Resources for Enhancing Alzheimer's Caregivers Health (REACH I and II)…

  15. [Social support in the family caregiver experience].

    PubMed

    Marques, Ana Karina Monte Cunha; Landim, Fátima Luna Pinheiro; Collares, Patrícia Moreira; de Mesquita, Rafael Barreto

    2011-01-01

    This is a qualitative and descriptive study aiming to know the experience of taking care of sick people in the context of homes, analyzing the implications of the social support in the physical and emotional health of the family caregiver. The data had been collected by means of the semi-structured interview with 18 family caregivers of people with chronic illnesses. The technique of the Collective subject discourse was used for the organization of the data. One evidenced that all the informers were of the feminine sex, with average age of 50 years and medium instructional level. They took care uninterruptedly of sick people predominating the mothers with sequel of stroke. They reported health complications related to the care carried through: back pain, hypertension, migraine and depression. The collective speeches are suggestive of the break of the social networks and of the scarcity of support, leading the person to reject the caregiver condition. The overload was characterized by the caregiver to face innumerable situations which he did not succeed to manage it.

  16. Family Caregiving. A Manual for Caregivers of Older Adults.

    ERIC Educational Resources Information Center

    Mehrotra, Chandra, Ed.; And Others

    This manual provides caregivers with practical knowledge and suggestions that could be of help to them in this important role. Chapter 1 gives an overview of the volume and tells how to use it. Chapter 2 identifies who caregivers are, what they do, and what changes have taken place in their lives since they became caregivers. Chapter 3 begins with…

  17. Classification of caregiving families according to the Family Caregivers' Appraisal Checklist.

    PubMed

    Horiguchi, Kazuko; Iwata, Noboru; Matsuda, Nobuko

    2012-01-01

    This study aimed to classify caregiving families according to the Family Caregivers' Appraisal Checklist (FACL; Horiguchi et al., 2012), which was originally developed to evaluate the probability of continuing caregiving. After nationwide targeting in Japan, the selected survey candidates included 1279 families utilizing domiciliary nursing services chosen by stratified two-stage sampling, and available data were obtained from 945 out of 1020 returned responses (return ratio: 79.8%). Scores for the seven components of FACL were cluster analyzed, and the following six clusters were extracted: Cluster A (12.8%) yielded high scores for all components; Cluster B (34.0%) yielded average scores; Cluster C (20.7%) scored mostly average but low for "quality of care service"; Cluster D (15.8%) showed relatively low scores for all components; Cluster E (11.4%) yielded low scores for all components except for "quality of care service" and "preparedness for emergencies"; and Cluster F (5.3%) scored significantly poorly for all components except for "preparedness for emergencies". Significant intercluster differences were observed for care recipient's age, the number of medical care, employment status, principal caregiver's subjective health, and the advice from family and friends. Caregiving duration was significantly associated with "positive appraisal of family caregiving", the number of medical care and the number of care types, and marginally with the level of care stipulated by the public long-term care insurance program (p < 0.07). Implications of classification of family type according to the FACL and the importance of positive appraisal of caregiving are discussed along with the future direction of use of the FACL. PMID:23666400

  18. Understanding Social Support Burden Among Family Caregivers

    PubMed Central

    Washington, Karla; Demiris, George; Parker Oliver, Debra; Shaunfield, Sara

    2014-01-01

    Despite the abundance of research on social support, both as a variable in larger studies and as a central focus of examination, there is little consensus about the relationship between social support and health outcomes. Current social support measures typically account only for frequency and size of network and a paucity of research exists that has explained social support burden, defined as the burden associated with accessing and receiving support from others. We analyzed audio-recorded discussions by hospice family caregivers about their caregiving problems and potential solutions to examine social relationships within networks and identify the processes that influence social support seeking and receiving. Using qualitative thematic analysis, we found that caregivers providing hospice care experience social support burden resulting from perceived relational barriers between friends and family, the inclination to remain in control, recognition of the loss of the patient as a source of social support and guidance in decision-making, family dynamics and decreased availability of emotional support. Social support researchers should consider how the quality of communication and relationships within social networks impacts the provision and subsequent outcomes of social support in varying contexts. Findings from this study suggest that hospice social support resources should be tailored to the caregiver’s support needs and include assessment on the type of support to be offered. PMID:24345081

  19. Family caregiving for adults with schizophrenia and diabetes mellitus.

    PubMed

    El-Mallakh, Peggy; Yates, Brittany Evans; Adkins, Sarah

    2013-08-01

    Diabetes mellitus (DM) is common among those with schizophrenia, but little is known about family members' roles in the care of relatives who have both schizophrenia and DM. The purpose of this descriptive correlational study was to examine DM knowledge and caregiver burden among 27 family caregivers of people with schizophrenia and DM. Findings indicate that DM knowledge was low. Objective caregiver burden was highest for providing assistance with daily living activities. Subjective burden was highest for preventing the care recipient from keeping people awake at night and dealing with the care recipient's non-adherence to DM care. Family caregivers are in need of education and support in the caregiving role.

  20. The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

    ERIC Educational Resources Information Center

    Moore, Crystal Dea

    2010-01-01

    A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden,…

  1. Impairment in family caregiving: a biological perspective.

    PubMed

    Hill, Elizabeth M; Grabel, Deana; McCurren, Robert

    2003-08-01

    This paper focuses on patterns in the care of children and dependent elders, providing a new perspective to understand impairment in family caregiving. One concept from evolutionary theory, kin selection, has promise for providing a broad framework for understanding patterns of family caregiving. We present an application of the evolutionary model to the issue of family care decisions in the face of potential conflicts of interest. Specifically, a mathematical biological model, which was developed to understand self-preservation motivation, is applied to the kin investment decision. Using the evolutionary model, the main predictors of investment would be relatedness, reproductive value, and expected benefit from the care invested. The biological model accounts very simply for decisions between caring for an elder parent or caring for your own child, and for decisions by two daughters (one with a child, one childless) to care for an elder parent. The factors that form the basis of an evolutionary model (relatedness, reproductive value, and benefit from care) have not been widely investigated in family care studies, however, and this absence reveals new directions for future research.

  2. Assessing family caregiver skill in managing behavioral symptoms of Alzheimer’s disease

    PubMed Central

    Farran, Carol J.; Fogg, Louis G.; McCann, Judith J.; Etkin, Caryn; Dong, Xinqi; Barnes, Lisa L.

    2011-01-01

    Objectives This measurement study operationalized family caregiver skill in managing behavioral symptoms associated with Alzheimer’s disease (AD) by testing a Caregiver Assessment of Behavioral Skill-Self Report measure (CAB-SR). Method A cross-sectional design was used. Caregivers had a family member with possible/probable AD, resided at home with the care recipient and provided the majority of care (N=82). The mail-administered assessment included the CAB-SR and other care recipient and caregiver measures. Results Preliminary CAB-SR reliability and validity were determined, using reliability, factor analytic and correlational procedures. Conclusion This measure provides a preliminary assessment of caregiver skill in managing behavioral symptoms of AD and shows promise for use in research and clinical intervention settings. PMID:21500018

  3. Transnational caregiving: Part 1, caring for family relations across nations.

    PubMed

    Dhar, V Erica

    2011-01-01

    This article concerns how globalization and the aging of the world's population are affecting the already complex issue of intergenerational transnational caregiving. Globalization has caused an increase in workforce mobility with large numbers of individuals seeking employment overseas. This, coupled with increased longevity globally, has resulted in many workers leaving their elderly parents in need of care in their home countries. This has spawned caregiving across national borders, or caring for family relations across nations. Currently in the United States, not enough emphasis is given to family caregiving. Data compiled by AARP and the National Alliance for Caregiving estimate the economic value for this group of family caregivers in 2007 to be $375 billion, accounting for 34-52 million family caregivers per given year. This does not include those families who are transnational caregivers. The seminal work in this emerging field has been done by social anthropologists Loretta Baldassar, Cora Velekoop Baldock, and Raelene Wilding, who have defined the components of transnational caregiving based on an ethnographic study using qualitative data to study nine immigrant communities in Western Australia. Although their research focused on caregiving from a distance, additional work has been added to the discussion by introducing the element of "care drain" and further cultural perspectives. Therefore, this research is an exploratory study on intergenerational transnational caregiving within the context of the changing world and its demographics. Within the context of globalization and global aging, the following questions are addressed: What is the significance of family caregiving? What is a transnational? How has technology changed "transnationalism" today? What are the elements that comprise transnational caregiving? How does culture play a role in transnational caregiving? What are some of the national initiatives undertaken by governments to aid in workforce

  4. Transnational caregiving: Part 1, caring for family relations across nations.

    PubMed

    Dhar, V Erica

    2011-01-01

    This article concerns how globalization and the aging of the world's population are affecting the already complex issue of intergenerational transnational caregiving. Globalization has caused an increase in workforce mobility with large numbers of individuals seeking employment overseas. This, coupled with increased longevity globally, has resulted in many workers leaving their elderly parents in need of care in their home countries. This has spawned caregiving across national borders, or caring for family relations across nations. Currently in the United States, not enough emphasis is given to family caregiving. Data compiled by AARP and the National Alliance for Caregiving estimate the economic value for this group of family caregivers in 2007 to be $375 billion, accounting for 34-52 million family caregivers per given year. This does not include those families who are transnational caregivers. The seminal work in this emerging field has been done by social anthropologists Loretta Baldassar, Cora Velekoop Baldock, and Raelene Wilding, who have defined the components of transnational caregiving based on an ethnographic study using qualitative data to study nine immigrant communities in Western Australia. Although their research focused on caregiving from a distance, additional work has been added to the discussion by introducing the element of "care drain" and further cultural perspectives. Therefore, this research is an exploratory study on intergenerational transnational caregiving within the context of the changing world and its demographics. Within the context of globalization and global aging, the following questions are addressed: What is the significance of family caregiving? What is a transnational? How has technology changed "transnationalism" today? What are the elements that comprise transnational caregiving? How does culture play a role in transnational caregiving? What are some of the national initiatives undertaken by governments to aid in workforce

  5. Discussion and Recommendations: Nurses and Social Workers Supporting Family Caregivers

    ERIC Educational Resources Information Center

    Lewis, Laurie

    2008-01-01

    Family members--whether people related by birth and marriage or friends and neighbors (sometimes called a "family of choice")--are the main caregivers for millions of older Americans. These family caregivers assist those they care for with activities of daily living such as bathing and dressing, with instrumental activities of daily living such as…

  6. Sampling Bias in Family Caregiving Studies: A Research Note.

    ERIC Educational Resources Information Center

    Walker, Alexis J.; Pratt, Clara C.

    This study examined the characteristics of elderly persons receiving help from family members as reported in published studies on family caregiving. The data were drawn from 10 volumes of the "Journal of Gerontology" and "The Gerontologist" (1978-1988). Thirty-one family caregiving studies were identified. Although few of the elderly require…

  7. Development of the Family Caregiver Medication Administration Hassles Scale

    ERIC Educational Resources Information Center

    Travis, Shirley S.; Bernard, Marie A.; McAuley, William J.; Thornton, Megan; Kole, Tristen

    2003-01-01

    Purpose: "Medication administration hassles" are the minor daily irritants that family caregivers experience when they assist a dependent family member with medication regimens. This study was designed to develop and test a multidimensional measure of the hassles in family caregiver medication administration. Design and Method: The authors…

  8. Family-based therapy for dementia caregivers: clinical observations

    PubMed Central

    MITRANI, V. B.; CZAJA, S. J.

    2008-01-01

    Family caregiving for dementia patients is a major social and clinical problem. Family caregivers face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected increase in the number of people with dementia, there is a need to identify approaches that will help families manage the challenges of caregiving. Social support from friends and family members has consistently been found to mediate caregiver outcomes, yet many caregivers face problems with isolation and estrangement from family members. In this regard, family-based therapy is a promising intervention for increasing social support for caregivers, and enhancing their quality of life and ability to provide care.This paper will discuss how family-based therapy can be applied as an intervention for family caregivers of dementia patients.The clinical implications of specific interactional patterns will be presented via case examples from an ongoing clinical trial with white American and Cuban American caregivers of dementia patients.The intent is to demonstrate how identification of interactional patterns is a valuable tool for implementing family-based interventions. PMID:18548132

  9. Assessing and Managing Caregiver Stress: Development of a Teaching Tool for Medical Residents

    ERIC Educational Resources Information Center

    Famakinwa, Abisola; Fabiny, Anne

    2008-01-01

    Forty medical residents from major teaching hospitals in Boston, Massachusetts, participated in small group teaching sessions about caregiver stress. A teaching tool was developed that included a teaching handout, interactive cases, standard instruments for assessing caregiver stress, peer-reviewed articles about caregiving, and a list of…

  10. Impact of mental health and caregiver burden on family caregivers' physical health.

    PubMed

    Chang, Hsing-Yi; Chiou, Chii-Jun; Chen, Nain-Sen

    2010-01-01

    Caregivers providing care to chronically ill family members at home are potentially at risk for caregiver burden and declining physical and psychological health. This study aims to understand how family caregivers' mental health and caregiver burden affects physical health simultaneously, controlling for factors such as age, education level, caring hours per day, and emotional, functional, and physical support systems used by caregivers. We recruited 388 caregivers from Kaohsiung and Pingtong region in Taiwan. Caregivers had to be 18 years or older and spend most of their time taking care of an ill family member at home. Mental health was assessed by the 12-item Chinese Health Questionnaire (CHQ-12) and burden was measured using a modified scale for caregiver's burden. Health status was assessed by self-perceived health (SPH), illness symptoms and the number of diagnosed chronic diseases. A high number of hours per day of caregiving was associated with low emotional support and SPH, poor mental health and high burden. Higher emotional support was associated with better mental health and fewer illness symptoms. Higher physical support was associated with poorer mental health, higher burden, a greater number of illness symptoms and chronic diseases, and a lower SPH score. Hours per day of caregiving, and use of emotional, functional, and physical support were associated with mental health, and the hours per day of caregiving and use of physical support were predictors of burden. Mental health and burden were significantly associated with caregivers' health problems simultaneously. Our results show the important influence of mental health on caregivers' physical health. Interventions for caregivers need to target health in a holistic way.

  11. Caregiver burden among Iranian heart failure family caregivers: A descriptive, exploratory, qualitative study

    PubMed Central

    Bahrami, Masoud; Etemadifar, Shahram; Shahriari, Mohsen; Farsani, Alireza Khosravi

    2014-01-01

    Background: Living with patients of chronic diseases such as heart failure (HF) is a difficult situation for the caregivers. This study explored the Iranian family caregivers’ burden of caregiving for patients with HF. Materials and Methods: Eighteen family caregivers of the HF patients from two governmental medical training centers in Isfahan, Iran were recruited using purposive sampling. Data were collected through face-to-face semi-structured interviews. Each interview was transcribed verbatim and was thematically analyzed concurrently. Results: Four major themes emerged from the analysis of the transcripts: Lack of care-related knowledge, physical exhaustion, psychosocial exhaustion, and lack of support. Family caregivers believed that they have little knowledge about the patients’ disease, drugs, and how to perform caregiving roles. They experienced negative physical and psychosocial consequences of full-time and highly extended caregiving roles, such as musculoskeletal disorder, fatigue, and sleep disturbance, and a high level of anxiety, stress, and social isolation. Caregivers believed that they receive little familial and organizational support on the emotional and financial dimensions of caregiving. Conclusions: The findings of this study can be used by healthcare providers, especially nurses, to provide more effective social, informational, and professional support for family caregivers. PMID:24554961

  12. Family Dynamics and Personal Strengths among Dementia Caregivers in Argentina

    PubMed Central

    Elnasseh, Aaliah G.; Trujillo, Michael A.; Peralta, Silvina Victoria; Stolfi, Miriam E.; Morelli, Eliana; Perrin, Paul B.

    2016-01-01

    This study examined whether healthier family dynamics were associated with higher personal strengths of resilience, sense of coherence, and optimism among dementia caregivers in Argentina. Caregivers are usually required to assist individuals with dementia, and family members have typically fulfilled that role. Personal strengths such as resilience, sense of coherence, and optimism have been shown to protect caregivers from some of the negative experiences of providing care, though the family-related variables associated with these personal strengths are largely unknown. Hierarchical multiple regressions investigated the extent to which family dynamics variables are associated with each of the caregiver personal strengths after controlling for demographic and caregiver characteristics. A sample of 105 caregivers from Argentina completed a set of questionnaires during a neurologist visit. Family dynamics explained 32% of the variance in resilience and 39% of the variance in sense of coherence. Greater family empathy and decreased family problems were uniquely associated with higher resilience. Greater communication and decreased family problems were uniquely associated with higher sense of coherence. Optimism was not found to be significantly associated with family dynamics. These results suggest that caregiver intervention research focused on the family may help improve caregiver personal strengths in Argentina and other Latin American countries. PMID:27413574

  13. The family caregiver of the older cancer patient.

    PubMed

    Weitzner, M A; Haley, W E; Chen, H

    2000-02-01

    Cancer care is becoming increasingly complex. The health care practices of the present day make it imperative that the family provide assistance in the day-to-day management of a patient's symptoms and in the implementation of home care. This increased responsibility for the family caregiver can come at great cost to the overall functioning of the family, because of role changes, changes in the family structure, and financial stressors, among others. Caregivers can experience adverse effects on their mental and physical health that can remain long after the caregiving role has ended. Although much of the research has focused on the negative elements of caregiving, it must be remembered that there are positive aspects to caregiving, which are now receiving attention in the research literature. Although other factors affect caregiving, the model of factors important in the caregiving experience presented in this article may provide the impetus for studying the relationships among these different factors. Results of these studies will allow the development of specific interventions to help caregivers be more effective in their caregiving role and, at the same time, address the overall impact of caregiving on the family.

  14. The Caregiving Experience in a Racially Diverse Sample of Cancer Family Caregivers

    PubMed Central

    Siefert, Mary Lou; Williams, Anna-leila; Dowd, Michael F.; Chappel-Aiken, Lolita; McCorkle, Ruth

    2009-01-01

    The literature supports a variety of predictor variables to account for the psychological and stress burden experienced by cancer family caregivers. Missing among the predictor variables are the differences by or influence of race/ethnicity. The purpose of this study was to describe the sample, explore differences in outcomes by patient and family caregiver characteristics, and determine if any of the patient and family characteristics, including race/ethnicity, predicted outcomes. Cross-sectional surveys were used to determine sociodemographics, psychological and physical health, and burdens of caregiving among 54 caregivers. The analysis consisted of descriptive methods, including frequencies and t tests, and regression modeling. The sample was 35% African American or Hispanic. African American and Hispanic caregivers were younger than white caregivers and more often women, were rarely the spouse of the patient, and frequently had other dependents, including children and older parents. African American and Hispanic caregivers reported lower incomes and more burden related to finances and employment than did white caregivers. When controlling for sociodemographic factors, there was no difference by race/ethnicity on the outcome measures. The experience of caregiving may supersede race/ethnicity and may be its own cultural entity. Areas of concern include the interrelationship between socioeconomic status and race/ethnicity, the absence of cultural frameworks to direct caregiver research, and the question of cultural relevance of measurement tools. PMID:18772665

  15. How Do Family Caregivers Describe Their Needs for Professional Help?

    ERIC Educational Resources Information Center

    Yedidia, Michael J.; Tiedemann, Amy

    2008-01-01

    How aligned are the needs of family caregivers with the professional supports available to them? This article presents the results of the first phase of a study, in which four focus group interviews were conducted with a total of 40 family caregivers to elicit their views of the kinds of assistance they expect from nurses and social workers. The…

  16. Family Caregivers' Patterns of Positive and Negative Affect

    ERIC Educational Resources Information Center

    Robertson, Suzanne M.; Zarit, Steven H.; Duncan, Larissa G.; Rovine, Michael J.; Femia, Elia E.

    2007-01-01

    Stressful and positive family caregiving experiences were examined as predictors of caregivers' patterns of positive and negative affect in a sample of families providing care for a relative with dementia (N = 234). Four affect pattern groups were identified: (a) Well Adjusted (i.e., high positive affect, low negative affect); (b) Ambiguous (i.e.,…

  17. 75 FR 67903 - National Family Caregivers Month, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... thirty-fifth. (Presidential Sig.) [FR Doc. 2010-28078 Filed 11-3-10; 8:45 am] Billing code 3195-W1-P ... Documents#0;#0; ] Proclamation 8593 of October 29, 2010 National Family Caregivers Month, 2010 By the... their daily lives. During National Family Caregivers Month, we honor the millions of Americans who...

  18. 77 FR 66525 - National Family Caregivers Month, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... Independence of the United States of America the two hundred and thirty-seventh. (Presidential Sig.) [FR Doc... Documents#0;#0; ] Proclamation 8900 of November 1, 2012 National Family Caregivers Month, 2012 By the... loved ones. During National Family Caregivers Month, we recognize and thank the humble heroes who do...

  19. Trends Impacting Public Policy Support for Caregiving Families

    ERIC Educational Resources Information Center

    Singer, George H. S.; Biegel, David E.; Ethridge, Brandy L.

    2010-01-01

    Public policy aimed at supporting the caregiving capacity of families has risen to prominence on the public agenda in the United States. Initiatives at the state and federal levels have created some initial services. Three trends that are pushing the issue of family caregiving to the surface are discussed, including large-scale social,…

  20. Relationships Between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health Among Homeless Families

    PubMed Central

    McGuire-Schwartz, Mandy; Small, Latoya A.; Parker, Gary; Kim, Patricia; McKay, Mary

    2015-01-01

    Homelessness affects a large and increasing number of families in the United States, and exposure to violence and other potentially traumatic events is common among homeless families. It is important to understand more about this population and, more specifically, about the relationship between youth mental health and caregiver mental health and trauma exposure among homeless families, in order to better serve the needs of this vulnerable population. The objective of this study is to explore the relationships between caregiver exposure to violence, caregiver depression, and youth depression and behavioral problems among homeless families. Preliminary findings indicate that among this sample of homeless families, caregiver violence exposure has statistically significant relationships with both youth behavioral problems and youth depression symptoms, as mediated by caregiver depression. These findings indicate that youth behavioral health is associated with caregiver mental health, which, in turn, is associated with caregiver trauma exposure. This highlights the importance of taking into account adult mental health while treating youth externalizing and internalizing behaviors and ensuring that caregivers, too, have access to adequate treatment and supports. Furthermore, this treatment should be trauma informed, given the link between trauma and mental health. PMID:26420978

  1. Sleep in Persons with Frontotemporal Dementia and Their Family Caregivers

    PubMed Central

    Merrilees, Jennifer; Hubbard, Erin; Mastick, Judy; Miller, Bruce L.; Dowling, Glenna A.

    2014-01-01

    Background Dementia is associated with disruptions in sleep and sleep quality for patients and their family caregivers. Little is known about the impact of frontotemporal dementia (FTD) on sleep. Objective The purpose of this study was to characterize sleep in patients with frontotemporal dementia and their family caregivers. Methods Twenty-two patient-caregiver dyads were enrolled: Thirteen behavioral variant FTD (bvFTD) and nine semantic dementia (SD). Sleep and sleep quality data were collected for two weeks using diaries and Actiwatches. Results Patients with bvFTD and SD spent more time in bed at night compared to their caregivers. Nighttime behaviors were reported more frequently by caregivers for the bvFTD patients and strongly correlated with caregiver distress. Actigraphy data demonstrated normal sleep efficiency and timing of the nighttime sleep period for both patients and their caregivers. Caregivers of patients with bvFTD reported poorer sleep quality compared to the SD caregivers. A greater number of bvFTD caregivers compared to SD reported negative aspects of sleep quality for themselves and used sleep medications more frequently. Conclusion The clinical manifestations of bvFTD appear to be associated with different and more distressing impacts on the caregiver sleep quality than SD. PMID:24589648

  2. The Effects of Caregiving on the Family.

    ERIC Educational Resources Information Center

    Bailey, Eric J.; Young, Rosalie F.

    The topic of caregiving was investigated with respect to the burden experienced by primary caregivers of older persons who had recently suffered a myocardial infarction. Structured interviews were completed with 104 primary care providers who were part of a larger National Institute on Aging funded survey. The caregivers were of both sexes and…

  3. Information needs and sources of family caregivers of home elderly patients.

    PubMed

    Hirakawa, Yoshihisa; Kuzuya, Masafumi; Enoki, Hiromi; Uemura, Kazumasa

    2011-01-01

    Meeting the information needs of family caregivers in a timely and appropriate way is a key concern of home care. The present study aimed to explore the following two areas: (a) the priority information needs and sources of family caregivers of home elderly patients and (b) the differences in information needs according to severity of dementia. The subjects were 475 family caregivers of home elderly patients residing in Nagoya city. Data was collected through questionnaires. Severity of dementia was evaluated according to the criteria of the public long-term care insurance policy (levels 0-5). The top 3 items they perceived as of most concern were dementia, first aid, and available public long-term care insurance services. A few respondents felt the need for information on public long-term care insurance services. Nearly half of the caregivers were interested in food and nutrition. The respondents were more likely to receive information from their care managers or physicians than any other source. Caregivers of elderly dependents with severe dementia reported a greater need for information on the spread of dementia, dementia-specific care, or the negative effects of dementia on family and neighborhood. Our results provide useful information on how family caregivers should be educated.

  4. Caregiving Practice Patterns of Asian, Hispanic, and Non-Hispanic White American Family Caregivers of Older Adults Across Generations.

    PubMed

    Miyawaki, Christina E

    2016-03-01

    This study is a cross-sectional investigation of caregiving practice patterns among Asian, Hispanic and non-Hispanic White American family caregivers of older adults across three immigrant generations. The 2009 California Health Interview Survey (CHIS) dataset was used, and 591 Asian, 989 Hispanic and 6537 non-Hispanic White American caregivers of older adults were selected. First, descriptive analyses of caregivers' characteristics, caregiving situations and practice patterns were examined by racial/ethnic groups and immigrant generations. Practice patterns measured were respite care use, hours and length of caregiving. Three hypotheses on caregiving patterns based on assimilation theory were tested and analyzed using logistic regression and generalized linear models by racial/ethnic groups and generations. Caregiving patterns of non-Hispanic White caregivers supported all three hypotheses regarding respite care use, caregiving hours and caregiving duration, showing less caregiving involvement in later generations. However, Asian and Hispanic counterparts showed mixed results. Third generation Asian and Hispanic caregivers used respite care the least and spent the most caregiving hours per week and had the longest caregiving duration compared to earlier generations. These caregiving patterns revealed underlying cultural values related to filial responsibility, even among later generations of caregivers of color. Findings suggest the importance of considering the cultural values of each racial/ethnic group regardless of generation when working with racially and ethnically diverse populations of family caregivers of older adults.

  5. Telephone Networks Connect Caregiving Families of Alzheimer's Victims.

    ERIC Educational Resources Information Center

    Goodman, Catherine Chase; Pynoos, Jon

    1988-01-01

    Describes telephone network bringing family caregivers of Alzheimer's victims together over telephone in rotating pattern of twosomes. Explains how five caregiving spouses and five adult children were matched and connected over three months. Describes program's 25 telephone-accessed audiotapes that guided networks and provided information on…

  6. Family Stigma and Caregiver Burden in Alzheimer's Disease

    ERIC Educational Resources Information Center

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  7. Physical and Mental Health Effects of Family Caregiving

    ERIC Educational Resources Information Center

    Schulz, Richard; Sherwood, Paula R.

    2008-01-01

    The associations between physical and psychological health and being an informal caregiver are well established. In this article, "caregiving" denotes care that is provided by a family member or friend rather than by a professional who is reimbursed for services. Clinical observation and early empirical research showed that assuming a caregiving…

  8. Clinical Efficacy of Psychoeducational Interventions with Family Caregivers

    ERIC Educational Resources Information Center

    Limiñana-Gras, Rosa M.; Colodro-Conde, Lucía; Cuéllar-Flores, Isabel; Sánchez-López, M. Pilar

    2016-01-01

    The goal of this study is to investigate the efficacy of psychoeducational interventions geared to reducing psychological distress for caregivers in a sample of 90 family caregivers of elderly dependent (78 women and 12 men). We conducted an analysis of the statistical and clinical significance of the changes observed in psychological health…

  9. Equity Matters: Doing Fairness in the Context of Family Caregiving

    ERIC Educational Resources Information Center

    Lashewicz, Bonnie; Manning, Gerald; Hall, Margaret; Keating, Norah

    2007-01-01

    Although family scholars conceptualize caregiving in terms of networks of carers, little attention has been given to equity within these groups. Siblings comprise a prevalent caregiving network of members who feel responsible for parent care, expect to share these responsibilities with each other, and look to each other to evaluate the fairness of…

  10. Caring for the Family Caregiver: Lessons Learned in Child Health.

    PubMed

    Keilty, Krista; Cohen, Eyal

    2015-01-01

    Policy to support informal caregivers is a critical health policy issue in Canada. Lessons may be learned from the perspectives and experience in the child health field with applicability for all cared-for persons and their informal caregivers. Familycentred care addresses the centrality of the family caregiver in the design and delivery of health services. A life course approach focuses on key periods of transition and downstream effects facing caregivers over their lifetime. The medical home model where care delivery is more coordinated offers potential direct cost savings for both family caregivers and the healthcare system. Models of pediatric home care that focus on promoting caregiver capacity and integration of unregulated providers show the promise of being acceptable and sustainable solutions to increasing demands for caregiver respite. Finally, a number of assumptions that are somewhat unique to the pediatric caregiver experience are explored and/or challenged. These lessons and assumptions may provide insight for policymakers in the development of systems and supports for all cared-for persons and their caregivers in Canada. PMID:26626116

  11. Caring for the Family Caregiver: Lessons Learned in Child Health.

    PubMed

    Keilty, Krista; Cohen, Eyal

    2015-01-01

    Policy to support informal caregivers is a critical health policy issue in Canada. Lessons may be learned from the perspectives and experience in the child health field with applicability for all cared-for persons and their informal caregivers. Familycentred care addresses the centrality of the family caregiver in the design and delivery of health services. A life course approach focuses on key periods of transition and downstream effects facing caregivers over their lifetime. The medical home model where care delivery is more coordinated offers potential direct cost savings for both family caregivers and the healthcare system. Models of pediatric home care that focus on promoting caregiver capacity and integration of unregulated providers show the promise of being acceptable and sustainable solutions to increasing demands for caregiver respite. Finally, a number of assumptions that are somewhat unique to the pediatric caregiver experience are explored and/or challenged. These lessons and assumptions may provide insight for policymakers in the development of systems and supports for all cared-for persons and their caregivers in Canada.

  12. Cancer Family Caregivers: A New Direction for Interventions

    PubMed Central

    Bakitas, Marie

    2012-01-01

    Abstract Background Descriptive studies of cancer family caregivers demonstrate role-related psychosocial and physical burden; however, little is known about which factors contribute to or obviate burden. Systematic reviews of caregiver intervention studies demonstrate mixed results, perhaps because some caregiver needs are still unknown and not adequately addressed. The purpose of our study was to explore the lived experience of being a caregiver for an adult with lung or colon cancer, so as to guide the development of future intervention studies. Method Using phenomenologic methods, open-ended interviews were conducted at a chemotherapy clinic, New Haven, CT with 135 caregivers to adults with lung or colon cancer. Interviews were audio-recorded and transcribed. Thematic analysis was conducted with transcripts coded, reviewed, and recoded multiple times. The final 69 codes were reduced to 13 code clusters (thematic categories) distributed among 4 themes. Results Four inter-related themes emerged: 1) becoming a caregiver; 2) new and altered relationships; 3) personal responses to caregiving and 4) antecedents and social context. Caregivers describe hearing the cancer diagnosis as “life-changing”. The cancer creates the context for the caregiver's relationships (with the patient, self, others, and the healthcare system), and cognitive, behavioral, affective, and spiritual responses. The caregiver's antecedent experiences and social support network form the foundation for their perceptions of the diagnosis, relationships, and personal responses. Conclusion This study implicates several intervention components to be developed and tested as favorably supporting caregivers, namely, reinforcing positive aspects of caregiving, cultivating open communication, and acknowledging the prior experiences and social foundation of the caregiver's life that can be supportive or burdensome. PMID:22612407

  13. Behavioral and Psychosocial Interventions for Family Caregivers

    ERIC Educational Resources Information Center

    Zarit, Steven; Femia, Elia

    2008-01-01

    Gerontologic research in the past 40 years has shown that caring for an older, disabled person affects the health and well-being of the caregiver. This important contribution led to a wide range of programs and services designed to buffer caregivers from the effects of stressors. Many of these programs have been quite innovative. Although…

  14. Relationships between quality of life and family function in caregiver

    PubMed Central

    2011-01-01

    Background There are caregivers who see their quality of life (QoL) impaired due to the demands of their caregiving tasks, while others manage to adapt and overcome the crises successfully. The influence of the family function in the main caregiver's situation has not been the subject of much evaluation. The aim of this study is to analyse the relationship between the functionality of the family and the QoL of caregivers of dependent relatives. Methods We conducted a cross-sectional study including 153 caregivers. Setting: Two health centers in the city of Salamanca(Spain). Caregiver variables analysed: demographic characteristics, care recipient features; family functionality (Family APGAR-Q) and QoL (Ruiz-Baca-Q) perceived by the caregiver. Five multiple regressions are performed considering global QoL and each of the four QoL dimensions as dependent variables. The Canonical Correspondence Analysis (CCA) was used to study the influence of the family function questionnaire on QoL. Results Family function is the only one of the variables evaluated that presented an association both with global QoL and with each of the four individual dimensions (p < 0.05). Using the CCA, we found that the physical and mental well-being dimensions are the ones which present a closer relationship with family functionality, while social support is the quality dimension that is least influenced by the Family APGAR-Q. Conclusion We find an association between family functionality and the caregiver's QoL. This relation holds for both the global measure of QoL and each of its four individual dimensions. PMID:21496270

  15. Gender differences in caregiving among family - caregivers of people with mental illnesses

    PubMed Central

    Sharma, Nidhi; Chakrabarti, Subho; Grover, Sandeep

    2016-01-01

    All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregiver-gender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly

  16. Gender differences in caregiving among family - caregivers of people with mental illnesses.

    PubMed

    Sharma, Nidhi; Chakrabarti, Subho; Grover, Sandeep

    2016-03-22

    All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregiver-gender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly

  17. Predictors of emotional distress, general health, and caregiving outcomes in family caregivers of stroke survivors.

    PubMed

    Bakas, Tamilyn; Burgener, Sandy C

    2002-01-01

    Predictors of emotional distress, general health, and stroke-related caregiving outcomes were determined in 104 family caregivers of stroke survivors based on a conceptual model derived from Lazarus' theory of stress and coping. Predictors of emotional distress (R(2) =.48, p <.001) were low caregiver self-esteem, high task difficulty, and high threat appraisal. Predictors of poorer health (R(2) =.25, p <.001) were not living with the patient, low household income, and high threat appraisal. Predictors of poor stroke-related care-giving outcomes (R(2) =.45, p <.001) were emotional distress, low benefit appraisal, high task difficulty, and high threat appraisal. Findings suggest potential areas for multidimensional caregiver interventions.

  18. Innovative Program Aims to Improve Support for Cancer Family Caregivers

    Cancer.gov

    An article about an educational program at the City of Hope Cancer Center intended to provide health professionals with the tools and information needed to help family caregivers care for themselves and their loved ones with cancer.

  19. Family, religion, and depressive symptoms in caregivers of disabled elderly

    PubMed Central

    Zunzunegui, M. V.; Beland, F.; Llacer, A.; Keller, I.

    1999-01-01

    STUDY OBJECTIVE: To explain the variations in depressive symptomatology among primary caregivers of community dwelling activities of daily living disabled elderly and to evaluate the role of family and religiosity on the mental health consequences of caregiving in Spain. DESIGN: Cross sectional study. SETTING: City of Leganes in the metropolitan area of Madrid, Spain. PARTICIPANTS: All caregivers of a representative sample of community dwelling activities of daily living disabled persons, aged 65 and over were approached. The response rate was 85% (n = 194). Depression was assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale. MAIN RESULTS: Controlling for caregivers' income, education, health status, and caregiving stress, religiosity was associated with more depressive symptoms among children caregivers while for spouses the association was negative. Emotional support was negatively associated with depression, but instrumental support was not significant. CONCLUSIONS: Depressive symptomatology is frequent among Spanish caregivers of disabled elderly. This study concludes that religiosity and family emotional support play an important part in the mental health of Spanish caregivers. The role of religiosity may be different according to kinship tie and needs further investigation.   PMID:10396484

  20. Availability of caregiver support services: implications for implementation of the National Family Caregiver Support Program.

    PubMed

    Whittier, Stephanie; Scharlach, Andrew E; Dal Santo, Teresa S

    2005-01-01

    This study examines the scope and range of existing resources for family caregivers from the perspective of the Area Agencies on Aging (AAAs), which are charged with implementing Title III-E of the reauthorized Older Americans Act. California is used as a case example because of its substantial experience in providing caregiver support services. In particular, we examine the extent and adequacy of resources available in California corresponding to each of the five Title III-E service areas, utilizing data from AAAArea Plans, a follow-up survey of AAAs, and an Internet search. AAAs identified more than 276 providers of caregiver support services, and our Internet search identified another 195. Nearly two-thirds of these programs offer access to respite care, while other support services (e.g., counseling, training, support groups) are less often available. Service gaps most frequently identified included culturally and linguistically appropriate caregiver services, transportation, respite care, financial assistance, and services in rural areas. These findings suggest the need for enhanced efforts to improve the service network for supporting family caregivers, as states implement the National Family Caregiver Support Program.

  1. Relationships between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health among Homeless Families

    ERIC Educational Resources Information Center

    McGuire-Schwartz, Mandy; Small, Latoya A.; Parker, Gary; Kim, Patricia; McKay, Mary

    2015-01-01

    Homelessness affects a large and increasing number of families in the United States, and exposure to violence and other potentially traumatic events is common among homeless families. It is important to understand more about this population and, more specifically, about the relationship between youth mental health and caregiver mental health and…

  2. Pharmacists teaching in family medicine residency programs

    PubMed Central

    Jorgenson, Derek; Muller, Andries; Whelan, Anne Marie; Buxton, Kelly

    2011-01-01

    Abstract Objective To determine the percentage of family medicine residency programs that have pharmacists directly involved in teaching residents, the types and extent of teaching provided by pharmacists in family medicine residency programs, and the primary source of funding for the pharmacists. Design Web-based survey. Setting One hundred fifty-eight resident training sites within the 17 family medicine residency programs in Canada. Participants One hundred residency program directors who were responsible for overseeing the training sites within the residency programs were contacted to determine the percentage of training sites in which pharmacists were directly involved in teaching. Pharmacists who were identified by the residency directors were invited to participate in the Web-based survey. Main outcome measures The percentage of training sites for family medicine residency that have pharmacists directly involved in teaching residents. The types and the extent of teaching performed by the pharmacists who teach in the residency programs. The primary source of funding that supports the pharmacists’ salaries. Results More than a quarter (25.3%) of family medicine residency training sites include direct involvement of pharmacist teachers. Pharmacist teachers reported that they spend a substantial amount of their time teaching residents using a range of teaching modalities and topics, but have no formal pharmacotherapy curriculums. Nearly a quarter (22.6%) of the pharmacists reported that their salaries were primarily funded by the residency programs. Conclusion Pharmacists have a role in training family medicine residents. This is a good opportunity for family medicine residents to learn about issues related to pharmacotherapy; however, the role of pharmacists as educators might be optimized if standardized teaching methods, curriculums, and evaluation plans were in place. PMID:21918131

  3. The Role of Family Functioning in the Stress Process of Dementia Caregivers: A Structural Family Framework

    ERIC Educational Resources Information Center

    Mitrani, Victoria B.; Lewis, John E.; Feaster, Daniel J.; Czaja, Sara J.; Eisdorfer, Carl; Schulz, Richard; Szapocznik, Jose

    2006-01-01

    Purpose: The purpose of the study was to evaluate the role of family functioning in the stress process in a sample of caregivers of dementia patients by using a structural family framework. The stress-process model of caregiver distress included family functioning as an intervening variable in the relationship between objective burden and…

  4. Partners in Caregiving in a Special Care Environment: Cooperative Communication between Staff and Families on Dementia Units

    ERIC Educational Resources Information Center

    Robison, Julie; Curry, Leslie; Gruman, Cynthia; Porter, Martha; Henderson, Charles R., Jr.; Pillemer, Karl

    2007-01-01

    Purpose: This article reports the results of a randomized, controlled evaluation of Partners in Caregiving in a Special Care Environment, an intervention designed to improve communication and cooperation between staff and families of residents in nursing home dementia programs. Design and Methods: Participants included 388 family members and 384…

  5. Informal caregiving to persons with AIDS in the United States: caregiver burden among central cities residents eighteen to forty-nine years old.

    PubMed

    Turner, H A; Catania, J A

    1997-02-01

    Characteristics and caregiving experiences of friends and family members caring for people with AIDS (PWAs) were examined. Based on a probability sample of informal AIDS caregivers ages 18-49 living in central cities of the United States (n = 260), analyses were conducted to (a) identify the sociodemographic characteristics of young central city caregivers; and (b) examine the effects of caregiver characteristics (relationship to PWA, gender, race/ethnicity, income, sexual orientation, HIV status, perceived susceptibility), and level of objective caregiving demands, on subjective caregiver burden. Results indicate that the largest group of caregivers in this age category are male friends of the PWA--a group not typically found among caregivers to persons with other types of illnesses. In general, gay or bisexual caregivers, caregivers who have traditional family ties to the PWA, men relative to women, and lower income caregivers, report the greatest burden. While level of caregiving demands represents the most influential predictor of caregiver burden, white and male caregivers experience greater burden, independent of level of involvement and other caregiver characteristics. Receiving instrumental support with caregiving buffers the impact of high objective demands on subjective burden.

  6. The Sociocultural Context of Caregiving Experiences for Vietnamese Dementia Family Caregivers

    PubMed Central

    Nguyen, Kim Hanh; Dao, To Nhu; Vu, Phuoc; Arean, Patricia; Hinton, Ladson

    2015-01-01

    The goal of this qualitative study was to describe the beliefs and experiences of Vietnamese caregivers caring for a family member with dementia and to elicit their ideas about promising interventions. We recruited 10 caregivers from support groups, the Alzheimer’s Association, and local community-based organizations in Northern California. We conducted semi-structured in-depth interviews with all caregivers, as well as a focus group to obtain ideas about supportive strategies. Several themes emerged from the data: (1) Filial piety was influential in caregiving; (2) A sense of loss/grief or trauma was pervasive; and (3) Caregivers had clear sources of stress and sources of support. An overarching theme underlying these three topics was that cultural beliefs, values, and expectations impacted the caregiving experience. Suggestions for promising interventions included education, language-congruent and/or telephone support groups, case management, inclusion of the care recipient in the intervention, and importance of credibility of the intervention. It also may be valuable to include an understanding of cultural values and promotion of spirituality and religion as key components. Findings highlight targets for dementia caregiver interventions to reduce burden and distress in an understudied population. PMID:26617956

  7. Family Caregivers in Cancer: Roles and Challenges (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the challenges faced by family caregivers of cancer patients. This summary focuses on typical caregiver roles and concerns, and helpful interventions for caregivers.

  8. Caring for bereaved family caregivers: analyzing the context of care.

    PubMed

    Holtslander, Lorraine F

    2008-06-01

    Deaths from cancer will continue to rise with an increasing and aging population. Family caregivers of patients with cancer will face loss, grief, and bereavement as a result. As mandated by cancer and palliative care clinical practice guidelines, support for family caregivers continues through the processes of grief and bereavement to facilitate a positive transition through loss. To provide evidence-based nursing with this population, an analysis of their context of care was undertaken. Key health policies, characteristics of the healthcare delivery system, and the results of research with bereaved palliative caregivers are described. A model of effectiveness, efficiency, and equity is used to examine the situation of bereaved caregivers and to suggest research questions to fill the gaps in what is known about their needs and experience. Bereaved caregivers are at high risk for many distressing symptoms, including depression and sleeplessness, related to a range of complex variables, such as age, gender, social support, resources, and their experiences during caregiving. Current systems of support have not been adequate to meet the needs of this population and very little is known about the caregivers' quality of life, well-being, and health outcomes or how best to provide compassionate and effective nursing care.

  9. Caregiving is not a disease: moving from reactive to proactive supports for family caregivers across the healthcare system.

    PubMed

    Giosa, Justine; Holyoke, Paul

    2014-01-01

    Saint Elizabeth partnered directly with family caregivers in a study to develop promising practices and indicators of effective caregiver education and support. Researchers heard that caregivers want and need proactive supports to help them thrive and equip them with tools and resources to protect their capacity to care and prevent distress; however, the current system of support is heavily focused on a reactive, medical approach to managing and treating caregiver "burden." Saint Elizabeth is dedicated to promoting a philosophical shift in thinking about caregiver education and support and is actively re-designing support services to reflect what caregivers say they need. PMID:25591608

  10. Information needs of family caregivers regarding liver transplant candidates.

    PubMed

    Sá, Amanda Silva; Ziviani, Luciana Costa; Castro-E-Silva, Orlando; Galvão, Cristina Maria; Mendes, Karina Dal Sasso

    2016-03-01

    Objective To assess the information needs of family caregivers of candidates on the waiting list for a liver transplant. Methods It is a cross-sectional study conducted in a transplant center in São Paulo State in the period between April and October of 2012. For the assessment of information needed, an instrument submitted to face and content value was used. The caregivers put 10 subjects in order according to their importance and the amount of interest they had in learning about each, prior to the transplant their family member would be subjected to. Sociodemographic characteristics were also recorded. For data analysis, descriptive statistics were used. Results 42 families participated in the study. The information need about liver disease complications, complications after transplantation and care needed after surgery had higher averages. Conclusions Knowing the information needs of caregivers is important to plan teaching-learning strategies aimed at improving assistance to patients and families in transplant programs.

  11. Relationships between nurses and family caregivers: partners in care?

    PubMed

    Ward-Griffin, C; McKeever, P

    2000-03-01

    Increasing reliance on family care of elderly people at home calls for a critical analysis of the relationship between formal and informal caregivers. Although much has been written about how health professionals and family caregivers should relate to one another, we know very little about the relationships that develop between them. Using data from a qualitative study, this article illustrates that relationships between community nurses and family members caring for frail elders are complex, dynamic, and multifaceted. Shifting boundaries in caring work leads to changes in nurse-family caregiver relationships, which can be categorized as four distinct, yet interconnected, types: (1) nurse-helper, (2) worker-worker, (3) manager-worker, and (4) nurse-patient. Each type is described, and implications for nursing practice and research are discussed.

  12. Sleep complaints in older women who are family caregivers.

    PubMed

    Wilcox, S; King, A C

    1999-05-01

    Providing care to a family member with dementia has significant psychological and physical consequences. Sleep quality is likely affected by caregiving, yet this domain has received surprisingly little empirical study. In this study, sleep complaints were examined in 90 older women who were family caregivers of adults with dementia. Caregivers reported more sleep complaints than similarly aged healthy adults on all seven components of the Pittsburgh Sleep Quality Index, and a similar level of sleep complaints to those of sleep-impaired women and depressives on 6 and 4 components, respectively. Sleep medication was used by 38% of caregivers in the past month. The most common sleep complaints that occurred at least weekly were waking up in the night or early morning (84%), bathroom needs (83%), and sleep onset difficulties (41%). Sixty percent of the sample reporting nighttime care recipient disruptions stated that these disruptions occurred 3 or more times per week. Caregiver relationship and care recipient diagnosis were unrelated to sleep complaints. Lower levels of education, less internalized anger, care recipient disruptions, and psychological distress were related to poorer overall sleep quality. Sleep complaints are a common yet understudied problem in family caregivers. PMID:10363041

  13. Effects of Guided Care on Family Caregivers

    ERIC Educational Resources Information Center

    Wolff, Jennifer L.; Giovannetti, Erin R.; Boyd, Cynthia M.; Reider, Lisa; Palmer, Sara; Scharfstein, Daniel; Marsteller, Jill; Wegener, Stephen T.; Frey, Katherine; Leff, Bruce; Frick, Kevin D.; Boult, Chad

    2010-01-01

    Purpose: Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of…

  14. [Family caregiver issues: gender, privacy, and public policy perspectives].

    PubMed

    Lee, I; Chou, Fan-Hao; Chen, Chung-Hey

    2011-04-01

    Due to the phenomenon of Taiwan'saging population has made, long-term care has become an issue of increasingly emphasized importance. According to the statistics, the family takes responsibility for most long-term care duties and more than 70% of primary family caregivers are female. In the past, because of gender-based divisions of labor and gender role expectations made, it was taken for granted that females would be the socially preferred family caregivers. Those men who devoting in themselves to such work were regarded as a rare precious. As such, family care signified entailed different life experiences for males and females. Over the years, amendments to the civil code have recognized family care contributions, and the allowance for caregivers underlines that care responsibilities have shifted away from the family to society. Traditional gender divisions of labor today are significantly more blurred; family structures have become smaller in size; female labor in the workplace has increased; and ten-year long-term care plans and long-term care insurance have been successively implemented. These transformations will make labor outsourcing more and more popular and transform family care from a private problem to a pubic policy issue. In the future, family caregivers require consideration and support on a sustained basis. It is also important to improve and monitor the quality of care services. Nurses, the major professional members of long-term care teams, should be concerned over the issue of family care while providing nursing care. They should include family caregivers in the care plan so that they can make sure that patients receive comprehensive and constant care in order to enhance the overall quality of nursing care.

  15. [Family caregiver issues: gender, privacy, and public policy perspectives].

    PubMed

    Lee, I; Chou, Fan-Hao; Chen, Chung-Hey

    2011-04-01

    Due to the phenomenon of Taiwan'saging population has made, long-term care has become an issue of increasingly emphasized importance. According to the statistics, the family takes responsibility for most long-term care duties and more than 70% of primary family caregivers are female. In the past, because of gender-based divisions of labor and gender role expectations made, it was taken for granted that females would be the socially preferred family caregivers. Those men who devoting in themselves to such work were regarded as a rare precious. As such, family care signified entailed different life experiences for males and females. Over the years, amendments to the civil code have recognized family care contributions, and the allowance for caregivers underlines that care responsibilities have shifted away from the family to society. Traditional gender divisions of labor today are significantly more blurred; family structures have become smaller in size; female labor in the workplace has increased; and ten-year long-term care plans and long-term care insurance have been successively implemented. These transformations will make labor outsourcing more and more popular and transform family care from a private problem to a pubic policy issue. In the future, family caregivers require consideration and support on a sustained basis. It is also important to improve and monitor the quality of care services. Nurses, the major professional members of long-term care teams, should be concerned over the issue of family care while providing nursing care. They should include family caregivers in the care plan so that they can make sure that patients receive comprehensive and constant care in order to enhance the overall quality of nursing care. PMID:21455893

  16. Assisting Cognitively Impaired Nursing Home Residents with Bathing: Effects of Two Bathing Interventions on Caregiving

    ERIC Educational Resources Information Center

    Hoeffer, Beverly; Talerico, Karen Amann; Rasin, Joyce; Mitchell, C. Madeline; Stewart, Babara J.; McKenzie, Darlene; Barrick, Ann Louise; Rader, Joanne; Sloane, Philip D.

    2006-01-01

    Purpose: When cognitively impaired nursing home residents exhibit agitated and aggressive behaviors during bathing, nursing home caregivers are in a unique position to improve residents' experience. This report addresses whether certified nursing assistants (CNAs) who received training in a person-centered approach with showering and with the…

  17. The interplay of institution and family caregiving: relations between patient hassles, nursing home hassles and caregivers' burnout.

    PubMed

    Almberg, B; Grafström, M; Krichbaum, K; Winblad, B

    2000-10-01

    This population-based study investigated the relationship between stresses (hassles) and burnout for 30 family caregivers and their institutionalized demented elderly. The Burnout Measure, the Patient Hassles Scales and the Nursing Home Hassles Scale were used. Hassles included: patient hassles (cognitive, behavior, basic ADL) and nursing home hassles (caregiver - staff, patient - staff, practical/logistical). The caregiver's characteristics are described in relation to burnout and the caregiver's most frequent hassles are discussed. All subscales except basic ADL were correlated to burnout. However, regression analysis showed the nursing home hassles to be the most important stresses explaining variance in burnout among family caregivers.

  18. Information disclosure to family caregivers: applying Thiroux's framework.

    PubMed

    Rowe, John

    2010-07-01

    In the UK, community care has led to more complex relationships for mental health nurses. They need to respect the rights of service users to confidentiality while also respecting the rights of family caregivers to information that directly affects them. An unsatisfactory situation has arisen in which utilitarian and legally driven motives have seen family caregivers' interests become subsidiary to those of service users and providers. An ethical case is made for sharing information with family caregivers, even against the wishes of service users. Through the use of a conceptual framework based on elements proposed by Thiroux - value of life, goodness or rightness, justice or fairness, truth-telling or honesty, and individual freedom - the article concludes that there is an ethical argument for sharing some information with family caregivers and that nurses should respect caregivers' rights through their actions. Nurses' actions are a commitment to seeking what is 'good' by making judgements based on what matters. It is argued that people and their relationships matter more than strict adherence to laws and codes. PMID:20610577

  19. Religious Involvement and Telomere Length in Women Family Caregivers.

    PubMed

    Koenig, Harold G; Nelson, Bruce; Shaw, Sally F; Saxena, Salil; Cohen, Harvey Jay

    2016-01-01

    Telomere length (TL) is an indicator of cellular aging associated with longevity and psychosocial stress. We examine here the relationship between religious involvement and TL in 251 stressed female family caregivers recruited into a 2-site study. Religious involvement, perceived stress, caregiver burden, depressive symptoms, and social support were measured and correlated with TL in whole blood leukocytes. Results indicated a U-shaped relationship between religiosity and TL. Those scoring in the lowest 10% on religiosity tended to have the longest telomeres (5743 bp ± 367 vs. 5595 ± 383, p = 0.069). However, among the 90% of caregivers who were at least somewhat religious, religiosity was significantly and positively related to TL after controlling for covariates (B = 1.74, SE = 0.82, p = 0.034). Whereas nonreligious caregivers have relatively long telomeres, we found a positive relationship between religiosity and TL among those who are at least somewhat religious.

  20. Family practice clinics. Survey of family practice residents' attitudes.

    PubMed Central

    Rubenstein, H.; Levitt, C.

    1993-01-01

    All residents of McGill University's Department of Family Medicine were surveyed by mail about their family practice clinic experience. Residents were generally satisfied with their training site and their supervision, but noted problems with volume and diversity of patients, learning certain procedures, and knowledge of community resources. They did not want more family medicine clinic time. PMID:8219838

  1. Building bridges between families and nursing home staff: the Partners in Caregiving Program.

    PubMed

    Pillemer, K; Hegeman, C R; Albright, B; Henderson, C

    1998-08-01

    Compelling evidence exists that conflict and communication problems occur between nursing home staff and family members of residents. However, few interventions have been documented that simultaneously address the needs of both groups. The Partners in Caregiving program was created to train staff and family members in communication techniques and conflict resolution skills. Through a joint meeting with facility administrators, both groups also have the opportunity to influence facility practices. Evaluation data indicated that satisfaction with the program was extremely high, and that positive changes in staff-family interactions occurred. PMID:9726137

  2. The role of attitudes and culture in family caregiving for older adults.

    PubMed

    Anngela-Cole, Linda; Hilton, Jeanne M

    2009-01-01

    This study evaluated cultural differences in attitudes toward caregiving and the stress levels of family caregivers. Participants included 98 Japanese American and 86 Caucasian American family caregivers caring for frail elders. Analyses using MANOVA and multiple regression analyses revealed that the Caucasian caregivers had more positive attitudes and provided more hours of care than the Japanese caregivers but that both groups had elevated levels of caregiver stress. The stress that family caregivers currently experience could lead to a future generation of care recipients who enter old age in worse condition than their predecessors. Professionals need to work together to develop culturally appropriate, evidence-based interventions to address this issue.

  3. Distance caregiving a family member with cancer: A review of the literature on distance caregiving and recommendations for future research

    PubMed Central

    Douglas, Sara L; Mazanec, Polly; Lipson, Amy; Leuchtag, Mary

    2016-01-01

    Distance caregivers (DCGs) are a growing phenomenon in the United States Family members are struggling to provide care to loved ones with chronic illnesses such as cancer, from a distance. Unlike local caregiving research, distance caregiving research is limited and inconsistent definitions of distance make it difficult to compare studies. To date, DCGs have not been afforded the opportunities for educational and emotional support that local caregivers have received from the health care teams. Because they are not usually present at medical appointments, DCGs do not receive first-hand information from the health care team about the patient’s condition, disease progression, and/or treatment options. These caregivers report feeling left out of important family discussions. They experience anxiety related to the uncertainty of the family members’ well-being and guilt related to not being available to help local caregivers more. The challenges of distance caregiving are especially evident when the distance caregiver has a parent with advanced cancer. Family-centered care, attending to the needs of the whole family regardless of their geographic location is critical for quality cancer care. In this manuscript, the sparse literature on distance caregiving is reviewed. Recommendations for future research and for the development of creative technologically advanced interventions for this underserved caregiving population are suggested. PMID:27081643

  4. Distance caregiving a family member with cancer: A review of the literature on distance caregiving and recommendations for future research.

    PubMed

    Douglas, Sara L; Mazanec, Polly; Lipson, Amy; Leuchtag, Mary

    2016-04-10

    Distance caregivers (DCGs) are a growing phenomenon in the United States Family members are struggling to provide care to loved ones with chronic illnesses such as cancer, from a distance. Unlike local caregiving research, distance caregiving research is limited and inconsistent definitions of distance make it difficult to compare studies. To date, DCGs have not been afforded the opportunities for educational and emotional support that local caregivers have received from the health care teams. Because they are not usually present at medical appointments, DCGs do not receive first-hand information from the health care team about the patient's condition, disease progression, and/or treatment options. These caregivers report feeling left out of important family discussions. They experience anxiety related to the uncertainty of the family members' well-being and guilt related to not being available to help local caregivers more. The challenges of distance caregiving are especially evident when the distance caregiver has a parent with advanced cancer. Family-centered care, attending to the needs of the whole family regardless of their geographic location is critical for quality cancer care. In this manuscript, the sparse literature on distance caregiving is reviewed. Recommendations for future research and for the development of creative technologically advanced interventions for this underserved caregiving population are suggested.

  5. Home visits in family medicine residency

    PubMed Central

    Jakubovicz, Difat; Srivastava, Anita

    2015-01-01

    Abstract Problem addressed There has been a decline in family physicians providing home visits to housebound patients. Objective of program To increase family medicine residents’ exposure to home visits; their comfort and skills in providing home visits; and their willingness to provide home visits after graduation. Program description Between 2000 and 2010, each family practice resident at St Joseph’s Health Centre Family Medicine Teaching Unit in Toronto, Ont, was assigned at least 1 housebound patient to care for longitudinally over 2 years; the rationale for this was to increase the sense of “ownership” and responsibility among residents for their assigned homebound patients. Starting in 2003, until the program’s conclusion in 2010, residents were asked to fill out surveys before and after the program to assess their comfort with and confidence in providing home visits, as well as their satisfaction with the program. Survey responses were analyzed for changes over the course of residency training. A total of 85 residents completed the home visit teaching program between 2003 and 2010 inclusive. Conclusion While residents’ willingness to provide home visits did not increase over the course of residency, their confidence in making housecalls did increase. There was also a trend toward increased confidence among residents in working with community agencies. Thus, having home visit patients be a part of resident practices might play an important role in increasing the likelihood that future family physicians will continue to care for their patients when those patients are no longer ambulatory. PMID:26052599

  6. 76 FR 68621 - National Family Caregivers Month, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-04

    .... (Presidential Sig.) [FR Doc. 2011-28843 Filed 11-3-11; 11:15 am] Billing code 3295-F2-P ... short-term comfort and security, facilitate social engagement, and help individuals stay in their homes... observe National Family Caregivers Month, we honor the tireless compassion of Americans who heal,...

  7. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....71 Participant and family caregiver responsibilities. The program management has a written statement... program director about medications and remedies used by the participant; (h) Let the program director know.... (The Office of Management and Budget has approved the information collection requirements in...

  8. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....71 Participant and family caregiver responsibilities. The program management has a written statement... program director about medications and remedies used by the participant; (h) Let the program director know.... (The Office of Management and Budget has approved the information collection requirements in...

  9. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....71 Participant and family caregiver responsibilities. The program management has a written statement... program director about medications and remedies used by the participant; (h) Let the program director know.... (The Office of Management and Budget has approved the information collection requirements in...

  10. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....71 Participant and family caregiver responsibilities. The program management has a written statement... program director about medications and remedies used by the participant; (h) Let the program director know.... (The Office of Management and Budget has approved the information collection requirements in...

  11. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....71 Participant and family caregiver responsibilities. The program management has a written statement... program director about medications and remedies used by the participant; (h) Let the program director know.... (The Office of Management and Budget has approved the information collection requirements in...

  12. Accessible Support for Family Caregivers of Seniors with Chronic Conditions: From Isolation to Inclusion

    ERIC Educational Resources Information Center

    Stewart, Miriam; Barnfather, Alison; Neufeld, Anne; Warren, Sharon; Letourneau, Nicole; Liu, Lili

    2006-01-01

    Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family…

  13. Wearable Technology to Garner the Perspective of Dementia Family Caregivers

    PubMed Central

    Matthews, Judith T.; Campbell, Grace B.; Hunsaker, Amanda E.; Klinger, Julie; Mecca, Laurel Person; Hu, Lu; Hostein, Sally; Lingler, Jennifer H.

    2015-01-01

    Family caregivers of persons with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions that they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. We describe a prototype wearable camera system used to gather image and voice data from the caregiver’s perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that incorporate salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by our team during screening) identified in the resulting video. We anticipate that future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses. PMID:26468655

  14. Burden on Family Caregivers Caring for Patients with Schizophrenia

    PubMed Central

    Shamsaei, Farshid; Cheraghi, Fatemeh; Bashirian, Saied

    2015-01-01

    Objective: The aim of this study ‎was to determine the prevalence ‎of the burden reported by familycaregivers of Patients with ‎schizophrenia.‎ Methods: This cross sectional ‎study involved face-to-face ‎interviews with family caregivers ‎of patients with schizophrenia. ‎Using convenience sampling, ‎‎225 caregivers were selected ‎from Farshchian psychiatry ‎Hospital in Hamadan, Iran from ‎July to September 2012. ‎Measures included patients and ‎caregivers’ demographic ‎variables and caregivers’ burden ‎using the Zarit Burden Interview ‎‎(ZBI). Data were analyzed by ‎SPSS-18 with Pearson ‎correlation and t-test.‎ Results: Using the ZBI, we found ‎that 7.6% of the caregivers ‎experienced “no to low” burden, ‎‎23.5% “mild to moderate”, 41.8% ‎‎“moderate to severe” and 27.1% ‎‎“severe” burden. The mean ‎average score of the responses ‎to ZBI was 51.73 (SD: ± 18.23). ‎The level of burden experienced ‎was significantly associated with ‎age, gender, and educational ‎level, relation to care recipient, ‎caregiving duration and duration ‎of schizophrenia illness.‎ Conclusion: ‎ ‏ ‏Mental health ‎professionals need to develop ‎more innovative programs for ‎families of schizophrenic ‎patients. Furthermore, as a ‎replacement for supporting the ‎families and easing their ‎burdens, it may be more ‎effective to include them in the ‎health care team by assigning ‎specific tasks and providing the ‎required resources to them to ‎perform such tasks. ‎ PMID:27006669

  15. Influence of family dynamics on burden among family caregivers in aging Japan

    PubMed Central

    Kusaba, Tesshu; Sato, Kotaro; Fukuma, Shingo; Yamada, Yukari; Matsui, Yoshinori; Matsuda, Satoshi; Ando, Takashi; Sakushima, Ken; Fukuhara, Shunichi

    2016-01-01

    Background. Long-term care for the elderly is largely shouldered by their family, representing a serious burden in a hyper-aging society. However, although family dynamics are known to play an important role in such care, the influence of caring for the elderly on burden among caregiving family members is poorly understood. Objective. To examine the influence of family dynamics on burden experienced by family caregivers. Methods. We conducted a cross-sectional study at six primary care clinics, involving 199 caregivers of adult care receivers who need long-term care. Participants were divided into three groups based on tertile of Index of Family Dynamics for Long-term Care (IF-Long score), where higher scores imply poorer relationships between care receivers and caregiving family: best, <2; intermediate, 2 to <5; worst, ≥5. The mean differences in burden index of caregivers (BIC-11) between the three groups were estimated by linear regression model with adjustment for care receiver’s activity of daily living and cognitive function. Results. Mean age of caregivers was 63.2 years (with 40.7% aged ≥ 65 years). BIC-11 scores were higher in the worst IF-Long group (adjusted mean difference: 4.4, 95% confidence interval: 1.2 to 7.5) than in the best IF-Long group. We also detected a positive trend between IF-Long score and BIC-11 score (P-value for trend <0.01). Conclusion. Our findings indicate that family dynamics strongly influences burden experienced by caregiving family members, regardless of the care receiver’s degree of cognitive impairment. These results underscore the importance of evaluating relationships between care receivers and their caregivers when discussing a care regimen for care receivers. PMID:27450988

  16. Evaluating the Impact of the Life of a Caregiver Simulation on Student Attitudes, Understanding, and Knowledge of Frail Older Adults and Their Family Caregivers.

    PubMed

    Sawin, Erika Metzler; Mast, Merle E; Sessoms, John C; Fulcher, Keston H

    2016-01-01

    Many older adults age at home, cared for by family caregivers. Nurse educators need effective educational strategies to teach students family caregiving issues. This article examines how the Life of a Caregiver (LOC) simulation influences students' understanding and knowledge of aging, family caregiving issues, and related community services. A descriptive mixed-methods study was used with a student sample (n = 46). Participants reported significantly higher knowledge of caregiving terminology and significantly greater understanding of caregiving challenges and community services. The LOC simulation was found to be an effective strategy to teach students to care for older adults and their caregivers. PMID:27164776

  17. Developing a Measurement Strategy for Assessing Family Caregiver Skills: Conceptual Issues

    PubMed Central

    Farran, Carol J.; McCann, Judith J.; Fogg, Louis G.; Etkin, Caryn D.

    2009-01-01

    This report presents a conceptual approach to assessing skills of family caregivers for persons with Alzheimer’s disease and recommends next steps for development of this science. Researchers used multiple methods to develop a conceptual strategy for assessing family caregiver skills. Study participants included clinical/outreach staff from an Alzheimer’s Disease Center, nursing faculty with expertise in dementia care, and family caregivers. Mixed methods contributed to the conceptual clarification of caregiving skill and to the development of three approaches to assessing caregiver skill: caregiver self report, clinician assessment, and direct observational assessment. Caregiver effectiveness has the potential to affect the process of caregiving and outcomes for the person with dementia and caregiver. PMID:20179779

  18. Health-Related Quality of Life in the Family Caregivers of Stroke Survivors

    ERIC Educational Resources Information Center

    Chen, Yangkun

    2010-01-01

    The objective of this cross-sectional study was to identify the factors associated with health-related quality of life (HRQOL) of family caregivers of Chinese stroke patients. One hundred and twenty-three stroke patients consecutively admitted to a stroke clinic and their 123 family caregivers were recruited. The caregivers' HRQOLs were assessed…

  19. Experiences of caregiving, satisfaction of life, and social repercussions among family caregivers, two years post-stroke.

    PubMed

    Lurbe-Puerto, Kàtia; Leandro, Maria-Engracia; Baumann, Michèle

    2012-01-01

    Cerebrovascular diseases are a public health and social policy priority in Europe due to their high prevalence and the long-term disability they may result in (as the principal cause of handicap). Increasingly, family caregivers take over the care at home of these patients. Two years post-stroke, our study analyzed the feelings of family caregivers from Luxembourg and northeastern Portugal toward their experience of caregiving and its repercussions on social and couple relationships, life satisfaction, and socioeconomic characteristics. Participating hospitals identified survivors and consent was sought by letter. Patients (n = 62) and their main caregivers (n = 46 pairs) were interviewed at home. The mean life satisfaction of caregivers was similar, but the experience of providing care differed in terms of family support, and disruptions of the caregivers' family responsibilities. More Portuguese respondents gave activities up, found little time for relaxation, and estimated that their health had deteriorated; more Luxembourgers felt strong enough to cope. More Portuguese spouses reported an impact on their sex lives. Family caregivers represent a "population at risk." Social workers can help them by providing domestic assistance, undertaking coaching activities, fostering favorable attitudes, and offering reassurance. Home-based rehabilitation in Europe involving family care must take account of cultural lifestyle issues.

  20. Executive Summary: Professional Partners Supporting Family Caregivers

    ERIC Educational Resources Information Center

    Kelly, Kathleen; Reinhard, Susan C.; Brooks-Danso, Ashley

    2008-01-01

    Today, more than three-quarters of adults who live in the community and need long-term care depend on family and friends as their only source of assistance with activities of daily living (such as bathing, dressing, and eating) or instrumental activities of daily living (such as transportation and managing finances). Research suggests that the…

  1. 3 CFR 8900 - Proclamation 8900 of November 1, 2012. National Family Caregivers Month, 2012

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... caregivers to the ones they love even as they navigate their own health challenges. Mothers and fathers... stability to those they love. Family caregivers have an immeasurable impact on the lives of those...

  2. Taking care of one's own: justice and family caregiving.

    PubMed

    Jecker, Nancy S

    2002-01-01

    This paper asks whether adult children have a duty of justice to act as caregivers for their frail, elderly parents. I begin (Sections I. and II.) by locating the historical reasons why relationships within families were not thought to raise issues of justice. I argue that these reasons are misguided. The paper next presents specific examples showing the relevance of justice to family relationships. I point out that in the United States today, the burden of caregiving for dependent parents falls disproportionately on women (Sections III. and IV.). The paper goes on to use Rawls' theoretical tool of the veil of ignorance to argue that caring for parents should not be linked to a person's sex and more generally, that there is no duty of justice to assume the role of caregiver for dependent parents (Sections V.). Although justice does not provide the moral foundations for parent care, I show that it nonetheless places important limits on the instinct to care. I conclude that the voice of justice should be audible, and is intrinsically present, within families.

  3. Family caregivers of individuals with frontotemporal dementia: examining the relationship between coping and caregiver physical and mental health.

    PubMed

    Wong, Cindy C; Wallhagen, Margaret I

    2014-01-01

    To identify strategies to assist family caregivers of individuals with frontotemporal dementia (FTD) in dealing with their caregiving demands, nurses must understand these family members' unique needs and how they currently deal with their demands. The purpose of this study was to examine the relationship between coping and caregiver physical and mental health among FTD family caregivers. Participants were primary caregivers of individuals with FTD (with behavioral symptoms) living at home (N = 61). A small positive association was noted between problem-focused coping and caregiver physical health (r = 0.29, p < 0.05), and a small but nonsignificant positive correlation was noted between emotion-focused coping and caregiver mental health (r = 0.21, p = 0.10). However, multiple regression analysis showed that emotion-focused coping (β = 0.46, p < 0.05) made a statistically significant, unique contribution to caregiver mental health and explained approximately 14% of its variance. These findings support the potential value of emotion-focused coping strategies when dealing with behavioral symptoms manifested by individuals with FTD.

  4. Adapting the Structural Family Systems Rating to Assess the Patterns of Interaction in Families of Dementia Caregivers

    PubMed Central

    Mitrani, Victoria B.; Feaster, Daniel J.; McCabe, Brian E.; Czaja, Sara J.; Szapocznik, Jose

    2008-01-01

    Purpose: This study adapted the Structural Family Systems Ratings (SFSR), an observational measure of family interactions, for dementia caregivers. This article presents the development of the SFSR-Dementia Caregiver adaptation (SFSR-DC) and examines relationships between specific family-interaction patterns and caregiver distress. Design and Methods: The families of 177 Cuban American and White non-Hispanic American caregivers of dementia patients were assessed at baseline, 6, 12, and 18 months. Structural family theory and clinical experience were used to identify family interaction patterns believed to be related to caregiver emotional functioning. Factor analysis was used to refine subscales and develop a multiscale measure. Results: Six reliable subscales were related to caregiver distress and included in the SFSR-DC. There were two second-order factors. The SFSR-DC was provisionally cross-validated and showed invariance across the two ethnic groups. Implications: The SFSR-DC provides a method for examining specific and multiple interaction patterns in caregiver families and thus can advance knowledge regarding the role of the family in the stress processes of caregiving. These findings support the relevance of family interactions in caregiver distress and suggest that a treatment approach aimed at supporting family closeness and conflict resolution and reducing negativity might enhance caregiver well-being. PMID:16051907

  5. Attachment and caregiving relationships in families affected by parental incarceration.

    PubMed

    Shlafer, Rebecca J; Poehlmann, Julie

    2010-07-01

    This longitudinal, mixed method study focused on 57 families of children who participated in a mentoring program for children of incarcerated parents. Children ranged in age from 4 to 15 years. Monthly interviews were conducted with children, caregivers, and mentors during the first six months of program participation, and questionnaires were administered at intake and six months to assess caregiver-child and incarcerated parent-child relationships, contact with incarcerated parents, and children's behavior problems. Although some children viewed their incarcerated parents as positive attachment figures, other children reported negative feelings toward or no relationship with incarcerated parents. In addition, our assessments of children nine years old and older revealed that having no contact with the incarcerated parent was associated with children reporting more feelings of alienation toward that parent compared to children who had contact. Children's behavior problems were a primary concern, often occurring in a relational context or in reaction to social stigma associated with parental imprisonment.

  6. Balancing needs as a family caregiver in Huntington's disease: a qualitative interview study.

    PubMed

    Røthing, Merete; Malterud, Kirsti; Frich, Jan C

    2015-09-01

    Family members in families with severe chronic disease play important roles in care-giving. In families affected by Huntington's disease (HD), caregivers encounter practical and emotional challenges and distress. Enduring caregiver burdens may lead to problems and caregivers are in need of social support and health services to deal with challenges. We wanted to explore coping strategies and behaviour patterns used by family caregivers to care for themselves, while caring for a family member with HD. Participants were recruited from hospitals and community-based healthcare. The sample represents experiences from care-giving in all stages of the disease. We conducted semi-structured interviews with 15 family caregivers in Norway. The transcribed material was analysed by use of systematic text condensation, a method for cross-case thematic analysis of qualitative data. We found that family members used various coping strategies, adjusted to the stage and progression of HD. They tried to regulate information about the disease, balancing considerations for protection and disclosure, within and outside the family. The participants made efforts to maintain a balance between their own needs in everyday life and the need for care for affected family member(s). As the disease progressed, the balance was skewed, and the family caregivers' participation in social activities gradually decreased, resulting in experiences of isolation and frustration. In later stages of the disease, the need for care gradually overshadowed the caregivers' own activities, and they put their own life on hold. Health professionals and social workers should acknowledge that family caregivers balance their needs and considerations in coping with HD. They should, therefore, tailor healthcare services and social support to family caregivers' needs during the different stages of HD to improve caregivers' abilities to maintain some of their own activities, in balance with care-giving.

  7. Families With Special-Needs Children. Starting a Healthy Family Series/Family and Community Health Through Caregiving.

    ERIC Educational Resources Information Center

    Education Development Center, Inc., Newton, MA.

    This student manual, part of the Family and Community Health Through Caregiving program, focuses on the impact of children with birth defects on families, and the ways families cope with the needs of these children. Topics include: (1) genetic causes of birth defects; (2) how the community and individuals can help families with special-needs…

  8. Caregiving families within the long-term services and support system for older adults.

    PubMed

    Qualls, Sara Honn

    2016-01-01

    Long-term care services and supports are primarily a family industry that warrants psychologists' involvement through practice, research, and policy advocacy. Families are poorly integrated into service systems despite the dominance of family caregiving work within health care and long-term care. This article positions family caregiving work within the context of family life across the life span, noting overlaps and distinctions between normal family life and caregiving work for older adults whose physical or cognitive challenges require assistance. The prevalence, work, and consequences of family caregiving for older adults are described. Families are identified as key partners in long-term care, despite substantial policy and practice barriers to integrating them into care structures and systems. Policy options for reducing or eliminating barriers are suggested, as are professional practice opportunities for psychologists to support caregiving families. Approaches to assessment and interventions for caregivers across a variety of settings are described. Gaps in research are highlighted, with a focus on how to understand caregiving as embedded within context of family, long-term care services and supports, and health care. Caregiving work presents an imperative for expanding psychologists' engagement in integrating and supporting the families whose caregiving is so critical to a rapidly aging society. (PsycINFO Database Record PMID:27159435

  9. Effects of the situational context and interactional process on the quality of family caregiving.

    PubMed

    Phillips, L R; Morrison, E; Steffl, B; Chae, Y M; Cromwell, S L; Russell, C K

    1995-06-01

    A staged theoretical model designed to explain the quality of elder caring by family members was tested. The model posits how the situational context, interactional process, and caregiving burden perceived by the caregiver affect the quality of elder caring. The purpose was to determine the amount of variance explained by the interactional process beyond that explained by the situational context and caregiving burden. Data were collected from 209 elder-caregiver dyads using interviews, observations, and caregiver self-reports. The strongest predictors of caregiving burden were the caregiver's stressful negative life events (situational context) and discrepancy between past and present image of elder (interactional process). The strongest predictors of quality of elder caring were the caregiver's perception of subjective burden and a monitoring role definition on the part of the caregiver (interactional process).

  10. The Effect of a Family Therapy and Technology-Based Intervention on Caregiver Depression

    ERIC Educational Resources Information Center

    Eisdorfer, Carl; Czaja, Sara J.; Loewenstein, David A.; Rubert, Mark P.; Arguelles, Soledad; Mitrani, Victoria B.; Szapocznik, Jose

    2003-01-01

    Purpose: The majority of persons with Alzheimer's disease (AD) are cared for at home by a family member such as a spouse or daughter. Caregiving places enormous demands on these caregivers, and the negative consequences associated with caregiving are well documented. This paper reports results from the Miami site of the REACH (Resources for…

  11. Employed Mothers and Family Day-Care Substitute Caregivers: A Comparative Analysis of Infant Care.

    ERIC Educational Resources Information Center

    Stith, Sandra M.; Davis, Albert J.

    1984-01-01

    Provides a comparative assessment of maternal and nonmaternal infant caregiving practices in own-home and unregulated family day-care homes, respectively. A total of 30 caregivers (10 employed mothers, 10 substitute caregivers, and 10 nonemployed mothers) were observed in interaction with five- to six-month-old infants. (Author/RH)

  12. Effects of Social Support and Coping of Family Caregivers of Older Adults with Dementia in Taiwan

    ERIC Educational Resources Information Center

    Huang, Chiung-Yu; Musil, Carol M.; Zauszniewski, Jaclene A.; Wykle, May L.

    2006-01-01

    The purpose of this study was to explore the relationship of demographic characteristics, contextual factors, social support, and coping on health outcomes of family caregivers of older adults with dementia in Taiwan. This study also examined caregiving stress and whether support moderated the effects of caregiver stress on health. Lazarus and…

  13. Older and Younger Family Caregivers of Adults with Intellectual Disability: Factors Associated with Future Plans

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Lee, Yue-Chune; Lin, Li-Chan; Kroger, Teppo; Chang, Ai-Ning

    2009-01-01

    A structured interview survey was conducted in a major city in Taiwan to explore and compare older and younger family primary caregivers' well being and their future caregiving plans for these adults with intellectual disability. The sample size was 315 caregivers who were 55 years or older and who cared for adults with intellectual disability and…

  14. Socialization of Coping with Community Violence: Influences of Caregiver Coaching, Modeling, and Family Context

    ERIC Educational Resources Information Center

    Kliewer, Wendy; Parrish, Katie Adams; Taylor, Kelli W.; Jackson, Kate; Walker, Jean M.; Shivy, Victoria A.

    2006-01-01

    A socialization model of coping with community violence was tested in 101 African American adolescents (55% male, ages 9-13) and their maternal caregivers living in high-violence areas of a mid-sized, southeastern city. Participants completed interviews assessing caregiver coping, family context, and child adjustment. Caregiver-child dyads also…

  15. Conflict Resolution and Distress in Dementia Caregiver Families: Comparison of Cubans and White Non-Hispanics.

    PubMed

    Mitrani, Victoria B; Vaughan, Ellen L; McCabe, Brian E; Feaster, Daniel J

    2008-01-01

    This study investigated the role of family conflict resolution as a mediator of the relationship between ethnicity and psychological distress in dementia caregivers. The sample was composed of the families of 182 caregivers who participated in REACH (Resources for Enhancing Alzheimer's Caregiver Health). The sample consisted of 84 Cuban American and 98 non-Hispanic White American families. Mediation analyses revealed that both income and conflict resolution partially mediated the relationship between ethnicity and caregiver psychological distress. Specifically, Cuban American families were less likely than non-Hispanic White families to reach a resolution to their disagreements, which may have rendered the caregiver at greater risk for psychological distress. These results suggest that Cuban American caregivers may benefit from interventions that improve the family's ability to resolve conflicts. PMID:20448830

  16. Family Caregivers' Experiences of Caring for a Relative With Younger Onset Dementia: A Qualitative Systematic Review.

    PubMed

    Cabote, Christy Joy; Bramble, Marguerite; McCann, Damhnat

    2015-08-01

    Family caregiving for people with younger onset dementia affects everyone in the family unit. This article presents findings of a qualitative systematic review exploring the experiences of family caregivers of persons with younger onset dementia. A systematic search resulted in the inclusion of five relevant articles, and two groups within the family unit were identified-child caregivers and adult and spousal caregivers. Using the thematic synthesis approach, five themes emerged: dementia damage, grief for loss of relationship, changes in family roles, positive and negative impacts of family caregiving, and transition to formal care. The review findings support increasing evidence that despite the stress of caring for a person with dementia damage, family members have the capacity to cope, adapt, and grow through their experiences. Nurses can assist families to identify their unique strengths and enhance family resiliency so they can navigate the "lonely road" of younger onset dementia.

  17. Family Caregivers' Experiences of Caring for a Relative With Younger Onset Dementia: A Qualitative Systematic Review.

    PubMed

    Cabote, Christy Joy; Bramble, Marguerite; McCann, Damhnat

    2015-08-01

    Family caregiving for people with younger onset dementia affects everyone in the family unit. This article presents findings of a qualitative systematic review exploring the experiences of family caregivers of persons with younger onset dementia. A systematic search resulted in the inclusion of five relevant articles, and two groups within the family unit were identified-child caregivers and adult and spousal caregivers. Using the thematic synthesis approach, five themes emerged: dementia damage, grief for loss of relationship, changes in family roles, positive and negative impacts of family caregiving, and transition to formal care. The review findings support increasing evidence that despite the stress of caring for a person with dementia damage, family members have the capacity to cope, adapt, and grow through their experiences. Nurses can assist families to identify their unique strengths and enhance family resiliency so they can navigate the "lonely road" of younger onset dementia. PMID:25724671

  18. Usability of a Wearable Camera System for Dementia Family Caregivers.

    PubMed

    Matthews, Judith T; Lingler, Jennifer H; Campbell, Grace B; Hunsaker, Amanda E; Hu, Lu; Pires, Bernardo R; Hebert, Martial; Schulz, Richard

    2015-01-01

    Health care providers typically rely on family caregivers (CG) of persons with dementia (PWD) to describe difficult behaviors manifested by their underlying disease. Although invaluable, such reports may be selective or biased during brief medical encounters. Our team explored the usability of a wearable camera system with 9 caregiving dyads (CGs: 3 males, 6 females, 67.00 ± 14.95 years; PWDs: 2 males, 7 females, 80.00 ± 3.81 years, MMSE 17.33 ± 8.86) who recorded 79 salient events over a combined total of 140 hours of data capture, from 3 to 7 days of wear per CG. Prior to using the system, CGs assessed its benefits to be worth the invasion of privacy; post-wear privacy concerns did not differ significantly. CGs rated the system easy to learn to use, although cumbersome and obtrusive. Few negative reactions by PWDs were reported or evident in resulting video. Our findings suggest that CGs can and will wear a camera system to reveal their daily caregiving challenges to health care providers. PMID:26288888

  19. Usability of a Wearable Camera System for Dementia Family Caregivers

    PubMed Central

    Matthews, Judith T.; Lingler, Jennifer H.; Campbell, Grace B.; Hunsaker, Amanda E.; Hu, Lu; Pires, Bernardo R.; Hebert, Martial; Schulz, Richard

    2015-01-01

    Health care providers typically rely on family caregivers (CG) of persons with dementia (PWD) to describe difficult behaviors manifested by their underlying disease. Although invaluable, such reports may be selective or biased during brief medical encounters. Our team explored the usability of a wearable camera system with 9 caregiving dyads (CGs: 3 males, 6 females, 67.00 ± 14.95 years; PWDs: 2 males, 7 females, 80.00 ± 3.81 years, MMSE 17.33 ± 8.86) who recorded 79 salient events over a combined total of 140 hours of data capture, from 3 to 7 days of wear per CG. Prior to using the system, CGs assessed its benefits to be worth the invasion of privacy; post-wear privacy concerns did not differ significantly. CGs rated the system easy to learn to use, although cumbersome and obtrusive. Few negative reactions by PWDs were reported or evident in resulting video. Our findings suggest that CGs can and will wear a camera system to reveal their daily caregiving challenges to health care providers. PMID:26288888

  20. You Are Not Alone: PARISH NURSES BRIDGE CHALLENGES FOR FAMILY CAREGIVERS.

    PubMed

    Grebeldinger, Teresa A; Buckley, Kathleen M

    2016-01-01

    In 2015, there were 43.5 million informal, unpaid caregivers in the United States. Caregivers reported a moderate to high level of burden of care, including performing medical and nursing tasks they were not trained to do. A study of family caregiver experiences with parish/faith community nurses reveals four key ways parish nurses support caregivers and offers important implications for parish nurse preparation and practice.

  1. For love, legacy, or pay: legal and pecuniary aspects of family caregiving.

    PubMed

    Kapp, Marshall B

    2013-01-01

    Most caregiving and companionship provided by family members and friends to older individuals in home environments occurs because of the caregiver's feelings of ethical and emotional obligation and attachment. From a legal perspective, though, it might be ill-advised for an informal caregiver to admit such a motivation. Building on a recently published study of relevant litigation, this essay discusses changing cultural and legal aspects of family caregiving when there is some expectation of pay, property, or fuiture financial legacy in return for the caregiver's present work and sacrifices. PMID:24283003

  2. Psychosocial condition of family caregivers of patients with chronic obstructive pulmonary disease in Hong Kong.

    PubMed

    Lee, E; Lum, C M; Xiang, Y T; Ungvari, G S; Tang, W K

    2010-12-01

    OBJECTIVES. Chronic obstructive pulmonary disease is associated with physical and psychological burdens. Although there is research about health-related quality of life (HRQOL) of such patients, less is known about the psychosocial condition of their family caregivers. The objectives of this study were to examine the HRQOL and the burden of chronic obstructive pulmonary disease patient caregivers, and to identify associated relevant factors. METHODS. A total of 81 eligible caregivers completed a caregiver survey on HRQOL (Short Form-36 Questionnaire), caregiving burden (Cumulative Illness Rating Scale, CIRS) and other biopsychosocial factors. Descriptive statistics, correlations, and multiple linear regression models were used to analyse data. RESULTS. The caregiver's Mental Component Summary measure of the Short Form-36 was associated with each caregiver's total CIRS scores, the anxiety subscale of the Hospital Anxiety and Depression Scale, and the Lubben Social Network Scale. The caregiver's Physical Component Summary measure was associated with the patient's disability allowance, the caregiver's total CIRS score, and the Barthel Index score. Caregivers' Caregiving Burden Scale scores were associated with their Geriatric Depression Scale total score and the need to take care of other family members. CONCLUSIONS. This study demonstrates that depressive and anxiety symptoms are associated with caregivers' burden and HRQOL. Further studies on evaluating interventions on caregivers' HRQOL and burden should take mood symptoms into consideration. PMID:22348927

  3. Role of the Lebanese family caregivers in cardiac self-care: a collective approach

    PubMed Central

    Dumit, Nuhad Y; Abboud, Sarah; Massouh, Angela; Magilvy, Joan K

    2015-01-01

    Aims and objectives The purpose of this study was to explore perceptions of cardiac self-care among Lebanese family caregivers of cardiac patients. The specific aims were to describe the cultural context of cardiac care-giving in Lebanon and to explore the roles of family caregivers in enhancing self-care practices in patients with cardiac diseases. Background The role of family caregivers in Lebanon, a country in the Middle East, is assumed to extend beyond care-giving to making decisions on behalf of the patient and assuming responsibility for patient care. To date, there has been no study done to empirically validate this impression. Design The design of the study is qualitative descriptive that used semi-structured individual interviews with family caregivers of Lebanese cardiac patients. Method Thirteen family caregivers of cardiac patients were recruited from a referral medical centre in Lebanon. The participants were designated by their patients and interviewed in a place of their choice. Results One overarching and three themes emerged from data analysis describing roles of family care givers in cardiac self-care. The overarching theme was: Family caregivers of Lebanese cardiac patients were unfamiliar with the term, concept and meaning of Self-Care. The moral and emotional duty to care for the family member stemmed from obligation and responsibility towards patients (theme I). Interdependent care (theme II) between cardiac patients and their families emerged as a significant cultural role. Family members play multiple supportive roles in care-giving namely emotional, informational and instrumental role (theme III). Conclusion In this study, family caregiver role is shown to be based in the sense of obligation and duty towards the sick family member who collectively provide different types of supportive care. Relevance to clinical practice Nurses have to give significant importance to the family caregiver role as an integral part of any culturally sensitive

  4. Family caregiver versus nursing assessments of elderly self-care abilities.

    PubMed

    Biggs, A J

    1990-08-01

    An assessment guide to be used by family caregivers would provide positive reinforcement oriented to what elderly family members can do in caring for themselves. Findings from this study indicate that there is an acceptable level of agreement between assessments of elderly self-care by family caregivers of dependent elderly and nursing assessments of the same self-care abilities. By actively involving family caregivers in the assessment of self-care abilities of their dependent elderly, family integrity and functioning may also be enhanced and families may feel more competent and less burdened as they provide assistance to elderly family members.

  5. Family caregivers' burden, quality of life, and health following patients' renal transplantation.

    PubMed

    Wicks, M N; Milstead, E J; Hathaway, D K; Cetingok, M

    1998-09-01

    Improved quality of life and physical functioning among renal transplant recipients have been documented; however, little of the literature has addressed the effects of transplantation on family caregivers. The purpose of this exploratory descriptive study was to characterize the level of subjective burden, quality of life, and self-rated health of caregivers who assist family members prior to transplantation as well as at 6 months following. The study sample included 19 caregivers of 19 renal transplant recipients. In general, caregiver burden, quality of life, and self-rated health did not improve following patients' transplants. In addition, 9 of 19 family caregivers reported increased burden. Because much of healthcare is family-based and greater reliance on family support seems inevitable, further studies are needed to examine the impact of transplantation on the family as well as the impact of the family on patients' posttransplant outcomes. PMID:9866547

  6. Remediation plans in family medicine residency

    PubMed Central

    Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

    2015-01-01

    Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

  7. 1. VIEW OF THE SOUTHEAST CORNER OF THE FAMILY RESIDENCE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW OF THE SOUTHEAST CORNER OF THE FAMILY RESIDENCE (FEATURE B-10), FACING NORTH. - Nevada Lucky Tiger Mill & Mine, Family Residence, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  8. Caregiving Styles: A Cognitive and Behavioral Typology Associated with Dementia Family Caregiving

    ERIC Educational Resources Information Center

    Corcoran, Mary A.

    2011-01-01

    Purpose: An increasing number of elderly individuals are diagnosed with Alzheimer's disease and related disorders (ADRD), many of whom receive daily caregiving from spouse or adult child. Caregiving is a "cultural activity," and as such it is strongly influenced by sociocultural beliefs about caregiving and how it should be enacted. Understanding…

  9. Satisfaction with civilian family medicine residency training

    PubMed Central

    Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre

    2016-01-01

    Abstract Objective To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. Design A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Setting Canada. Participants General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Main outcome measures Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Results Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. Conclusion General duty medical officers were satisfied with many aspects of

  10. Family caregiver preferences for patient decisional control among Hispanics in the United States and Latin America

    PubMed Central

    Yennurajalingam, Sriram; Noguera, Antonio; Parsons, Henrique Afonseca; Torres-Vigil, Isabel; Duarte, Eva Rosina; Palma, Alejandra; Bunge, Sofia; Palmer, J. Lynn; Delgado-Guay, Marvin Omar; Bruera, Eduardo

    2013-01-01

    Background Understanding family caregivers’ decisional role preferences is important for communication, quality of care, and patient and family satisfaction. The family caregiver has an important role in a patient’s decisional role preferences. There are limited studies on family caregivers’ preferences of the patient’s decisional control at the end of life among Hispanics. Aims To identify Hispanic caregivers’ preferences of the decision control of patients with advanced cancer and to compare the preferences of caregivers in Latin America (HLA) and Hispanic American (HUSA) caregivers. Design We surveyed patients and their family caregivers referred to outpatient palliative care clinics in the United States, Chile, Argentina, and Guatemala. Caregiver preferences of patient’s decisional control were evaluated using the Control Preference Scale. Caregivers’ and patients’ socio-demographic variables, patient performance status, and HUSA patient acculturation level was also collected. Participants A total of 387 caregivers were surveyed: 100 (26%) in Chile, 99 (26%) in Argentina, 97 (25%) in Guatemala, and 91 (24%) in the United States. The median age was 56 years, and 59% were female. Results Caregiver preference of patients decisions control was passive, shared, and active by 10 (11%), 45 (52%) and 32 (37%) HUSA caregivers and 54 (19%), 178 (62%) and 55 (19%) HLA caregivers (p=0.0023). Caregiver acculturation level did not affect the preferences of the HUSA sample (p=0.60). Conclusions Most Hispanic family caregivers preferred the patient to make shared decisions. HLA caregivers preferred more frequently patients to assume a passive decisional role. Acculturation did not influence the preferences of HUSA caregivers. PMID:23670718

  11. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively...

  12. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 5 2012-04-01 2012-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively...

  13. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 5 2013-04-01 2013-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively...

  14. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively...

  15. Filming the family: a documentary film to educate clinicians about family caregivers of patients with brain tumors.

    PubMed

    Rabow, Michael W; Goodman, Steffanie; Chang, Susan; Berger, Mitchel; Folkman, Susan

    2010-06-01

    The objective of this paper is to evaluate the educational value of a documentary film about family caregiving for patients with brain tumors. The method used in this study is a pre-post survey among neurosurgeons, neuro-oncologist, and other clinician viewers. Viewers evaluated the film highly and reported an intention to change their practice as a result of watching the film. Following viewing, participants felt more strongly that "all families of patients with brain cancers should meet with a social worker" (P = 0.01) and that "family caregivers greatly impact the health of patients" (P = 0.002), and they were less likely to believe that "supporting family caregivers is primarily someone else's job" (P = 0.009). A documentary film about family caregiving is an effective educational tool to increase awareness among neurosurgery/neuro-oncology clinicians about the importance and needs of family caregivers of patients with brain tumors.

  16. Support Service Use and Interest in Support Services among Distressed Family Caregivers of Lung Cancer Patients

    PubMed Central

    Mosher, Catherine E.; Champion, Victoria L.; Hanna, Nasser; Jalal, Shadia I.; Fakiris, Achilles J.; Birdas, Thomas J.; Okereke, Ikenna C.; Kesler, Kenneth A.; Einhorn, Lawrence H.; Given, Barbara A.; Monahan, Patrick O.; Ostroff, Jamie S.

    2012-01-01

    Objective This study examined support service use and interest in support services among distressed family caregivers of patients recently entering a comprehensive cancer care facility. Methods Primary family caregivers of lung cancer patients (N = 83) were recruited from three medical centers within 12 weeks of the patient’s new visit to the oncology clinic. All family caregivers were screened for psychological distress and those reporting significant anxiety or depressive symptoms were eligible for this study. Caregivers completed a baseline assessment of support service use (i.e., use of mental health services and complementary and alternative medicine [CAM]) and interest in support services. Support service use was also assessed three months later. Results Although all caregivers reported clinically meaningful distress, only 26% used mental health and 39% used CAM services during the 3-month study period. Patients’ receipt of chemotherapy was positively associated with caregivers’ mental health service use, whereas greater education and receiving assistance with caregiving tasks were associated with CAM use. Forty percent of caregivers who did not use CAM at baseline were interested in CAM. In addition, 29% of caregivers who did not receive mental health services at baseline were interested in professional psychosocial support, and 29% of caregivers who did not receive staff assistance with practical needs at baseline were interested in this service. Conclusions Findings suggest that distressed family caregivers of lung cancer patients underuse mental health services and that a sizable minority are interested in professional help with psychosocial and practical needs. PMID:22941782

  17. Respite Utilization and Responses to Loss among Family Caregivers: Relationship Matters

    ERIC Educational Resources Information Center

    DeCaporale, Lauren; Mensie, Lauren; Steffen, Ann

    2013-01-01

    Family caregivers of physically and cognitively impaired older adults face multiple challenges when providing care, including responses to tangible and anticipated losses. However, little is known about the grief experiences of family caregivers and how these might differentially influence the care-related behaviors of spouses and adult children.…

  18. FOCUS on the Family Caregiver: A Problem-Solving Training Intervention.

    ERIC Educational Resources Information Center

    Kurylo, Monica F.; Elliott, Timothy R.; Shewchuk, Richard M.

    2001-01-01

    Discusses the application of training in social problem solving with family caregivers of persons who have incurred severe physical disabilities. Outlines training procedures (i.e., Project FOCUS) that enable counselors to assist family caregivers in developing effective problem-solving skills that may translate to increased wellness for each…

  19. Understanding Discrepancy in Perceptions of Values: Individuals with Mild to Moderate Dementia and Their Family Caregivers

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2011-01-01

    Purpose of the Study: We explore discrepancies in perceptions of values and care preferences between individuals with dementia (IWDs) and their family caregivers. Design and Methods: We interviewed 266 dyads consisting of an individual with mild to moderate dementia and his or her family caregiver to determine IWDs' beliefs for 5 values related to…

  20. Burden and associated pathologies in family caregivers of Alzheimer’s disease patients in Spain

    PubMed Central

    Cotelo, Natalia Vérez; Rodríguez, N. Floro Andrés; PÉREZ, José A. Fornos; Iglesias, J. Carlos Andrés; Lago, Marcos Ríos

    2014-01-01

    Objectives: To evaluate the profile of family caregivers of Alzheimer’s disease patients, identify any signs of psychopathology, quantify the level of perceived burden on the caregiver, and determine the caregiver’s relationship with their pharmacist. Methods: A cross-sectional study was conducted at a community pharmacy in Pontevedra, Spain. Demographic variables were collected, and the following questionnaires were administered: the Beck Depression Inventory-II, STAI-Anxiety Questionnaire, Zarit Burden Scale, family APGAR scale, and the Duke-UNC questionnaire. Results: The typical caregiver profile consists of a 55-year old first degree relative (mostly daughters) with a primary education who belongs to a functional or mildly dysfunctional family. Nearly one quarter (24%) of caregivers had a high perception of burden, with anxiety in 20% of caregivers and symptoms of depression in 20%. Family caregivers usually went to the same pharmacy as the patients (96%), were treated with psychotropic drugs (68%), and interacted with the pharmacist (92%). Conclusion: This study confirmed that psychological distress and burden is present among family caregivers. Care for caregivers should be integrated into patient care as part of a national plan, including grants and subsidies, which will result in better care of Alzheimer’s patients. Pharmacists are the most accessible health care professionals and can provide information about Alzheimer’s disease management to caregivers to ease the burden of care. PMID:26131040

  1. Age Effects on Cognitive and Physiological Parameters in Familial Caregivers of Alzheimer's Disease Patients

    PubMed Central

    Corrêa, Márcio Silveira; Giacobbo, Bruno Lima; Vedovelli, Kelem; de Lima, Daiane Borba; Ferrari, Pamela; Argimon, Irani Iracema de Lima; Walz, Julio Cesar

    2016-01-01

    Objectives Older familial caregivers of Alzheimer’s disease patients are subjected to stress-related cognitive and psychophysiological dysfunctions that may affect their quality of life and ability to provide care. Younger caregivers have never been properly evaluated. We hypothesized that they would show qualitatively similar cognitive and psychophysiological alterations to those of older caregivers. Method The cognitive measures of 17 young (31–58 years) and 18 old (63–84 years) caregivers and of 17 young (37–57 years) and 18 old (62–84 years) non-caregiver controls were evaluated together with their salivary cortisol and dehydroepiandrosterone (DHEA) levels, as measured by radioimmunoassays and ELISA assays of brain-derived neurotrophic factor (BDNF) in serum. Results Although younger caregivers had milder impairments in memory and executive functions than older caregivers, their performances fell to the same or lower levels as those of the healthy older controls. Decreases in DHEA and BDNF levels were correlated with the cognitive dysfunctions observed in the older and younger caregivers, respectively. Cortisol at 10PM increased in both caregiver groups. Discussion Younger caregivers were prone to cognitive impairments similar to older caregivers, although the degree and the neuropsychological correlates of the cognitive dysfunctions were somewhat different between the two groups. This work has implications for caregiver and care-recipient health and for research on the neurobiology of stress-related cognitive dysfunctions. PMID:27706235

  2. Effects of Green House nursing homes on residents' families.

    PubMed

    Lum, Terry Y; Kane, Rosalie A; Cutler, Lois J; Yu, Tzy-Chyi

    2008-01-01

    A longitudinal quasi-experimental study with two comparison groups was conducted to test the effects of a Green House (GH) nursing home program on residents' family members. The GHs are individual residences, each serving 10 elders, where certified nursing assistant (CNA)-level resident assistants form primary relationships with residents and family, family is encouraged to visits, and professionals adapted their roles to support the model. GH family were somewhat less involved in providing assistance to their residents although family contact did not differ among the settings at any time period. GH family were more satisfied with their resident's care and with their own experience as family members, and had no greater family burden. Issues in studying family outcomes are discussed as well as implications for roles of various personnel, including social service and activities staff in a GH model.

  3. Creating Patient and Family Education Websites: Design and Content of the Home Parenteral Nutrition Family Caregivers Website

    PubMed Central

    Fitzgerald, Sharon; Yadrich, Donna Macan; Werkowitch, Marilyn; Piamjariyakul, Ubolrat; Smith, Carol

    2011-01-01

    When managing chronic illnesses, caregivers repeatedly seek online information about providing complex, long-term care but often neglect to find information about how to care for themselves. Poor health among caregivers is not only detrimental to their own well-being but may also result in harm to those for whom they care. For this reason, caregivers need access to information and activities about caring for themselves in addition to the information about managing home care they were already likely to seek. The HPN Family Caregivers Website was developed to guide caregivers through the process of caring for themselves by establishing a caregiving routine, self-monitoring their mental and physical health, practicing good sleep hygiene, etc., while also managing the complexities of home care. While website information, activities and algorithms for managing chronic illnesses need to be specific to each population, the content guiding caregivers to care for their own health is universal. PMID:21825970

  4. Nurses negotiating professional-familial care boundaries: striving for balance within double duty caregiving.

    PubMed

    Ward-Griffin, Catherine; Brown, Judith Belle; St-Amant, Oona; Sutherland, Nisha; Martin-Matthews, Anne; Keefe, Janice; Kerr, Mickey

    2015-02-01

    The purpose of this sequential, two-phase mixed-methods study was to examine the health of male and female nurses who provided care to older relatives (i.e., double duty caregivers). We explored the experiences of 32 double duty caregivers, which led to the development of an emergent grounded theory, Negotiating Professional-Familial Care Boundaries with two broad dialectical processes: professionalizing familial care and striving for balance. This article examines striving for balance, which is the process that responds to familial care expectations in the midst of available resources and reflects the health experiences of double duty caregivers. Two subprocesses of striving for balance, reaping the benefits and taking a toll, are presented in three composite vignettes, each representing specific double duty caregiving (DDC) prototypes (making it work, working to manage, living on the edge). This emergent theory extends current thinking of family caregiving that will inform the development and refinement of practices and policies relevant to DDC.

  5. Family Caregiving for Immigrant Seniors Living With Heart Disease and Stroke: Chinese Canadian Perspective.

    PubMed

    Liu, Lichun Willa; McDaniel, Susan A

    2015-01-01

    Heart disease and stroke are two leading causes of death and disability among older Canadians. Family support and caregiving are crucial to the positive functional recovery and psychological well-being of heart disease and stroke survivors. Based on focus groups and individual interviews with Chinese family caregivers in the Canadian province of Ontario, we explored the caregiver's experience, including the challenges, needs, and service gaps in providing care for immigrant seniors with heart disease and stroke. We found that caregiving practices and the strategies used to cope with caregiving challenges varied by gender, ethnicity, age, and length of migration. We provide recommendations for narrowing the gaps in caregiving at the end of the article.

  6. Life orientation in Finnish family caregivers' of persons with Alzheimer's disease: a diary study.

    PubMed

    Välimäki, Tarja; Vehviläinen-Julkunen, Katri; Pietilä, Anna-Maija; Koivisto, Anne

    2012-12-01

    Family caregivers provide the majority of home care of people with Alzheimer's disease. In this study, we discuss family caregivers' life orientation and changes in life orientation during the first year after the diagnosis of Alzheimer's disease. Family caregivers' unstructured diaries (n = 83), of the first six months after diagnosis (years 2002-2004), were analyzed using qualitative content analysis. Two core themes emerged from the data analysis: the meaning of the onset of Alzheimer's disease for the lives of family caregivers, and restructuring life in its entirety. Family caregivers face challenges in their life orientation after the onset of their family members' Alzheimer's disease. Their personal milieu, familial cohesion, and conception of the future consequentially change. They face multiple challenges in the process of becoming caregivers. In this study, it was revealed that the process starts before the diagnosis of Alzheimer's disease and has an impact on their future. We conclude that family caregivers' well-being should be assessed at the time of the diagnosis of Alzheimer's disease. PMID:23186523

  7. Experience with a Family-Practice-Resident-Directed Obstetrical Clinic.

    ERIC Educational Resources Information Center

    Hunter, Jerry L.; Snyder, Frank

    1980-01-01

    At Toledo Hospital, family practice residents have assumed responsibility for the normal obstetrics clinic. Specialty consultations are provided by the hospital's obstetrics residency program. A medical audit of the clinic indicates that the family practice residents obtained consultations and made referrals at the appropriate times. (JMD)

  8. Interventions with family caregivers of cancer patients: meta-analysis of randomized trials.

    PubMed

    Northouse, Laurel L; Katapodi, Maria C; Song, Lixin; Zhang, Lingling; Mood, Darlene W

    2010-01-01

    Family caregivers of cancer patients receive little preparation, information, or support to perform their caregiving role. However, their psychosocial needs must be addressed so they can maintain their own health and provide the best possible care to the patient. The purpose of this article is to analyze the types of interventions offered to family caregivers of cancer patients, and to determine the effect of these interventions on various caregiver outcomes. Meta-analysis was used to analyze data obtained from 29 randomized clinical trials published from 1983 through March 2009. Three types of interventions were offered to caregivers: psychoeducational, skills training, and therapeutic counseling. Most interventions were delivered jointly to patients and caregivers, but they varied considerably with regard to dose and duration. The majority of caregivers were female (64%) and Caucasian (84%), and ranged in age from 18 to 92 years (mean age, 55 years). Meta-analysis indicated that although these interventions had small to medium effects, they significantly reduced caregiver burden, improved caregivers' ability to cope, increased their self-efficacy, and improved aspects of their quality of life. Various intervention characteristics were also examined as potential moderators. Clinicians need to deliver research-tested interventions to help caregivers and patients cope effectively and maintain their quality of life.

  9. Factors affecting burden of family caregivers of community-dwelling ambulatory elders with dementia in Korea.

    PubMed

    Lim, Young Mi; Son, Gwi-Ryung; Song, Jun-Ah; Beattie, Elizabeth

    2008-08-01

    The purpose of the study was to test a staged causal model as a theoretical base to explain the burden of family caregivers of community-dwelling self-ambulatory persons with dementia (PWDs) in Korea. The model contained three stages including antecedents (Stage 1), behavior (Stage 2), and outcome (Stage 3). The antecedents were variables of the PWDs (e.g., cognitive impairment and activities of daily living [ADL] dependency of the PWDs) and caregiver variables (e.g., age, gender of caregiver, and the relationship of caregiver to PWD). Stage 2 focused on wandering behavior. In Stage 3, the outcome variable was caregiver burden. A total of 83 noninstitutionalized, community-dwelling elders with dementia and their family caregivers participated. The instruments used in this study were the Korean version of Mini Mental State Examination, K-PADL (Korean-Physical Activities of Daily Living), Korean-Revised Algase Wandering Scale-Community Version, and K-CWOB (Caregiver Worry, Overload, and Role Captivity Scale-Korean) Korean versions of standardized Western instruments. Results indicate that cognitive impairment and ADL dependency had an indirect influence on caregiver burden through wandering behavior. In addition, caregiver age had a direct impact on caregiver burden. The findings of this study suggest that further refinement of the underlying model is warranted.

  10. The Savvy Caregiver Program: Developing and Testing a Transportable Dementia Family Caregiver Training Program

    ERIC Educational Resources Information Center

    Hepburn, Kenneth W.; Lewis, Marsha; Sherman, Carey Wexler; Tornatore, Jane

    2003-01-01

    Purpose: This article reports on the development and field testing of the Savvy Caregiver Program, the transformation of a successful, academic-based caregiver psychoeducational program into a self-contained program that can be adopted in other locations. Design and Methods: Program development began with a prototype of a 12-hr course with the…

  11. Pain Medication Management Processes Used by Oncology Outpatients and Family Caregivers Part I: Health Systems Contexts

    PubMed Central

    Schumacher, Karen L.; Plano Clark, Vicki L.; West, Claudia M.; Dodd, Marylin J.; Rabow, Michael W.; Miaskowski, Christine

    2014-01-01

    Context Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical, day-to-day experiences with pain medication management. Objective To describe day-to-day pain medication management from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psycho-educational intervention called the Pro-Self© Plus Pain Control Program. In this article, we focus on pain medication management by patients and family caregivers in the context of multiple, complex health systems. Methods We qualitatively analyzed audio-recorded intervention sessions that included extensive dialogue between patients, family caregivers, and nurses about pain medication management during the 10-week intervention. Results The health systems context for pain medication management included multiple complex systems for clinical care, reimbursement, and regulation of analgesic prescriptions. Pain medication management processes particularly relevant to this context were getting prescriptions and obtaining medications. Responsibilities that fell primarily to patients and family caregivers included facilitating communication and coordination among multiple clinicians, overcoming barriers to access, and serving as a final safety checkpoint. Significant effort was required of patients and family caregivers to insure safe and effective pain medication management. Conclusion Health systems issues related to access to needed analgesics, medication safety in outpatient settings, and the effort expended by oncology patients and their family caregivers require more attention in future research and healthcare reform initiatives. PMID:24704800

  12. The influence of culture on home-based family caregiving at end-of-life: a case study of Dutch reformed family care givers in Ontario, Canada.

    PubMed

    Donovan, Rhonda; Williams, Allison; Stajduhar, Kelli; Brazil, Kevin; Marshall, Denise

    2011-02-01

    Families are facing increased pressure to provide care to their terminally-ill or dying kin in the home. It is known that balancing care with other personal and social roles can adversely affect family caregivers' (FCGs) health, yet access to supportive services which can mitigate burden is often inadequate. Cultural factors are known to shape the experience of caregiving; however, most research to date tends to neglect the experiences of FCGs from different cultural groups. This understanding is necessary to ensure that supportive services are both meaningful and culturally-appropriate. Using qualitative methods, we undertook longitudinal research with a sample of Dutch Reformed FCGs (n = 5) to understand their experiences of caregiving and bereavement. The results of the study are suggestive of a cultural specificity with respect to caregiving that impacts both responsibilities and reactions to care. Three themes were salient to this group as a cultural entity: cultural attitudes towards care, religious beliefs and coping, and culturally-informed care-seeking behaviours. These three themes were seen to be a function of their religious and ethnic identities and were reinforced by ties to the communities in which they resided. Cultural identity provided a framework through which to understand and make sense of the experience, while group membership provided access to networks of informal support. This research contributes to the geographical literature on care/caregiving by providing insight into the social, cultural and religious context of informal family caregiving with a population who live in close geographic proximity. On a practical level, this case study indicates the importance of considering how these factors may operate in other settings in order to implement timely and appropriate interventions to better support FCGs who are caring for their terminally-ill loved-ones at home.

  13. Families Who Care: Assisting African American and Rural Caregivers Dealing with Dementia. A Replication Plan.

    ERIC Educational Resources Information Center

    Coogle, Constance L., Ed.; Finley, Ruth B., Ed.

    This Replication Plan describes an Administration on Aging funded Project, "Assisting Caregivers of Black and Rural Elders with Dementia: Progressive Training through Trusted Resources." The project directly developed the capacities of trusted community leaders (n=69) who served as trainers of African American and rural family caregivers (n=200)…

  14. Families Who Care: Assisting African American and Rural Caregivers Dealing with Dementia. A Training Manual.

    ERIC Educational Resources Information Center

    Coogle, Constance L., Ed.; Finley, Ruth B., Ed.

    Although this training manual was developed as a tool for trainers of African American and rural family caregivers of elders with dementia, it can easily be adapted for trainers of caregivers (both formal and informal) of persons other than those with dementia. The first section educates potential trainers about dementia, rural issues, ethnic…

  15. Relationships between Perceptions of Personal and Family Functioning, Defensive Functioning, and Working Models of Caregiving.

    ERIC Educational Resources Information Center

    Meyers, Steven A.; And Others

    Current psychological literature suggests that positive representations of self and others are associated with sensitivity of caregiving. This study was designed to examine the relationship among self-perceptions, perceptions of family functioning, and caregiving schemata in 618 undergraduates (437 females, 181 males) enrolled in Introductory…

  16. Values and Preferences of Individuals with Dementia: Perceptions of Family Caregivers over Time

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2013-01-01

    Purpose of the Study: Cross-sectional evidence indicates that family caregivers reporting on the importance of daily care values and preferences of individuals with mild-to-moderate dementia consistently report less importance than individuals with dementia (IWDs) self-report. Discrepancy is primarily associated with caregivers' beliefs about…

  17. Family caregivers in public tertiary care hospitals in Bangladesh: Risks and opportunities for infection control

    PubMed Central

    Islam, M. Saiful; Luby, Stephen P.; Sultana, Rebeca; Rimi, Nadia Ali; Zaman, Rashid Uz; Uddin, Main; Nahar, Nazmun; Rahman, Mahmudur; Hossain, M. Jahangir; Gurley, Emily S.

    2015-01-01

    Background Family caregivers are integral to patient care in Bangladeshi public hospitals. This study explored family caregivers’ activities and their perceptions and practices related to disease transmission and prevention in public hospitals. Methods Trained qualitative researchers conducted a total of 48 hours of observation in 3 public tertiary care hospitals and 12 in-depth interviews with family caregivers. Results Family caregivers provided care 24 hours a day, including bedside nursing, cleaning care, and psychologic support. During observations, family members provided 2,065 episodes of care giving, 75% (1,544) of which involved close contact with patients. We observed family caregivers washing their hands with soap on only 4 occasions. The majority of respondents said diseases are transmitted through physical contact with surfaces and objects that have been contaminated with patient secretions and excretions, and avoiding contact with these contaminated objects would help prevent disease. Conclusion Family caregivers are at risk for hospital-acquired infection from their repeated exposure to infectious agents combined with their inadequate hand hygiene and knowledge about disease transmission. Future research should explore potential strategies to improve family caregivers’ knowledge about disease transmission and reduce family caregiver exposures, which may be accomplished by improving care provided by health care workers. PMID:24406254

  18. Preserving Personhood of Individuals with Advanced Dementia: Lessons from Family Caregivers

    PubMed Central

    Palmer, Janice L.

    2014-01-01

    This article reports on a phenomenological study of 15 family caregivers who admitted their spouse or parent with probable Alzheimer’s disease to long-term care. The caregivers were attuned to the needs, desires, moods and concerns of their family members with dementia; thus, they were attuned to personhood. Caregivers also reported observations of care by nurses and nursing staff. Observations were of individualized care and actions that promoted personhood and impoverished care delivered with minimal or no communication. These family caregivers’ perspectives can inform the care of individuals with advanced dementia by nurses and nursing staff. PMID:23583171

  19. Shaping mutuality: nurse-family caregiver interactions in caring for older people with depression.

    PubMed

    Jeon, Yun-Hee

    2004-06-01

    This paper reports on the research findings derived from a grounded theory study that examined the processes through which community mental health nurses work with families of older people with depression. Data were collected through semistructured, in-depth interviews with six community mental health nurses and seven family caregivers of older people with depression, and observations of their interactions in natural settings. Data collection and analysis were guided by theoretical sampling and the constant comparative process. The findings indicate that the nurse-family caregiver relationship involves working towards mutuality, which is shaped by both the nurse and family caregiver. It is through the process of "shaping mutuality" that a nurse and family caregiver learn to collaborate, and achieve their individual goals and desired outcomes, both for the patient and for themselves.

  20. The attitude of Japanese family caregivers toward the elderly with dementia.

    PubMed

    Yamamoto-Mitani, N; Tamura, M; Deguchi, Y; Ito, K; Sugishita, C

    2000-10-01

    This research examined family caregivers' attitudes toward their elderly relatives living with dementia. A convenience sample of fifty-nine Japanese caregivers was used. Caregiver attitudes were investigated multi-dimensionally (negative attitude, attitude of acceptance, and attitude of active interaction) using a questionnaire developed specifically for this study. The dimensions did not correlate with one another but were associated with different caregiver/elderly characteristics: i.e., negative attitude with short stay use, length of time caregivers and elderly relatives were living together and problem behaviors; attitude of acceptance with sleeping pill use and the type of relationship; and attitude of active interaction with dementia diagnosis. The results have implications for nurses in facilitating constructive caregiver attitudes. PMID:10785532

  1. The attitude of Japanese family caregivers toward the elderly with dementia.

    PubMed

    Yamamoto-Mitani, N; Tamura, M; Deguchi, Y; Ito, K; Sugishita, C

    2000-10-01

    This research examined family caregivers' attitudes toward their elderly relatives living with dementia. A convenience sample of fifty-nine Japanese caregivers was used. Caregiver attitudes were investigated multi-dimensionally (negative attitude, attitude of acceptance, and attitude of active interaction) using a questionnaire developed specifically for this study. The dimensions did not correlate with one another but were associated with different caregiver/elderly characteristics: i.e., negative attitude with short stay use, length of time caregivers and elderly relatives were living together and problem behaviors; attitude of acceptance with sleeping pill use and the type of relationship; and attitude of active interaction with dementia diagnosis. The results have implications for nurses in facilitating constructive caregiver attitudes.

  2. Families and Futures: Helping Self and Others. Starting a Healthy Family Series/Family and Community Health Through Caregiving.

    ERIC Educational Resources Information Center

    Education Development Center, Inc., Newton, MA.

    This student manual, part of the Family and Community Health Through Caregiving program, focuses on the special needs of teenagers with birth defects. Topics include: (1) the effect of informal contacts with the community, neighbors, and school age peers on the special needs adolescent; (2) society's attempts to meet these needs; (3) problems of…

  3. Partners Plus: Families and Caregivers in Partnerships. Model Demonstration. Final Report.

    ERIC Educational Resources Information Center

    Garland, Corrine W.; Frank, Adrienne; Ownby, Lisa L.

    This final report discusses the activities and outcomes of Partners Plus: Families and Caregivers in Partnerships, a model demonstration project designed to expand respite care options for families of children (birth to 8 years old) with disabilities. The program uses a natural and family-centered model that involves families in the design,…

  4. Family physicians’ perspectives on care of dementia patients and family caregivers

    PubMed Central

    Yaffe, Mark J.; Orzeck, Pam; Barylak, Lucy

    2008-01-01

    ABSTRACT OBJECTIVE To identify factors that facilitate or impede family physicians in ambulatory care of patients with dementia and the family caregivers of such patients. DESIGN Explanatory qualitative analyses of focus group discussions. SETTING Large, medium, and small urban; suburban; and rural family practices from various regions of the province of Quebec. PARTICIPANTS Twenty-five family doctors whose practices had at least 75% ambulatory patients; of these patients, an estimated minimum of 20% were 65 years old or older and at least 2% suffered from dementia. METHOD Physicians were recruited by telephone to be paid participants in their regions in focus groups studying aspects of dementia care in ambulatory settings. Grounded theory and constant comparative methods were used to explore data from 3 French-speaking focus groups and 1 English-speaking focus group. MAIN FINDINGS Physicians were 72% male, had a mean of 21.3 years in practice, and spent about 87% of their professional time in office practice. An estimated 38.7% of their patients were 65 years old or older, and 5.6% of these patients had Alzheimer disease or related dementias. Physicians were comfortable caring for these patients and their family caregivers but thought much of this care should come from support services offered elsewhere. Physicians admitted they had little knowledge of these services and had little interest in acquiring information about them. Government-run, community-based health and social service centres were the “black boxes” to which they referred patients and their caregivers for any form of help. Inconsistencies in the services offered by these centres were noted. CONCLUSION While family doctors are seeking a more seamless form of interdisciplinary dementia care, a large amount of that care comes from support services about which physicians are not well informed and are not interested in learning. PMID:18625826

  5. Caring for the brain tumor patient: Family caregiver burden and unmet needs

    PubMed Central

    Schubart, Jane R.; Kinzie, Mable B.; Farace, Elana

    2008-01-01

    The rapid onset and progression of a brain tumor, cognitive and behavioral changes, and uncertainty surrounding prognosis are issues well known to health practitioners in neuro-oncology. We studied the specific challenges that family caregivers face when caring for patients experiencing the significant neurocognitive and neurobehavioral disorders associated with brain tumors. We selected 25 family caregivers of adult brain tumor patients to represent the brain tumor illness trajectory (crisis, chronic, and terminal phases). Interviews documented caregiving tasks and decision-making and information and support needs. Themes were permitted to emerge from the data in qualitative analysis. We found that the family caregivers in this study provided extraordinary uncompensated care involving significant amounts of time and energy for months or years and requiring the performance of tasks that were often physically, emotionally, socially, or financially demanding. They were constantly challenged to solve problems and make decisions as care needs changed, yet they felt untrained and unprepared as they struggled to adjust to new roles and responsibilities. Because the focus was on the patient, their own needs were neglected. Because caregiver information needs are emergent, they are not always known at the time of a clinic visit. Physicians are frequently unable to address caregiver questions, a situation compounded by time constraints and cultural barriers. We provide specific recommendations for (1) improving the delivery of information; (2) enhancing communication among patients, families, and health care providers; and (3) providing psychosocial support for family caregivers. PMID:17993635

  6. Employed mothers and family day-care substitute caregivers: a comparative analysis of infant care.

    PubMed

    Stith, S M; Davis, A J

    1984-08-01

    Despite dramatic increases in recent decades in the number of employed mothers with children under 3 years of age and the greater utilization of nonmaternal child-care services (particularly unregulated family day care), little is known about the nature and quality of care provided to these infants by their employed mothers and substitute caregivers. This study was conducted to provide a comparative assessment of maternal and nonmaternal infant caregiving practices in own-home and unregulated family day-care homes, respectively. 30 caregivers (10 employed mothers, 10 substitute caregivers, and 10 nonemployed mothers) were observed in interaction with 5-6-month-old infants using Yarrow, Rubenstein, and Pedersen's Home Environment and Mother-Infant Interaction scales. While no differences were observed in the caregiving of employed and nonemployed mothers, both of these groups exceeded the sitters in socially mediated stimulation, contingent responsiveness, positive affect, and overall level and variety of social stimulation. In addition, employed mothers provided more tactile-kinesthetic, visual, and auditory stimulation to their infants than did the substitute caregivers. However, no differences were found between the infants reared in the home and day-care settings in Bayley Mental and Psychomotor developmental abilities. Evidence implicated group size (total number of children) in the quality of caregiving in family day-care homes. The impact of daily separations and qualitatively different caregiving experiences on infants is discussed.

  7. 78 FR 66617 - National Family Caregivers Month, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... take up the selfless and unheralded work of delivering care to seniors or people with disabilities or... behind closed doors and without fanfare every day, and we recommit to ensuring the well-being of their loved ones and of the caregivers themselves. Under the Affordable Care Act, patients and caregivers...

  8. Family Caregivers' Motives for Helping Scale derived from motivation-to-help theory.

    PubMed

    Smith, C E; Kleinbeck, S V; Boyle, D; Kochinda, C; Parker, S

    2001-01-01

    The literature does not contain a measure of family caregivers' motives for helping provide daily complex home care. Such a measure will permit nurses to assess and provide interventions specific to each caregiver's motivation for helping. The purpose of this study was to apply Batson's empirically derived helping pathway theory to the measurement of caregiver motives for helping and develop a short form that does not add to the burden of caregiving. A Principal Components factor analysis (N = 93) of Family Caregivers' Motives for Helping Scale is used. Criterion-related validity is ascertained using a triangulated, independent validation procedure with qualitative data from a subsample (N = 41). Subsample subjects' interview data were categorized, based on Batson's theoretical pathway definitions, by coders blinded to caregiver Motives for Helping Scale scores. Three of Batson's four helping pathways (reward seeking, altruism, and punishment-avoidance) were extracted during factor analysis. This three-factor solution explained 66.6% of the variance and was confirmed by a 97% agreement between three of Batson's pathways and caregivers' helping motive score. The content analyses of the descriptive interview data also coincide with the 3-factor solution. The scale items representing Batson's fourth helping pathway, distress reaction, were not retained due to cross loading. The Family Caregivers' Motives for Helping Scale accurately measures three of four theoretically derived motivations for helping another. The scale should be reanalyzed in a larger sample of caregivers. Aligning nursing interventions to caregiver motives for helping can provide reinforcement for caregivers and potentially enhance home care outcomes.

  9. Parental psychopathology and treatment outcome for anxious youth: Roles of family functioning and caregiver strain

    PubMed Central

    Schleider, Jessica L.; Ginsburg, Golda S.; Keeton, Courtney P.; Weisz, John R.; Birmaher, Boris; Kendall, Phillip C.; Piacentini, John; Sherrill, Joel; Walkup, John T.

    2014-01-01

    Objective Research has examined the effects of parental psychopathology, family functioning, and caregiver strain on treatment response in anxious youths. Although these variables have shown individual links to youth treatment response, theoretical models for their combined effects remain unexplored. This study tested the hypothesis that improvements in family functioning and reductions in caregiver strain explained the effects of parental psychopathology on youth treatment outcome in an anxiety treatment trial. Method A multiple mediation technique was used to test the proposed model across independent evaluator (IE), parent, and youth informants in 488 youths, aged 7–17 years (50% female; mean age 10.7) meeting DSM-IV-TR criteria for social phobia, separation anxiety, and/or generalized anxiety disorder. Youths were randomized to receive 12 weeks of cognitive-behavioral treatment (Coping Cat), medication (sertraline), their combination, or a pill placebo. At pre- and post-treatment, parents completed self-report measures of global psychopathology symptoms, family functioning, and caregiver strain; parents, youths, and IEs rated youths’ anxiety symptom severity. Results Changes in family functioning and caregiver strain jointly explained relations between parental psychopathology and reductions in youth anxiety. Specifically, across IE and parent informants, families with higher pre-treatment parental psychopathology showed more improvement in family functioning and caregiver strain, which in turn predicted greater youth anxiety reductions. Further, higher pre-treatment parental psychopathology predicted greater caregiver strain reductions, and in turn, greater youth anxiety reductions, based on youths’ reports of their own anxiety. Conclusions Findings suggest that improvements in family functioning and reductions in caregiver strain can influence treatment outcomes for anxious youths, especially among youths with more distressed parents. Public health

  10. Attachment and caregiving relationships in families affected by parental incarceration

    PubMed Central

    Shlafer, Rebecca J.; Poehlmann, Julie

    2011-01-01

    This longitudinal, mixed method study focused on 57 families of children who participated in a mentoring program for children of incarcerated parents. Children ranged in age from 4 to 15 years. Monthly interviews were conducted with children, caregivers, and mentors during the first six months of program participation, and questionnaires were administered at intake and six months to assess caregiver–child and incarcerated parent–child relationships, contact with incarcerated parents, and children’s behavior problems. Although some children viewed their incarcerated parents as positive attachment figures, other children reported negative feelings toward or no relationship with incarcerated parents. In addition, our assessments of children nine years old and older revealed that having no contact with the incarcerated parent was associated with children reporting more feelings of alienation toward that parent compared to children who had contact. Children’s behavior problems were a primary concern, often occurring in a relational context or in reaction to social stigma associated with parental imprisonment. PMID:20582847

  11. Perception Gap in Quality-of-Life Ratings: An Empirical Investigation of Nursing Home Residents and Caregivers

    ERIC Educational Resources Information Center

    Mittal, Vikas; Rosen, Jules; Govind, Rahul; Degenholtz, Howard; Shingala, Sunil; Hulland, Shelley; Rhee, YongJoo; Kastango, Kari B.; Mulsant, Benoit H.; Castle, Nick; Rubin, Fred H.; Nace, David

    2007-01-01

    Purpose: Several studies have previously documented the existence of a perception gap--the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual…

  12. Caregiving Statistics

    MedlinePlus

    ... more likely than non-caregivers to live in poverty and five times more likely to receive Supplemental ... caregiving families. In every state and DC the poverty rate is higher among families with members with ...

  13. The ACTive Intervention in Hospice Interdisciplinary Team Meetings: Exploring family caregiver and hospice team communication

    PubMed Central

    Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Demiris, George; Baldwin, Paula

    2010-01-01

    This paper presents the theoretical framework and rationale for the ACTive intervention which proposes the use of video technology to facilitate patient and family participation in hospice interdisciplinary team meetings where plans of care are determined. It is surmised that patient and family involvement will improve communication and compliance in hospice care. An analysis of data from a pilot project of the ACTive intervention was conducted to explore active participation among family caregivers and the hospice team. Through the use of videophone technology caregivers participated in video-recorded team meetings. The actual communication behaviors of caregivers and team members were analyzed for active participation. Findings revealed that team–prompted caregiver participation was most common, however, team use of supportive talk in this context was considerably less frequent. The study also found that the team’s use of active participation behaviors elicits caregiver active participation behaviors. The results of this study suggest the intervention was an effective way to involve family caregivers as active participants in the designing of care for their loved one. Findings also suggest that hospice staff would benefit from education and training on best practices for communicating with caregivers in the team meeting setting. PMID:20543889

  14. Morning Report in Family Medicine Residency Programs: A Descriptive Study.

    ERIC Educational Resources Information Center

    Kuncharapu, Indumathi; Cass, Alvah R.; Carlson, Carol A.; Scott, Jack R.

    Morning Report (MR) is a frequently held case conference in most Family Medicine (FM) residency programs among medical learners who discuss recent inpatient admissions before the day's care of patients. This study conducted a national survey of FM residency program directors to describe the roles of faculty and residents in facilitating MR.…

  15. Stress in Family Practice Residents: An Exploratory Study Using Art.

    ERIC Educational Resources Information Center

    Julliard, Kell; Intilli, Nancy; Ryan, Jennifer; Vollmann, Sarah; Seshadri, Mahalakshmi

    2002-01-01

    Investigates the themes of 16 family practice residents' art work and their characteristics (age, gender, resident year, undergraduate training location) in relationship to stress. Residents' drawing were linked by common themes of psychological pressure, anxiety, a sense of being overwhelmed, and depression. Evidence of stress was more frequently…

  16. An exploratory study of how occupational therapists develop therapeutic relationships with family caregivers.

    PubMed

    Clark, C A; Corcoran, M; Gitlin, L N

    1995-01-01

    Family members, who provide 70% to 80% of all long-term care, have often been perceived by occupational therapists as a barrier to, rather than a partner in, effective care for elderly persons. This perception suggests that in order to build effective partnerships to manage complex issues, occupational therapists working with elderly persons must develop effective strategies for involving family members in the therapeutic process. This article describes a pilot study that examined how occupational therapists engage family caregivers of elderly persons receiving home care services. A qualitative descriptive approach was used to explore the behaviors demonstrated by two occupational therapists when working with family caregivers. The findings point to four primary types of occupational therapist-caregiver interaction, categorized as: caring, partnering, informing, and directing. These interaction styles were compared with current literature describing state-of-the-art occupational therapy practices with older adults and family caregivers. An emphasis was placed on examining how therapeutic interactions can evoke different caregiver responses and influence the development and maintenance of collaborative therapeutic relationships. The results of this pilot study can serve as a framework for further exploration of interactive strategies that promote caregiver empowerment and ultimately influence the ability of families to assume responsibility for the long-term care required by many chronically disabled older adults. PMID:7573329

  17. Recruiting and retaining family caregivers to a randomized controlled trial on mindfulness-based stress reduction.

    PubMed

    Whitebird, Robin R; Kreitzer, Mary Jo; Lewis, Beth A; Hanson, Leah R; Crain, A Lauren; Enstad, Chris J; Mehta, Adele

    2011-09-01

    Caregivers for a family member with dementia experience chronic long-term stress that may benefit from new complementary therapies such as mindfulness-based stress reduction. Little is known however, about the challenges of recruiting and retaining family caregivers to research on mind-body based complementary therapies. Our pilot study is the first of its kind to successfully recruit caregivers for a family member with dementia to a randomized controlled pilot study of mindfulness-based stress reduction. The study used an array of recruitment strategies and techniques that were tailored to fit the unique features of our recruitment sources and employed retention strategies that placed high value on establishing early and ongoing communication with potential participants. Innovative recruitment methods including conducting outreach to health plan members and generating press coverage were combined with standard methods of community outreach and paid advertising. We were successful in exceeding our recruitment goal and retained 92% of the study participants at post-intervention (2 months) and 90% at 6 months. Recruitment and retention for family caregiver interventions employing mind-body based complementary therapies can be successful despite many challenges. Barriers include cultural perceptions about the use and benefit of complementary therapies, cultural differences with how the role of family caregiver is perceived, the use of group-based designs requiring significant time commitment by participants, and travel and respite care needs for busy family caregivers. PMID:21601010

  18. Recruiting and Retaining Family Caregivers to a Randomized Controlled Trial on Mindfulness-Based Stress Reduction

    PubMed Central

    Whitebird, Robin R.; Kreitzer, Mary Jo; Lewis, Beth A.; Hanson, Leah R.; Crain, A. Lauren; Enstad, Chris J.; Mehta, Adele

    2011-01-01

    Caregivers for a family member with dementia experience chronic long-term stress that may benefit from new complementary therapies such as mindfulness-based stress reduction. Little is known however, about the challenges of recruiting and retaining family caregivers to research on mind-body based complementary therapies. Our pilot study is the first of its kind to successfully recruit caregivers for a family member with dementia to a randomized controlled pilot study of mindfulness-based stress reduction. The study used an array of recruitment strategies and techniques that were tailored to fit the unique features of our recruitment sources and employed retention strategies that placed high value on establishing early and ongoing communication with potential participants. Innovative recruitment methods including conducting outreach to health plan members and generating press coverage were combined with standard methods of community outreach and paid advertising. We were successful in exceeding our recruitment goal and retained 92% of the study participants at post-intervention (2 months) and 90% at 6 months. Recruitment and retention for family caregiver interventions employing mind-body based complementary therapies can be successful despite many challenges. Barriers include cultural perceptions about the use and benefit of complementary therapies, cultural differences with how the role of family caregiver is perceived, the use of group-based designs requiring significant time commitment by participants, and travel and respite care needs for busy family caregivers. PMID:21601010

  19. Family-to-work spillover and appraisals of caregiving by employed women caring for their elderly parents in Japan

    PubMed Central

    SAKKA, Mariko; SATO, Iori; IKEDA, Mari; HASHIZUME, Hirofumi; UEMORI, Masayo; KAMIBEPPU, Kiyoko

    2016-01-01

    We examined the differences in family-to-work spillover between employed women who did and did not have caregiving responsibilities for elderly parents and the relationship between family-to-work spillover and negative and positive appraisals of caregiving using moderation analysis. A cross-sectional survey was conducted with middle-aged employed women (age ≥40 years) from four large companies. Negative and positive family-to-work spillover (FWNS and FWPS, respectively) and negative and positive appraisals of caregiving were measured. Data from 386 non-caregivers and 82 caregivers were analyzed using Fisher’s exact tests, Welch’s t-tests, and hierarchical multiple regression. Results showed that FWNS was higher in caregivers than in non-caregivers, while there was no significant difference in FWPS. Caregiver “fulfillment from the caregiving role” (a subscale of positive appraisal) buffered the effects of caregiver “feelings of social restriction” (a subscale of negative appraisal) on FWNS. On the other hand, caregiver “commitment to caregiving tasks” (another positive subscale) intensified the effects of “feelings of social restriction” on FWNS. However, there was no relationship between negative and positive appraisals of caregiving and FWPS. These findings suggest that both negative and positive appraisals of caregiving are important contributors to FWNS among employed women caring for their parents. PMID:26829970

  20. The benefits of e-health support for older family caregivers in rural areas.

    PubMed

    Blusi, Madeleine; Dalin, Rolf; Jong, Mats

    2014-03-01

    We conducted a pragmatic, mixed methods study comparing rural family caregivers receiving e-health caregiver support (n = 35) with a control group (n = 21) receiving conventional, non-e-health, caregiver support. After 18 months, the benefits of support were evaluated using the Care Effectiveness Scale (40-items exploring the domains of preparedness, enrichment and predictability). In all domains the e-health group scored significantly higher than the control group. The adjusted difference for overall benefits was 3.0 (P = 0.02) on the scale 0-10. In addition, semi structured interviews were conducted with a sub-sample of the caregivers. For the e-health group flexibility, availability and being able to individualise the support were essential factors. All caregivers in the control group found conventional support to be beneficial, but also stressed unmet needs related to the conventional support being standardised and non-flexible. The study suggests that providers of caregiver support should offer e-health support as an alternative to conventional caregiver support, as it can be more beneficial to family caregivers.

  1. Putting theory to the test: examining family context, caregiver motivation, and conflict in the Family Check-Up model.

    PubMed

    Fosco, Gregory M; Van Ryzin, Mark; Stormshak, Elizabeth A; Dishion, Thomas J

    2014-05-01

    This study examined contextual factors (caregiver depression, family resources, ethnicity, and initial levels of youth problem behavior) related to the effectiveness of the Family Check-Up (FCU) and evaluated family processes as a mediator of FCU intervention response and adolescent antisocial behavior. We followed a sample of 180 ethnically diverse youths of families who engaged in the FCU intervention. Family data were collected as part of the FCU assessment, and youth data were collected over 4 years, from sixth through ninth grade. Findings indicated that caregiver depression and minority status predicted greater caregiver motivation to change. In turn, caregiver motivation was the only direct predictor of FCU intervention response during a 1-year period. Growth in family conflict from sixth through eighth grade mediated the link between FCU response and ninth-grade antisocial behavior. This study explicitly tested core aspects of the FCU intervention model and demonstrated that caregiver motivation is a central factor that underlies family response to the FCU. The study also provided support for continued examination of family process mechanisms that account for enduring effects of the FCU and other family-centered interventions.

  2. The relationship between socio-demographic characteristics, family environment, and caregiver coping in families of children with cancer.

    PubMed

    Gage-Bouchard, Elizabeth A; Devine, Katie A; Heckler, Charles E

    2013-12-01

    The factors that influence caregiver coping mechanism preferences after a child's diagnosis with cancer are not fully understood. This study examines the relationship between caregivers' socio-demographic characteristics and the coping strategies they use to adapt to childhood cancer. Sixty caregivers of pediatric cancer patients completed a socio-demographic questionnaire, the Family Environment Scale, and the COPE inventory. There were no significant differences in family environment by income or education. Caregiver educational attainment was positively associated with use of planning and active coping styles, while income was not associated with caregiver coping style. Mothers were more likely than fathers to use active coping, instrumental support, religious coping, and emotional support. Men with lower education engaged in greater substance use coping and lower planning. The findings show that educational attainment and caregiver gender influence caregiver coping styles following a pediatric cancer diagnosis and suggest that educational attainment rather than financial resources drive the association between SES and coping. Programs that address educational gaps and teach caregivers planning and active coping skills may be beneficial for parents with lower educational attainment, particularly men.

  3. Characteristics of Combined Family Practice-Psychiatry Residency Programs

    ERIC Educational Resources Information Center

    Rachal, James; Lacy, Timothy J.; Warner, Christopher H.; Whelchel, Jennifer

    2005-01-01

    Objective: To evaluate how family practice-psychiatry residency programs meet the challenges of rigorous accreditation demands, clinical supervision, and boundaries of practice. Method: A 54-question survey of program directors of family practice-psychiatry residency programs outlining program demographic data, curricula, coordination, resident…

  4. 12 CFR 1010.10 - Single-family residence exemption.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Single-family residence exemption. 1010.10 Section 1010.10 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION LAND REGISTRATION (REGULATION J) General Requirements § 1010.10 Single-family residence exemption. (a) General. The sale of a lot...

  5. 12 CFR 1010.10 - Single-family residence exemption.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Single-family residence exemption. 1010.10 Section 1010.10 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION LAND REGISTRATION (REGULATION J) General Requirements § 1010.10 Single-family residence exemption. (a) General. The sale of a lot...

  6. 12 CFR 1010.10 - Single-family residence exemption.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Single-family residence exemption. 1010.10 Section 1010.10 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION LAND REGISTRATION (REGULATION J) General Requirements § 1010.10 Single-family residence exemption. (a) General. The sale of a lot...

  7. Chapter 8 family caregivers of veterans: a critical review of the empirical literature and recommendations for future research.

    PubMed

    Uphold, Constance R; Jordan, Meggan; Freytes, Magaly

    2014-01-01

    In recent years, research on caregiving has grown in both quality and quantity. Caregivers play an important role in supporting and promoting the health and recovery of injured, disabled, and ill family members in their care. Although researchers have made a substantial contribution to our understanding of family caregiving, less is known about family caregivers of U.S. Veterans. The purpose of this review is to identify and evaluate the research surrounding caregivers of U.S. Veterans, particularly two populations of Veterans: those who returned from the wars in Iraq and Afghanistan and those who had suffered a stroke. A search of the available literature from 1987 to present day resulted in a review of 18 publications on Operation Enduring Freedom/Operation Iraqi Freedom caregivers and 19 publications on caregivers of Veterans with stroke. We summarize empirical findings, critique the study methods, and provide our recommendations to improve the quality of care of Veterans and their caregivers.

  8. Perception of social support among family caregivers of vegetative patients: A qualitative study.

    PubMed

    Noohi, Esmat; Peyrovi, Hamid; Imani Goghary, Zahra; Kazemi, Majid

    2016-04-01

    A vegetative state (VS) is the probable result after brain damage. After VS patients are discharged from the hospital, the responsibility of caring of them is transferred to their families, which impacts a caregiver's physical and psychological health. Social support as a valuable resource reduces the negative effects of stressful events. This study aimed to explore the perception of social support among family caregivers of VS patients. This study is a part of a larger qualitative study which used the descriptive and qualitative method. Purposeful and theoretical sampling was done, and data was gathered through face-to-face, in-depth interviews. The four categories of "Family, a supporter in all aspects," "Beautiful emanation of the nurse's role," "Revitalization via empathy and companionship," and "Defects in support," were extracted. The primary concern of participants was receiving social support which can facilitate caregiving and coping with difficulties, but there are many shortcomings in supporting these caregivers.

  9. Religious Coping in Caregivers of Family Members With Dementia.

    PubMed

    Rathier, Lucille A; Davis, Jennifer Duncan; Papandonatos, George D; Grover, Christine; Tremont, Geoffrey

    2015-12-01

    The degree of depression experienced by caregivers of individuals with dementia was examined in relation to religious coping strategies, religious practice, and spirituality in the framework of the stress and coping model. Caregivers of 191 persons with dementia completed the Religious Coping Scale, self-report measures of religious practices and spirituality, burden, and depression. There was no evidence that any religious coping strategy or religious practice moderated the relationship between caregiving stress and depression. Certain types of religious coping strategies had a direct effect on depression. Higher levels of religious coping working with God were associated with decreased depression, whereas higher levels of religious coping working through God were associated with increased depression. Higher burden, lower overall caregiver health rating, and worse reactions to memory and behavior problems were associated with higher levels of depression. Frequency of prayer and the importance of spirituality were weakly associated with lower levels of depression.

  10. Multiple Family Groups for Child Behavior Difficulties: Retention Among Child Welfare-Involved Caregivers

    ERIC Educational Resources Information Center

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P.

    2015-01-01

    Purpose: The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders has shown promise in engaging child welfare-involved families. This qualitative study examines caregivers' perceptions of factors that influence retention in MFGs among child welfare-involved families. Methods: Twenty-five…

  11. Caregiver Assessment

    ERIC Educational Resources Information Center

    Feinberg, Lynn

    2008-01-01

    Assessment is a critical step in determining appropriate support services. This article discusses "caregiver assessment," a systematic process of gathering information to describe a caregiving situation. Caregiver assessment identifies the particular problems, needs, resources, and strengths of the family caregiver and approaches issues from the…

  12. Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.

    PubMed

    Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita

    2015-09-01

    The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia.

  13. Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.

    PubMed

    Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita

    2015-09-01

    The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia. PMID:25935206

  14. Intervention to improve social and family support for caregivers of dependent patients: ICIAS study protocol

    PubMed Central

    2014-01-01

    Background Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver. Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life. Methods/design Design: Controlled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT). Study area: Primary Health Care network (9 PHCTs). Study participants: Primary informal caregivers of patients receiving home health care from participating PHCTs. Sample: Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group. Intervention: a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support. Control: Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request. Data analysis Dependent variables: Caregiver burden (short-form Zarit test), caregivers’ social support (Medical Outcomes Study), and

  15. A Comparative Descriptive Study of Characteristics of Early- and Late-Onset Dementia Family Caregivers.

    PubMed

    Ducharme, Francine; Lachance, Lise; Kergoat, Marie-Jeanne; Coulombe, Renée; Antoine, Pascal; Pasquier, Florence

    2016-02-01

    Characteristics of early- and late-onset dementia family caregivers were described and compared. Based on a theoretical model of role transition, data were collected through structured interviews from 48 caregivers of adults with Alzheimer's disease or a related dementia older than the age of 70 and 48 caregivers of similarly diagnosed adults younger than the age of 60. A significantly higher proportion of caregivers of younger adults were spouses and gainfully employed compared with those of older adults; they had more years of schooling, took care of a person with more severe impairments, received more help, perceived themselves as better prepared to deal with future needs, and better informed about services. They did not differ from caregivers of older adults in terms of psychological distress, role confidence, self-efficacy, and social support. This study highlights differences and similarities to be considered in the development of services tailored to the specific needs of each group.

  16. Responsibility and burden from the perspective of seniors’ family caregivers: a qualitative study in Shanghai, China

    PubMed Central

    Zeng, Li; Zhu, Xiaoping; Meng, Xianmei; Mao, Yafen; Wu, Qian; Shi, Yan; Zhou, Lanshu

    2014-01-01

    Objectives: This study aimed to explore the experience of seniors’ family caregivers with regarding the responsibility, burden and support needs during caregiving in Shanghai, China. Materials and methods: An exploratory, descriptive, qualitative design was used and a semi-structure interview was conducted. A convenience sample of 11 participants in two community service centers in Shanghai was recruited. Data saturation guided the size of the sample. The Colaizzi method of empirical phenomenology was used for interviewing and analyzing data obtained from 11 caregivers. Results: Three major themes were found: It is a hard work; It is my responsibility; Social support is not enough. Conclusion: The findings of the study are practical and helpful for health care providers to develop appropriate caregiver support services, to balance the responsibility and burden of caregivers, and to consider the factors influencing the utility of support services. PMID:25126186

  17. Rural Caregivers for a Family Member With Dementia: Models of Burden and Distress Differ for Women and Men.

    PubMed

    Stewart, Norma J; Morgan, Debra G; Karunanayake, Chandima P; Wickenhauser, Joseph P; Cammer, Allison; Minish, Duane; O'Connell, Megan E; Hayduk, Leslie A

    2016-02-01

    Forecasts of increasing prevalence of dementia in rural settings, coupled with reliance on family caregiver support, indicate that a greater understanding of caregiver distress in these contexts is necessary. The purpose of this study was to examine family caregiver burden and severity of distress on the day that a family member was diagnosed with dementia at a memory clinic that serves a rural population. Participants in this retrospective study were 231 primary family caregivers of a rural community-dwelling person with dementia. On the diagnostic day, women reported more burden and severity of distress than men and spouses reported more severity of distress than adult children. A structural equation model was not supported for the entire sample, but was supported for women caregivers only (n = 161). Caregiver distress related to dementia-specific behaviors explained both global distress and burden. Patients' functional decline was related to caregiver burden.

  18. Family caregivers and care manager support under long-term care insurance in rural Japan.

    PubMed

    Yamada, Miho; Hagihara, Akihito; Nobutomo, Koichi

    2009-01-01

    Care managers are expected to coordinate care services for the elderly and to function as a source of social support under the Long-term Care Insurance programme in Japan. Thus far, however, little attention has been paid to the social support function of the care manager. To clarify the role of care manager support, we evaluated how care manager support ('social talk,' 'information giving' and 'reassurance') affects the burden of family caregivers categorised by caregiver gender and living arrangement. The interaction between 'information giving' and 'memory and behaviour problems' had a negative effect on 'social activity' among females living with elderly relatives (p < 0.05). 'Information giving' had a direct negative effect on caregiver burden among males living with elderly relatives (p < 0.05). Although 'social talk' had a moderating effect on caregiver burden (p < 0.05), the interaction between 'social talk' and 'memory and behaviour problems' had a negative impact on caregiver burden among females living with elderly relatives (p < 0.05). These results indicate that care manager support is only effective for female caregivers living with elderly relatives, and is ineffective or works poorly for female caregivers living separately and male caregivers living with elderly relatives. We concluded that the social support function of care managers would be improved by ensuring that they have adequate time for each case, and the skills to assess psychosocial needs. To achieve these goals, it is necessary to improve the work environment and introduce systematic training for psychosocial needs assessment.

  19. Caregiver Attitudes toward Disabled Elderly Family Members and Institutional Placement in a Home-Based Behavioral Treatment Program.

    ERIC Educational Resources Information Center

    Rankin, Eric; And Others

    Although the effectiveness of home-based, behaviorally-oriented treatment programs with the elderly and their families has been well documented, assessment of caregivers' attitudes toward those programs remains rare. To assess the relationship between outcome measures and client and principal caregiver characteristics, 21 client-caregiver dyads,…

  20. Exploring Spirituality in Family Caregivers of Patients With Primary Malignant Brain Tumors Across the Disease Trajectory

    PubMed Central

    Newberry, Alyssa G.; Jean Choi, Chien-Wen; Donovan, Heidi S.; Schulz, Richard; Bender, Catherine; Given, Barbara; Sherwood, Paula

    2013-01-01

    Purpose/Objectives To determine whether the perceived level of spirituality in family caregivers of patients with primary malignant brain tumors (PMBTs) changes across the disease trajectory. Design Ongoing descriptive, longitudinal study. Setting Southwestern Pennsylvania. Sample 50 family caregivers of patients with PMBT. Methods Caregivers and care recipients were recruited at time of diagnosis. Participants were interviewed at two subse-quent time points, four and eight months following diagnosis. Main Research Variables Care recipients’ symptoms, neuro-psychologic status, and physical function, as well as caregiver social support. Findings Results showed no significant difference in spirituality scores reported at baseline and eight months (p = 0.8), suggesting that spirituality may be a stable trait across the disease trajectory. Conclusions Spirituality remains relatively stable along the course of the disease trajectory. Reports of caregiver depressive symptoms and anxiety were lower when paired with higher reports of spirituality. Implications for Nursing Clinicians can better identify caregivers at risk for negative outcomes by identifying those who report lower levels of spirituality. Future interventions should focus on the development and implementation of interventions that provide protective buffers such as increased social support. Knowledge Translation Spirituality is a relatively stable trait. High levels of spirituality can serve as a protective buffer from negative mental health outcomes. Caregivers with low levels of spirituality may be at risk for greater levels of burden, anxiety, and stress. PMID:23615145

  1. Impaired autonomic nervous system activity during sleep in family caregivers of ambulatory dementia patients in Japan.

    PubMed

    Sakurai, Shihomi; Onishi, Joji; Hirai, Makoto

    2015-01-01

    The number of dementia patients requiring care is rapidly increasing in Japan. Consequently, a large percentage of family members, including spouses and children of those with dementia, are assuming the role of primary caregiver. Many caregivers develop health problems including sleep disorders. Some report poor quality of sleep even when sleep duration is normal. In the present study, we used actigraphy and heart rate variability spectral analysis to assess autonomic nervous system activity and quality of sleep in family caregivers of people with ambulatory dementia. The 20 caregivers who participated in our study exhibited significantly higher levels of sympathetic nervous system activity during sleep than noncaregivers. This abnormal activity was most prominent during the first half of the sleep period and was not related to overall sleep duration. We propose that relaxation is inhibited during the first half of the sleep period in this caregiver population. This may be due to increased stress, as caregivers of people with ambulatory dementia may worry about their patients waking and wandering at night, potentially injuring themselves. Our findings indicate a need for increased support for caregivers of people with dementia, including the assessment and treatment of sleep disorders. PMID:25504947

  2. Educational needs of employed family caregivers of older adults: Evaluation of a workplace project.

    PubMed

    Curry, Linda Cox; Walker, Charles; Hogstel, Mildred O

    2006-01-01

    Family members provide 80% of care for older adults in the United States. Many family caregivers are employed either full or part time. For employed caregivers, personal health, job performance, and the ability to advance their career are affected by the weight of their caregiving responsibilities. Some find it necessary to quit their jobs. Employed caregivers report a need for caregiving information; however, they seldom think of their workplace as a valuable resource. Results of the second of a 3-phase research and service project are discussed. Based on a needs assessment completed by employees of a large institution, educational sessions were offered during 3 consecutive months. Thirty-five employees attended 1 or more sessions. The sessions were evaluated highly on a 5-point Likert-type scale for usefulness of information, quality of presentation, and value of session. Sharing project results with the employing institution's human resources department yielded commitment to integrate caregiver education and referral into a newly organized work-life program. When properly managed, such workplace programs can provide needed assistance to employed caregivers. A nurse working with older adults is an ideal provider to initiate and manage this kind of program. PMID:16757388

  3. Physical and mental health correlates of self-efficacy in dementia family caregivers.

    PubMed

    George, Nika R; Steffen, Ann

    2014-01-01

    This study examined whether self-efficacy for controlling upsetting caregiving thoughts would longitudinally predict mental and physical health as well as utilization of psychotropic medications in help-seeking dementia family caregivers (N = 53). Positive associations were found between self-efficacy and self-reported mental health and physical health subscales of the Short Form Health Questionnaire-12, and negative correlations were found between self-efficacy for controlling upsetting thoughts about caregiving and the number of psychotropic medications being utilized both cross-sectionally and longitudinally. These results suggest that self-efficacy for controlling upsetting thoughts may be a fruitful target area for further intervention research with dementia family caregivers.

  4. Symptoms of mental impairment among elderly adults and their effects on family caregivers.

    PubMed

    Deimling, G T; Bass, D M

    1986-11-01

    Research that has examined the relationship between caregiving stress and elders' symptoms of mental impairment has focused primarily on cognitive incapacity. This research expands the symptoms of mental impairment to include caregivers' reports of problems in elders' social functioning and the presence of disruptive behavior, in addition to the traditional measure of cognitive incapacity. Results from a study of 614 families living with and caring for an impaired elder show cognitive incapacity to have a less important direct effect on caregiving stress than disruptive behavior and impaired social functioning. Cognitive incapacity does have an important indirect effect through its influence on disruptive behavior and social functioning.

  5. Anxiety in family caregivers of hospitalized persons with dementia: Contributing factors and responses

    PubMed Central

    Chippendale, Tracy; Resnick, Barbara; Galvin, James E.

    2016-01-01

    Background Baseline health and functional vulnerabilities increase the risk for complications in persons with dementia and predispose family caregivers (FCGs) to increased stress. Methods This secondary analysis used a combined quantitative and qualitative approach. Regression analyses examined the contribution of patient and family caregiver characteristics to FCG anxiety. Interviews with FCGs explored the experiences and responses of FCGs during hospitalization of their family member with dementia. Results Lower patient physical function and higher caregiver strain were associated with higher FCG anxiety. FCGs described the following themes related to the hospitalization: 1) added strain; 2) care-related worries; 3) keeping vigil; 4) need to be heard; and 5) enablers of family caregivers. Conclusions Routine evaluation of caregiver strain and baseline patient function is integral to informing the transitional planning for persons with dementia. The FCG responses suggest that a multi-factorial approach (family-centered policies of partnership in care, staff education addressing the specialized needs of patients and family- members, and attention to promoting functional recovery) may benefit both hospitalized patients with dementia as well as FCGs and warrants future research. PMID:25635341

  6. The Crisis of Stroke: Experiences of Patients and Their Family Caregivers

    PubMed Central

    Lutz, Barbara J.; Young, Mary Ellen; Cox, Kim J.; Martz, Crystal; Creasy, Kerry Rae

    2013-01-01

    Purpose Approximately 4.8 million stroke survivors are living in the community with some level of disability requiring the assistance of family caregivers. Stroke family caregivers are often unprepared for the demands required of them. The purpose of this grounded theory study was to explore the needs of stroke patients and their family caregivers as they transitioned through the stroke care continuum from acute care to inpatient rehabilitation to home. Methods Thirty-eight participants, 19 recovering stroke patients (11 male, 8 female), 15 primary family caregivers (14 spouses, 1 mother), and 4 adult children were interviewed during their stay at a rehabilitation facility and within 6 months of discharge. Interview questions were loosely structured and focused on the stroke experience and how patients and caregivers were managing postdischarge. Data were analyzed using dimensional and comparative analysis. Results Findings were organized in a conceptual framework illustrating the trajectory of the crisis of stroke. Stroke survivors and their caregivers faced enormous challenges as they moved through 3 phases of the trajectory: the stroke crisis, expectations for recovery, and the crisis of discharge. Findings from this study suggest that as caregivers move through the phases of the trajectory, they do not have a good understanding of the role to which they are committing, and they are often underprepared to take on even the basic tasks to meet the patients’ needs on discharge. Conclusion Stroke survivors and their caregivers do not have adequate time to deal with the shock and crisis of the stroke event, let alone the crisis of discharge and all of the new responsibilities with which they must deal. PMID:22436315

  7. Research on caregiving in Chinese families living with mental illness: a critical review.

    PubMed

    Hsiao, Chiu-Yueh; Van Riper, Marcia

    2010-02-01

    Much of the existing research on caregiving in families of individuals with mental illness has been conducted in Western societies. Therefore, the purpose of this review was to critically examine research on caregiving in families of individuals with mental illness living in Taiwan, Hong Kong, and Mainland China. A search using computerized databases, public search engines, and references from retrieved articles revealed 37 studies published from 1990 to 2009. Four studies were theory driven at an individual level, and one study was guided by a family-level framework. Thirty-two articles were quantitative studies, and 5 were qualitative studies. All but 5 of 37 studies were cross-sectional. Findings suggest that misconceptions about mental illness, behavior disturbances, inadequate social support, and the limited value placed on caregiving contribute to maladaptation. Future research should include longitudinal studies guided by culturally appropriate family frameworks and studies using mixed methods.

  8. Rethinking Family Caregiving: Tailoring Cognitive–Behavioral Therapies to the Hospice Experience

    PubMed Central

    Washington, Karla T.; Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Baldwin, Paula K.; Tappana, Jessica; Wright, Jesse H.; Demiris, George

    2014-01-01

    Hospice family caregivers experience significantly higher rates of psychological distress than demographically similar noncaregivers. Interventions based on cognitive–behavioral therapy have been shown to reduce psychological distress in the general population by providing tools to modify thinking patterns that directly affect emotions and behavior. Such interventions might reasonably be incorporated into hospice social work; however, numerous contextual factors must be taken into account to ensure that any interventions are appropriate to the unique needs of clients. The purpose of the study discussed in this article was to contextualize one aspect of the cognitive–behavioral model based on firsthand accounts of hospice family caregivers. Following a modified grounded theory approach, researchers engaged in a secondary analysis of data from a larger study provided in a subsample of 90 audio-recorded conversations between hospice family caregivers and interventionists. Findings indicated that distressed caregivers engaged in five dominant thinking patterns: (1) “should” statements, (2) catastrophizing or minimizing, (3) personalizing, (4) absolute thinking, and (5) making assumptions. Implementing cognitive–behavioral therapies based on identified caregiver thinking patterns will allow hospice social workers to empower caregivers to cope more effectively with the numerous stressors they encounter while caring for a dying loved one. PMID:25369725

  9. Workplace characteristics and work-to-family conflict: does caregiving frequency matter?

    PubMed

    Brown, Melissa; Pitt-Catsouphes, Marcie

    2013-01-01

    Many workers can expect to provide care to an elder relative at some point during their tenure in the workforce. This study extends previous research by exploring whether caregiving frequency (providing care on a regular, weekly basis vs. intermittently) moderates the relationship between certain workplace characteristics and work-to-family conflict. Utilizing a sample of 465 respondents from the National Study of the Changing Workforce (Families and Work Institute, 2008), results indicate that access to workplace flexibility has a stronger effect on reducing work-to-family conflict among intermittent caregivers than among those who provide care regularly.

  10. Care-related decision-making satisfaction and caregiver well-being in families caring for older members.

    PubMed

    Smerglia, V L; Deimling, G T

    1997-10-01

    Families provide care and make decisions regarding care within the context of specific structural characteristics and the broader family environment. This research analyzes data from 244 adult child and spouse caregiver interviews. It examines the impact of structural variables (e.g., caregiver type, elder impairment) and family environment (adaptability, conflict, cohesion) on satisfaction with care-related decision making and caregiver well-being. Regression analysis results indicate that aspects of family environment such as adaptability and conflict are the best predictors of decision-making satisfaction are the best predictors of caregiver depression.

  11. Training family medicine residents to care for children

    PubMed Central

    Duke, Pauline; Curran, Vernon; Hollett, Ann

    2011-01-01

    Abstract Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents’ satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation. PMID:21321160

  12. Schizophrenia in Malaysian families: A study on factors associated with quality of life of primary family caregivers

    PubMed Central

    2011-01-01

    Background Schizophrenia is a chronic illness which brings detrimental effects in the caregivers' health. This study was aimed at highlighting the socio-demographic, clinical and psychosocial factors associated with the subjective Quality of Life (QOL) of Malaysian of primary family caregivers of subjects with schizophrenia attending an urban tertiary care outpatient clinic in Malaysia. Methods A cross-sectional study was performed to study patient, caregiver and illness factors associated with the QOL among 117 individuals involved with caregiving for schizophrenia patients. The study used WHOQOL-BREF to assess caregivers' QOL and Brief Psychiatric Rating Scale (BPRS) to assess the severity of patients' symptoms. Social Readjustment Rating Scale (SRRS) assessed the stress level due to life events. Results The mean scores of WHOQOL-BREF in physical, psychological, social and environmental domains were 66.62 (14.36), 61.32 (15.52), 62.77 (17.33), 64.02 (14.86) consecutively. From multiple regression analysis, factors found to be significantly associated with higher QOL were higher educational level among caregivers in social and environmental domains; caregivers not having medical problem/s in physical and psychological domains; later onset and longer illness duration of illness in social domains; patients not attending day care program in environmental domain; lower BPRS score in physical and environmental domains. SRRS score of caregivers was also found to have a significant negative correlation with QOL in environmental and psychological domains. Other factors were not significantly associated with QOL. Conclusion Caregivers with more social advantages such as higher educational level and physically healthier and dealing with less severe illness had significantly higher QOL in various aspects. Supporting the caregivers in some of these modifiable factors in clinical practice is important to achieve their higher level QOL. PMID:21651770

  13. The Impact of Intellectual Disability, Caregiver Burden, Family Functioning, Marital Quality, and Sense of Coherence

    ERIC Educational Resources Information Center

    Al-Krenawi, Alean; Graham, John R.; Al Gharaibeh, Fakir

    2011-01-01

    The present article is the first to consider the impact of intellectual disability on Bedouin-Arab families' caregiver burden, family functioning, marital quality, and sense of coherence. A random sample of 300 Bedouin-Arab parents with one or more intellectually disabled children, and a control group (n = 100) completed the McMaster Family…

  14. A Digital Program Informs Low-Income Caregivers of Preschool-Age Children about Family Meals

    ERIC Educational Resources Information Center

    Lohse, Barbara; Rifkin, Robin; Arnold, Kristen; Least, Christine

    2012-01-01

    Objective: To evaluate the digital program, "Mealtime is Family Time", as a means of educating caregivers of preschoolers on the importance of family meals within the division of feeding responsibility framework. Methods: Descriptive design using 2 approaches: focus group program review and discussion or self-report survey after independent…

  15. Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults with Dementia

    ERIC Educational Resources Information Center

    Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin

    2010-01-01

    Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…

  16. The Effect of Home Caregiving Program for Family Members Providing Care for Chronically Ill Relative Client

    ERIC Educational Resources Information Center

    Mohammed, Hussein Jassim; Kamel, Andaleeb Abu

    2015-01-01

    Health care systems in many countries are moving towards outpatient care in which family members are central in providing care for patients with life-threatening illness. Family members and friends haven't knowledge and skills to become caregivers as many studies found that, the need to involve in such program to enhance their ability to be…

  17. [Exhaustion of family caregivers: a masked domestic crisis? A psychodynamic and systemic approach].

    PubMed

    Bouati, Noureddine; Sagne, Alain; Hunsicker, Morgane; Gavazzi, Gaëtan; Couturier, Pascal

    2016-03-01

    We try, from our clinical practice in a geriatric medicine department, to identify the processes involved in family crisis, especially in the relationship carer/cared. Psychodynamic and systemic determinants are highlighted to understand how family caregivers may suffer burn out, and suggest preventive measures.

  18. Working with Family, Friend, and Neighbor Caregivers: Lessons from Four Diverse Communities

    ERIC Educational Resources Information Center

    Powell, Douglas R.

    2011-01-01

    This article is excerpted from "Who's Watching the Babies? Improving the Quality of Family, Friend, and Neighbor Care" by Douglas R. Powell ("ZERO TO THREE," 2008). The article explores questions about program development and implementation strategies for supporting Family, Friend, and Neighbor (FFN) caregivers: How do programs and their host…

  19. Family Caregiving Project. Proceedings of a Conference (Washington, D.C., June 23-24, 1986).

    ERIC Educational Resources Information Center

    Berul Associates, Ltd., Rockville, MD.

    The conference on "Support for Family Caregivers" reported in this document was designed to identify, encourage the development of, and disseminate information about effective approaches for strengthening the capacity of families to care for their impaired relatives. The first of two presentations in the opening plenary session reviews the needs…

  20. Use of Equipment and Respite Services and Caregiver Health among Australian Families Living with Rett Syndrome

    ERIC Educational Resources Information Center

    Urbanowicz, Anna; Downs, Jenny; Bebbington, Ami; Jacoby, Peter; Girdler, Sonya; Leonard, Helen

    2011-01-01

    This study assessed factors that could influence equipment and respite services use among Australian families caring for a girl/woman with Rett syndrome and examined relationships between use of these resources and the health of female caregivers. Data was sourced from questionnaires completed by families (n=170) contributing to the Australian…

  1. Factors Associated with Family Caregivers' Burden and Depression in Korea

    ERIC Educational Resources Information Center

    Yoon, Hyunsook

    2003-01-01

    This study determines the relative effects of functional impairment, cognitive impairment, and duration of care of the elderly on caregivers' depression, and identifies the factors that influence this relationship. The variables were entered individually, based on a logical order in the path modeling. For mediators, the order of three types of…

  2. Patterns of Coping Among Family Caregivers of Frail Older Adults

    PubMed Central

    Lin, I-Fen; Wu, Hsueh-Sheng

    2014-01-01

    Past studies have extensively examined factors associated with coping strategies that caregivers use to ameliorate distress or solve problems. While these studies have found that stressors and individual resources influence choices of coping strategies, they have tended to overlook caregivers’ social resources and have rarely considered the possibility that distinct groups of caregivers may use different sets of coping strategies. We conducted latent-class analyses to identify distinct groups of caregivers: those using no particular patterns of coping (unpatterned-coping), those centering on ameliorating distress (emotional-coping), and those focusing on both ameliorating distress and solving problems (hybrid-coping). Stressors distinguished all three coping groups, individual resources differentiated the hybrid-coping group from the emotional-coping group and the unpatterned-coping group, and social resources separated the emotional-coping group and the hybrid-coping group from the unpatterned-coping group. These findings indicate different factors contributing to caregivers’ use of different coping styles and suggest ways to better help caregivers. PMID:25651512

  3. Family caregiver perspective-taking and accuracy in estimating cancer patient symptom experiences.

    PubMed

    Lobchuk, Michelle M; Vorauer, Jacquie D

    2003-12-01

    As family caregivers assume more prominent roles in the provision of home care to persons with serious illness, investigators must test the effectiveness of novel interventions to facilitate family caring for cancer patients. This article is based on results derived from a larger study carried out in Canada that was designed to compare 98 advanced cancer patient and family caregiver perceptions of 32 patient symptom experiences as captured by the Memorial Symptom Assessment Scale. We examined two main questions: (1) whether "natural" family caregivers' perceptions of patient lack of energy and worrying are more closely related to a self- or patient-oriented viewpoint and (2) whether induced "imagine-patient" perspective-taking can assist caregivers to achieve better perceptual accuracy. The caregiver's natural responses to neutral instructions that neither encouraged nor discouraged perspective-taking served as the baseline comparison with three other instructional sets, in which caregivers were prompted to: (1) provide a self-report on their own symptom experiences, (2) imagine how they would feel in the patient's situation (imagine-self), or (3) imagine how the patient would respond to his or her symptom situation (imagine-patient). Findings suggested that the family caregivers' natural judgments correspond most closely to what they do under an imagine-patient set than to what they do under any other set. Findings with respect to accuracy indicated that instructions to imagine the patient's perspective helped to prompt adjustments down from a self-oriented viewpoint, although definitive conclusions were precluded by difficulties with order effects.

  4. A Balint seminar in the family practice residency setting.

    PubMed

    Scheingold, L

    1980-02-01

    British psychoanalyst Michael Balint made important theoretical and pragmatic contributions to family practice, through the seminars of general practitioners he led at the Tavistock Clinic. A weekly Balint seminar, modeled on the Tavistock groups, was held in a family practice residency. The group of second and third year residents, co-led by a behavioral scientist and a family practice faculty member, met for 12 weeks and then re-evaluated topics and discussion format. Issues covered included physician-patient relationships, ethical dilemmas, group therapy concerns, and coping with clinic pressures. Objective evaluation of these seminars, where the goal is attitudinal rather than behavioral change, presents some difficulty. The conclusion is that residents benefited from the seminar, and that some aspects of psychoanalytic theory and technique are applicable to the teaching of behavioral science in family practice residencies.

  5. The Influence of Sekentei on Family Caregiving and Underutilization of Social Services among Japanese Caregivers

    ERIC Educational Resources Information Center

    Asai, Masayuki O.; Kameoka, Velma A.

    2005-01-01

    The Asian family is regarded as a close-knit social unit in which elderly people are believed to occupy a highly respected position. Family members are thought to provide care for elderly parents gratefully because of filial piety. This stereotypic portrayal of Asian families, however, may not apply fully to Japanese families. This article points…

  6. Multiple Family Groups for Child Behavior Difficulties Retention Among Child Welfare–Involved Caregivers

    PubMed Central

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P.

    2013-01-01

    Among children who remain at home with their permanent caregivers following a child welfare investigation, few who manifest emotional and behavioral difficulties actually engage in mental health treatment. The Multiple Family Group service delivery model to reduce childhood disruptive behavior disorders (MFG) has shown promise in engaging child welfare-involved families. This qualitative study examines caregiver perceptions of factors that influence retention in MFGs among child welfare-involved families. Methods Twenty-five predominantly Black and Hispanic adult (ages 26–57) female caregivers with child welfare services involvement participated in individual, in-depth interviews about their experience with MFGs. Transcribed interview data were thematically coded guided by grounded theory methodology. Emergent themes were subsequently organized into a conceptual framework. Results Within the overarching influence of child welfare services involvement, specific components of MFGs influencing retention included the quality of interaction among group members, group facilitators’ attentive approach with caregivers, supports designed to overcome logistical barriers (i.e., child care, transportation expenses, meals), and perceptions of MFG content and activities as fun and helpful. Caregiver factors, including their mental health and personal characteristics, as well as children’s behavior, (i.e., observed changes in behavioral difficulties) were also associated with retention. Conclusions High acceptability suggest utility for implementing MFGs within settings serving child welfare involved families, with additional modifications to tailor to setting and client features. PMID:26527856

  7. The feasibility of a telephone coaching program on heart failure home management for family caregivers

    PubMed Central

    Piamjariyakul, Ubolrat; Smith, Carol E.; Russell, Christy; Werkowitch, Marilyn; Elyachar, Andrea

    2012-01-01

    Objectives To test the feasibility of delivery and evaluate the helpfulness of a coaching heart failure (HF) home management program for family caregivers. Background The few available studies on providing instruction for family caregivers are limited in content for managing HF home care and guidance for program implementation. Method This pilot study employed a mixed methods design. The measures of caregiver burden, confidence, and preparedness were compared at baseline and 3 months post-intervention. Descriptive statistics were used to summarize program costs and demographic data. Content analysis research methods were used to evaluate program feasibility and helpfulness. Results Caregiver (n=10) burden scores were significantly reduced and raw scores of confidence and preparedness for HF home management improved 3 months after the intervention. Content analyses of nurse and caregiver post-intervention data found caregivers rated the program as helpful and described how they initiated HF management skills based on the program. Conclusion The program was feasible to implement. These results suggest the coaching program should be further tested with a larger sample size to evaluate its efficacy. PMID:23116654

  8. Neuropsychiatric symptoms of the elderly with Alzheimer's disease and the family caregivers' distress 1

    PubMed Central

    Storti, Luana Baldin; Quintino, Débora Teles; Silva, Natália Michelato; Kusumota, Luciana; Marques, Sueli

    2016-01-01

    ABSTRACT Objective: to analyze the relationship between the distress of the family caregiver and the presence of neuropsychiatric symptoms in elderly patients with Alzheimer's disease or mixed dementia. Method: a descriptive, cross-sectional study conducted in the Geriatric and Dementias Clinic of a general tertiary hospital, with 96 elderly people with Alzheimer's disease or mixed dementia and their family caregivers. Questionnaires to characterize the elderly and caregivers, and the Neuropsychiatric Inventory were used. Descriptive statistics and Pearson correlation test were performed. Results: 68.7% of the elderly were women, average age 80.8 years, 56.2% had Alzheimer's disease and 43.7%, mixed dementia. Among caregivers, 90.6% were women, average age 56, 70.8% took care of parents and 64.6% lived with the elderly. There was a strong (r = 0.82) and significant (p <0.01) correlation between the total score on the Neuropsychiatric Inventory and the total score on the Neuropsychiatric Inventory-Distress and strong (r = 0.80) and significant (p <0 01) correlation between the total score on the Neuropsychiatric Inventory Distress and the number of neuropsychiatric symptoms, i.e., the higher the number, frequency and severity of these symptoms in the elderly, the more intense is the caregiver distress. Conclusion: the presence of neuropsychiatric symptoms in the elderly was related to increased distress in caregivers. PMID:27533264

  9. Correlates of Caregiver Burden among Family Members of Patients with Schizophrenia in Lagos, Nigeria

    PubMed Central

    Adeosun, Increase Ibukun

    2013-01-01

    Family members of patients with schizophrenia have enormous roles in the care of their patients, which could negatively impact their well being. Development of interventions targeted at alleviating the burden of informal care giving is hinged on the recognition of the factors associated with the various dimensions of burden. This study determined the correlates of caregiver burden among family members of patients with schizophrenia in Lagos, Nigeria. The study instruments included the Zarit burden interview (ZBI) and the positive and negative syndrome scale for schizophrenia (PANSS). Exploratory factor analysis of the ZBI produced a five-factor structure with “financial/physical strain”, “time/dependence strain”, “emotional strain”, “uncertainty”, and “self-criticism” domains. On multiple regression analyses, total PANSS scores, poor social support, and lower educational levels of caregivers were predictive of higher burden scores on the “financial/physical strain”, “time/dependence”, and “emotional strain” domains. Longer duration of illness, shorter patient-caregiver contact time, and being a female caregiver were predictive of higher burden scores on the “uncertainty”, “self-criticism”, and “emotional strain” domains, respectively. There is need for interventions to alleviate the burden on caregivers of patients with schizophrenia in Nigeria. These strategies must include comprehensive social support and improve access to services for patients and their caregivers. PMID:24222848

  10. Correlates of Caregiver Burden among Family Members of Patients with Schizophrenia in Lagos, Nigeria.

    PubMed

    Adeosun, Increase Ibukun

    2013-01-01

    Family members of patients with schizophrenia have enormous roles in the care of their patients, which could negatively impact their well being. Development of interventions targeted at alleviating the burden of informal care giving is hinged on the recognition of the factors associated with the various dimensions of burden. This study determined the correlates of caregiver burden among family members of patients with schizophrenia in Lagos, Nigeria. The study instruments included the Zarit burden interview (ZBI) and the positive and negative syndrome scale for schizophrenia (PANSS). Exploratory factor analysis of the ZBI produced a five-factor structure with "financial/physical strain", "time/dependence strain", "emotional strain", "uncertainty", and "self-criticism" domains. On multiple regression analyses, total PANSS scores, poor social support, and lower educational levels of caregivers were predictive of higher burden scores on the "financial/physical strain", "time/dependence", and "emotional strain" domains. Longer duration of illness, shorter patient-caregiver contact time, and being a female caregiver were predictive of higher burden scores on the "uncertainty", "self-criticism", and "emotional strain" domains, respectively. There is need for interventions to alleviate the burden on caregivers of patients with schizophrenia in Nigeria. These strategies must include comprehensive social support and improve access to services for patients and their caregivers.

  11. The contribution of practice skills in a care management process for family caregivers.

    PubMed

    Rowe, Jeannine M; Rizzo, Victoria M

    2013-01-01

    Practice skills are believed to improve practice, yet, little is known about the extent to which skills affect outcomes. This exploratory study examined the extent to which 3 practice skills specific to a care management context for family caregivers, including communication skills, supportive skills, and linking skills, were associated with fidelity of a care management process. Twenty-one care managers who used a single process to serve 113 family caregivers were included in the study. Bivariate correlation analysis revealed the 3 practice skills are positively associated with process fidelity. Implications for social work practice, education, and research are discussed.

  12. A conceptual model and key variables for guiding supportive interventions for family caregivers of people receiving palliative care.

    PubMed

    Hudson, Peter

    2003-12-01

    According to the World Health Organization, the patient and family should be viewed as the "unit of care" when palliative care is required. Therefore family caregivers should receive optimal supportive care from health professionals. However, the impact of supporting a dying relative is frequently described as having negative physical and psychosocial sequalae. Furthermore, family caregivers consistently report unmet needs and there has been a dearth of rigorous supportive interventions published. In addition, comprehensive conceptual frameworks to navigate the family caregiver experience and guide intervention development are lacking. This article draws on Lazarus and Folkman's seminal work on the transactional stress and coping framework to present a conceptual model specific to family caregivers of patients receiving palliative care. A comprehensive account of key variables to aid understanding of the family caregiver experience and intervention design is provided.

  13. “This Case Is Closed”: Family Caregivers and the Termination of Home Health Care Services for Stroke Patients

    PubMed Central

    Levine, Carol; Albert, Steven M; Hokenstad, Alene; Halper, Deborah E; Hart, Andrea Y; Gould, David A

    2006-01-01

    Policies promoting home- and community-based services and disease management models implicitly rely on family care, still the bedrock of long-term and chronic care in the United States. The United Hospital Fund studied family caregivers of stroke and brain injury patients when home care cases were opened and closed and found that even with short-term formal services, family caregivers provided three-quarters of the care. Patients' mobility impairments and Medicaid eligibility were the main factors in determining the amount and duration of formal services. Between one-third and one-half of family caregivers reported being inadequately prepared for the case closing. At all stages, family caregivers expressed significant isolation, anxiety, and depression. Therefore, home care agency practice and public policies should provide better education, support, and services for family caregivers. PMID:16771820

  14. Needs of family caregivers of advanced cancer patients: a survey in Shanghai of China.

    PubMed

    Cui, J; Song, L J; Zhou, L J; Meng, H; Zhao, J J

    2014-07-01

    It is important to understand the unmet needs of family caregivers of advanced cancer patients for developing and refining services to address the identified gaps in cancer care. To explore their needs in Chinese mainland and the possible factors associated with their needs, a self-developed questionnaire was used to survey a sample of 649 participants in 15 hospitals of Shanghai. The data were analysed using descriptive statistics, factor analysis, t-test, one-way ANOVA, and Fishers least significant difference t-test. All statistical analyses were performed using SPSS 13.0. Seven dimensions of needs (maintaining health, support from healthcare professionals, knowledge about the disease and treatment, support on funeral, information on hospice care, psychological support for patients and symptoms control for patients) were extracted from the results by factor analysis. The dimension with the highest score was 'knowledge about the disease and treatment' (4.37), and that with the lowest score named 'support on funeral' (2.85). The results showed that the factors including burden of payment for treatment, former caregiving experience of family caregivers and length of caregiving time were associated with their needs. Cancer services need to consider how to tailor resources and interventions to meet these needs of family caregivers of advanced cancer patients.

  15. The experiences of culturally and linguistically diverse family caregivers in utilising dementia services in Australia

    PubMed Central

    2013-01-01

    Background Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. Methods The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Results Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. Conclusions The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia. PMID:24148155

  16. Dignity Therapy for People with Motor Neuron Disease and Their Family Caregivers: A Feasibility Study

    PubMed Central

    Chochinov, Harvey M.; Kristjanson, Linda J.

    2015-01-01

    Abstract Background: There are calls to explore psychological interventions to reduce distress in patients with motor neuron disease (MND) and their family caregivers. Dignity therapy is a short-term psychotherapy intervention shown to alleviate distress for people with life-limiting illnesses. Objectives: To assess the acceptability, feasibility, and effectiveness of dignity therapy to reduce distress in people with MND and their family caregivers. Methods: The study used a repeated-measures design pre- and post-intervention. Acceptability and feasibility were assessed using participants' ratings of the helpfulness of the intervention across several domains and time and resources required. Effectiveness measures for patients included: dignity-related distress, hopefulness, and spiritual well-being; and those for family caregivers included burden, hopefulness, anxiety, and depression. Results: Twenty-seven patients and 18 family caregivers completed the intervention. Dignity therapy was well accepted, including those patients who required assisted communication devices. The feasibility may be limited in small or not well-resourced services. There were no significant differences in all outcome measures for both groups. However, the high satisfaction and endorsement of dignity therapy by patients suggests it has influenced various important aspects of end-of-life experience. Family caregivers overwhelmingly agreed that the dignity therapy document is and will continue to be a source of comfort to them and they would recommend dignity therapy to others in the same situation. Conclusions: This is the first dignity therapy study to focus on MND and on home-based caregiving. Results established the importance of narrative and generativity for patients with MND and may open the door for other neurodegenerative conditions. PMID:25314244

  17. The Caregiver Strain Questionnaire: Measuring the Impact on the Family of Living with a Child with Serious Emotional Disturbance.

    ERIC Educational Resources Information Center

    Brannan, Ana Maria; Heflinger, Craig Anne; Bickman, Leonard

    1997-01-01

    A study of 984 families of children with emotional and behavioral disturbance used the Caregiver Strain Questionnaire to assess the effects of the shift of primary caregiving to the family due to deinstitutionalization. Results indicate the reliability and validity of the questionnaire, which also identified three related but unique dimensions of…

  18. Family Caregivers of Adults with Intellectual and Developmental Disabilities: Outcomes Associated with U.S. Services and Supports

    ERIC Educational Resources Information Center

    Williamson, Heather J.; Perkins, Elizabeth A.

    2014-01-01

    Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver…

  19. Finding the Common Ground of Family and Professional Caregiving: The Education Agenda at the Rosalynn Carter Institute

    ERIC Educational Resources Information Center

    Haigler, David H.; Bauer, Laura J.; Travis, Shirley S.

    2004-01-01

    The Rosalynn Carter Institute (RCI) for Human Development is the only national institute or center to integrate both professional and family caregiver issues in research, education, and advocacy agendas. This paper focuses on caregiver education and support and includes: (1) a discussion of the limitations of models that separate family versus…

  20. Factors Influencing Satisfaction for Family Practice Residency Faculty.

    ERIC Educational Resources Information Center

    Kay, Lawrence E.; D'Amico, Frank

    1999-01-01

    A survey of 383 faculty in family medical-residency programs explored perceptions of 60 professional, scheduling, compensation, and regional factors as they related to overall job satisfaction and career plans, and 59 factors related to the initial decision to enter academic family medicine. Results indicate high levels of satisfaction, feeling…

  1. Factors impacting the mental health of the caregivers of children with asthma in china: effects of family socioeconomic status, symptoms control, proneness to shame, and family functioning.

    PubMed

    Zhou, Ting; Yi, Chunli; Zhang, Xuxia; Wang, Yuyin

    2014-12-01

    Caregiver mental health is widely considered to be an important factor influencing children's asthma symptoms. The present study aimed to examine key factors that contribute to caregiver mental health in pediatric asthma with a Chinese sample. Two hundred participants reported their family socioeconomic status (SES), proneness to shame, asthma symptoms control of their child, family functioning, and their depression and anxiety symptoms. Results suggested that low family SES, low family functioning, and a high level of shame proneness were associated with high levels of anxiety and depression for caregivers. Family functioning mediated the effects of SES and shame on caregiver mental health and also moderated the effects of SES and shame on caregiver depression. This study highlights the importance of reducing experience of shame and enhancing family functioning in families affected by pediatric asthma.

  2. Caring for and caring about: disentangling the caregiver effect and the family effect.

    PubMed

    Bobinac, Ana; van Exel, N Job A; Rutten, Frans F H; Brouwer, Werner B F

    2010-07-01

    Besides patients' health and well-being, healthcare interventions may affect the well-being of significant others. Such 'spill over effects' in significant others may be distinguished in two distinct effects: (i) the caregiving effect and (ii) the family effect. The first refers to the welfare effects of providing informal care, i.e., the effects of caring for someone who is ill. The second refers to a direct influence of the health of a patient on others' well-being, i.e., the effects of caring about other people. Using a sample of Dutch informal caregivers we found that both effects exist and may be comparable in size. Our results, while explorative, indicate that economic evaluations adopting a societal perspective should include both the family and the caregiving effects measured in the relevant individuals.

  3. Anger expression and natural killer cell activity in family caregivers participating in a physical activity trial.

    PubMed

    Wilcox, S; King, A C; Vitaliano, P P; Brassington, G S

    2000-07-01

    Associations between psychological functioning and natural killer cell activity (NKA) were examined in 23 older (62.2 ± 7.5 years) family caregivers randomized to a moderate intensity four-month exercise program or to a wait-list control condition. At baseline, although NKA was related to anger-control (r = -.42; trend p < .06) and anger-out (r = .50; p < .03), it was not related to depression, anxiety, perceived stress, or caregiver burden. After controlling for baseline NKA, changes in anger-control explained 14 percent of the variance in NKA four months later. Decreases in anger-control predicted increases in NKA. Group assignment (exercise vs control) was unrelated to changes in NKA over the four-month period; however, the study was not powered to detect this effect. These results are consistent with reported relationships of anger expression with other physiological measures, and extend the importance of anger expression to immune functioning in older family caregivers.

  4. A model for communication skills development for family practice residents.

    PubMed

    Hornsby, J L; Payne, F E

    1979-01-01

    The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described. PMID:759551

  5. A model for communication skills development for family practice residents.

    PubMed

    Hornsby, J L; Payne, F E

    1979-01-01

    The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described.

  6. [Association between the functional capacity of dependent elderly people and the burden of family caregivers].

    PubMed

    Fuhrmann, Ana Cláudia; Becker Kottwitz Bierhals, Carla Cristiane; dos Santos, Naiana Oliveira; Paskulin, Lisiane Manganelli Girardi

    2015-03-01

    The aim of this study was to characterize dependent elderly people and their main family caregivers and the association between functional capacity of the elderly and the burden of caregivers. This cross-sectional study was conducted with 112 elderly people and caregivers connected to a primary care service in Porto Alegre, Brazil. The applied instruments related to care and socioeconomic variables were Physical and Instrumental Activities of Daily Living (PADL and IADL) and the Burden Interview. The Spearman correlation coefficient was also used. Average age of the elderly individuals in this study was 81.41 years, while the average score for PADL was 10.36 and 6.25 for IADL. Of the 112 elderly individuals, 71.4% had severe dependence. Among caregivers, 75% were women, 61.6% were the sons or daughters with an average age of 57.98 and an average burden of 29.53, which is equivalent to moderate burden. Results revealed a significant correlation between functional capacity of the elderly and caregiver burden. It was verified that the higher the dependence of elderly people, the greater the burden of caregivers.

  7. Obstetrics anyone? How family medicine residents' interests changed.

    PubMed Central

    Ruderman, J.; Holzapfel, S. G.; Carroll, J. C.; Cummings, S.

    1999-01-01

    OBJECTIVE: To determine family medicine residents' attitudes and plans about practising obstetrics when they enter and when they graduate from their residency programs. DESIGN: Residents in each of 4 consecutive years, starting July 1991, were surveyed by questionnaire when they entered the program and again when they graduated (ending in June 1996). Only paired questionnaires were used for analysis. SETTING: Family medicine residency programs at the University of Toronto in Ontario. PARTICIPANTS: Of 358 family medicine residents who completed the University of Toronto program, 215 (60%) completed questionnaires at entry and exit. MAIN OUTCOME MEASURES: Changes in attitudes and plans during the residency program as ascertained from responses to entry and exit questionnaires. RESULTS: Analysis was based on 215 paired questionnaires. Women residents had more interest in obstetric practice at entry: 58% of women, but only 31% of men were interested. At graduation, fewer women (49%) and men (22%) were interested in practising obstetrics. The intent to undertake rural practice was strongly associated with the intent to practise obstetrics. By graduation, residents perceived lifestyle factors and compensation as very important negative factors in relation to obstetric practice. Initial interest and the eventual decision to practise obstetrics were strongly associated. CONCLUSIONS: Intent to practise obstetrics after graduation was most closely linked to being a woman, intending to practise in a rural area, and having an interest in obstetrics prior to residency. Building on the interest in obstetrics that residents already have could be a better strategy for producing more physicians willing to practise obstetrics than trying to change the minds of those uninterested in such practice. PMID:10099803

  8. Human subjects protection in a study of caregivers of community-residing persons with dementia.

    PubMed

    Gerber, T; Toseland, R W; McCallion, P

    2000-11-01

    This article describes the processes and methods used to protect human subjects during a joint research project undertaken by a state health department and a university-based research team. The use of a statewide registry to obtain a sample of primary caregivers of persons with dementia provided a unique opportunity for the research team to interview a large and representative sample of caregivers. At the same time, it raised complex issues regarding the privacy of the primary caregivers and the confidentiality of the patient data that were drawn from the state-operated mandatory dementia registry. Guidelines for enabling access while ensuring the privacy and confidentiality of the study participants are presented.

  9. A chronic grief intervention for dementia family caregivers in long-term care.

    PubMed

    Paun, Olimpia; Farran, Carol J; Fogg, Louis; Loukissa, Dimitra; Thomas, Peggy E; Hoyem, Ruby

    2015-01-01

    Dementia caregivers do not relinquish their role after placing family members in long-term care and they experience increased chronic grief. The Chronic Grief Management Intervention (CGMI) is a12-week group-based program that uses guided discussion to deliver knowledge of Alzheimer's or a related dementia and teach skills in communication, conflict resolution, and chronic grief management in dementia caregivers who placed their family members in long-term care. Using a quasi-experimental design, 83 caregivers from 15 long-term care facilities received either the CGMI (n = 34) or a comparison condition consisting of two check-in calls (n = 49). In this pilot study, we examined the feasibility of implementing the CGMI and evaluated the effects of the intervention on caregivers' knowledge and skill and their chronic grief and depression. The intervention was feasible and resulted in significant improvement in caregivers' heartfelt sadness and longing at 3 months and a significant drop in their guilt at the 6-month follow-up. PMID:24510968

  10. Structured intervention in family caregivers of the demented elderly and changes in their immune function.

    PubMed

    Hosaka, Takashi; Sugiyama, Yoko

    2003-04-01

    The aim of the present study was to investigate the effects of a group structured intervention on the mental and physical discomfort and immune function of 20 family caregivers. A structured intervention for caregivers consists of five sessions, each of which lasts 90 min. This was a modified version of the program that had been originally developed for cancer patients. All the family caregivers were female and ranged in age from 47 to 66 years (mean: 54.7 +/- 4.4). The period of care at home ranged from 1 to 12 years (mean: 5.8 +/- 2.7). Concerning the original diseases of the care-receivers, 10 had vascular dementia and eight had Alzheimer's disease. Nine out of 20 caregivers had no care support, and seven utilized no public resources such as day-care centers. Only five caregivers felt that they were healthy. Two psychometries, that is, Profile of Mood States (POMS) and General Health Questionnaire-30 (GHQ-30) were administered and blood samples were drawn before and after intervention. Comparison of results showed that there was significant improvement (P < 0.05) in the scores of depression, anger-hostility, fatigue and confusion in the POMS, and physical symptoms, anxiety-mood disorder, suicidality-depression in the GHQ-30. Also, there was significant (P = 0.0325) augmentation of natural-killer cell activity. The present study suggests that this kind of intervention was effective for relieving emotional and physical discomfort, and also for improving immune function.

  11. Coaching Family Caregivers to Become Better Problem Solvers When Caring for Persons with Advanced Cancer.

    PubMed

    Dionne-Odom, J Nicholas; Lyons, Kathleen D; Akyar, Imatullah; Bakitas, Marie A

    2016-01-01

    Family caregivers of persons with advanced cancer often take on responsibilities that present daunting and complex problems. Serious problems that go unresolved may be burdensome and result in negative outcomes for caregivers' psychological and physical health and affect the quality of care delivered to the care recipients with cancer, especially at the end of life. Formal problem-solving training approaches have been developed over the past several decades to assist individuals with managing problems faced in daily life. Several of these problem-solving principles and techniques were incorporated into ENABLE (Educate, Nurture, Advise, Before Life End), an "early" palliative care telehealth intervention for individuals diagnosed with advanced cancer and their family caregivers. A hypothetical case resembling the situations of actual caregiver participants in ENABLE that exemplifies the complex problems that caregivers face is presented, followed by presentation of an overview of ENABLE's problem-solving key principles, techniques, and steps in problem-solving support. Though more research is needed to formally test the use of problem-solving support in social work practice, social workers can easily incorporate these techniques into everyday practice. PMID:27143574

  12. The psychological well-being of disability caregivers: examining the roles of family strain, family-to-work conflict, and perceived supervisor support.

    PubMed

    Li, Andrew; Shaffer, Jonathan; Bagger, Jessica

    2015-01-01

    We draw on the cross-domain model of work-family conflict and conservation of resources theory to examine the relationship between disability caregiving demands and the psychological well-being of employed caregivers. Using a sample of employed disability caregivers from a national survey, we found that the relationship between caregiving demands and family-to-work conflict was stronger when employees experienced high levels of strain from family. Additionally, we found high levels of family to-work conflict were subsequently associated with decreases in life satisfaction and increases in depression, but only when perceived supervisor support was low. Overall, our findings suggest an indirect relationship between caregiving demands and psychological well-being that is mediated by family-to-work conflict and is conditional on family strain and perceived supervisor support. The theoretical and practical implications of these findings are discussed.

  13. The psychological well-being of disability caregivers: examining the roles of family strain, family-to-work conflict, and perceived supervisor support.

    PubMed

    Li, Andrew; Shaffer, Jonathan; Bagger, Jessica

    2015-01-01

    We draw on the cross-domain model of work-family conflict and conservation of resources theory to examine the relationship between disability caregiving demands and the psychological well-being of employed caregivers. Using a sample of employed disability caregivers from a national survey, we found that the relationship between caregiving demands and family-to-work conflict was stronger when employees experienced high levels of strain from family. Additionally, we found high levels of family to-work conflict were subsequently associated with decreases in life satisfaction and increases in depression, but only when perceived supervisor support was low. Overall, our findings suggest an indirect relationship between caregiving demands and psychological well-being that is mediated by family-to-work conflict and is conditional on family strain and perceived supervisor support. The theoretical and practical implications of these findings are discussed. PMID:25181282

  14. Parenting Attitudes, Family Environments, Depression, and Anxiety in Caregivers of Maltreated Children

    ERIC Educational Resources Information Center

    Mennen, Ferol E.; Trickett, Penelope K.

    2011-01-01

    This study evaluated parenting attitudes, family environments, depression, and anxiety in a sample of primarily minority urban mothers to better understand maltreating mothers (n = 83), who retain custody of their children and how they are similar to and different from foster mothers (n = 50), kin caregivers (n = 52) of maltreated children, and…

  15. Building Bridges between Families and Nursing Home Staff: The "Partners in Caregiving" Program.

    ERIC Educational Resources Information Center

    Pillemer, Karl; Hegeman, Carol R.; Albright, Bonnie; Henderson, Charles

    1998-01-01

    The Partners in Caregiving Program was created to train staff and family members in communication techniques and conflict-resolution skills. Through a joint meeting with facility administrators, both groups influenced facility practices. Evaluation indicates that satisfaction with the program was high and that positive changes in staff/family…

  16. "A Great Program...for Me as a Gramma": Caregivers Evaluate a Family Literacy Initiative

    ERIC Educational Resources Information Center

    Anderson, Jim; Morrison, Fiona

    2007-01-01

    In this article, we report a study in which we asked 137 parents and caregivers to evaluate a year-long family literacy program in which they participated. Parents valued the insights they gained about children's learning in general and literacy development in particular. They reported that they learned from each other as well as from the program…

  17. [Proposal for a survey for assisting the family and caregivers of patients with spinal cord injuries].

    PubMed

    Mancussi e Faro, A C

    1999-12-01

    This study proposes a basis survey for assistance to the family and caregivers because we believe there is necessity of family participation on the treatment, trying to understand and share the disease or deficiency situation. We objectified to sketch the relationship degree and the people's gender that accompanied the spinal cord injured hurt medular patient in nursing consultations and to discuss the necessity of basis survey to the assistance family and to the caregiver. 101 nursing consultations were accomplished, in clinic health, to the spinal cord injured patient and his/her relative and 36 patients were totalized, from this number 26 (72.22%) were male and 10 (27.78%), were female. It was verified that the men with medular lesion, in the greater number (27-80.7 O/o), were accompanied with his relatives specially mother and wife, while the women with medular lesion, in the greater number too (7-70%) were accompanied with her relatives of diversified proximity. In reference to the basis survey that comprehend the care at house and the caregiver necessity, we can affirm its relevance, trying to context the family support identified attending the caregivers. PMID:11337805

  18. [Proposal for a survey for assisting the family and caregivers of patients with spinal cord injuries].

    PubMed

    Mancussi e Faro, A C

    1999-12-01

    This study proposes a basis survey for assistance to the family and caregivers because we believe there is necessity of family participation on the treatment, trying to understand and share the disease or deficiency situation. We objectified to sketch the relationship degree and the people's gender that accompanied the spinal cord injured hurt medular patient in nursing consultations and to discuss the necessity of basis survey to the assistance family and to the caregiver. 101 nursing consultations were accomplished, in clinic health, to the spinal cord injured patient and his/her relative and 36 patients were totalized, from this number 26 (72.22%) were male and 10 (27.78%), were female. It was verified that the men with medular lesion, in the greater number (27-80.7 O/o), were accompanied with his relatives specially mother and wife, while the women with medular lesion, in the greater number too (7-70%) were accompanied with her relatives of diversified proximity. In reference to the basis survey that comprehend the care at house and the caregiver necessity, we can affirm its relevance, trying to context the family support identified attending the caregivers.

  19. Dyadic Intervention for Family Caregivers and Care Receivers in Early-Stage Dementia

    ERIC Educational Resources Information Center

    Whitlatch, Carol J.; Judge, Katherine; Zarit, Steven H.; Femia, Elia

    2006-01-01

    Purpose: The Early Diagnosis Dyadic Intervention (EDDI) program provides a structured, time-limited protocol of one-on-one and dyadic counseling for family caregivers and care receivers who are in the early stages of dementia. The goals and procedures of EDDI are based on previous research suggesting that dyads would benefit from an intervention…

  20. Partners in Dementia Care: A Care Coordination Intervention for Individuals with Dementia and Their Family Caregivers

    ERIC Educational Resources Information Center

    Judge, Katherine S.; Bass, David M.; Snow, A. Lynn; Wilson, Nancy L.; Morgan, Robert; Looman, Wendy J.; McCarthy, Catherine; Kunik, Mark E.

    2011-01-01

    Purpose: This article provides a detailed description of a telephone-based care coordination intervention, Partners in Dementia Care (PDC), for veterans with dementia and their family caregivers. Essential features of PDC included (a) formal partnerships between Veterans Affairs (VA) medical centers and Alzheimer's Association Chapters; (b) a…

  1. Family Caregivers as Lay Trainers: Perceptions of Learning and the Relationship between Life Experience and Learning

    ERIC Educational Resources Information Center

    Conceição, Simone C.O.; Johaningsmeir, Sarah; Colby, Holly; Gordon, John

    2014-01-01

    This article describes an initiative to train lay people, predominantly parents of children and youth with special health care needs (CYSHCN), to teach "Bridge to Independence"--a care coordination curriculum--to other family caregivers of CYSHCN. Using a model based on Kirkpatrick and Kirkpatrick's levels of evaluation, the goal…

  2. 3 CFR 8748 - Proclamation 8748 of November 1, 2011. National Family Caregivers Month, 2011

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... with disabilities to help improve their quality of life. Their efforts help deliver short-term comfort... 3 The President 1 2012-01-01 2012-01-01 false Proclamation 8748 of November 1, 2011. National... 8748 of November 1, 2011 Proc. 8748 National Family Caregivers Month, 2011By the President of...

  3. Family Child Care Learning Environments: Caregiver Knowledge and Practices Related to Early Literacy and Mathematics

    ERIC Educational Resources Information Center

    Phillips, Beth M.; Morse, Erika E.

    2011-01-01

    This paper presents findings from a stratified-random survey of family child care providers' backgrounds, caregiving environments, practices, attitudes, and knowledge related to language, literacy, and mathematics development for preschool children. Descriptive results are consistent with prior studies suggesting that home-based providers are…

  4. Caregiver Emotional Expressiveness, Child Emotion Regulation, and Child Behavior Problems among Head Start Families

    ERIC Educational Resources Information Center

    McCoy, Dana Charles; Raver, C. Cybele

    2011-01-01

    The present study examined the relationships between caregivers' self-reported positive and negative emotional expressiveness, observer assessments of children's emotion regulation, and teachers' reports of children's internalizing and externalizing behaviors in a sample of 97 primarily African American and Hispanic Head Start families. Results…

  5. Responding to the needs of children and families after a disaster: linkages between unmet needs and caregiver functioning.

    PubMed

    Kilmer, Ryan P; Gil-Rivas, Virginia

    2010-01-01

    Disasters may negatively influence caregivers' ability to respond to the needs of their families. In this context, service organizations' response to families' needs may affect caregivers' symptoms and parenting. Interviews were conducted with caregivers affected by Hurricane Katrina approximately 1 year (T(1); N = 68) and 2 years posthurricane (T(2); N = 52). Caregivers reported high levels of service needs and unmet needs for themselves and their child(ren) and family at both time points. Regression analyses indicated that after accounting for hurricane exposure: (a) child unmet service needs significantly contributed to T(1) caregiver distress, (b) caregiver service needs and child unmet needs were associated with higher levels of posttraumatic stress symptoms, and (c) caregiver unmet needs related to greater strain at T(1). At T(2), after accounting for T(1) scores, service need variables did not contribute to distress or posttraumatic stress symptoms. Caregiver strain at T(1) and T(1) child service needs were associated with greater T(2) strain. These findings highlight the importance of extending the availability of services beyond the initial postdisaster recovery period to better meet the needs of caregivers and families.

  6. Designing and implementing a resiliency program for family medicine residents.

    PubMed

    Brennan, Julie; McGrady, Angele

    2015-01-01

    Family medicine residents are at risk for burnout due to extended work hours, lack of control over their work schedule, and challenging work situations and environments. Building resiliency can prevent burnout and may improve a resident's quality of life and health behavior. This report describes a program designed to build resiliency, the ability to bounce back from stress, in family medicine residents in a medium sized U.S. residency training program. Interactive sessions emphasized building self-awareness, coping skills, strengths and meaning in work, time management, self-care, and connections in and outside of medicine to support resident well-being. System changes which fostered wellness were also implemented. These changes included increasing the availability of fresh fruits in the conference and call room, purchasing an elliptical exercise machine for the on call room, and offering a few minutes of mindfulness meditation daily to the inpatient residents. Results to date show excellent acceptance of the program by trainees, increased consumption of nutritious foods, more personal exercise, and self-reported decreased overreactions to stress. Resiliency programs can effectively serve to meet accreditation requirements while fostering residents' abilities to balance personal and professional demands. PMID:26130769

  7. Registered Nurses’ Perceptions about the Situation of Family Caregivers to Patients with Heart Failure - A Focus Group Interview Study

    PubMed Central

    2016-01-01

    Introduction Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes. Aims The aims of this study are to explore registered nurses’ perceptions about the situation of family caregivers to patients with heart failure, and registered nurses’ interventions, in order to improve family caregivers’ situation. Methods The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis. Results Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area “Family caregivers' situation” includes two categories: “To be unburdened” and “To comprehend the heart failure condition and its consequences”. The content area “Interventions to improve family caregivers' situation” includes two categories: “Individualized support and information” and “Bridging contact”. Conclusions Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care

  8. Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity.

    PubMed

    Lindvall, Agneta; Kristensson, Jimmie; Willman, Ania; Holst, Göran

    2016-08-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity" found on pages 24-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe how older adults with multimorbidity experience care provided from informal/family

  9. Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity.

    PubMed

    Lindvall, Agneta; Kristensson, Jimmie; Willman, Ania; Holst, Göran

    2016-08-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity" found on pages 24-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe how older adults with multimorbidity experience care provided from informal/family

  10. Fear of death, mortality communication, and psychological distress among secular and religiously observant family caregivers of terminal cancer patients.

    PubMed

    Bachner, Yaacov G; O'Rourke, Norm; Carmel, Sara

    2011-02-01

    Previous research suggests that caregivers and terminally ill patients face substantial difficulties discussing illness and death. Existing research, however, has focused primarily on the experience of patients. The current study compared responses as well as the relative strength of association between mortality comunication, fear of death, and psychological distress (i.e., depressive symptomatology, emotional exhaustion) among secular and religiously observant family caregivers of terminally ill cancer patients. A total of 236 participants were recruited over 18 months within the first year of caregiver bereavement. Retrospectively reported mortality communication was statistically greater among secular caregivers; in contrast, both fear of death and depressive symptoms were greater among the religiously observant. Path analyses subsequently revealed notable differences between groups. Among secular caregivers, a significant inverse relationship between mortality communication and the two indices of caregiver distress emerged. In contrast, the association between mortality communication and psychological distress among the religious was moderated by these caregivers' fear of death. The results of this study suggest that fear of death is a significant predictor of psychological distress among religiously observant caregivers of terminal cancer patients (i.e., fear of their own death as elicited by the caregiving role). Fostering morality communication between secular caregivers and patients would appear to be one means of reducing the likelihood of clinically significant psychological distress. This may be insufficient among religiously observant caregivers, however, for whom fear of death may first need to be redressed.

  11. The Meaning of Parenteral Hydration to Family Caregivers and Patients with Advanced Cancer Receiving Hospice Care

    PubMed Central

    Cohen, Marlene Z; Torres-Vigil, Isabel; Burbach, Beth E.; de Rosa, Allison; Bruera, Eduardo

    2012-01-01

    Context In the U.S., patients with advanced cancer who are dehydrated or have decreased oral intake virtually always receive parenteral hydration in acute care facilities but rarely in the hospice setting. Objectives To describe the meaning of hydration for terminally ill cancer patients in home hospice care and for their primary caregivers. Methods Phenomenological interviews were conducted at two time points with 85 patients and 84 caregivers enrolled in a randomized, double-blind, controlled trial examining the efficacy of parenteral hydration in patients with advanced cancer receiving hospice care in the southern U.S. Transcripts were analyzed hermeneutically by the interdisciplinary research team until consensus on the theme labels was reached. Results Patients and their family caregivers both saw hydration as meaning hope and comfort. Hope was the view that hydration might prolong a life of dignity and enhance quality of life by reducing symptoms such as fatigue and increasing patients’ alertness. Patients and caregivers also described hydration as improving patients’ comfort by reducing pain, enhancing the effectiveness of pain medication, and nourishing the body, mind and spirit. Conclusion These findings differ from traditional hospice beliefs that dehydration enhances patient comfort given that patients and their families in the study viewed fluids as enhancing comfort, dignity and quality of life. Discussion with patients and families about their preferences for hydration may help tailor care plans to meet specific patient needs. PMID:22459230

  12. Addressing everyday challenges: feasibility of a family caregiver training program for people with dementia.

    PubMed

    DiZazzo-Miller, Rosanne; Samuel, Preethy S; Barnas, Jean M; Welker, Keith M

    2014-01-01

    OBJECTIVE. The purpose of this study was to examine the feasibility and efficacy of the Family Caregiver Training Program for assisting with the basic activities of daily living of people with dementia. METHOD. A one-group pretest-posttest research design with a 3-mo follow-up was used to examine the efficacy of a manualized education program for caregivers. The 6-hr training was delivered to 72 family caregivers over 3 consecutive weeks (2 hr/wk) by trained clinicians. RESULTS. Caregivers showed a significant gain in knowledge of how to effectively assist with communication and nutrition, t(52) = 7.05, p < .000; transfers and toileting, t(45) = 3.10, p < .003; and bathing and dressing, t(44) = 2.71, p < .01, of their care recipients. CONCLUSION. Our findings demonstrate that this manualized intervention protocol is a promising method of equipping family members with the skills needed to face their everyday challenges in caring for people with dementia.

  13. Family caregivers' use of humor in conveying information about caring for dependent older adults.

    PubMed

    Bethea, L S; Travis, S S; Pecchioni, L

    2000-01-01

    Twenty-three family caregivers were interviewed using a semistructured interview format to explore their experiences managing medication administration and providing long-term care to frail elderly family members. Content analysis of the transcripts utilized the arousal-relief theory of humor (Berlyne, 1969) to understand the frequent use of humorous anecdotes found throughout the interviews. For example, caregivers of individuals experiencing dementia often included smiles, jokes, and "punch lines" in their stories of behavioral problems that complicated medication administration schedules. Adult children frequently used humor to describe their role reversal with aged parents and the parents' forgetfulness, incontinence, or inability to dress without assistance. These accounts were placed in a taxonomy of humor response patterns that included categories for cognitive, affective, and behavioral responses. Second-level analysis created subcategories to reflect the function (relief or coping) that the humor served in the interview situation. It appears that humor is a useful communication tool for family caregivers that releases nervous energy about the interview process and the recall of difficult caregiving events. It is the responsibility of the interviewer to recognize the problems and issues embedded in the interview data and follow up humorous anecdotes with appropriate probes for additional information. Based on the results, a meta-humorous interaction theory is offered as an extension of the arousal-relief theory of humor.

  14. Vivekananda Yoga Program for Patients with Advanced Lung Cancer and their Family Caregivers

    PubMed Central

    Milbury, Kathrin; Mallaiah, Smitha; Lopez, Gabriel; Liao, Zhongxing; Yang, Chunyi; Carmack, Cindy; Chaoul, Alejandro; Spelman, Amy; Cohen, Lorenzo

    2015-01-01

    BACKGROUND Although yoga practice may improve quality of life (QOL) in cancer patients, feasibility in patients with lung cancer is largely unknown. Moreover, previous research has excluded patients’ family caregivers. Because caregivers are vulnerable to caregiver burden, a dyadic approach targeting QOL in both patient and caregiver may be particularly beneficial. Thus, the purpose of this study was to establish the feasibility of a couple-based Vivekananda Yoga (VKC) intervention in lung cancer patients and caregivers. Vivekananda Yoga may be suitable for a dyadic approach and address the multifaceted needs (e.g., emotional, physical, spiritual, and social) common among families coping with lung cancer. METHOD In this single-arm feasibility trial, patients with lung cancer undergoing radiotherapy and their caregivers participated in a 15-session VKC program focused on the interconnectedness of the dyad. The program consisted of four main components: 1) joint loosening with breath synchronization; 2) postures (asanas) and a deep relaxation technique; 3) breath energization (pranayama) with sound resonance; and 4) meditation. We assessed pre/post-intervention levels of fatigue (BFI), sleep disturbances (PSQI), psychological distress (BSI), overall mental and physical QOL (SF-36), spirituality (FACT-Sp) and relational closeness. We also tracked feasibility data, and participants completed program evaluations. RESULTS We approached 28 eligible dyads of which 15 (53%) consented and 9 (60%) completed the intervention. No adverse events were reported. Patients (mean age: 73 years, 63% female, all stage III) and caregivers (mean age: 62 years, 38% female, 63% spouses) completed a mean of 10 sessions (range: 4–14) and 95.5% of them rated the program as very useful. Paired t-tests revealed a significant increase in patients’ mental health (d=.84, P=.04) and a significant decrease in caregivers’ sleep disturbances (d=1.44, P=.02). Although not statistically

  15. Family Man in the Other America: New Opportunities, Motivations, and Supports for Paternal Caregiving

    PubMed Central

    WALLER, MAUREEN R.

    2009-01-01

    This analysis draws on longitudinal, qualitative interviews with disadvantaged mothers and fathers who participated in the Fragile Families Study (a U.S. birth cohort study) to examine how issues related to men's employment, social support, skills, and motivation facilitated their care of young children in different relationship contexts. Interviews with parents indicate that while some motivated and skilled men actively chose to become caregivers with the support of mothers, others developed new motivations, skills, and parenting supports in response to situations in which they were out of work or the mother was experiencing challenges. These findings suggest that disadvantaged men who assume caregiving responsibilities take different paths to involvement in the early years after their child's birth. Policies that overlook paternal caregivers may not only miss the opportunity to support relationships that benefit at-risk children but also unintentionally undermine this involvement. PMID:19789724

  16. Coping with Physical and Psychological Symptoms: A Qualitative Study of Advanced Lung Cancer Patients and their Family Caregivers

    PubMed Central

    Mosher, Catherine E.; Ott, Mary A.; Hanna, Nasser; Jalal, Shadia I.; Champion, Victoria L.

    2014-01-01

    Purpose Advanced lung cancer patients have high rates of multiple physical and psychological symptoms, and many of their family caregivers experience significant distress. However, little is known about strategies that these patients and their family caregivers employ to cope with physical and psychological symptoms. This study aimed to identify strategies for coping with various physical and psychological symptoms among advanced, symptomatic lung cancer patients and their primary family caregivers. Methods Patients identified their primary family caregiver. Individual semi-structured qualitative interviews were conducted with 21 advanced, symptomatic lung cancer patients and primary family caregivers. Thematic analysis of interview data was framed by stress and coping theory. Results Patients and caregivers reported maintaining a normal routine and turning to family and friends for support with symptom management, which often varied in its effectiveness. Whereas support from healthcare professionals and complementary and alternative medicine were viewed favorably, reactions to Internet and in-person support groups were mixed due to the tragic nature of participants’ stories. Several cognitive coping strategies were frequently reported (i.e., changing expectations, maintaining positivity, and avoiding illness-related thoughts) as well as religious coping strategies. Conclusions Results suggest that advanced lung cancer patients and caregivers may be more receptive to cognitive and religious approaches to symptom management and less receptive to peer support. Interventions should address the perceived effectiveness of support from family and friends. PMID:25527242

  17. Working it out together: family caregivers' perceptions of relationship-building with in-home service providers.

    PubMed

    Gantert, Thomas W; McWilliam, Carol L; Ward-Griffin, Catherine; Allen, Natalie

    2009-09-01

    Provision of in-home services to seniors involves the contributions of numerous professional and paraprofessional health-care providers but is largely dependent upon the involvement of caregiver networks consisting of friends and family members. Therefore, in-home provider/family caregiver relationships have become an essential component of care provision. However, evidence suggests that provider/family caregiver interactions often are lacking or are ambiguous and characterized by tension and power struggles.The purpose of this study was to explore family caregivers' perceptions of their relationships with in-home care providers. Applying interpretive phenomenology, the authors conducted in-depth interviews with a purposive sample of family caregivers and used an immersion/crystallization analysis strategy to elicit the findings. The findings reveal that family caregivers perceive their relationship-building with in-home providers as a dynamic process with facilitators and barriers encountered at both individual and system levels.The interpretive findings afford several insights into building provider/family caregiver relationships within the in-home context.

  18. Intentional anticipatory mourning, caregiver and bereavement support program for terminally ill veterans, their families & caregivers in the VA Contract Home Hospice Program.

    PubMed

    Flanagan-Kaminsky, Donnamarie

    2013-01-01

    As a response to the increasing numbers of Veterans utilizing the Veterans Affairs (VA) Contract Home Hospice Program, and with growing awareness of the increased stress at end-of-life, the social work leadership of the Louis Stokes Cleveland VA Medical Center implemented a unique approach to support Veterans and their families. The role of a grief/bereavement counselor was added to enhance the VA Contract Home Hospice Program, to assess the needs of the Veterans and family caregivers, and to create a program in response to these findings. A three-prong module evolved encompassing: Anticipatory Mourning Support for both the Veteran and caregiver/ family; Caregiver Support; and Bereavement Support. The components of this module are described along with findings in each module.

  19. Intentional anticipatory mourning, caregiver and bereavement support program for terminally ill veterans, their families & caregivers in the VA Contract Home Hospice Program.

    PubMed

    Flanagan-Kaminsky, Donnamarie

    2013-01-01

    As a response to the increasing numbers of Veterans utilizing the Veterans Affairs (VA) Contract Home Hospice Program, and with growing awareness of the increased stress at end-of-life, the social work leadership of the Louis Stokes Cleveland VA Medical Center implemented a unique approach to support Veterans and their families. The role of a grief/bereavement counselor was added to enhance the VA Contract Home Hospice Program, to assess the needs of the Veterans and family caregivers, and to create a program in response to these findings. A three-prong module evolved encompassing: Anticipatory Mourning Support for both the Veteran and caregiver/ family; Caregiver Support; and Bereavement Support. The components of this module are described along with findings in each module. PMID:23977781

  20. Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

    PubMed Central

    Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

    2013-01-01

    Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

  1. The Evolution of Family Medicine Resident Projects at Dalhousie University

    PubMed Central

    O'Connor, John F.

    1989-01-01

    The Dalhousie Family Medicine Residency Program has always attempted to meet the research objectives of the College of Family Physicians of Canada. From a “Monitored Reading and Research” program, where projects were encouraged, the department developed a program which involved a mandatory project, preferably involving research, that is formally and objectively evaluated and supervised by faculty. The background, rationale, and problems encountered, as well as attempted solutions, are outlined. PMID:21249037

  2. Personality types of family practice residents in the 1980s.

    PubMed

    Taylor, A D; Clark, C; Sinclair, A E

    1990-03-01

    This study was based on a nationwide sample of 778 family practice residents in the mid-1980s and was conducted to determine the personality types that were most common among those residents. The results showed that the single most common personality type was that in which the individual prefers to see the world in terms of challenges and future possibilities and to make decisions based upon his or her subjective values. These results showed that the sample differed significantly in Myers-Briggs personality type from both the general practitioners of the 1950s and the early family practice residents of the 1970s, who preferred to see the world in terms of the immediate facts of experience and to make decisions objectively. There were also significant differences between the civilian and military family practice residents, but not between the community-based and university-based residents. Implications regarding future practice styles, physicians' personal values, and manpower needs are discussed. PMID:2306322

  3. Marital status of caregiving daughters and co-residence with dependent parents.

    PubMed

    Brody, E M; Litvin, S J; Hoffman, C; Kleban, M H

    1995-02-01

    The role of caregiving daughters' marital status is examined as it relates to their sharing households with disabled elderly parents. Married daughters fared best in well-being, income, and social support. Never-married women were the most likely to have never moved out of the parental home. Separated/divorced caregivers, more than the married and widowed, had moved into the parent's home rather than the reverse and widowed daughters had lived in re-formed joint households longest. The main reason for re-forming shared households was disability of the parent. Among other reasons were death or withdrawal of previous caregiver and financial problems, with separated/divorced daughters the most likely to mention finances.

  4. Supporting family caregivers at the end of life: "they don't know what they don't know".

    PubMed

    Rabow, Michael W; Hauser, Joshua M; Adams, Jocelia

    2004-01-28

    Even for patients receiving complex, intensive medical care for serious and life-threatening illness, family caregiving is typically at the core of what sustains patients at the end of life. The amorphous relationship between physicians and the families of patients at the end of life presents both challenges and opportunities for which physicians may be unprepared. Families play important roles in the practical and emotional aspects of patient care and in decision making at the end of life. At the same time, family members may carry significant burdens as a result of their work. Through the perspectives of the wife, daughter, and home care nurse of a patient who died from pancreatic cancer, we illustrate the range of family caregiver experiences and suggest potentially helpful physician interventions. We describe 5 burdens of family caregiving (time and logistics, physical tasks, financial costs, emotional burdens and mental health risks, and physical health risks) and review the responsibilities of physicians to family caregivers. Based on available evidence, we identify 5 areas of opportunity for physicians to be of service to family members caring for patients at the end of life, including promoting excellent communication with family, encouraging appropriate advance care planning and decision making, supporting home care, demonstrating empathy for family emotions and relationships, and attending to family grief and bereavement. In caring well for family caregivers at the end of life, physicians may not only improve the experiences of patients and family but also find greater sustenance and meaning in their own work.

  5. Teaching family medicine residents brief interventions for alcohol misuse.

    PubMed

    Rule, J Chris; Samuel, Pearl

    2015-01-01

    Across the lifespan, alcohol misuse affects a large percentage of patients seen in primary care clinics. It can lead to alcohol use disorders, ranging from risky use to alcohol dependence. Alcohol use disorders frequently complicate acute and chronic illnesses of patients seen in FM clinics. Screening patients for alcohol and substance use has become a standard of practice in most primary care settings. This report describes how a family medicine residency program solidified a residency curriculum in substance abuse screening, assessment, and brief intervention by merging three presentation-style didactics into a blended approach. The curriculum combines didactic teaching, motivational interviewing, and behavioral rehearsal of clinical practice skills. Qualitative feedback suggests that the curriculum has been successful in exposing residents to a variety of practical assessment methods and, through rehearsal, has improved resident confidence in addressing alcohol use and misuse in a primary care population. PMID:26130770

  6. The Effect of a Support and Education Program on Stress and Burden among Family Caregivers to Frail Elderly Persons.

    ERIC Educational Resources Information Center

    Greene, Vernon L.; Monahan, Deborah J.

    1989-01-01

    Studied effects on family caregivers (N=208) of frail elderly persons of eight-week professionally guided caregiver support group program to reduce anxiety, depression, and sense of burden. Found significant reductions immediately after intervention and continued but weaker effects four months later. (Author/CM)

  7. Contextual Risk, Caregiver Emotionality, and the Problem Behaviors of Six- and Seven-Year-Old Children from Economically Disadvantaged Families.

    ERIC Educational Resources Information Center

    Ackerman, Brian P.; Izard, Carroll E.; Schoff, Kristen; Youngstrom, Eric A.; Kogos, Jen

    1999-01-01

    Explored relations between additive and cumulative representations of contextual risk, caregiver emotionality, child adaptability, and teacher reports of problem behaviors of 6- and 7-year-olds from economically disadvantaged families. Found evidence that the relation for cumulative risk may be moderated by caregiver negative emotionality and…

  8. Caring for Others: Internet Video-Conferencing Group Intervention for Family Caregivers of Older Adults with Neurodegenerative Disease

    ERIC Educational Resources Information Center

    Marziali, Elsa; Donahue, Peter

    2006-01-01

    Purpose: The aim of this pilot feasibility study was to evaluate the effects of an innovative, Internet-based psychosocial intervention for family caregivers of older adults with neurodegenerative disease. Design and Methods: After receiving signed informed consent from each participant, we randomly assigned 66 caregivers to an Internet-based…

  9. Listening for the Communicative Signals of Humor, Narratives, and Self-Disclosure in the Family Caregiver Interview

    ERIC Educational Resources Information Center

    Sparks, Lisa; Travis, Shirley S.; Thompson, Sharlene R.

    2005-01-01

    The authors' previous work with long-term family caregivers demonstrated the importance of conversational cues, the reliance on humor to convey sensitive information, and the ways in which the interviewer can follow up, with appropriate probes and nonverbal encouragement, to gain necessary insight into the caregiver situation. This article offers…

  10. [Psychiatric distress and related risk factors of family caregivers who care for the demented elderly at home].

    PubMed

    Doi, Y; Ogata, K

    2000-01-01

    The objectives of our study were to assess psychiatric distress of caregivers who had been caring for the demented elderly at home and to examine the association of caregivers' psychiatric distress with putative risk factors. Subjects were 294 caregivers living in Amakusa, Kumamoto Prefecture of Japan, whose spouses, parents or other family members were registered at Amakusa Public Health Center as demented elderly. In 1998, Survey on Caregivers' Mental Health was conducted using the General Health Questionnaire (GHQ12) as a measurement for general psychiatric state of caregivers. Two hundred and eighty-two caregivers responded to interviews with complaints of the following psychological symptoms: feelings of unhappiness (55.7%), of stress (41.8%), insomnia (29.4%) and depressed mood (29.1%). Seventy-six caregivers (27.2%) were identified as being above the cut-off point 4 for psychiatric distress caseness. Multivariate logistic regression analysis indicated caregivers' psychiatric distress was statistically associated with caregivers' age, the caregivers' perception of the severity of dementia, the number of years devoted to caregiving at home and perceived financial state. Being 50 to 69 years (OR = 0.37, 95% CI: 0.17-0.81) and being 70 years or older (OR = 0.35, 95% CI: 0.14-0.83) were negatively associated with caseness as compared to being 20 to 49 years. Caseness was positively related to the severity of the elderly's demented state (OR = 6.93, 95% CI: 1.99-24.19), 1 year to 2 years devoted to caregiving at home (OR = 3.26, 95% CI: 1.02-10.38), no family or social support (OR = 2.99, 95% CI: 1.12-7.96) and lower perceived financial state (always OR = 6.99, 95% CI: 2.77-17.64, sometimes OR = 2.41, 95% CI: 1.19-4.85). Reduction of caregivers' psychiatric distress is important for not merely the enhancement of quality of care for demented elders and caregivers' life but for the prevention of elder abuse or neglect. Our study suggests that a comprehensive

  11. Effect of Prepaid Health Plans on a Family Practice Residency.

    ERIC Educational Resources Information Center

    Bradley, Don W.; Gehlbach, Stephen H.

    1988-01-01

    Residents and faculty members completed a survey covering the effect of prepaid health care plans at a family medicine center on the program's practice profile, cost-containment, and education activities over a three-year period. Respondents agreed that prepaid plans increased the number of patient visits. (Author/MLW)

  12. Family structure and mothers' caregiving of children with cystic fibrosis.

    PubMed

    Gayer, Debra; Ganong, Lawrence

    2006-11-01

    The purpose of this investigation is to examine differences in the experiences of mothers of children with cystic fibrosis who are in diverse family structures (first-marriage families, stepfamily households, single-parent households). In particular, mothers' perceptions of children's health, adherence to prescribed treatments, and help received from others were compared and predictors of treatment adherence were examined. Children's health and adherence to treatment regimens were not related to family structure. Mothers had the major responsibility for seeing that cystic fibrosis treatments were followed, regardless of family structure. Single mothers received less help than married and repartnered mothers. Married fathers helped with treatments more than nonresidential divorced fathers and stepfathers. Implications for nursing practice and suggestions for future research are offered.

  13. Association Between Anticipatory Grief and Problem Solving Among Family Caregivers of Persons with Cognitive Impairment

    PubMed Central

    Fowler, Nicole R.; Hansen, Alexandra S.; Barnato, Amber E.; Garand, Linda

    2013-01-01

    Objective Measure perceived involvement in medical decision making and determine if anticipatory grief is associated with problem solving among family caregivers of older adults with cognitive impairment. Method Retrospective analysis of baseline data from a caregiver intervention (n=73). Multivariable regression models testing the association between caregivers’ anticipatory grief, measured by the Anticipatory Grief Scale (AGS), with problem solving abilities, measured by the Social Problem Solving Inventory – Revised: Short Form (SPSI-R: S). Results 47/73 (64%) of caregivers reported involvement in medical decision making. Mean AGS was 70.1 (± 14.8) and mean SPSI-R:S was 107.2 (± 11.6). Higher AGS scores were associated with lower positive problem orientation (P=0.041) and higher negative problem orientation scores (P=0.001) but not other components of problem solving- rational problem solving, avoidance style, and impulsivity/carelessness style. Discussion Higher anticipatory grief among family caregivers impaired problem solving, which could have negative consequences for their medical decision making responsibilities. PMID:23428394

  14. Predicting Desire for Institutional Placement Among Racially Diverse Dementia Family Caregivers: The Role of Quality of Care

    PubMed Central

    Sun, Fei

    2013-01-01

    Purpose: Literature on institutionalization of patients with dementia has not considered the role of caregivers’ quality of care, which encompasses caregivers’ exemplary care (EC) behaviors and caregivers’ potentially harmful behaviors (PHBs) toward care recipients. This study sought to understand the role of quality of care in mediating between caregiving stressors and caregiver desire to institutionalize (DTI) a patient with dementia. Design and Methods: A sample of 612 family caregivers from diverse racial/ethnic backgrounds was drawn from the baseline data of the Resources for Enhancing Alzheimer’s Caregiver Heath (REACH II) project. Multiple mediator models were run using Preacher and Hayes asymptotic and resampling strategies to assess direct and indirect effects of caregiver stressors (daily care bother, behavioral bother, and burden) on caregiver desire to institutionalize a patient with dementia. Results: Overall, PHB was positively related to caregiver desire to institutionalize their care recipients. Specifically, PHB was found to mediate the relationship between caregiving stressors and DTI in the Caucasian and Latino groups, whereas only the mediation effect of EC was significant in the African American group. Implications: Caregivers’ perceptions of quality of care helped explain their desire to institutionalize their care recipients with dementia. Including assessment of EC and PHB in clinical and social service settings is recommended for all ethnic groups. Interventions should facilitate EC behaviors among African American caregivers and address concerns of PHBs in Caucasian and Latino caregivers. PMID:22961466

  15. The role of staff in health promotion in community residences for people with intellectual disabilities: variation in views among managers and caregivers.

    PubMed

    Bergström, Helena; Wihlman, Ulla

    2011-09-01

    Managers and caregivers in community residences for people with intellectual disabilities are expected both to promote residents' health and to support their autonomy. The aim of this article was to explore variation in views among managers and caregivers on the role of staff in health promotion. A qualitative study was conducted using semi-structured interviews with six managers and six caregivers. The analysis used a phenomenographic approach to categorize variation in views. We identified five qualitatively different main categories of roles staff play in health promotion: the parent, the manipulator, the coach, the educator and the libertarian. In addition lifestyle-related risk factors for ill-health and barriers to a healthy lifestyle were analysed and described using qualitative content analysis. The results highlight the ethical conflict that faces staff trying to support a healthy lifestyle as well as the autonomy of the residents.

  16. Effect of family medicine residents on use of diagnostic investigations

    PubMed Central

    Seong, Augene; Osmun, W.E.

    2014-01-01

    Abstract Objective To determine the effect of the presence of family medicine residents on the use of laboratory and imaging investigations in a rural emergency department (ED). Design A retrospective cross-sectional electronic chart audit was completed. Background characteristics, as well as type and number of ordered investigations, were compared between study groups. Setting Strathroy Middlesex General Hospital in Strathroy, Ont, a rural community hospital that sees approximately 20 000 ED visits per year. Participants A total of 2000 sequential ED visits, including adult and pediatric patients. The test group consisted of patients seen while a resident was present in the ED. The control group consisted of patients seen while no residents were present in the ED. Main outcome measures Twenty-two distinct categories of common ED investigations were studied. Results There was no statistically significant difference between study groups for 19 of the 22 categories of investigations. There were significant differences in 3 categories: an increased number of D-dimer assays for patients seen while there were no residents in the ED (1.7% of patients vs 0.5% of patients, P = .03) and increased computed tomography and ultrasound imaging for patients seen while a resident was in the ED (4.8% vs 1.8%, P = .0012, and 5.3% and 1.7%, P < .001, respectively). These differences are likely not owing to resident involvement but are explained by a difference in test availability between groups. Conclusion The study was underpowered for most categories of studied investigations. However, the trends demonstrated in this study suggest that the presence of family medicine residents in a rural community ED does not substantially affect the overall use of diagnostic investigations. PMID:25217692

  17. Normalization of Neglect: A Grounded Theory of RNs' Experiences as Family Caregivers of Hospitalized Seniors.

    PubMed

    Taverner, Tarnia; Baumbusch, Jennifer; Taipale, Priscilla

    2016-06-01

    Often older people, while maintaining a level of independence, rely on family members to provide care and assistance. Caregivers who are also registered nurses (RNs) may provide a different perspective around the experience when their older relative is admitted to acute care. The aim of our research was to investigate and develop theory regarding nursing care provision as described by RNs, who were family caregivers to older adults, when that older adult was admitted to acute care. Over a six-month period in 2011, RNs meeting this criterion (n = 12) were interviewed individually. We identified two central categories: "Culture of Neglect" and "Vigil by the Bedside". The core category "Normalization of Neglect" was identified as the theory, grounded in the data the participants provided which described a culture of neglect that had normalized poor nursing care. These findings highlight the issue of neglect and abuse, and further investigation is warranted.

  18. Caregivers' moral narratives of their African American children's out-of-school suspensions: implications for effective family-school collaborations.

    PubMed

    Gibson, Priscilla A; Haight, Wendy

    2013-07-01

    In this qualitative study, the authors examined the culturally nuanced meanings of out-of-school suspensions for 30 lower income caregivers of African American children suspended from school. Caregivers were invited to describe their experiences of their children's suspensions during in-depth, individual, audiotaped interviews. Caregivers generally valued their children's school success, recognized when their children had misbehaved, and supported educators' imposition of appropriate consequences. Out-of-school suspensions, however, were rarely viewed as appropriate consequences. On the contrary, caregivers produced emotionally laden moral narratives that generally characterized their children's suspensions as unjust; harmful to children; negligent in helping children with underlying problems such as bullying; undermining parents' racial socialization; and, in general, racially problematic. Suspensions also contributed to some families' withdrawal from participation in their schools. Understanding how caregivers experience children's out-of-school suspensions provides important clues to how families and schools can work together to effectively reduce racial disparities in out-of-school suspensions.

  19. Occupational Stress and Physical Symptoms among Family Medicine Residents

    PubMed Central

    Choi, So-Myung; Park, Yong Soon; Kim, Go-Young

    2013-01-01

    Background The purpose of this study was to examine the levels of occupational stress and physical symptoms among family medicine residents and investigate the effect of subscales of occupational stress on physical symptoms. Methods A self-administered questionnaire survey of 1,152 family medicine residents was carried out via e-mail from April 2010 to July 2010. The response rate was 13.1% and the R (ver. 2.9.1) was used for the analysis of completed data obtained from 150 subjects. The questionnaire included demographic factors, resident training related factors, 24-items of the Korean Occupational Stress Scales and Korean Versions of the Wahler Physical Symptom Inventory. Results The total score of occupational stress of family medicine residents was relatively low compared to that of average workers. The scores of 'high job demand', 'inadequate social support', 'organizational injustice', and 'discomfort in occupational climate' were within the top 50%. Parameters associated with higher occupational stress included level of training, on-duty time, daily patient load, critical patient assigned, total working days, night duty day, sleep duration, and sleep quality. The six subscales of occupational stress, except for 'Job insecurity', had a significant positive correlation with physical symptom scores after adjustment had been made for potential confounders (total score, r = 0.325 and P < 0.001; high job demand, r = 0.439 and P < 0.001). Conclusion After the adjustment had been made for potential confounders, the total score of occupational stress and six subscales in family medicine residents showed a significant positive correlation with physical symptom scores. PMID:23372906

  20. Parental caregiving of children with cancer and family impact, economic burden: nursing perspectives.

    PubMed

    Williams, Phoebe D; Williams, Kirstin A; Williams, Arthur R

    2014-03-01

    Pediatric cancer diagnoses affect the entire family: parents, well siblings, the ill child, and others. The objective of this study was to review nursing studies on parental caregiving of children with cancer, family impact, and costs. The study used inclusion/exclusion criteria and family systems theory, self/dependent-care, and symptom management (monitoring, alleviation) concepts. Regarding "levels of evidence," 3 studies were Level II; 7 were Level IV; 7 were Level VI; 1 review was Level V and the second was Level I. Of 19 studies: 11 were qualitative; 4, quantitative; 2 were mixed methods. Content analysis themes were: Parental caregiving and family impact, economic burden. Conclusions were that (a) qualitative studies are predominant; findings supported quantitative findings; (b) quantitative nursing studies are less common: found one longitudinal, randomized controlled trial (RCT) focused on outcomes of an intervention for well siblings and parents, implemented by Clinical Nurse Specialists, CNSs; (c) few quantitative studies with large samples were found, especially ones with theoretical models of the family system and measures of illness impact on families; and (d) "mixed methods" longitudinal nursing research is illustrated. There is a need for "evidence-based" practice (EBP) nursing studies of interventions focused on parent education/support/assistance; respite care, and increasing family/well sibling knowledge/other information on the child's illness. PMID:24261317

  1. Differences between family caregivers and people with dementia in recognizing the difficulties encountered in the lives of people with dementia.

    PubMed

    Miyamura, Toshihiro

    2016-01-01

    Objectives Dementia brings new difficulties in the lives of people with this disorder. It is important that family caregivers accurately recognize these difficulties to help their family members live fulfilling lives. Based on information gathered from people with dementia, family caregivers, and nurses providing medical care to this population, this study compared the differences in perspectives related to the difficulties associated with dementia between the family member with dementia and the family caregiver.Methods The primary participants in this investigation were 106 people with dementia and their family caregivers. Participants with dementia were 65 years and older who were receiving home care in Tokyo. Participants were interviewed about their difficulties while family caregivers completed a questionnaire with basic information regarding people with dementia. Additionally, the nurse providing medical care to the person with dementia completed a questionnaire about the medical care. In this study, difficulties in the lives of people with dementia was defined as impediments in life due to dementia. Difficulties were classified according to 12 symptoms based on responses that appeared frequently in the interviews. The 12 symptoms were pain, hallucinations/delusions, aggressive behavior, memory loss, disorientation, communication impairment, anxiety/confusion, toileting problems, gait disturbance, dietary deficiency, sleep disorder, and social withdrawal. Additional information was gathered and analyzed that included diagnosis and severity of dementia, need for long-term care, core symptoms of dementia, behavioral and psychological symptoms of dementia (BPSD), and delirium.Results The family caregiver's perspective about the difficulties encountered in the life of their family member with dementia was often different from the perspective of the associated family member. No family caregivers recognized that pain was a difficulty, and there were only a

  2. Results of the 2001 National Resident Matching Program: family practice.

    PubMed

    Pugno, P A; McPherson, D S; Schmittling, G T; Kahn, N B

    2001-09-01

    The results of the 2001 National Resident Matching Program (NRMP) reflect a persistent decline of student interest in family practice residency training in the United States. Compared with the 2000 Match, 240 fewer positions (317 fewer US seniors) were filled in family practice residency programs through the NRMP in 2001, as well as 76 fewer (47 fewer US seniors) in primary care internal medicine, 5 fewer in pediatrics-primary care (7 fewer US seniors), and 7 fewer (1 fewer US senior) in internal medicine-pediatric programs. In contrast, 40 more positions (64 more US seniors) were filled in anesthesiology and 11 more (10 more US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past 3 years. Ninety-one fewer positions (2 fewer US seniors) were also filled in categorical internal medicine, while 49 more positions (67 more US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. While the needs of the nation, especially rural and underserved populations, continue to offer a market for family physicians, family practice experienced a fourth year of decline though the 2001 NRMP. Current forces, including student perspectives of specialty prestige, the turbulence of the health care environment, media hype, market factors, lifestyle choices, and student debt, all appear to be influencing many students to choose subspecialty rather than primary care careers. PMID:11573716

  3. Results of the 2002 National Resident Matching Program: family practice.

    PubMed

    Pugno, Perry A; McPherson, Deborah S; Schmittling, Gordon T; Kahn, Norman B

    2002-09-01

    The results of the 2002 National Resident Matching Program (NRMP) reflect a persistent decline of student interest in family practice residency training in the United States. Compared with the 2001 Match, six fewer positions (103 fewer US seniors) were filled in family practice residency programs through the NRMP in 2002, as well as 48 fewer (30 fewer US seniors) in primary care internal medicine, 1 fewer in pediatrics-primary care (8 more US seniors), and 45 fewer (45 fewer US seniors) in internal medicine-pediatric programs. In comparison, 43 more positions (70 more US seniors) were filled in anesthesiology, but 11 fewer (16 fewer US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past 3 years. Eight fewer positions (60 fewer US seniors) were also filled in categorical internal medicine while 99 fewer positions (142 fewer US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. While the needs of the nation, especially rural and underserved populations, continue to offer opportunities for family physicians, family practice experienced a fifth year of decline through the 2002 NRMP. Many different forces, however, are impacting medical student career choices, including student perspectives of the demands, rewards, and prestige of the specialty, the turbulence and uncertainty of the health care environment, liability protection issues, and the impact of faculty and resident role models. The 2002 NRMP results may herald the leveling of recent trends away from family practice careers. PMID:12269534

  4. Results of the 2004 national resident matching program: family medicine.

    PubMed

    Pugno, Perry A; McPherson, Deborah S; Schmittling, Gordon T; Fetter, Gerald T; Kahn, Norman B

    2004-09-01

    The results of the 2004 National Resident Matching Program (NRMP) reflect a leveling in the recent trend of declining student interest in family medicine residency training in the United States. Compared with the 2003 Match, 34 more positions (36 fewer US seniors) were filled in family medicine residency programs through the NRMP in 2004, at the same time as 14 fewer (four fewer US seniors) in primary care internal medicine, 10 more in pediatrics-primary care (one more US senior), and 35 more (38 more US seniors) in internal medicine-pediatric programs. In comparison, one less position (one more US senior) was filled in anesthesiology and seven fewer (five more US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past several years. Many different forces, including student perspectives of the demands, rewards, and prestige of the specialty; the turbulence and uncertainty of the health care environment; liability protection issues; and the impact of faculty and resident role models, continue to influence medical student career choices. A total of 165 more positions (12 more US seniors) were filled in categorical internal medicine while 164 more positions (15 more US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. With the needs of the nation, especially for rural and underserved populations, continuing to offer opportunities for family physicians, family medicine experienced a slight increase through the 2004 NRMP. The 2004 NRMP suggests that the trend away from family medicine and primary care careers may be leveling off. PMID:15343417

  5. Results of the 2005 national resident matching program: family medicine.

    PubMed

    Pugno, Perry A; Schmittling, Gordon T; Fetter, Gerald T; Kahn, Norman B

    2005-09-01

    The results of the 2005 National Resident Matching Program (NRMP) reflect a currently stable level of student interest in family medicine residency training in the United States. Compared with the 2004 Match, 19 more positions (66 fewer US seniors) were filled in family medicine residency programs through the NRMP in 2005, at the same time as four fewer (18 fewer US seniors) in primary care internal medicine, seven more in pediatrics-primary care (three fewer US seniors), and 12 fewer (21 fewer US seniors) in internal medicine-pediatrics programs. In comparison, 25 more positions (four more US seniors) were filled in anesthesiology but two fewer (14 fewer US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past several years. Many different forces, including student perspectives of the demands, rewards, and prestige of the specialty, the turbulence and uncertainty of the health care environment, lifestyle issues, and the impact of faculty and resident role models, continue to influence medical student career choices. Seven more positions (57 more US seniors) were filled in categorical internal medicine while 48 more positions (68 more US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. With the needs of the nation, especially for rural and underserved populations, continuing to offer opportunities for family physicians, family medicine experienced another slight increase through the 2005 NRMP. The 2005 NRMP results suggest that interest in family medicine and primary care careers continues to be stable. PMID:16145633

  6. Results of the 2003 National Resident Matching Program: family practice.

    PubMed

    Pugno, Perry A; McPherson, Deborah S; Schmittling, Gordon T; Kahn, Norman B

    2003-09-01

    The results of the 2003 National Resident Matching Program (NRMP) reflect a persistent decline of student interest in family practice residency training in the United States. Compared with the 2002 Match, 118 fewer positions (179 fewer US seniors) were filled in family practice residency programs through the NRMP in 2003, as well as 23 fewer (12 fewer US seniors) in primary care internal medicine, 20 fewer in pediatrics-primary care (11 fewer US seniors), and 23 fewer (34 fewer US seniors) in internal medicine-pediatric programs. In comparison, 40 more positions (14 more US seniors) were filled in anesthesiology and 8 more (8 more US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past 3 years. Sixty-seven more positions (but 148 fewer US seniors) were also filled in categorical internal medicine, while 107 more positions (33 more US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. While the needs of the nation, especially rural and underserved populations, continue to offer opportunities for family physicians, family practice experienced continued decline though the 2003 NRMP. Many different forces, including student perspectives of the demands, rewards, and prestige of the specialty; the turbulence and uncertainty of the health care environment; liability protection issues; and the impact of faculty and resident role models, are impacting medical student career choices. The 2003 NRMP again confirms the trend away from family practice and primary care careers. PMID:12947519

  7. The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives.

    PubMed

    Zhang, Qiu; Xie, Chuanbo; Xie, Shanghang; Liu, Qing

    2016-01-01

    Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients' quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs. PMID:27529264

  8. A Yoga and Compassion Meditation Program Reduces Stress in Familial Caregivers of Alzheimer's Disease Patients

    PubMed Central

    Danucalov, M. A. D.; Kozasa, E. H.; Ribas, K. T.; Galduróz, J. C. F.; Garcia, M. C.; Verreschi, I. T. N.; Oliveira, K. C.; Romani de Oliveira, L.; Leite, J. R.

    2013-01-01

    Familial caregivers of patients with Alzheimer's disease exhibit reduced quality of life and increased stress levels. The aim of this study was to investigate the effects of an 8-week yoga and compassion meditation program on the perceived stress, anxiety, depression, and salivary cortisol levels in familial caregivers. A total of 46 volunteers were randomly assigned to participate in a stress-reduction program for a 2-month period (yoga and compassion meditation program—YCMP group) (n = 25) or an untreated group for the same period of time (control group) (n = 21). The levels of stress, anxiety, depression, and morning salivary cortisol of the participants were measured before and after intervention. The groups were initially homogeneous; however, after intervention, the groups diverged significantly. The YCMP group exhibited a reduction of the stress (P < 0.05), anxiety (P < 0.000001), and depression (P < 0.00001) levels, as well as a reduction in the concentration of salivary cortisol (P < 0.05). Our study suggests that an 8-week yoga and compassion meditation program may offer an effective intervention for reducing perceived stress, anxiety, depression, and salivary cortisol in familial caregivers. PMID:23690846

  9. The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives

    PubMed Central

    Zhang, Qiu; Xie, Chuanbo; Xie, Shanghang; Liu, Qing

    2016-01-01

    Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients’ quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs. PMID:27529264

  10. Family Caregiving and the Older American Act: Caring for the Caregiver. Hearing before the Special Committee on Aging. United States Senate, One Hundred Seventh Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

    This is the report of a congressional hearing on the new National Family Caregiver Support Program. First, it looks at this new program before it is fully implemented in the states and assesses how the states are setting up their programs. Second, it examines whether the States are receiving the clear and effective guidance they need from the…

  11. A Geriatric Clinical Training Model for Social Workers/Students Working Together with the Alzheimer Patient and Family Caregiver(s).

    ERIC Educational Resources Information Center

    Long Island Jewish Medical Center, NY.

    Discussed in this report is a geriatric clinical training model for social workers and students dealing with Alzheimer patients and family caregivers. The project was conceived to develop student interest and competence to work in this specialized area. One goal was to incorporate relevant components in the social work curriculum in both classroom…

  12. Stress, social support, and psychological distress of family caregivers of the elderly.

    PubMed

    Baillie, V; Norbeck, J S; Barnes, L E

    1988-01-01

    The effects of stress and social support and their interaction with the psychological well-being of 87 family caregivers of impaired elderly were examined. Perceived stress and satisfaction with support accounted for 32% to 36% of the variance in psychological distress or depression, p less than .001; however, when characteristics of the caregiver situation were included in the models, the effects of perceived stress were found to be spurious. The revised models accounted for 44% to 48% of the variance in psychological distress or depression, p less than .000, and included years of caregiving and mental impairment of the elder instead of perceived stress. Although there were no buffering effects for social support, main effects accounted for 19% to 22% of the variance in psychological distress or depression. The findings indicate that caregivers who are caring for a mentally impaired elder, who have been providing care for an extended time, and who have low social support are at high risk for psychological distress or depression.

  13. "Learning to Become a Family Caregiver" Efficacy of an Intervention Program for Caregivers Following Diagnosis of Dementia in a Relative

    ERIC Educational Resources Information Center

    Ducharme, Francine C.; Levesque, Louise L.; Lachance, Lise M.; Kergoat, Marie-Jeanne; Legault, Alain J.; Beaudet, Line M.; Zarit, Steven H.

    2011-01-01

    Purpose: The purpose of this experimental study was to test the efficacy of a psychoeducational individual program conceived to facilitate transition to the caregiver role following diagnosis of Alzheimer disease in a relative. Design and Methods: Caregivers were recruited in memory clinics and randomized to an experimental group (n = 62) or a…

  14. Test ordering for preventive health care among family medicine residents

    PubMed Central

    Fung, Daisy; Schabort, Inge; MacLean, Catherine A.; Asrar, Farhan M.; Khory, Ayesha; Vandermeer, Ben; Allan, G. Michael

    2015-01-01

    Abstract Objective To determine which screening tests family medicine residents order as part of preventive health care. Design A cross-sectional survey. Setting Alberta and Ontario. Participants First- and second-year family medicine residents at the University of Alberta in Edmonton, the University of Calgary in Alberta, and McMaster University in Hamilton, Ont, during the 2011 to 2012 academic year. Main outcome measures Demographic information, Likert scale ratings assessing ordering attitudes, and selections from a list of 38 possible tests that could be ordered for preventive health care for sample 38-year-old and 55-year-old female and male patients. Descriptive and comparative statistics were calculated. Results A total of 318 of 482 residents (66%) completed the survey. Recommended or appropriate tests were ordered by 82% (for cervical cytology) to 95% (for fasting glucose measurement) of residents. Across the different sample patients, residents ordered an average of 3.3 to 5.7 inappropriate tests per patient, with 58% to 92% ordering at least 1 inappropriate test per patient. The estimated average excess costs varied from $38.39 for the 38-year-old man to $106.46 for the 55-year-old woman. More regular use of a periodic health examination screening template did not improve ordering (P = .88). Conclusion In general, residents ordered appropriate preventive health tests reasonably well but also ordered an average of 3.3 to 5.7 inappropriate tests for each patient. Training programs need to provide better education for trainees around inappropriate screening and work hard to establish good ordering behaviour in preparation for entering practice. PMID:25767171

  15. Health Literacy Needs Related to Incontinence and Skin Damage among Family and Friend Caregivers of Individuals with Dementia

    PubMed Central

    Rolnick, Cheri; Jackson, Jody; Arntson, Casey; Mullins, Jean; Hepburn, Kenneth

    2013-01-01

    Purpose The purpose of this study was to describe health literacy needs related to incontinence and skin care among family or friend caregivers of individuals with Alzheimer’s disease and develop supportive and educational materials that address these needs. Design Descriptive Subjects and Settings The sample included 48 family/friend adult caregivers of individuals who had advanced dementia. Caregivers were spouses (44%), daughters (31%) or extended family members/friends (25%) recruited from community-based agencies, aged 64 (14) years (mean (SD)), and 75% female. Nearly half (48%) had a racially or ethnically diverse background. Methods Focus groups, interviews, and written surveys were conducted to assess health literacy needs of AD caregivers related to incontinence and skin care; verbal responses were audiotaped, transcribed, and summarized. To address these needs, a set of educational and supportive materials were developed whose content was directed by caregiver responses and supported by a literature review of current evidence and consultation with clinical and research experts. Study procedures were guided by advisory committee of AD caregivers. Results Caregivers had numerous health literacy needs related to incontinence and skin care; areas of need were categorized into knowledge, skills, and attitudes. Caregivers expressed a need to validate the health literacy they possessed. Fourteen educational and supportive documents were developed to address these needs. Conclusion Materials developed in this study are suitable to incorporate into interventions that support caregivers of persons with Alzheimer’s disease. They offer the potential to raise health literacy and care capacity of caregivers, increase communication with healthcare providers, and improve health outcomes of care recipients. PMID:24448620

  16. Caring for the frail elderly at home: toward a theoretical explanation of the dynamics of poor quality family caregiving.

    PubMed

    Phillips, L R; Rempusheski, V F

    1986-07-01

    Using the grounded theory approach, 39 family caregivers were theoretically sampled using newspaper advertising to explore their perceptions of providing home care for frail elders and to generate a theoretical model that describes the dynamics of good quality and poor quality family caregiving; explains the relationships among certain contextual and perceptual variables and the behaviors exchanged by elders and caregivers; and identifies points where interventions by nurses could be effective. The model consists of five constructs that were identified from the data and were staged within the framework provided by symbolic interactionism and social exchange theory. The five constructs and two related driving forces provide a partial explanation for the quality of family caregiving and a beginning explanation for the phenomenon of elder abuse.

  17. Caregiver Objective Burden and Assessments of Patient-Centered, Family-Focused Care for Frail Elderly Veterans

    ERIC Educational Resources Information Center

    Rose, Julia Hannum; Bowman, Karen F.; O'Toole, Elizabeth E.; Abbott, Katherine; Love, Thomas E.; Thomas, Charles; Dawson, Neal V.

    2007-01-01

    Purpose: There is a growing consensus that quality of care for frail elders should include family and be evaluated in terms of patient-centered, family-focused care (PCFFC). Family caregivers are in a unique and sometimes sole position to evaluate such care. In the context of caring for physically frail elders, this study examined the extent to…

  18. Effectiveness of an Internet Intervention for Family Caregivers of People with Dementia: Results of a Randomized Controlled Trial

    PubMed Central

    Blom, Marco M.; Zarit, Steven H.; Groot Zwaaftink, Rob B. M.; Cuijpers, Pim; Pot, Anne Margriet

    2015-01-01

    Background The World Health Organization stresses the importance of accessible and (cost)effective caregiver support, given the expected increase in the number of people with dementia and the detrimental impact on the mental health of family caregivers. Methods This study assessed the effectiveness of the Internet intervention ‘Mastery over Dementia’. In a RCT, 251 caregivers, of whom six were lost at baseline, were randomly assigned to two groups. Caregivers in the experimental group (N = 149) were compared to caregivers who received a minimal intervention consisting of e-bulletins (N = 96). Outcomes were symptoms of depression (Center for Epidemiologic Studies Depression Scale: CES-D) and anxiety (Hospital Anxiety and Depression Scale: HADS-A). All data were collected via the Internet, and an intention-to-treat analysis was carried out. Results Almost all caregivers were spouses or children (in-law). They were predominantly female and lived with the care recipient in the same household. Age of the caregivers varied from 26 to 87 years. Level of education varied from primary school to university, with almost half of them holding a bachelor’s degree or higher. Regression analyses showed that caregivers in the experimental group showed significantly lower symptoms of depression (p = .034) and anxiety (p = .007) post intervention after adjustment for baseline differences in the primary outcome scores and the functional status of the patients with dementia. Effect sizes were moderate for symptoms of anxiety (.48) and small for depressive symptoms (.26). Conclusions The Internet course ‘Mastery over Dementia’ offers an effective treatment for family caregivers of people with dementia reducing symptoms of depression and anxiety. The results of this study justify further development of Internet interventions for family caregivers of people with dementia and suggest that such interventions are promising for keeping support for family caregivers accessible and

  19. Perceptions and Preferences of Patients with Terminal Lung Cancer and Family Caregivers about DNR

    PubMed Central

    Lobchuk, Michelle; Hunter, William M; Johnston, Pam; Nugent, Zoann; Sharma, Ankur; Ahmed, Shahida; Sisler, Jeff

    2015-01-01

    Background: Patients with terminal lung cancer and their families are challenged and stressed with the end of life discussions. Do Not Resuscitate (DNR) orders are a critical part of such discussions. Objective: To understand the perceptions and preferences of patients with terminal lung cancer and their family caregivers around DNR discussions. . Methods: Our quantitative component consisted of a pen-and-paper questionnaire that was followed by a ‘think aloud’ process to capture perceptions of participants in response to questionnaire items. Qualitative methods included content analysis and constant comparison techniques to identify, code, and categorize primary themes arising from ‘think aloud’ responses. Results: In this pilot study, 10 patients with advanced stage lung cancer and nine family caregivers were enrolled from one tertiary cancer care centre. Three major themes and several sub-themes were identified reflecting participants’ psychosocial environment, emotional responses to DNR discussions, and suggestions to improve DNR discussions. Most of the time, both patients and caregivers perceived a supportive environment within their family unit. Some patients were uncertain about their disease extent but most had entertained thoughts about prognosis and DNR status prior to having a discussion with their physician. A range of situations stimulated the DNR discussion. Most patients were uncertain about identifying the most appropriate health care provider (HCP) for DNR discussion. While participants found DNR discussions distressing, patients maintained hope in the face of accepting a terminal diagnosis. There were mixed feelings about the reversibility of a DNR decision and concerns about the care of the patients after being stated as DNR. Participants desired their HCP to be emotionally sensitive, knowledgeable, respectful, and straightforward. Conclusions: Most participants were open about their experiences with psychosocial supports and

  20. Improving Doctor/Caregiver Communication

    MedlinePlus

    ... Month Friend: Living Independently Group Improving Doctor/ Caregiver Communications Helpful Ideas for Family Caregivers From NFCA There is much to be gained by improving communications between family caregivers and health care professionals, especially ...

  1. Family caregiver challenges in dementia care in Australia and China: a critical perspective

    PubMed Central

    2014-01-01

    Background Both Australia and China have a large proportion of people with dementia and the prevalence will triple in Australia and increase five times in China by 2050. The majority of people with dementia are reliant on family caregivers to provide daily care and to maintain the dignity in both countries. As a consequence, caregiver burden has become a major concern because of the negative impact on the care recipients’ and the caregivers’ health. It is strongly recommended that cross-national collaboration should be conducted to share experiences in fighting dementia. The aim of this study was to compare socially and culturally constructed enablers and barriers pertinent to dementia caregivers in one capital city in Australia and one capital city in China through critical reflection on the caregivers’ subjective and objective experiences for the improvement of dementia care services in both countries. Methods Giddens’ Structuration Theory was used as a framework to guide a concurrent mixed methods design with the qualitative strand as a priority. In the qualitative strand, data were collected by focus groups and in-depth interviews while in the quantitative strand, data were collected by questionnaire survey. Results In total 148 caregivers participated in the project with 57 of them from Australia (26 and 31 in the qualitative and quantitative strands respectively) and 91 of them from China (23 and 68 in the qualitative and quantitative strands respectively). Findings from the qualitative and quantitative strands were presented as three categories: A higher objective burden in the Chinese cohort versus a higher subjective burden in the Australian cohort; Unmet need for caregiver support in Australia and China; and Expectations for improving dementia services in Australia and for developing dementia services in China. Conclusions Dementia policy, services and resources need to be grounded on current research evidence in an ever-changing society like

  2. The Effects of a Family Support Program Including Respite Care on Parenting Stress and Family Quality of Life Perceived by Primary Caregivers of Children with Disabilities in Korea

    ERIC Educational Resources Information Center

    Sung, Minjung; Park, Jiyeon

    2012-01-01

    In this study, a family support program was carried out for primary caregivers of children with disabilities. The program included respite care, recreation programs, counseling, and social support coordination based on individual needs of each family. In order to verify the intervention effects, parenting stress and family quality of life were…

  3. Results of the 1999 National Resident Matching Program: family practice.

    PubMed

    Kahn, N B; Schmittling, G T; Graham, R

    1999-09-01

    The 1999 National Resident Matching Program (NRMP) results reflect continued volatility in the perceptions and career choices of physicians entering graduate medical education in the United States. A total of 117 fewer positions (155 fewer US seniors) were filled in family practice residency programs in 1999, as well as 23 fewer (29 fewer US seniors) in primary care internal medicine and 38 fewer (27 fewer US seniors) in internal medicine-pediatric programs. In contrast, nine more positions (19 more US seniors) were filled in anesthesiology and one more (10 more US seniors) in diagnostic radiology, two "marker" disciplines that have recently been market sensitive. Seventy-three more positions (but 67 fewer US seniors) were also filled in categorical internal medicine, while 30 more positions (40 more US seniors) were filled in categorical pediatrics programs, where trainees are "pluripotential" with perceived options for practicing as generalists or entering subspecialty fellowships, depending on the market. While the demands of managed care and the needs of rural and underserved populations continue to offer a market for family physicians, family practice experienced a second year of "primary care backlash" through the 1999 NRMP. In addition, current forces appear to be influencing some students to choose subspecialty rather than primary care careers. PMID:10489637

  4. Results of the 2000 National Resident Matching Program: family practice.

    PubMed

    Pugno, P A; McPherson, D S; Schmittling, G T; Kahn, N B

    2000-09-01

    The results of the 2000 National Resident Matching Program (NRMP) reflect substantial volatility in the perceptions and career choices of physicians entering graduate medical education in the United States. Ninety-four fewer positions (191 fewer US seniors) were filled in family practice residency programs through the NRMP in 2000, compared with 1999, as well as 60 fewer (66 fewer US seniors) in primary care internal medicine, 12 fewer in pediatrics-primary care (6 fewer US seniors), and 10 fewer (9 fewer US seniors) in internal medicine-pediatric programs. In contrast, 37 more positions (36 more US seniors) were filled in anesthesiology and 4 more (13 more US seniors) in diagnostic radiology, two "marker" disciplines that have recently been market sensitive. Twelve fewer positions (63 fewer US seniors) were also filled in categorical internal medicine, while 35 fewer positions (104 fewer US seniors) were filled in categorical pediatrics programs, where trainees perceive options for practicing as generalists or entering subspecialty fellowships, depending on the market. While the needs of the nation, especially rural and underserved populations, continue to offer a market for family physicians, family practice experienced a third year of decline through the 2000 NRMP. Current forces, including media hype, market factors, lifestyle choices, debt, and the turbulence of the health care environment, appear to be influencing many students to choose subspecialty rather than primary care careers. PMID:11002864

  5. Are family medicine residents adequately trained to deliver palliative care?

    PubMed Central

    Mahtani, Ramona; Kurahashi, Allison M.; Buchman, Sandy; Webster, Fiona; Husain, Amna; Goldman, Russell

    2015-01-01

    Objective To explore educational factors that influence family medicine residents’ (FMRs’) intentions to offer palliative care and palliative care home visits to patients. Design Qualitative descriptive study. Setting A Canadian, urban, specialized palliative care centre. Participants First-year (n = 9) and second-year (n = 6) FMRs. Methods Semistructured interviews were conducted with FMRs following a 4-week palliative care rotation. Questions focused on participant experiences during the rotation and perceptions about their roles as family physicians in the delivery of palliative care and home visits. Participant responses were analyzed to summarize and interpret patterns related to their educational experience during their rotation. Main findings Four interrelated themes were identified that described this experience: foundational skill development owing to training in a specialized setting; additional need for education and support; unaddressed gaps in pragmatic skills; and uncertainty about family physicians’ role in palliative care. Conclusion Residents described experiences that both supported and inadvertently discouraged them from considering future engagement in palliative care. Reassuringly, residents were also able to underscore opportunities for improvement in palliative care education. PMID:27035008

  6. The information transfer and knowledge acquisition geographies of family caregivers: an analysis of Canada's Compassionate Care Benefit.

    PubMed

    Crooks, Valorie A; Williams, Allison; Stajduhar, Kelli I; Allan, Diane E; Cohen, S Robin

    2007-09-01

    The authors explore an underdeveloped area of health geography by examining information transfer and knowledge acquisition for a health-related social program. Specifically, they discuss the findings of a small-scale utilization-focused evaluation of Canada's Compassionate Care Benefit (CCB). The CCB allows workers who are eligible for employment insurance to leave work to care for family members at end-of-life. Using the findings of 25 interviews with family caregivers, the authors explore their geographies of information transfer and knowledge acquisition. First, however, they introduce their respondent group and provide an overview of their socio-spatial lives as family caregivers. They then examine 3 specific thematic findings: awareness of the CCB, access to information related to the CCB, and the application process. The authors discuss the implications of the findings for the information needs and burdens of family caregivers and for Canadian nursing practice. They also consider directions for future CCB research. PMID:17970459

  7. Information and Resources for Caregivers: Sickle Cell Disease

    MedlinePlus

    ... Decisions Find Help Caregiver Stress NYC Services National Resources Specific Illness E- Newsletter What's New Beth Israel ... Advance Directives Frequently Asked Questions Caregiver Guides Caregiver Resource Directory Asian Family Caregiver Handbook Asian Family Caregiver ...

  8. Exploring the Support Needs of Family Caregivers of Patients with Brain Cancer Using the CSNAT: A Comparative Study with Other Cancer Groups.

    PubMed

    Aoun, Samar M; Deas, Kathleen; Howting, Denise; Lee, Gabriel

    2015-01-01

    A substantial burden is placed on family caregivers of patients diagnosed with brain cancers. Despite this, the support needs of the caregivers are often under-recognised and not addressed adequately in current routine and patient centred clinical care. The Carer Support Needs Assessment Tool (CSNAT) is a validated instrument designed to systematically identify and address caregiver needs [corrected]. It has been trialled in an Australian palliative care community setting using a stepped wedge cluster design involving 322 family carers of terminally ill patients. The current article reports on a subset from this trial, 29 caregivers of patients with primary brain cancer, and compares their profile and outcomes to those of other cancer groups. Caregiver strain was assessed using the Family Appraisal of Caregiving Questionnaire, caregiver physical and mental wellbeing using SF12 and caregiver workload using a questionnaire on support with activities of daily living (ADL). In comparison to caregivers of patients with all other cancers, the primary brain cancer group had significantly higher levels of caregiver strain, lower levels of mental wellbeing and a higher level of ADL workload. Their physical wellness also deteriorated significantly over time. An action plan approach led to practical solutions for addressing highlighted concerns. Four themes evolved from the family caregivers' feedback interviews: The extremely challenging caregiver experience with brain cancer; the systematic and practical approach of the CSNAT during rapid changes; connection with health professionals, feeling acknowledged and empowered; and timely advice and assurance of support during the caregiving journey. This preliminary study has demonstrated that the CSNAT provides a practical and useful tool for assessing the support needs of family caregivers of patients with brain cancer and has provided the basis for a larger scale, longitudinal study that allows a more detailed characterisation

  9. Exploring the Support Needs of Family Caregivers of Patients with Brain Cancer Using the CSNAT: A Comparative Study with Other Cancer Groups.

    PubMed

    Aoun, Samar M; Deas, Kathleen; Howting, Denise; Lee, Gabriel

    2015-01-01

    A substantial burden is placed on family caregivers of patients diagnosed with brain cancers. Despite this, the support needs of the caregivers are often under-recognised and not addressed adequately in current routine and patient centred clinical care. The Carer Support Needs Assessment Tool (CSNAT) is a validated instrument designed to systematically identify and address caregiver needs [corrected]. It has been trialled in an Australian palliative care community setting using a stepped wedge cluster design involving 322 family carers of terminally ill patients. The current article reports on a subset from this trial, 29 caregivers of patients with primary brain cancer, and compares their profile and outcomes to those of other cancer groups. Caregiver strain was assessed using the Family Appraisal of Caregiving Questionnaire, caregiver physical and mental wellbeing using SF12 and caregiver workload using a questionnaire on support with activities of daily living (ADL). In comparison to caregivers of patients with all other cancers, the primary brain cancer group had significantly higher levels of caregiver strain, lower levels of mental wellbeing and a higher level of ADL workload. Their physical wellness also deteriorated significantly over time. An action plan approach led to practical solutions for addressing highlighted concerns. Four themes evolved from the family caregivers' feedback interviews: The extremely challenging caregiver experience with brain cancer; the systematic and practical approach of the CSNAT during rapid changes; connection with health professionals, feeling acknowledged and empowered; and timely advice and assurance of support during the caregiving journey. This preliminary study has demonstrated that the CSNAT provides a practical and useful tool for assessing the support needs of family caregivers of patients with brain cancer and has provided the basis for a larger scale, longitudinal study that allows a more detailed characterisation

  10. Caregiver Action Network

    MedlinePlus

    ... MS, to adult children caring for parents with Alzheimer’s disease. CAN (the National Family Caregivers Association) is a non-profit organization providing education, peer support, and resources to family caregivers across ...

  11. The Impact of a Substance Abuse Disorder on the Well-Being of Family Caregivers of Adults with Mental Illness

    ERIC Educational Resources Information Center

    MacMaster, Samuel A.

    2008-01-01

    The impact that substance use has on an individual with mental illness has been documented; however, little is known about the impact that this may have for a family caregiver. Data was collected in a cross sectional study using mailed questionnaires to a convenience sample of family members of persons with mental illness (n = 110). Hierarchical…

  12. The economic impacts of Oklahoma's Family Medicine residency programs.

    PubMed

    Lapolla, Michael; Brandt, Edward N; Barker, Andréa; Ryan, Lori

    2004-06-01

    The enactment of Medicare and Medicaid created a new demand for medical services in Oklahoma, particularly in rural areas. The state of Oklahoma responded by creating The Oklahoma Physician Manpower Training Commission in 1975. The overall purpose of the Commission was to increase the number of primary care physicians and influence distribution into non-metro areas. This analysis concerns the public policy value of this ongoing program. The PMTC has provided resident stipend funding to each of Oklahoma's publicly funded Family Medicine residency programs. Since 1975, the PMTC has provided over 139 million dollars in resident stipend funding and support; and there have been 749 program graduates with 431 practicing in Oklahoma. This model calculates that the Oklahoma-based physicians have created a cumulative 3.7 billion dollars of economic impact on the state; and conservatively estimates that only 10% of the practice decisions/locations were influenced by the PMTC. This creates an estimated return of 370 million dollars on an "investment" of 139 million dollars. Additionally the model demonstrates that the current cohort of physicians is annually responsible for 15,530 jobs and an associated payroll of 428 million dollars. PMID:15346805

  13. Information and Service Needs among Active and Former Family Caregivers of Persons with Alzheimer's Disease.

    ERIC Educational Resources Information Center

    Fortinsky, Richard H.; Hathaway, Tania Jo

    1990-01-01

    Interpreted results of needs assessment completed by active caregivers (n=58) and former caregivers (n=57) of relatives with Alzheimer's disease (AD). Results imply need for high-quality educational material throughout caregiving, improved training for health professionals about AD, and role for former caregivers as information resources.…

  14. Impact of Spina Bifida on Parental Caregivers: Findings from a Survey of Arkansas Families

    ERIC Educational Resources Information Center

    Grosse, Scott D.; Flores, Alina L.; Ouyang, Lijing; Robbins, James M.; Tilford, John M.

    2009-01-01

    The well-being of caregivers of children with spina bifida and other conditions is an important topic. We interviewed the primary caregivers of 98 children aged 0-17 years with spina bifida sampled from a population-based birth defects registry in Arkansas and the caregivers of 49 unaffected children. Measures of caregiver well-being were compared…

  15. Information Needs of Family Caregivers of Persons with Cognitive versus Physical Deficits

    ERIC Educational Resources Information Center

    Koenig, Kelly N.; Steiner, Victoria; Pierce, Linda L.

    2011-01-01

    This study compared information needs of caregivers of persons with dementia with caregivers of those who received rehabilitation treatment. Caregivers were provided a 48-item survey and asked to choose their top ten information needs. Dementia caregivers' (n = 33) top needs were dealing with forgetfulness/confusion (91%) and repeating…

  16. Parenting Mediates the Impact of Caregivers' Distress on Children's Well-Being in Families Affected by HIV/AIDS

    PubMed Central

    Chi, Peilian; Li, Xiaoming; Tam, Cheuk Chi; Du, Hongfei; Guoxiang, Zhao; Zhao, Junfeng

    2015-01-01

    Parental illness imposes great challenges to children's life and mental health. Having a parent infected by HIV may further challenge children's psychological well-being. Existing studies have demonstrated a negative impact of caregiver's distress on children's well-being. Limited studies examined the potential pathways of the link. This study aims to examine whether parenting stress, parenting competence and parental responsiveness can explain the relationship between caregivers' distress and children's well-being. A community sample of children of parents living with HIV and their current caregivers (n = 754 dyads) was recruited in rural central China. Children completed the measures on their psychological well-being and perceived parental responsiveness of their caregivers. Caregivers reported on their psychological well-being, parenting stress, and parenting competence. Structural equation modeling analysis showed that caregivers' distress indirectly affect children's well-being through parenting stress, parenting competence and parental responsiveness. Parenting stress explained the impact of caregiver's distress on parental responsiveness and showed pervasive effects on parenting competence. Our findings lend credence to family-based intervention for children affected by HIV and affirm the importance of incorporating the cognitive, emotional and behavioral components of parenting practices in such intervention. PMID:26078116

  17. Parenting Mediates the Impact of Caregivers' Distress on Children's Well-Being in Families Affected by HIV/AIDS.

    PubMed

    Chi, Peilian; Li, Xiaoming; Tam, Cheuk Chi; Du, Hongfei; Zhao, Guoxiang; Zhao, Junfeng

    2015-11-01

    Parental illness imposes great challenges to children's life and mental health. Having a parent infected by HIV may further challenge children's psychological well-being. Existing studies have demonstrated a negative impact of caregiver's distress on children's well-being. Limited studies examined the potential pathways of the link. This study aims to examine whether parenting stress, parenting competence and parental responsiveness can explain the relationship between caregivers' distress and children's well-being. A community sample of children of parents living with HIV and their current caregivers (n = 754 dyads) was recruited in rural central China. Children completed the measures on their psychological well-being and perceived parental responsiveness of their caregivers. Caregivers reported on their psychological well-being, parenting stress, and parenting competence. Structural equation modeling analysis showed that caregivers' distress indirectly affect children's well-being through parenting stress, parenting competence and parental responsiveness. Parenting stress explained the impact of caregiver's distress on parental responsiveness and showed pervasive effects on parenting competence. Our findings lend credence to family-based intervention for children affected by HIV and affirm the importance of incorporating the cognitive, emotional and behavioral components of parenting practices in such intervention.

  18. Information needs of family caregivers of persons with cognitive versus physical deficits.

    PubMed

    Koenig, Kelly N; Steiner, Victoria; Pierce, Linda L

    2011-01-01

    This study compared information needs of caregivers of persons with dementia with caregivers of those who received rehabilitation treatment. Caregivers were provided a 48-item survey and asked to choose their top ten information needs. Dementia caregivers' (n = 33) top needs were dealing with forgetfulness/confusion (91%) and repeating questions/actions (61%) in care recipients. Rehabilitation caregivers' (n = 40) top needs were handling care recipients' mobility problems (75%) and dealing with their own stress (65%). Dementia caregivers focused on care recipients' needs related to behavioral symptoms, whereas rehabilitation caregivers focused on needs related to physical care of care recipients and their own needs. PMID:22087784

  19. Applicability of the pre‐death grief concept to dementia family caregivers in Asia

    PubMed Central

    2015-01-01

    Objective Pre‐death grief is prevalent among dementia family caregivers. When unaddressed, it produces adverse outcomes. With its research primarily conducted in Caucasians, its applicability to non‐Caucasians is uncertain. We explore the existence and the characteristics of pre‐death grief in a multi‐ethnic Asian population using an established pre‐death grief scale—Marwit–Meuser Caregiver Grief Inventory (MM‐CGI). Methods Seventy‐two dementia family caregivers were recruited from a tertiary hospital. Existence of pre‐death grief was shown by its measurability on MM‐CGI, together with good internal consistency reliability and construct validity. Characteristics of pre‐death grief were explored through multivariate linear regression of MM‐CGI and by comparing MM‐CGI scores with those from the original US study using one‐sample T‐test. Results In the Asian context, pre‐death grief was measurable in a reliable and valid manner. Risk factors of pre‐death grief included caring for patients with severe dementia, spousal relationship and secondary or below education. Influence of culture was palpable—Asians had more worries and felt isolation, and certain ethnicity showed more pre‐death grief. Conclusions Pre‐death grief is applicable even to the non‐Caucasian population. It bears much similarity to that in Caucasians. Yet, its expression is modified by culture. Clinicians working with non‐Caucasian populations need to be sensitive to its presence and to the influence of culture on its expression. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. PMID:26555857

  20. Music therapy with Alzheimer's patients and their family caregivers: a pilot project.

    PubMed

    Brotons, Melissa; Marti, Patricia

    2003-01-01

    The purpose of this paper is to present the results of a pilot project sponsored by a private foundation in Spain ("Fundació la Caixa"), in order to demonstrate some of the applications of music therapy, and to measure more systematically some of its effects on people with a probable diagnosis of Alzheimer's Disease and Related Disorders (ADRD) in early-moderate stages of the disease, and their family caregivers. Subjects for this project were 14 patients (5 women and 9 men) with a probable diagnosis of Alzheimer's disease, and 14 family caregivers (9 women and 5 men) from a rural area outside of Barcelona. Their age range was 70 to 80 years. Prior to the beginning of the project, a neuropsychologist specialized in gerontology administered a series of standardized tests to the participants. These same tests were administered again 2 days before the end of the project and 2 months later for follow-up purposes. The results of the satisfaction questionnaire showed that the caregivers perceived an improvement in the social and emotional areas of their patients, and statistical tests showed significant differences between pre and posttest scores in the following tests: (a) Dementia Scale (X2 = 12.29, p = .002), (b) NPI (X2 = 17.72, p = .001), (c) the Cohen-Mansfield agitation scale (X2 = 11.45, p = .003), (d) Burden Interview (X2 = 9.19, p = .01), (e) Memory and Behavior Problems Checklist (frequency subscale) (X2 = 11.09, p = .004), (f) STAI-S (X2 = 14.72, p = .001), and (g) Beck's Depression Inventory (X2 = 9.38, p = .009). These results and their implications are discussed extensively.

  1. Subjective Experiences of an Art Museum Engagement Activity for Persons with Early Alzheimer’s disease and their Family Caregivers

    PubMed Central

    Flatt, Jason D.; Liptak, Amy; Oakley, Mary Ann; Gogan, Jessica; Varner, Tresa; Lingler, Jennifer H.

    2014-01-01

    Objective To describe the subjective experiences of older adults with early-stage Alzheimer’s disease or related cognitive disorders (ADRD) and their family caregivers who participated in an art museum engagement activity. Methods Four focus groups were conducted with 10 persons with ADRD and 10 family caregivers following the completion one-time, three hour engagement activity. Participants also completed a brief satisfaction survey, and associations were examined using nonparametric statistics. Results Three key themes were identified: cognitive stimulation, social connections, and a sense of self. In addition, we identified programmatic issues such as activity-specific concerns and program logistics that could help improve future art program offerings. Past experience with art and perceived social cohesion were correlated with participants’ overall satisfaction with the program. Discussion Efforts aimed at improving the quality of life of those with Alzheimer’s and their family caregivers should consider the potential role of art museums. PMID:25216658

  2. Bad news and first impressions: patient and family caregiver accounts of learning the cancer diagnosis.

    PubMed

    Schaepe, Karen Sue

    2011-09-01

    Studies in medical journals regarding the delivery of a cancer diagnosis typically focus on a single clinic episode where the definitive news is disclosed to the patient by the physician. Far less research characterizes the diagnosis in the way patients and their family members often describe it: as a longitudinal, multi-sited search process culminating in a news-telling and realization event. This article analyzes lay accounts of learning a cancer diagnosis drawing on ethnographic interviews among a purposive sample of 28 patients recently diagnosed with leukemia, myeloma, or lymphoma and 30 of their family caregivers. The participants, recruited at a large cancer center in the United States, were asked to describe "the day" they learned the diagnosis. Narrative analysis revealed that in almost every case, detailed descriptions of preliminary events - such as the pace and sequence of testing; smooth or disorganized transitions between care providers; and the timeliness or delays in diagnosis - were used to contextualize the actual episode of hearing the diagnosis and reacting to the news. This study finds that patients' and caregivers' experience of the medical system prior to hearing the news played an important role in the way the news was ultimately internalized. The findings also provide empirical support for integrating lay perspectives on the diagnostic experience into future cancer disclosure guidelines.

  3. Exploring the Support Needs of Family Caregivers of Patients with Brain Cancer Using the CSNAT: A Comparative Study with Other Cancer Groups

    PubMed Central

    Aoun, Samar M.; Deas, Kathleen; Howting, Denise; Lee, Gabriel

    2015-01-01

    A substantial burden is placed on family caregivers of patients diagnosed with brain cancers. Despite this, the support needs of the caregivers are often under-recognised and not addressed adequately in current routine and patient centred clinical care. The Care Support Needs Assessment Tool (CSNAT) is a validated instrument designed to systematically identify and address caregiver needs. It has been trialled in an Australian palliative care community setting using a stepped wedge cluster design involving 322 family carers of terminally ill patients. The current article reports on a subset from this trial, 29 caregivers of patients with primary brain cancer, and compares their profile and outcomes to those of other cancer groups. Caregiver strain was assessed using the Family Appraisal of Caregiving Questionnaire, caregiver physical and mental wellbeing using SF12 and caregiver workload using a questionnaire on support with activities of daily living (ADL). In comparison to caregivers of patients with all other cancers, the primary brain cancer group had significantly higher levels of caregiver strain, lower levels of mental wellbeing and a higher level of ADL workload. Their physical wellness also deteriorated significantly over time. An action plan approach led to practical solutions for addressing highlighted concerns. Four themes evolved from the family caregivers’ feedback interviews: The extremely challenging caregiver experience with brain cancer; the systematic and practical approach of the CSNAT during rapid changes; connection with health professionals, feeling acknowledged and empowered; and timely advice and assurance of support during the caregiving journey. This preliminary study has demonstrated that the CSNAT provides a practical and useful tool for assessing the support needs of family caregivers of patients with brain cancer and has provided the basis for a larger scale, longitudinal study that allows a more detailed characterisation of the

  4. Depression of Family Caregivers Is Associated with Disagreements on Life-Sustaining Preferences for Treating Patients with Dementia

    PubMed Central

    Tsai, Chia-Fen; Lee, Yao-Tung; Lee, Wei-Ju; Hwang, Jen-Ping; Wang, Shuu-Jiun; Fuh, Jong-Ling

    2015-01-01

    Background Family caregivers may not agree with patients with dementia regarding attitudes toward end-of-life preferences, and the effects of this type of disagreement are not well understood. This study sought to identify such a disagreement and its predictors. Methods A cross-sectional sample of 84 family caregivers and patients with dementia was recruited from memory clinics. We used the Mini-Mental State Examination, Neuropsychiatric Inventory, Clinical Dementia Rating, and Katz index of independence in activities of daily living to assess patient symptoms, functions, and severity of dementia. Caregivers completed questionnaires on perceived patient end-of-life care preferences, caregiver end-of-life care preferences for patients, Zarit Burden Interview (ZBI), Center for Epidemiological Studies–Depression Scale (CES-D), and knowledge of clinical complications of advanced dementia. Results The self-disclosure rates of patient preferences were 34.5% for tube feeding, 39.3% for cardiopulmonary resuscitation, and 45.2% for mechanical ventilation. For patients who had disclosed preferences, the disagreement rate between them and their caregivers was 48.3% for tube feeding, 48.5% for cardiopulmonary resuscitation, and 60.3% for mechanical ventilation. Caregiver depression (i.e., CES-D ≥16) was associated with disagreements on cardiopulmonary resuscitation (adjusted odds ratio (aOR) = 6.6, 95% CI = 1.4–31.1, P = 0.01) and mechanical ventilation (aOR = 14, 95% CI = 2.2–87.2, P = 0.005) preferences. Conclusion The preferences of end-of-life issues differed greatly between dementia patients and their caregivers. Depression in caregivers is associated with such discrepancy. PMID:26230958

  5. Subjective well-being among family caregivers of individuals with developmental disabilities: the role of affiliate stigma and psychosocial moderating variables.

    PubMed

    Werner, Shirli; Shulman, Cory

    2013-11-01

    Studies have shown that stigmatization is linked to lower quality of life; however, only scant research has examined the association between family caregivers' internalization of stigma (affiliate stigma) and their subjective quality of life (subjective well-being, SWB). Furthermore, studies have rarely examined this association via comparison between caregivers of individuals with different developmental disabilities in addition to examining the influence of psychosocial protective factors. These were the aims of the current study. Family caregivers (N=176) of individuals with autism spectrum disorders (ASD), intellectual disabilities (ID), and physical disabilities (PD) completed a self-report structured questionnaire including scales measuring SWB, affiliate stigma, burden, positive meaning in caregiving, social support and self-esteem. Results showed that SWB of family caregivers was below the average normative level and especially low for caregivers of individuals with ASD. The strongest predictors of SWB were caregivers' self-esteem, social support, positive meaning in caregiving, and affiliate stigma. Furthermore, an interaction was found between affiliate stigma and diagnosis, showing that among caregivers of individuals with ASD, greater levels of stigma were associated with lower ratings of SWB, whereas such an association was not found among caregivers of individuals with ID or PD. Findings from this study point to the importance of supporting caregivers across the life-span in order to decrease stigma, improve social support and self-esteem and improve SWB. Further, findings point to the need to respond differentially to the various developmental disabilities. PMID:24055712

  6. Living kidney donors and their family caregivers: developing an evidence-based educational and social support website

    PubMed Central

    Taylor, Laura A.; Bahreman, Nasreen; Hayat, Matthew J.; Hoey, Frank; Rajasekaran, Geetha; Segev, Dorry L.

    2012-01-01

    Context Although graft and patient survival rates for living kidney donation are improved, some healthcare providers question whether volunteer donors and their informal caregivers are fully informed of the donation process and the risks involved. Donors and their family caregivers have reported that they receive limited information about the predonation and donor recovery process. Offering web-based information and social support is one way to address this gap. Strategy Living kidney donor candidates and their family caregivers participating in the Living Donor Information Network for Caregiving (LINC) have access to a variety of online informational resources and a social support discussion forum throughout their living kidney donation experience. Strategies in the development and implementation of an online information and social-support resource are presented. Conclusions Use of the LINC website for information and support may assist health care providers in identifying potential barriers in the current donation process and provide direction for enhancing knowledge and confidence among donors and family caregivers. PMID:22878067

  7. Symptom Profiles in Children With Advanced Cancer: Patient, Family Caregiver, and Oncologist Ratings

    PubMed Central

    Zhukovsky, Donna S.; Rozmus, Cathy L.; Robert, Rhonda S.; Bruera, Eduardo; Wells, Robert J.; Chisholm, Gary B.; Allo, Julio A.; Cohen, Marlene Z.

    2016-01-01

    BACKGROUND Systematic symptom assessment is not routinely performed in pediatric oncology. The objectives of the current study were to characterize the symptoms of pediatric oncology outpatients and evaluate agreement between patient and proxy reports and the association between children’s ratings and oncologists’ treatment recommendations. METHODS Two versions of the pediatric Memorial Symptom Assessment Scale (pMSAS) were translated into Spanish. An age-appropriate and language-appropriate pMSAS was administered independently before visits to the oncologist to patients and family caregivers (caregivers) and after visits to consenting oncologists. Statistical analysis included Spearman correlation coefficients and weighted kappa values. RESULTS English and Spanish results were similar and were combined. A total of 60 children and their caregivers completed the pMSAS. The children had a median age of 10 years (range, 7–18 years); approximately 62% were male and 33% were Spanish-speaking. Fourteen oncologists completed the pMSAS for 25 patients. Nine patients (15%) had no symptoms and 38 patients (63%) reported ≥2 symptoms. The most common symptoms were fatigue (12 patients; 40%) and itch (9 patients; 30%) for the younger children and pain (15 patients; 50%) and lack of energy (13 patients; 45%) among the older children. Total and subscale score agreement varied by proxy type and subscale, ranging from fair to good for most comparisons. Agreement for individual symptoms between the patient and proxy ranged from a kappa of −0.30 (95% confidence interval, −0.43 to −0.01) to 0.91 (95% confidence interval, 0.75 to 1.00). Three of 51 symptomatic patients (6%) had treatment recommendations documented in the electronic health record. CONCLUSIONS Symptoms are common and cross several functional domains. Proxy and child reports are often not congruent, possibly explaining apparent undertreatment among this group of patients. PMID:26218240

  8. Path Toward Economic Resilience for Family Caregivers: Mitigating Household Deprivation and the Health Care Talent Shortage at the Same Time

    PubMed Central

    Simon, Melissa A.

    2013-01-01

    Rising costs and a workforce talent shortage are two of the health care industry’s most pressing challenges. In particular, serious illnesses often impose significant costs on individuals and their families, which can place families at an increased risk for multigenerational economic deprivation or even an illness–poverty trap. At the same time, family caregivers often acquire a wide variety of health care skills that neither these caregivers nor the health care industry typically use. As these skills are marketable and could be paired with many existing medical certifications, this article describes a possible “path toward economic resilience” (PER) through a program whereby family caregivers could find meaningful employment using their new skills. The proposed program would identify ideal program candidates, assess and supplement their competencies, and connect them to the health care industry. We provide a set of practical steps and recommended tools for implementation, discuss pilot data on the program’s appeal and feasibility, and raise several considerations for program development and future research. Our analysis suggests that this PER program could appeal to family caregivers and the health care industry alike, possibly helping to address two of our health care system’s most pressing challenges with one solution. PMID:23633216

  9. Caregivers program. Final rule.

    PubMed

    2015-01-01

    The Department of Veterans Affairs (VA) adopts, with changes, the interim final rule concerning VA's Program of Comprehensive Assistance for Family Caregivers. VA administers this program to provide certain medical, travel, training, and financial benefits to caregivers of certain veterans and servicemembers who were seriously injured during service on or after September 11, 2001. Also addressed in this rulemaking is the Program of General Caregiver Support Services that provides support services to caregivers of veterans from all eras who are enrolled in the VA health care system. Specifically, changes in this final rule include a requirement that Veterans be notified in writing should a Family Caregiver request revocation (to no longer be a Family Caregiver), an extension of the application timeframe from 30 days to 45 days for a Family Caregiver, and a change in the stipend calculation to ensure that Primary Family Caregivers do not experience unexpected decreases in stipend amounts from year to year. PMID:25581943

  10. Exploring occupation roles of hospice family caregivers from Māori, Chinese and Tongan ethnic backgrounds living in New Zealand.

    PubMed

    Angelo, Jennifer; Wilson, Linda

    2014-06-01

    A major challenge to occupational therapists working in palliative care is determining the best ways to help family caregivers who are caring for family members. The purpose of this study was to explore palliative caregiver occupations among Māori, Chinese and Tongan ethnicities. Six informants participated, one woman and one man from each ethnic group. In each of their homes, informants were asked to discuss what it was like caring for their dying family member. The occupational themes resulting from these interviews were food preparation, spirituality and family gathering. Therapists need to be aware of the differences in how people care for family members within their ethnicity. Implications are that occupational therapists can help families identify activities important to them within the main occupational themes: different types of foods and their preparations, various ways to express spirituality and how families gather together members of their extended family. Further, clinicians need to take on the role of a "not-knowing" but curious health-care provider in order to meet the needs of caregivers. The limitation was the small number of participants who all lived in one geographic area. Future studies should include a wider group of ethnicities.

  11. Exploring occupation roles of hospice family caregivers from Māori, Chinese and Tongan ethnic backgrounds living in New Zealand.

    PubMed

    Angelo, Jennifer; Wilson, Linda

    2014-06-01

    A major challenge to occupational therapists working in palliative care is determining the best ways to help family caregivers who are caring for family members. The purpose of this study was to explore palliative caregiver occupations among Māori, Chinese and Tongan ethnicities. Six informants participated, one woman and one man from each ethnic group. In each of their homes, informants were asked to discuss what it was like caring for their dying family member. The occupational themes resulting from these interviews were food preparation, spirituality and family gathering. Therapists need to be aware of the differences in how people care for family members within their ethnicity. Implications are that occupational therapists can help families identify activities important to them within the main occupational themes: different types of foods and their preparations, various ways to express spirituality and how families gather together members of their extended family. Further, clinicians need to take on the role of a "not-knowing" but curious health-care provider in order to meet the needs of caregivers. The limitation was the small number of participants who all lived in one geographic area. Future studies should include a wider group of ethnicities. PMID:24578104

  12. Effect of the act on promotion of personal autonomy and care for dependent persons on their family caregivers

    PubMed Central

    2012-01-01

    Background The need of home care services is becoming an increasingly common scenario. These cares are mainly provided by the dependents’ relatives specifically, by the women part of the family. This situation might take years, decreasing the physical and psychological health of the caregiver. In Spain, the Act of Promotion of Personal Autonomy and Care for dependent persons, guarantees those dependent persons and their caregivers to have access to social services or to financial grants. The aim of this study is to Know the possible effects of the benefits provided by this Act in regards to the mental health, the quality of life and use of health services by the family caregivers assisting their relatives in situation of dependency. Methods and design A longitudinal descriptive study following-up a cohort of patients and caregivers. The study shall be carried out in Andalusia. It shall include the baseline assessment of the variables in those caregivers free from the exposure factor (reception of assistance pursuant to the Act). Following, once the benefits have been received, this cohort shall be followed-up. The study shall take three years, and the starting date for its development as well as its funding is January 2011. Discussion The longitudinal assessment of the rate of change of the variables studied shall allow us to know the implications which might be potentially generated as well as the natural evolution of those. PMID:23244337

  13. Late-stage HIV/AIDS patients' and their familial caregivers' agreement on the palliative care outcome scale.

    PubMed

    Krug, Rachel; Karus, Daniel; Selwyn, Peter A; Raveis, Victoria H

    2010-01-01

    This study compares the self-assessments of 67 late-stage HIV/AIDS patients regarding their symptomatology, sense of self-worth, and several other aspects of their health-care situation, to assessments of that situation provided by their informal caregivers. As part of a dyadic study of care preferences, the patients and caregivers independently completed nearly identical versions of the Palliative Care Outcome Scale, a short 10-item measure of the patient's current health, social, and psychological status. The participants in the study were recruited from inpatient and outpatient services at an urban medical center. Substantial or moderate agreement, assessed by weighted kappa, was found between patient and caregiver assessments with regard to only four items assessing physical or emotional states of the patient (pain, other symptoms, anxiety, and life worthwhile). Fair or slight agreement was found for the six remaining items, including those assessing the patient's sense of self-worth, family/friends' anxiety, interactions with family/friends, and practical matters. Mean ratings of self-worth were significantly different for patients and caregivers. These findings underscore the clinical need to assess patient care outcomes directly, and they suggest the importance of facilitating more effective communication about relevant health issues among seriously ill patients, caregivers, and health-care providers.

  14. A family-oriented treatment program for youths with ketamine abuse and their caregivers: a pilot study in Taiwan

    PubMed Central

    Wang, Liang-Jen; Lu, Shing-Fang; Chou, Wen-Jiun; Chong, Mian-Yoon; Wang, Yao-Hsing; Hsieh, Yu-Lian; Lee, Yi-Hsuan; Chen, Ching

    2015-01-01

    Objective The abuse of ketamine by youths has grown into a serious public health issue. However, a reliable and efficient treatment has still not been found for youths who abuse ketamine. This pilot study investigated the effects of a family-oriented treatment program for ketamine-using youths and their caregivers. Methods To carry out this study, 42 youths with ketamine use (mean age 16.6±1.1 years) who were referred to take part in a 10-week treatment program based on motivational enhancement principles were selected, as were their principal caregivers (mean age 46.4±7.1 years), who were similarly referred to take part in a 10-week training program for parenting skills. The study had the youths complete the Chinese Craving Beliefs Questionnaire, the Adolescents’ Behavior problem Scale, and the Family APGAR both immediately before and after the program. Likewise, the youths’ caregivers completed the Family APGAR, the 12-item version of the Chinese Health Questionnaire, and the Parenting Stress Index. Results Of the 42 youth–caregiver pairs that took part in this study, 37 (88%) completed the 10-week program and both sets of assessments. After the treatment, the participating youths’ substance cravings declined (t=3.88, P<0.001), while family function, as perceived by the participating caregivers, significantly increased (t=2.22, P=0.033). The improvement in caregivers’ perceptions of family function were positively related to the improvement of the caregivers’ health status (r=−0.36, P=0.022). Conclusion According to its results, this pilot study submits that family-oriented treatment programs may be considered a potentially effective treatment option for youths who abuse ketamine. Additional studies with larger sample sizes, as well as longer follow-up periods, are necessary to verify whether this type of treatment also prevents youths using ketamine from relapsing. PMID:26261419

  15. Attitudes toward the Diagnosis and Disclosure of Dementia among Family Caregivers and Primary Care Physicians

    ERIC Educational Resources Information Center

    Connell, Cathleen M.; Boise, Linda; Stuckey, John C.; Holmes, Sara B.; Hudson, Margaret L.

    2004-01-01

    Purpose: This study examined attitudes of caregivers and physicians toward assessing and diagnosing dementia, with an emphasis on how a diagnosis is disclosed. Design and Methods: Seventeen focus group interviews were conducted with caregivers or physicians from three sites; 52 caregivers participated in nine interviews (three each at the three…

  16. A DBT Skills Training Group for Family Caregivers of Persons with Dementia

    ERIC Educational Resources Information Center

    Drossel, Claudia; Fisher, Jane E.; Mercer, Victoria

    2011-01-01

    A Dialectical Behavior Therapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment,…

  17. Caregivers' Reasons for Nursing Home Placement: Clues for Improving Discussions with Families Prior to the Transition

    ERIC Educational Resources Information Center

    Buhr, Gwendolen T.; Kuchibhatla, Maragatha; Clipp, Elizabeth C.

    2006-01-01

    Purpose: This study identifies the relative importance of reasons for institutionalization endorsed by caregivers of patients with dementia; examines the relationship between caregivers' reasons for institutionalization and indicators of caregiver and patient physical and emotional functioning measured in the prior year; and compares, on these…

  18. To Pay or Not to Pay: Examining Underlying Principles in the Debate on Financial Support for Family Caregivers

    ERIC Educational Resources Information Center

    Keefe, Janice

    2007-01-01

    In many countries one approach to supporting family-and-friend caregivers is direct financial or monetary support. Debates about the benefits and consequences of such policies pervade the literature. Building on the premise that values underlie public policy, the paper examines four policy paradoxes in the literature and uses selected examples…

  19. Testing Self-Efficacy as a Pathway that Supports Self-Care among Family Caregivers in a Psychoeducational Intervention

    ERIC Educational Resources Information Center

    Savundranayagam, Marie Y.; Brintnall-Peterson, Mary

    2010-01-01

    This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care…

  20. Measuring the Values and Preferences for Everyday Care of Persons with Cognitive Impairment and Their Family Caregivers

    ERIC Educational Resources Information Center

    Whitlatch, Carol J.; Feinberg, Lynn Friss; Tucke, Shandra S.

    2005-01-01

    Purpose: This study describes the development and psychometric properties of a 24-item scale to be used in both research and practice settings that assesses the everyday care values and preferences of individuals with cognitive impairment and the perceptions of family caregivers about their relative's values and preferences for care. Design and…

  1. Role of technology in supporting quality control and treatment fidelity in a family caregiver clinical trial.

    PubMed

    Farran, Carol J; Etkin, Caryn D; McCann, Judith J; Paun, Olimpia; Eisenstein, Amy R; Wilbur, Joellen

    2011-11-01

    This article describes how a family caregiver lifestyle physical activity clinical trial uses research technology to enhance quality control and treatment fidelity. This trial uses a range of Internet, Blaise(®) Windows-based software and Echo Server technologies to support quality control issues, such as data collection, data entry, and study management advocated by the clinical trials literature, and to ensure treatment fidelity concerning intervention implementation (i.e., design, training, delivery, receipt, and enactment) as proposed by the National Institutes of Health Behavior Change Consortium. All research staff are trained to use these technologies. Strengths of this technological approach to support quality control and treatment fidelity include the comprehensive plan, involvement of all staff, and ability to maintain accurate and timely data. Limitations include the upfront time and costs for developing and testing these technological methods, and having support staff readily available to address technological issues if they occur.

  2. Gendered Processes in Hospice Palliative Home Care for Seniors With Cancer and Their Family Caregivers.

    PubMed

    Sutherland, Nisha; Ward-Griffin, Catherine; McWilliam, Carol; Stajduhar, Kelli

    2016-06-01

    There has been limited investigation into the processes that shape gender (in)equities in hospice palliative home care. As part of a larger critical ethnographic study, we examined how and why gender relations occur in this context. Using a critical feminist lens, we conducted in-depth interviews with clients living with terminal cancer, their family caregivers and primary nurses; observations of agency home visits; and review of institutional documents. A gender-based analysis revealed that gender enactments of Regulating Gender Relations were legitimized through ideological processes of Normalizing Gender Relations and Equalizing Gender Relations (Re)produced through institutional discourses of individualism and egalitarianism, these gendered processes both advantaged and disadvantaged men and women in hospice palliative home care. Findings suggest that to promote equity, health care providers and policy makers must attend to gender as a prevalent social determinant of health and health care. Implications for policy, practice, education, and research are discussed. PMID:26489710

  3. The relationship of caregiver coping to family outcomes during the initial year following pediatric traumatic injury.

    PubMed

    Wade, S L; Borawski, E A; Taylor, H G; Drotar, D; Yeates, K O; Stancin, T

    2001-06-01

    This study identified coping strategies associated with caregiver outcomes following pediatric injury and examined injury type as a moderator of coping efficacy. Families of 103 children with traumatic brain injury (TBI) and 71 children with orthopedic injuries were followed prospectively during the initial year postinjury. The groups had comparable preinjury characteristics and hospitalization experiences but differed on neurological insult. In hierarchical regression analyses, acceptance was associated with lower burden and denial was associated with greater distress in both groups. Active coping resulted in higher distress following TBI but not orthopedic injuries. Conversely, the use of humor was related to diminishing distress following TBI but unrelated to distress following orthopedic injuries. Results are discussed in terms of the implications for intervention following TBI.

  4. An intergenerational policy proposal for the 1990s: applying the temporary disability insurance model to family caregiving.

    PubMed

    Wisensale, S K

    1991-01-01

    This paper proposes a new policy initiative to assist family caregivers at a time when major demographic shifts in both the family and the workplace have taken place. Women especially are in the position of having to balance both work and family responsibilities without proper assistance. The initiative is based on an expansion of the Temporary Disability Insurance (TDI) model, to include care of family members of all ages by providing an adequate wage replacement. The shifting dependency ratio, resulting in a shrinking caregiver pool, is discussed as well as existing policies and their short-comings. For example, no current policies provide paid leave. The evolution of TDI, including resistance to it, is examined. Finally, Massachusetts' abortive attempt at a comprehensive plan for employment-leave insurance is discussed in detail and policy recommendations are outlined.

  5. The last mile of the way: understanding caregiving in African American families at the end-of-life.

    PubMed

    Turner, William L; Wallace, Beverly R; Anderson, Jared R; Bird, Carolyn

    2004-10-01

    This research is based on in-depth ethnographic interviews and focus groups with 88 African American family caregivers from various regions of the United States during a stressful time in their family development--caregiving at the end-of-life--and the grieving during the aftermath. The study employed a stratified purposeful sampling strategy. Subjects were African Americans from the Northern, Southern, and Midwestern United States. Formal care is complicated by the distrust that many African Americans hold toward the health care system, which has resulted from years of exclusion, racism and discrimination. The findings highlight the importance of hearing from African American families to gain an understanding of what services, including family therapy and other psychotherapy, they will need during this process.

  6. Perceived stigma of patients with severe mental illness in Hong Kong: relationships with patients' psychosocial conditions and attitudes of family caregivers and health professionals.

    PubMed

    Chien, Wai-Tong; Yeung, Frederick K K; Chan, Alan H L

    2014-03-01

    This descriptive survey investigated the level of perceived stigma among Chinese patients with severe mental illness (SMI) and its relationships with patients' psychosocial conditions and family caregivers' and mental health professionals' attitudes toward SMI in Hong Kong. A clustered, random sample of 311 patients and their family caregivers and 73 Chinese professionals participated. The patients reported a high level of withdrawal/secrecy and the professionals perceived a low to moderate level of stereotype/restriction to their patients. Families' expressed emotion and caregiving burden could increase patients' perceived stigma. Strategies in de-stigmatization of mental illness have been discussed, particularly from family-based approach.

  7. Friends, family, and caregiving among midlife and older lesbian, gay, bisexual, and transgender adults.

    PubMed

    Croghan, Catherine F; Moone, Rajean P; Olson, Andrea M

    2014-01-01

    The study examines the frequency and nature of the informal caregiving experience for midlife and older lesbian, gay, bisexual, or transgender (LGBT) adults. Responses from a Twin Cities Metropolitan Area LGBT aging needs assessment survey were analyzed for social supports, current caregiving activity and availability of a caregiver. The majority of respondents identified a primary caregiver who was not a legal relation; and compared to the general population were (a) less likely to have traditional sources of caregiver support and (b) more likely to be serving as a caregiver and caring for someone to whom they were not legally related. Implications of the findings for enhancing resources to more fully support the 10% of caregivers that are caring for non-kin are discussed.

  8. Pediatric Residents' Perspective on Family-Clinician Discordance in Primary Care: A Qualitative Study.

    PubMed

    Rosenthal, Marjorie S; Connor, Katherine A; Fenick, Ada M

    2016-01-01

    The engagement of families in health maintenance is associated with better child health outcomes, but demographic discordance between families and clinicians may be a barrier to family engagement. Using a longitudinal qualitative study design, we conducted 15 semi-structured interviews with five pediatric residents who elected to facilitate group well child care (GWCC). Four themes describing residents' perceptions of the role of discordance in family-clinician engagement include: 1) discordance was not a barrier; 2) discordance leads to a lack of engagement and trust; 3) residents transcended discordance in GWCC because either GWCC led residents to change their communication techniques or because, with GWCC, parents have concordant adults in the room; and 4) the education residents obtained in GWCC allowed them to empathize with the families' health-related decisions. Finding ways in which pediatric providers can improve skills in family engagement may be an important step in decreasing health inequities.

  9. Pediatric Residents' Perspective on Family-Clinician Discordance in Primary Care: A Qualitative Study.

    PubMed

    Rosenthal, Marjorie S; Connor, Katherine A; Fenick, Ada M

    2016-01-01

    The engagement of families in health maintenance is associated with better child health outcomes, but demographic discordance between families and clinicians may be a barrier to family engagement. Using a longitudinal qualitative study design, we conducted 15 semi-structured interviews with five pediatric residents who elected to facilitate group well child care (GWCC). Four themes describing residents' perceptions of the role of discordance in family-clinician engagement include: 1) discordance was not a barrier; 2) discordance leads to a lack of engagement and trust; 3) residents transcended discordance in GWCC because either GWCC led residents to change their communication techniques or because, with GWCC, parents have concordant adults in the room; and 4) the education residents obtained in GWCC allowed them to empathize with the families' health-related decisions. Finding ways in which pediatric providers can improve skills in family engagement may be an important step in decreasing health inequities. PMID:27524749

  10. To pay or not to pay: examining underlying principles in the debate on financial support for family caregivers.

    PubMed

    Keefe, Janice; Rajnovich, Beth

    2007-01-01

    In many countries one approach to supporting family-and-friend caregivers is direct financial or monetary support. Debates about the benefits and consequences of such policies pervade the literature. Building on the premise that values underlie public policy, the paper examines four policy paradoxes in the literature and uses selected examples from an international policy analysis to illustrate the underlying objectives and values upon which many of the policies were developed. These include the responsibility to care, economic or social objectives, gender equity, and the autonomy of care receivers. The authors conclude that policy makers need to be cautious about the unintended effects of financial support policy and develop a menu of policies and services to support caregivers. Future policy development in Canada must enable legitimate choice across the life course and ensure that neither the caregiver nor the care receiver will experience short- or long-term financial consequences of his or her choice. PMID:21598748

  11. Teaching adaptive leadership to family medicine residents: what? why? how?

    PubMed

    Eubank, Daniel; Geffken, Dominic; Orzano, John; Ricci, Rocco

    2012-09-01

    Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts.

  12. Structured interviews examining the burden, coping, self-efficacy, and quality of life among family caregivers of persons with dementia in Singapore.

    PubMed

    Tay, Kay Chai Peter; Seow, Chuen Chai Dennis; Xiao, Chunxiang; Lee, Hui Min Julian; Chiu, Helen F K; Chan, Sally Wai-Chi

    2016-03-01

    Dementia is a global health issue and the effects on caregivers are substantial. The study aimed to examine the associations of burden, coping, self-efficacy with quality of life among family caregivers of persons with dementia in Singapore. Structured interviews were conducted in a convenience sample of 84 family caregivers caring and seeking clinical care for the persons with dementia in an outpatient clinic of a public hospital in Singapore. The outcome measures included the Family Burden Interview Schedule, Family Crisis Oriented Personal Evaluation Scale, General Perceived Self-Efficacy Scale, and World Health Organization Quality of Life Scale - Brief Version. In general, significant correlations were observed between the quality of life scores with coping strategy and family burden scores, but not between the coping strategy and family burden scores. Compared to demographic factors such as caregiver age and household income, psychosocial factors including family burden, coping strategies, and self-efficacy demonstrated greater association with quality of life in the participants. However, the dynamics of these associations will change with an increasing population of persons with dementia, decreasing nuclear family size, and predicted changes in family living arrangements for the persons with dementia in future. As such, it necessitates continuous study examining the needs and concerns of family caregivers and the relevance of ongoing interventions specific to caregivers of persons with dementia.

  13. 2. VIEW OF THE BELL FAMILY RESIDENCE (FEATURE C1), WEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. VIEW OF THE BELL FAMILY RESIDENCE (FEATURE C-1), WEST END, FACING SOUTHEAST. PRIVY (FEATURE C-2) IS VISIBLE IN BACKGROUND, UPPER LEFT SIDE OF FRAME. - Bell Family Residence, House, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  14. Expressed reasons for the choice of a residency in family practice.

    PubMed

    Asken, M J; Strock, B K

    1978-04-01

    An analysis was conducted of expressed reasons for the choice of a family practice residency by prospective residents. The nature and frequency of reasons are presented. An attempt was also made to judge the importance of saliency of specific reasons expressed. The results are discussed in relation to past studies and future directions for the training of family physicians.

  15. Collaborative Counselor and Medical Training at a Family Practice Residency Program: A Sharing of the Experience.

    ERIC Educational Resources Information Center

    McBride, LeBron; Pilkington, Lloyd; Murray, Paige Johnson; Whitfield, Donna

    2000-01-01

    The reactions of a Ph.D.-level, counselor-in-training, a medical student, and a family practice resident to collaborative systems clinical training at a family practice residency program are given in this article. Addresses the initial impressions of the content and process of the teaching model and how the experience changed their views of…

  16. Family Skills for General Psychiatry Residents: Meeting ACGME Core Competency Requirements

    ERIC Educational Resources Information Center

    Berman, Ellen M.; Heru, Alison M.; Grunebaum, Henry; Rolland, John; Wood, Beatrice; Bruty, Heidi

    2006-01-01

    Objective: The authors discuss the knowledge, attitudes, and skills needed for a resident to be competent in supporting and working with families, as mandated by the residency review committee (RRC) core competencies. Methods: The RRC core competencies, as they relate to patients and their families, are reviewed. The Group for Advancement of…

  17. Cash Assistance as a Support for In-Home Care: Caregivers' Perspectives.

    ERIC Educational Resources Information Center

    Adamek, Margaret E.

    Recognition of the importance of families in providing care to older persons has led to advocacy for a variety of supports to assist them. This study was conducted to describe caregivers' perceptions of the helpfulness of cash assistance and to identify factors associated with perceived helpfulness. Subjects were co-resident caregivers (N=155)…

  18. The interactive effect of maltreatment in the family and unstable institutional caregiving in predicting behavior problems in toddlers.

    PubMed

    Baptista, Joana; Belsky, Jay; Marques, Sofia; Silva, Joana R; Oliveira, Paula; Mesquita, Ana; Martins, Carla; Soares, Isabel

    2014-12-01

    The current study extends research on the effects of institutionalization, most notably by examining whether-and how-both pre-institutional maltreatment in the family and the stability and consistency of institutional care interact to shape emotional and behavioral development. Fifty Portuguese children, placed in residential institutions when 8 days to 26 months of age, were evaluated using the Child Behavior Checklist when aged 18-31 months. Caregiver-rated internalizing and externalizing behavior problems proved to be unrelated to both early family and institutional experiences, as main effects, but the interaction of these factors significantly predicted externalizing problems: a history of maltreatment in the family coupled with unstable institutional caregiving arrangements predicted especially elevated levels of externalizing problems. Results are discussed in terms of the importance of more distal and proximate developmental experiences. PMID:25459985

  19. Bad News and First Impressions: Patient and Family Caregiver Accounts of Learning the Cancer Diagnosis

    PubMed Central

    Schaepe, Karen Sue

    2011-01-01

    Studies in medical journals regarding the delivery of a cancer diagnosis typically focus on a single clinic episode where the definitive news is disclosed to the patient by the physician. Far less research characterizes the diagnosis in the way patients and their family members often describe it: as a longitudinal, multi-sited search process culminating in a news-telling and realization event. This article analyzes lay accounts of learning a cancer diagnosis drawing on ethnographic interviews among a purposive sample of 28 patients recently diagnosed with leukemia, myeloma, or lymphoma and 30 of their family caregivers. The participants, recruited at a large cancer center in the United States, were asked to describe “the day” they learned the diagnosis. Narrative analysis revealed that in almost every case, detailed descriptions of preliminary events -- such as the pace and sequence of testing; smooth or disorganized transitions between care providers; and the timeliness or delays in diagnosis – were used to contextualize the actual episode of hearing the diagnosis and reacting to the news. This study finds that patients’ and caregivers’ experience of the medical system prior to hearing the news played an important role in the way the news was ultimately internalized. The findings also provide empirical support for integrating lay perspectives on the diagnostic experience into future cancer disclosure guidelines. PMID:21813220

  20. Association of Filial Responsibility, Ethnicity, and Acculturation Among Japanese American Family Caregivers of Older Adults

    PubMed Central

    Miyawaki, Christina E.

    2015-01-01

    Challenges of filial caregiving practices by 1st-generation immigrants due to differences in caregiving values between their home and host countries are well documented. This study explored the filial responsibility of later generation Japanese American caregivers of older adults. Acculturation and filial responsibility were measured using the Suinn-Lew Asian Self Identity Acculturation scale and Filial Values Index, respectively. A qualitative interview guide was developed using Gordon’s assimilation theory, and 21 caregivers (M age = 68 years, 86% female, seven in each generation) were interviewed. Despite the 3rd-generation caregivers’ high acculturation level, their filial responsibility scores remained high. Qualitative interviews also revealed later generation caregivers’ strong filial responsibility and continued caregiving involvement. Unexpectedly, caregivers’ own future expectancy of care included placement in mainstream residential facilities rather than ethnicspecific settings. Findings point to the need to develop caregiver services that consider later generation caregivers’ culture and level of assimilation. PMID:25883044

  1. Pain Medication Management Processes Used by Oncology Outpatients and Family Caregivers Part II: Home and Lifestyle Contexts

    PubMed Central

    Schumacher, Karen L.; Plano Clark, Vicki L.; West, Claudia M.; Dodd, Marylin J.; Rabow, Michael W.; Miaskowski, Christine

    2014-01-01

    Context Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home. Objectives To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial (RCT) of a psycho-educational intervention called the Pro-Self © Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles. Methods This qualitative study was conducted as part of a RCT in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods. Results Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes. Conclusion Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and family caregivers when cancer treatment and supportive care is provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles. PMID:24709364

  2. Health Literacy Teaching in U.S. Family Medicine Residency Programs: A National Survey.

    PubMed

    Coleman, Clifford A; Nguyen, Nancy T; Garvin, Roger; Sou, Channbunmorl; Carney, Patricia A

    2016-01-01

    Health care providers, including medical residents, often lack adequate knowledge and skills to work effectively with patients who have limited health literacy. Little is known about the degree to which medical residents are trained to communicate effectively with people who have limited health literacy. This study aimed to assess the status of health literacy training for physicians in U.S. family medicine residency programs. We conducted an online survey of residency directors at 444 U.S. family medicine residencies. Among 138 respondents (31% response rate), 58 programs (42%) reported teaching residents about health literacy as part of the required curriculum. Most instruction occurred during the 1st year of training. Hours of instruction ranged from 2 to 5 during Years 1 through 3. Skills-based training (e.g., plain language techniques) was taught by most programs. Not having access to a faculty authority on health literacy was strongly associated with lack of a required health literacy curriculum. Respondents overwhelmingly agreed that increasing health literacy training for medical students and residents would help improve residents' clinical skills. This study provides a baseline snapshot of health literacy curricula in U.S. family medicine residencies and likely overestimates the prevalence of such curricula. Additional studies are needed to determine the quality of health literacy instruction in U.S. family medicine residencies and the most effective methods for teaching residents about health literacy. PMID:27043758

  3. Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives

    PubMed Central

    Chan Carusone, Soo; Loeb, Mark; Lohfeld, Lynne

    2006-01-01

    Background Nursing home residents are frequently sent to hospital for diagnostic tests or to receive acute health care services. These transfers are both costly and for some, associated with increased risks. Although improved technology allows long-term care facilities to deliver more complex health care on site, if this is to become a trend then residents and family members must see the value of such care. This qualitative study examined resident and family member perspectives on in situ care for pneumonia. Methods A qualitative descriptive study design was used. Participants were residents and family members of residents treated for pneumonia drawn from a larger randomized controlled trial of a clinical pathway to manage nursing home-acquired pneumonia on-site. A total of 14 in-depth interviews were conducted. Interview data were analyzed using the editing style, described by Miller and Crabtree, to identify key themes. Results Both residents and family members preferred that pneumonia be treated in the nursing home, where possible. They both felt that caring and attention are key aspects of care which are more easily accessible in the nursing home setting. However, residents felt that staff or doctors should make the decision whether to hospitalize them, whereas family members wanted to be consulted or involved in the decision-making process. Conclusion These findings suggest that interventions to reduce hospitalization of nursing home residents with pneumonia are consistent with resident and family member preferences. PMID:16430782

  4. Deciding to institutionalize: why do family members cease caregiving at home?

    PubMed

    McLennon, Susan M; Habermann, Barbara; Davis, Linda Lindsey

    2010-04-01

    The primary purpose of this secondary analysis was to identify common themes from the statements of caregivers who ultimately decided to institutionalize their relative with Alzheimer or Parkinson disease. Content analysis of transcripts from caregivers (n=11) who institutionalized their relative during their participation in a caregiver intervention study was performed. Two categories identified from the caregivers' stories were anticipating the inevitable and reaching the limit. The results of the descriptive analysis indicated that 3 to 4 months before institutionalization, caregivers discussed knowing that they would not be able to continue caring for their relative. The most frequent reasons for institutionalization were serious health events. The incidental finding that there were more institutionalizations in the Alzheimer disease participant group than in the Parkinson disease group may indicate that caregiving is more difficult for caregivers in Alzheimer disease than in Parkinson disease. This analysis contributes new and important information about the time interval between caregivers' anticipation of the need for alternative care arrangements and the subsequent placement in formal care. Nurses and other healthcare providers should be alert to the fact that when caregivers express anticipation of the need for change in care arrangements, it may be a signal for immediate assessment and referral to appropriate resources for assistance.

  5. The cost-effectiveness of a family meetings intervention to prevent depression and anxiety in family caregivers of patients with dementia: a randomized trial

    PubMed Central

    2013-01-01

    Background Dementia imposes a heavy burden on health and social care systems as well as on family caregivers who provide a substantial portion of the care. Interventions that effectively support caregivers may prevent or delay patient institutionalization and hence be cost-effective. However, evidence about the cost-effectiveness of such interventions is scarce. The aim of this study was to evaluate the cost-effectiveness of a family meetings intervention for family caregivers of dementia patients in comparison with usual care over a period of 12 months. Methods The economic evaluation was conducted from a societal perspective alongside a randomized trial of 192 primary caregivers with community-dwelling dementia patients. Outcome measures included the Quality Adjusted Life-Years (QALY) of caregivers and patients and the incidence of depression and anxiety disorders in caregivers. Missing cost and effect data were imputed using multiple imputations. Bootstrapping was used to estimate uncertainty around the cost-differences and the incremental cost-effectiveness ratio (ICER). The bootstrapped cost-effect pairs were plotted on a cost-effectiveness plane and used to estimate cost-effectiveness curves. Results No significant differences in costs and effects between the groups were found. At 12 months, total costs per patient and primary caregiver dyad were substantial: €77,832 for the intervention group and €75,201 for the usual care group (adjusted mean difference per dyad €4,149, 95% CI -13,371 to 21,956, ICER 157,534). The main cost driver was informal care (66% of total costs), followed by patients’ day treatment and costs of hospital and long-term care facility admissions (23%). Based on the cost-effectiveness acceptability curves, the maximum probability that the intervention was considered cost-effective in comparison with usual care reached 0.4 for the outcome QALY per patient-caregiver dyad and 0.6 for the caregivers’ incidence of depression and

  6. Social support and barriers to family involvement in caregiving for persons with AIDS: implications for patient education.

    PubMed

    Smith, M Y; Rapkin, B D

    1996-01-01

    If efforts to promote family involvement in patient education and other caregiving activities for people with AIDS (PWAs) are to be successful, clinicians need information concerning PWAs' family network and the barriers PWAs face in obtaining support. Using data from interviews with 224 PWAs in New York City, we assessed the size and composition of their family network and the self-identified barriers to support. Overall, respondents mentioned having an average of less than two sources of close support. Women relied on children for support more than men did. Male injection drug users and men reporting sex with men relied on friends and traditional family almost equally, while men at risk for HIV via heterosexual contact relied more on traditional family sources. Barriers to support included interpersonal costs, lack of access, lack of acceptance, lack of intimacy, negative interactions and fear of disclosure. Health professionals need to conduct comprehensive network assessments with PWAs in order to determine the full scope of support resources available to each patient. Educational initiatives that provide information about family conflict resolution and the course and transmission of HIV may assist in alleviating these barriers. Clinicians can facilitate family involvement in patient education by addressing the informational needs that are salient to both PWAs' and their family caregivers. PMID:8788752

  7. Weaving public health education into the fabric of a family medicine residency.

    PubMed

    Potts, Stacy E; Deligiannidis, Konstantinos E; Cashman, Suzanne B; Caggiano, Marie E; Carter, Lisa H; Haley, Heather-Lyn; Ferguson, Warren J

    2011-10-01

    Policymakers and accrediting bodies have recognized the importance of integrating public health, population health, and prevention into graduate medical education programs. The high prevalence of chronic illness, coupled with the impact of behavioral and societal determinants of health, necessitate an urgent call for family medicine residencies to prepare future leaders to meet these challenges. The University of Massachusetts Worcester Family Medicine Residency recently developed an integrated curriculum that strives to develop a culture of incorporating fundamental public health principles into everyday practice. This public health curriculum was designed to integrate new topics within the current residency structure through longitudinal and concentrated experiences. This strategy has substantially improved public health and prevention education without substantial impact on the already strained residency curricular structure. This paper describes the integration of public health and prevention education into a family medicine residency to help residents acquire the fundamental skills necessary to improve a population's health.

  8. Alternative families in recovery: fictive kin relationships among residents of sober living homes.

    PubMed

    Heslin, Kevin C; Hamilton, Alison B; Singzon, Trudy K; Smith, James L; Anderson, Nancy Lois Ruth

    2011-04-01

    Sober living homes are group residences for people attempting to maintain abstinence from alcohol and drugs in a mutually supportive setting. Residents typically develop strong psychological and economic ties and have been referred to as "alternative families," thus evoking the anthropological concept of fictive kinship. We analyzed data from seven focus groups with sober living home residents to assess the prevalence and functions of fictive kinship in these settings. Results suggest that residents created kinship by exchanging various types of support, and by incorporating other residents into existing family relationships, particularly in homes where there were children. Residents perceived fictive kin as more supportive than actual kin, encouraging them toward greater individuation, in contrast with family backgrounds that were sometimes described as stifling. These accounts of the therapeutic qualities of fictive kin in sober living homes could inform the work of fair housing advocates and other community stakeholders.

  9. Caregiving Hassles Scale: Assessing the Daily Hassles of Caring for a Family Member with Dementia.

    ERIC Educational Resources Information Center

    Kinney, Jennifer M.; Stephens, Mary Ann Parris

    1989-01-01

    Primary caregivers to Alzheimer disease patients (N=60) twice completed Caregiving Hassles Scale and reported on their well-being. Scale provided reliable and psychometrically sound instrument for assessing hassles associated with assistance in basic and instrumental activities of daily living, care-recipient cognitive status and behavior, and…

  10. Quality of care in family practice: does residency training make a difference?

    PubMed Central

    Borgiel, A E; Williams, J I; Bass, M J; Dunn, E V; Evensen, M K; Lamont, C T; MacDonald, P J; McCoy, J M; Spasoff, R A

    1989-01-01

    As the proportion of physicians who enter residency training in family practice steadily increases, so does the need to evaluate the impact of their training and postgraduate education on the quality of care in their practices. We audited the practices of 120 randomly selected family physicians in Ontario, who were separated into four groups: nonmembers of the College of Family Physicians of Canada (CFPC), members of the CFPC with no certification in family medicine, certificated members without residency training in family medicine and certificated members with residency training in family medicine. The practices were assessed according to predetermined criteria for charting, procedures in periodic health examination, quality of medical care and use of indicator drugs. Generally the scores were significantly higher for CFPC members with residency training in family medicine than for those in the other groups, nonmembers having the lowest scores. Patient questionnaires indicated no difference in satisfaction with specific aspects of care between the four groups. Self-selection into residency training and CFPC membership may account for some of the results; nevertheless, the findings support the contention that residency training in family medicine should be mandatory for family physicians. PMID:2706590

  11. Resident Health Advocates in Public Housing Family Developments

    PubMed Central

    Bowen, Deborah J; Bhosrekar, Sarah Gees; Rorie, Jo-Anna; Goodman, Rachel; Thomas, Gerry; Maxwell, Nancy Irwin; Smith, Eugenia

    2015-01-01

    Translation of research to practice often needs intermediaries to help the process occur. Our Prevention Research Center has identified a total of 89 residents of public housing in the last 11 years who have been working in the Resident Health Advocate (RHA) program to engage residents in improving their own and other residents’ health status, by becoming trained in skills needed by Community Health Workers. Future directions include training for teens to become Teen RHAs and further integration of our RHA program with changes in the health care system and in the roles of community health workers in general. PMID:25739061

  12. Caring for Caregivers of People Living with HIV in the Family: A Response to the HIV Pandemic from Two Urban Slum Communities in Pune, India

    PubMed Central

    Kohli, Rewa; Purohit, Vidula; Karve, Latika; Bhalerao, Vinod; Karvande, Shilpa; Rangan, Sheela; Reddy, Srikanth; Paranjape, Ramesh; Sahay, Seema

    2012-01-01

    Introduction In low resource settings, the vast majority of ‘Person/people Living with HIV’ (PLHIV/s) and inadequate healthcare delivery systems to meet their treatment and care needs, caregivers play a vital role. Home based caregivers are often unrecognized with limited AIDS policies and programs focusing on them. We explored the perceptions and norms regarding care being provided by family caregivers of PLHIVs in India. Methodology A community based qualitative study to understand the issues pertaining to home based care for PLHIV was conducted in urban settings of Pune city, in Maharashtra, India. Eight Focus Group Discussions (FGDs) among men, women and peer educators were carried out. A total of 44 in-depth Interviews (IDIs) with PLHIVs (20) and their caregivers (24), were conducted using separate guides respectively. Data was analyzed thematically. Results Home based care was perceived as economically viable option available for PLHIVs. ‘Care’ comprised of emotional, adherence, nursing and financial support to PLHIV. Home based care was preferred over hospital based care as it ensured confidentiality and patient care without hampering routine work at home. Women emerged as more vital primary caregivers compared to men. Home based care for men was almost unconditional while women had no such support. The natal family of women also abandoned. Their marital families seemed to provide support. Caregivers voiced the need for respite care and training. Discussion Gender related stigma and discrimination existed irrespective of women being the primary family caregivers. The support from marital families indicates a need to explore care and support issues at natal and marital homes of the women living with HIV respectively. Home based care training and respite care for the caregivers is recommended. Gender sensitive interventions addressing gender inequity and HIV related stigma should be modeled while designing interventions for PLHIVs and their family

  13. [Voluntary help in dementia - predictors for utilisation and expected quality from a family caregiver's point of view].

    PubMed

    Grässel, E; Luttenberger, K; Römer, H; Donath, C

    2010-09-01

    Although support services are considered cost-effective in the relief of care-giving family members of dementia patients, there has been little research to date on the predictors of use and quality expectations. These two questions are examined for the first time based on cross-sectional data of 404 care-giving family members, users and non-users of voluntary help services. Quantitative data are evaluated using binary logistical regression analysis, qualitative data using content analysis. The rating of how helpful the use of a voluntary help service is in the personal situation was found to be the only significant predictor of use. With respect to quality, it is most important that the persons giving support be punctual and well-trained. To increase the rate of use, care-giving family members must be convinced of the relevant benefits of using a voluntary help service. In addition, attention must be paid to the professional organization and training of voluntary helpers.

  14. Dyadic associations between cancer-related stress and fruit and vegetable consumption among colorectal cancer patients and their family caregivers.

    PubMed

    Shaffer, Kelly M; Kim, Youngmee; Llabre, Maria M; Carver, Charles S

    2016-02-01

    This study examined how stress from cancer affects fruit and vegetable consumption (FVC) in cancer patients and their family caregivers during the year following diagnosis. Colorectal cancer patients and their caregivers (92 dyads) completed questionnaires at two (T1), six (T2), and 12 months post-diagnosis (T3). Individuals reported perceived cancer-related stress (CRS) at T1 and days of adequate FVC at T1 through T3. Both patients and caregivers reported inadequate FVC during the first year post-diagnosis. Latent growth modeling with actor-partner interdependence modeling revealed that, at T1, one's own greater CRS was associated with one's partner having fewer concurrent days of adequate FVC (ps = .01). Patients' greater CRS predicted their own more pronounced rebound pattern in FVC (p = .01); both patients' and caregivers' CRS marginally predicted their partners' change in FVC (p = .09). Findings suggest that perceived stress from cancer hinders FVC around the diagnosis, but motivates positive dietary changes by the end of the first year.

  15. A Model for Reintegrating Couples and Family Therapy Training in Psychiatric Residency Programs

    ERIC Educational Resources Information Center

    Rait, Douglas; Glick, Ira

    2008-01-01

    Objective: The authors propose a family-systems training model for general residency training programs in psychiatry based on the couples and family therapy training program in Stanford's Department of Psychiatry and Behavioral Sciences. Methods: The authors review key elements in couples and family therapy training. Examples are drawn from the…

  16. Family Support in Nursing Homes Serving Residents with a Mental Health History

    ERIC Educational Resources Information Center

    Frahm, Kathryn; Gammonley, Denise; Zhang, Ning Jackie; Paek, Seung Chun

    2010-01-01

    Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were…

  17. Quality of Life of Families with Children Who Have Severe Developmental Disabilities: A Comparison Based on Child Residence

    ERIC Educational Resources Information Center

    McFelea, Joni Taylor; Raver, Sharon

    2012-01-01

    This study measured the quality of life of two groups of families with children who had severe developmental disabilities-families whose child lived at home and families whose child lived in a residential facility. Participants were 54 primary caregivers of children who had severe intellectual disabilities and who lacked the ability to both…

  18. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the WHO World Mental Health (WMH) Surveys

    PubMed Central

    Shahly, V.; Chatterji, S.; Gruber, M. J.; Al-Hamzawi, A.; Alonso, J.; Andrade, L. H.; Angermeyer, M. C.; Bruffaerts, R.; Bunting, B.; Caldas-de-Almeida, J. M.; de Girolamo, G.; de Jonge, P.; Florescu, S.; Gureje, O.; Haro, J. M.; Hinkov, H. R.; Hu, C.; Karam, E. G.; Lépine, J.-P.; Levinson, D.; Medina-Mora, M. E.; Posada-Villa, J.; Sampson, N. A.; Trivedi, J.K.; Viana, M. C.; Kessler, R. C.

    2014-01-01

    Background Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiologic research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Methods Cross-sectional community surveys in 20 countries asked 13,892 respondents ages 50+ about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly-defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status, and type of condition. Results Among the 26.9-42.5% respondents in high, upper-middle, and low/lower-middle income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4% money, while 24.4-30.6% felt distress and 6.4-21.7% embarrassment. Mean caregiving hours/week given any was 16.6-23.6 (169.9-205.8 hours/week/100 people ages 50+). Burden in low/lower-middle income countries was 2-3-fold higher than in higher income countries, with financial burden given any averaging 14.3% of median family income in high, 17.7% in upper-middle, and 39.8% in low/lower-middle income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. Conclusions Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low/lower-middle income countries. PMID:22877824

  19. A mixed methods study of hope, transitions, and quality of life in family caregivers of persons with Alzheimer's disease

    PubMed Central

    2011-01-01

    Background Several research studies have reported the poor quality of life of family caregivers of persons with Alzheimer's disease (AD). However, factors that influence their quality of life have not been clearly defined. The purpose of this study was to examine factors associated with the quality of life of these caregivers such as demographic variables, their transition experience, and hope. A secondary aim was to explore the transition experience of family caregivers of persons with AD. Methods A cross-sectional triangulation data transformation model mixed method design (Quant +Qual) was utilized to address the purpose of the study. Eighty family caregivers of persons with AD completed a survey with quantitative measures [demographic variables, Herth Hope Index (HHI-hope), World Health Organization Quality of Life -BREF (WHOQOL-BREF)] and a qualitative survey about their transitions experience. The qualitative data (transition open ended- survey) was converted to quantitative data using content analysis. Variables significant at the p < 0.10 level in the univariate analysis were entered in the multivariate generalized linear model used to determine significant factors associated with quality of life. Results Subjects with higher hope scores (p < 0.0001) (Factor 1: temporality and future-cognitive-temporary dimension of hope) and who dealt with their transitions by actively seeking out knowledge and assistance (p = 0.02) had higher overall quality of life scores. HHI scores were associated with overall quality of life and for each of the four quality of life domains (physical psychosocial, relationships, and environment). Conclusions Hope played a significant role in the subjects' perceptions of overall quality of life as well as the 4 quality of life domains. This underscores the need to develop ways to foster hope in family caregivers. Moreover, the active engagement of families in seeking information and help, as a way to deal with their transitions

  20. Breadwinner and caregiver: a cross-sectional analysis of children's and emerging adults' visions of their future family roles.

    PubMed

    Fulcher, Megan; Coyle, Emily F

    2011-06-01

    Participants were 150 school-age boys and girls, 58 high school students, and 145 university students drawn from communities in the Southeastern United States. In this cross-sectional study, family role attitudes and expectations were examined across development. Parental work traditionality (occupational prestige and traditionality, and employed hours) predicted daughters' social role attitudes and plans for future family roles, such that daughters' envisioned families resembled that of their parents. Sons' and daughters' own attitudes about adult family roles predicted their plans to work or stay home with their future children; however, mothers' work traditionality predicted daughters' future plans over and above daughters' own attitudes. The only exception to this was in the case of university daughters, where university women's attitudes about social roles fully mediated this relationship. It may be that, as young women approach adulthood and the formation of families, they adjust their vision of their future self to match more closely their own attitudes about the caregiving role.

  1. Cultural aspects within caregiver interactions of ultra-orthodox Jewish women and their family members with mental illness.

    PubMed

    Weiss, Penina; Shor, Ron; Hadas-Lidor, Naomi

    2013-10-01

    The role of cultural dynamics and norms within families of persons with mental illness has been an underexplored subject, although the familial context has been recognized as influential. This subject was studied with 24 ultra-Orthodox Jewish mothers of persons with mental illness who live in a relatively closed religious community. While participating in the Keshet educational program designed for family caregivers in mental health, they wrote Meaningful Interactional Life Episodes that involved a dialogue exchange in their lives. Qualitative analysis of 50 episodes illuminates the significant role that religious and cultural norms have in the perceptions of what are considered stressors and the dynamics in these families surrounding these stressors. The necessity and value of incorporating cultural competence into family educational programs and interventions is emphasized, as this may contribute to the potential use and success of mental health service models within a population that essentially underutilizes these services.

  2. A comparative study of resident, family, and administrator expectations for service quality in nursing homes.

    PubMed

    Duffy, J A; Duffy, M; Kilbourne, W E

    2001-01-01

    This article compares the service quality expectations of residents, family, and administrators within a long-term-care context. Expectations for service quality are measured using the SERVQUAL scale. The results support the reliability of the SERVQUAL instrument for nursing home residents. Resident expectations were significantly different from administrators' expectations on all dimensions of quality. The findings are interpreted in terms of expectation formation and the nature of service encounters.

  3. A comparative study of resident, family, and administrator expectations for service quality in nursing homes.

    PubMed

    Duffy, J A; Duffy, M; Kilbourne, W E

    2001-01-01

    This article compares the service quality expectations of residents, family, and administrators within a long-term-care context. Expectations for service quality are measured using the SERVQUAL scale. The results support the reliability of the SERVQUAL instrument for nursing home residents. Resident expectations were significantly different from administrators' expectations on all dimensions of quality. The findings are interpreted in terms of expectation formation and the nature of service encounters. PMID:11482179

  4. 2. VIEW OF FAMILY RESIDENCE (FEATURE B10) FACING SOUTHWEST. PHOTO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. VIEW OF FAMILY RESIDENCE (FEATURE B-10) FACING SOUTHWEST. PHOTO LOOKING UP THE ROAD STABLE (FEATURE B-14). - Nevada Lucky Tiger Mill & Mine, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  5. Qualification test procedures and results for Honeywell solar collector subsystem, single-family residence

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The test procedures and results in qualifying the Honeywell single family residence solar collector subsystem are presented. Testing was done in the following areas: pressure, service loads, hail, solar degradation, pollutants, thermal degradation, and outgassing.

  6. Multi-Source Evaluation of Interpersonal and Communication Skills of Family Medicine Residents

    ERIC Educational Resources Information Center

    Leung, Kai-Kuen; Wang, Wei-Dan; Chen, Yen-Yuan

    2012-01-01

    There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and…

  7. A National Survey of Procedural Skill Requirements in Family Practice Residency Programs.

    ERIC Educational Resources Information Center

    Tenore, Josie L.; Sharp, Lisa K.; Lipsky, Martin S.

    2001-01-01

    Surveyed the use and composition of required procedure lists in U.S. family practice residency programs. Although a majority of respondents reported use of a required procedure list, programs differed greatly in terms of required procedures, and few defined how to evaluate the technical competency of their residents. (EV)

  8. Acting as Standardized Patients Enhances Family Medicine Residents' Self-Reported Skills in Palliative Care

    ERIC Educational Resources Information Center

    Sittikariyakul, Pat; Jaturapatporn, Darin; Kirshen, A. J.

    2015-01-01

    Recent publications have confirmed the use of standardized patients (SPs) in improving clinical skills and enhancing competency. Little research has studied the benefits residents may themselves gain in palliative care playing the role of SPs. Nineteen Family Medicine residents were recruited as standardized patients (FMR-SPs) for a mandatory…

  9. Reintegrating Family Therapy Training in Psychiatric Residency Programs: Making the Case

    ERIC Educational Resources Information Center

    Rait, Douglas; Glick, Ira

    2008-01-01

    Objective: Given the marginalization of couples and family therapy in psychiatric residency programs over the past two decades, the authors propose a rationale for the reintegration of these important psychosocial treatments into the mainstream of general psychiatric residency education. Methods: After reviewing recent trends in the field that…

  10. Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

    ERIC Educational Resources Information Center

    Silk, Hugh; Shields, Sara

    2012-01-01

    Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

  11. The relationship between treatment attendance, adherence, and outcome in a caregiver-mediated intervention for low-resourced families of young children with autism spectrum disorder.

    PubMed

    Carr, Themba; Shih, Wendy; Lawton, Kathy; Lord, Catherine; King, Bryan; Kasari, Connie

    2016-08-01

    Rates of participation in intervention research have not been extensively studied within autism spectrum disorder. Such research is important given the benefit of early intervention on long-term prognosis for children with autism spectrum disorder. The goals of this study were to examine how family demographic factors predicted treatment attendance and adherence in a caregiver-mediated randomized controlled trial targeting core deficits of autism spectrum disorder, and whether treatment attendance and adherence predicted outcome. In all, 147 caregiver-child dyads from a low-resourced population were randomized to in-home caregiver-mediated module or group-based caregiver education module treatment. Treatment attendance, adherence, and outcome (time spent in joint engagement) were the primary outcome variables. The majority of families who entered treatment (N = 87) maintained good attendance. Attendance was significantly predicted by socioeconomic status, site, and treatment condition. Families in caregiver-mediated module reported lower levels of treatment adherence, which was significantly predicted by site, condition, caregiver stress, and child nonverbal intelligence quotient. Dyads in caregiver-mediated module had significantly longer interactions of joint engagement, which was significantly predicted by an interaction between treatment attendance and condition. Overall, the results from this study stress the importance of considering demographic variables in research design when considering barriers to treatment attendance and adherence.

  12. Emergence of Yalom's therapeutic factors in a peer-led, asynchronous, online support group for family caregivers.

    PubMed

    Diefenbeck, Cynthia A; Klemm, Paula R; Hayes, Evelyn R

    2014-01-01

    Support groups fill a critical void in the health care system, harnessing the power of shared experiences to provide support to group members. Likewise, family caregivers fill a void in the health care system, providing billions in unpaid care to the chronically ill. Caregiver support groups offer an opportunity for alleviating the psychological burden of caregiving. The power of any group, including a support group, to foster psychological well-being lies in its ability to cultivate Yalom's therapeutic factors. Gaps in the literature remain regarding the ability of non-prototypical groups to promote therapeutic mechanisms of change. The purpose of this study was to determine if and when Yalom's therapeutic group factors emerged in a peer-led support group delivered in an asynchronous, online format. Qualitative content analysis utilizing deductive category application was employed. Participants' responses were coded and frequency counts were conducted. Results revealed that 9 of 11 therapeutic factors emerged over the course of the group, with Group Cohesiveness, Catharsis, Imparting of Information, and Universality occurring most often. Several factors, including Interpersonal Learning, Corrective Recapitulation of the Primary Family Group, Imitative Behavior, and Development of Socializing Techniques were absent or virtually absent, likely due to the peer-led format of the group. Progression of therapeutic factors over the course of the group is presented. Findings demonstrate the presence of a variety of Yalom's therapeutic factors in an asynchronous, peer-led online support group. PMID:24350748

  13. Emergence of Yalom's therapeutic factors in a peer-led, asynchronous, online support group for family caregivers.

    PubMed

    Diefenbeck, Cynthia A; Klemm, Paula R; Hayes, Evelyn R

    2014-01-01

    Support groups fill a critical void in the health care system, harnessing the power of shared experiences to provide support to group members. Likewise, family caregivers fill a void in the health care system, providing billions in unpaid care to the chronically ill. Caregiver support groups offer an opportunity for alleviating the psychological burden of caregiving. The power of any group, including a support group, to foster psychological well-being lies in its ability to cultivate Yalom's therapeutic factors. Gaps in the literature remain regarding the ability of non-prototypical groups to promote therapeutic mechanisms of change. The purpose of this study was to determine if and when Yalom's therapeutic group factors emerged in a peer-led support group delivered in an asynchronous, online format. Qualitative content analysis utilizing deductive category application was employed. Participants' responses were coded and frequency counts were conducted. Results revealed that 9 of 11 therapeutic factors emerged over the course of the group, with Group Cohesiveness, Catharsis, Imparting of Information, and Universality occurring most often. Several factors, including Interpersonal Learning, Corrective Recapitulation of the Primary Family Group, Imitative Behavior, and Development of Socializing Techniques were absent or virtually absent, likely due to the peer-led format of the group. Progression of therapeutic factors over the course of the group is presented. Findings demonstrate the presence of a variety of Yalom's therapeutic factors in an asynchronous, peer-led online support group.

  14. TRAJECTORIES OF ANXIETY IN ONCOLOGY PATIENTS AND FAMILY CAREGIVERS DURING AND AFTER RADIATION THERAPY

    PubMed Central

    Dunn, Laura B.; Aouizerat, Bradley E.; Cooper, Bruce A.; Dodd, Marylin; Lee, Kathryn; West, Claudia; Paul, Steven M.; Wara, William; Swift, Patrick; Miaskowski, Christine

    2011-01-01

    Purpose Anxiety is common in patients undergoing radiation therapy (RT) and in their family caregivers (FCs). Little is known about individual differences in anxiety trajectories during and after RT. This study aimed to identify distinct latent classes of oncology patients and their FCs based on self-reported anxiety symptoms from the beginning to four months after the completion of RT. Method Using growth mixture modeling (GMM), longitudinal changes in Spielberger State Anxiety Inventory (STAI-S) scores among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 FCs were evaluated to determine distinct anxiety symptom profiles. STAI-S scores were assessed just prior to, throughout the course of, and for four months following RT (total of 7 assessments). Baseline trait anxiety and depressive symptoms (during and after RT) were also assessed. Results The GMM analysis identified three latent classes of oncology patients and FCs with distinct trajectories of state anxiety: Low Stable (n=93, 36.9%), Intermediate Decelerating (n=82, 32.5%), and High (n=77, 30.6%) classes. Younger participants, women, ethnic minorities, and those with children at home were more likely to be classified in the High anxiety class. Higher levels of trait anxiety and depressive symptoms, at the initiation of RT, were associated with being in the High anxiety class. Conclusions Subgroups of patients and FCs with high, intermediate, and low mean levels of anxiety during and after RT were identified with GMM. Additional research is needed to better understand the heterogeneity of symptom experiences as well as comorbid symptoms in patients and FCs. PMID:21324418

  15. Cytokine Gene Variation is Associated with Depressive Symptom Trajectories in Oncology Patients and Family Caregivers

    PubMed Central

    Dunn, Laura B.; Aouizerat, Bradley E.; Langford, Dale J.; Cooper, Bruce A.; Dhruva, Anand; Cataldo, Janine K.; Baggott, Christina R.; Merriman, John D.; Dodd, Marylin; West, Claudia; Paul, Steven M.; Miaskowski, Christine

    2014-01-01

    Purpose Depressive symptoms are common in cancer patients and their family caregivers (FCs). While these symptoms are characterized by substantial interindividual variability, the factors that predict this variability remain largely unknown. This study sought to confirm latent classes of oncology patients and FCs with distinct depressive symptom trajectories and to examine differences in phenotypic and genotypic characteristics among these classes. Method Among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM) was used to identify latent classes of individuals based on Center for Epidemiological Studies-Depression (CES-D) scores obtained prior to, during, and for four months following completion of radiation therapy. One hundred four single nucleotide polymorphisms (SNPs) and haplotypes in 15 candidate cytokine genes were interrogated for differences between the two largest latent classes. Multivariate logistic regression analyses assessed effects of phenotypic and genotypic characteristics on class membership. Results Four latent classes were confirmed: Resilient (56.3%), Subsyndromal (32.5%), Delayed (5.2%), and Peak (6.0%). Participants who were younger, female, non-white, and who reported higher baseline trait and state anxiety were more likely to be in the Subsyndromal, Delayed, or Peak groups. Variation in three cytokine genes (i.e., interleukin 1 receptor 2 [IL1R2], IL10, tumor necrosis factor alpha [TNFA]), age,and performance status predicted membership in the Resilient versus Subsyndromal classes. Conclusions Findings confirm the four latent classes of depressive symptom trajectories previously identified in a sample of breast cancer patients. Variations in cytokine genes may influence variability in depressive symptom trajectories. PMID:23187335

  16. Implementation and effects of an individual stress management intervention for family caregivers of an elderly relative living at home: a mixed research design.

    PubMed

    Ducharme, Francine; Lebel, Paule; Lachance, Lise; Trudeau, Denise

    2006-10-01

    The purpose of this project was to evaluate the implementation and effects of a stress management intervention for family caregivers of elderly persons. The intervention was implemented through an action research design with the collaboration of case managers working in community health centers. A total of 81 caregivers participated in the study. The quasi-experimental design used to test the effects of the intervention showed significant effects on perceived challenge associated with caregiver role, control by self, use of social support, and use of problem solving. Qualitative data demonstrate caregiver empowerment with respect to the caregiving role. This study illustrates the relevance of using a mixed research design in order to provide evidence for changes in practice.

  17. A Randomized Controlled Trial of Clinician-Supported Problem-Solving Bibliotherapy for Family Caregivers of People With First-Episode Psychosis

    PubMed Central

    Chien, Wai Tong; Thompson, David R.; Lubman, Dan I.; McCann, Terence V.

    2016-01-01

    Family interventions for first-episode psychosis (FEP) are an integral component of treatment, with positive effects mainly on patients’ mental state and relapse rate. However, comparatively little attention has been paid to the effects of family interventions on caregivers’ stress coping and well-being, especially in non-Western countries. We aimed to test the effects of a 5-month clinician-supported problem-solving bibliotherapy (CSPSB) for Chinese family caregivers of people with FEP in improving family burden and carers’ problem-solving and caregiving experience, and in reducing psychotic symptoms and duration of re-hospitalizations, compared with those only received usual outpatient family support (UOFS). A randomized controlled trial was conducted across 2 early psychosis clinics in Hong Kong, where there might be inadequate usual family support services for FEP patients. A total of 116 caregivers were randomly selected, and after baseline measurement, randomly assigned to the CSPSB or UOFS. They were also assessed at 1-week and 6- and 12-month post-intervention. Intention-to-treat analyses were applied and indicated that the CSPSB group reported significantly greater improvements in family burden and caregiving experience, and reductions in severity of psychotic symptoms and duration of re-hospitalizations, than the UOFS group at 6- and 12-month follow-up. CSPSB produces moderate long-term benefits to caregivers and FEP patients, and is a low-cost adjunct to UOFS. PMID:27147450

  18. "La CLAve" to Increase Psychosis Literacy of Spanish-Speaking Community Residents and Family Caregivers

    ERIC Educational Resources Information Center

    Lopez, Steven R.; Lara, Ma. Del Carmen; Kopelowicz, Alex; Solano, Susana; Foncerrada, Hector; Aguilera, Adrian

    2009-01-01

    The authors developed and tested a 35-min psychoeducational program with the goal of increasing Spanish-speaking persons' literacy of psychosis. The program uses popular cultural icons derived from music, art, and videos, as well as a mnemonic device--La CLAve (The Clue)--to increase (a) knowledge of psychosis, (b) efficacy beliefs that one can…

  19. New family medicine residency training programme: Residents’ perspectives from the University of Botswana

    PubMed Central

    Tshitenge, Stephane; Setlhare, Vincent; Tsima, Billy; Adewale, Ganiyu; Parsons, Luise

    2016-01-01

    Background Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. Aims This study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. Methods A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Results Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be. Conclusions Despite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation. PMID:27796117

  20. New family medicine residency training programme: Residents’ perspectives from the University of Botswana

    PubMed Central

    Tshitenge, Stephane; Setlhare, Vincent; Tsima, Billy; Adewale, Ganiyu; Parsons, Luise

    2016-01-01

    Background Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. Aims This study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. Methods A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Results Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be. Conclusions Despite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation.

  1. Re-focusing the Gender Lens: Caregiving Women, Family Roles and HIV/AIDS Vulnerability in Lesotho

    PubMed Central

    Harrison, Abigail; Short, Susan E.; Tuoane-Nkhasi, Maletela

    2013-01-01

    Gender and HIV risk have been widely examined in southern Africa, generally with a focus on dynamics within sexual relationships. Yet the social construction of women’s lives reflects their broader engagement with a gendered social system, which influences both individual-level risks and social and economic vulnerabilities to HIV/AIDS. Using qualitative data from Lesotho, we examine women’s lived experiences of gender, family and HIV/AIDS through three domains: 1) marriage; 2) kinship and social motherhood, and 3) multigenerational dynamics. These data illustrate how women caregivers negotiate their roles as wives, mothers, and household heads, serving as the linchpins of a gendered family system that both affects, and is affected by, the HIV/AIDS epidemic. HIV/AIDS interventions are unlikely to succeed without attention to the larger context of women’s lives, namely their kinship, caregiving, and family responsibilities, as it is the family and kinship system in which gender, economic vulnerability and HIV risk are embedded. PMID:23686152

  2. Psychological distress and mental health of Thai caregivers.

    PubMed

    Yiengprugsawan, Vasoontara; Seubsman S, Sam-Ang; Sleigh, Adrian C

    2012-08-01

    BACKGROUND: As the proportion of elderly people within a population increases there is an accompanying increase in the role of informal caregivers. Many studies on caregivers report negative health outcomes but very few have addressed positive aspects of caregiving. This study examines characteristics of Thai caregivers, the distribution of psychological distress and mental health among caregivers, and the association between caregiver status and psychological distress. METHODS: This report is based on an ongoing national cohort study of 60,569 Thai adults. Caregiving was common in the cohort, and in 2009 6.6% were full-time and 27.5% were part-time caregivers. Outcomes of the study were reported using an international standard Kessler 6 for psychological distress and a national Thai Mental Health Indicator. Determinants included age, sex, marital status, household income, work status and urban-rural residence. Frequency of social contacts was also included as explanatory variable. RESULTS: Among cohort members, 27.5% were part-time caregivers and 6.6% were full-time caregivers. Compared to non-caregivers, full-time caregivers tended to be older, to be married, more likely to be in the lowest household income group, to be unpaid family members, and to reside in rural areas. We noted the seeming contradiction that when compared to non-caregivers, the caregivers reported higher psychological distress but higher positive mental health (i.e., self-esteem and content with life), higher positive mental capacity (i.e., coping with crises), and higher positive mental quality (i.e., helping others). After adjusting for possible covariates, part-time and full-time caregivers were more likely to report high psychological distress (Adjusted Odds Ratios, AOR 1.33 and 1.78 among males and 1.32 and 1.45 among females). Less contact with colleagues was associated with high psychological distress both in males and females (AOR 1.36 and 1.33). Less contact with friends was also

  3. Cultural Competency Training in a New-Start Rural/Frontier Family Practice Residency Program: A Cultural Immersion Integrative Model.

    ERIC Educational Resources Information Center

    Doty, Barbara J.; Pastorino, Ray

    The Alaska Family Practice Residency (AFPR) is a graduate medical education training program for family physicians headed for rural and remote practice sites. Located in Anchorage and affiliated with the University of Washington family practice residency network, the program has an integrated curriculum aimed at preparing family physicians to…

  4. The effect of altruism on the spending behavior of elderly caregivers of family members with HIV/AIDS in South African townships.

    PubMed

    Klemz, Bruce R; Boshoff, Christo; Mazibuko, Noxolo-Eileen; Asquith, Jo Ann

    2015-01-01

    HIV/AIDS has led to an enormous demand for health care in the developing world and many governments have opted to capitalize on altruistic home-based caregivers. These caregivers are mainly poor older women and their financial survival is critically important to themselves and their families. We found that as the patient's illness progressed: (a) the altruistic cultural norm "ubuntu" led the caregiver to increase spending and (b) the social pressure (sanction) of stigma led to a very dramatic drop in direct interpersonal assistance. The impact on their spending, health care, and the related public policies are discussed.

  5. Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study

    PubMed Central

    Awadalla, Abdel W; Ohaeri, Jude U; Gholoum, Abdullah; Khalid, Ahmed OA; Hamad, Hussein MA; Jacob, Anila

    2007-01-01

    Background Quality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care. Methods Responses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics. Results The cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age. Conclusion Cancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if

  6. Comparison of caregivers', residents', and community-dwelling spouses' opinions about expressing sexuality in an institutional setting.

    PubMed

    Gibson, M C; Bol, N; Woodbury, M G; Beaton, C; Janke, C

    1999-04-01

    Opinions regarding the appropriateness of elderly residents' sexual behaviors in a chronic care hospital and how to respond to inappropriate behaviors were surveyed. Study participation was open to all staff (N = 1,205), eligible residents (N = 182) and community-dwelling spouses (N = 103). Participation rates were 40% (residents), 42% (spouses), 34% (nursing staff), 50% (allied health staff), and 22% (support staff). Staff completed the questionnaire independently, while residents and spouses were offered self-completion or a structured interview. Almost all selected the interview. Residents and spouses were less tolerant than staff of residents' masturbating, engaging in sexual relationships, viewing sexual materials, and making sexual approaches to staff. Privacy was the primary determinant of appropriateness for behaviors for all groups. Staff and spouses were more likely to endorse counseling when behaviors were perceived as inappropriate than residents. Nurses endorsed counseling less frequently than allied health professionals and support staff. Nurses were more likely to have been approached sexually by a resident. Differences of opinion are interpreted in terms of cohort influences on values and contextual influences on behavior.

  7. Family or Caregiver Instability, Parental Attachment, and the Relationship to Juvenile Sex Offending.

    PubMed

    Felizzi, Marc V

    2015-01-01

    A violent or unstable home life-characterized by caregivers physically or sexually abusing children, physical violence in the home, homelessness, and other factors-and disrupted parental attachment are examined in this secondary data analysis for their possible relationship to juvenile sex offending. Parent or caregiver instability is measured by a demographic questionnaire administered to participants. Parental attachment is measured by the Inventory of Peer and Personal Attachment. The population included 502 adjudicated juvenile male sexual and nonsexual offenders in a Midwest state who responded to questionnaires in order to examine juvenile offending antecedents. The highest correlated parent or caregiver instability variables to juvenile sex offending status were multiple relocations or homelessness, children placed out of the home, slapping or punching in the home, and sexual abuse victimization. The quality of parental attachment had little impact on the respondents' offense status. PMID:26340072

  8. Literacy, Education, and Inequality: Assimilation and Resistance Narratives from Families Residing at a Homeless Shelter

    ERIC Educational Resources Information Center

    Jacobs, Mary M.

    2014-01-01

    In this article, I draw on data from my qualitative dissertation study of the literacy practices of five families who resided in a homeless shelter to complicate the relationship between literacy, education, and inequality. Homelessness is examined through the lens of sponsorship to understand the differential access the families have to powerful…

  9. Relative Preservation of Advanced Activities in Daily Living among Patients with Mild-to-Moderate Dementia in the Community and Overview of Support Provided by Family Caregivers

    PubMed Central

    Takechi, Hajime; Kokuryu, Atsuko; Kubota, Tomoko; Yamada, Hiroko

    2012-01-01

    Little is known about the extent to which advanced activities of daily living among patients with dementia are preserved and how family caregivers of these patients support them in the community. In this cross-sectional assessment of pairs of patients with dementia and their family caregivers, we evaluated basic, instrumental, and advanced activities of daily living by comparing past and present status observed by caregivers with subjective estimations by patients with dementia. We also asked about ways in which support was provided by family caregivers. Thirty-nine pairs of patients with dementia and caregivers who presented to our memory clinic were interviewed. The mean age of patients with dementia was 75.3 ± 7.0 years, and Mini-Mental State Examination scores were 22.3 ± 3.4. We found relative preservation of advanced activities of daily living compared with instrumental activities of daily living. Caregivers provided instrumental, informational, and reminding support to patients with dementia. These findings may reinforce the concept of person-centered support of patients with dementia in the community. PMID:22811947

  10. Filial piety and parental responsibility: an interpretive phenomenological study of family caregiving for a person with mental illness among Korean immigrants

    PubMed Central

    2012-01-01

    Background Despite the strong influence of culture on family involvement in disease management, few studies have examined how immigrant families care for persons with mental illness. The purpose of this study was to examine how immigrant families organize their world to care for a mentally ill person in the United States. The current analysis focused on how Confucian notions of filial piety and parental obligation shape caregiving in Korean immigrant families. Methods Participants in this interpretive phenomenological study were comprised of six Korean immigrant women caring for a family member with mental illness. Participants provided narratives that illustrate challenges and opportunities in caring for their mentally ill family member. Results Three family caregiving patterns were discerned. Insulating from the outside world describes a family’s effort to accept a member's illness and to manage it within the family. Prioritizing education over well-being concerns parental commitment to the Confucian priority of educating one’s children. Reciprocating the sacrifice describes how a family adapts and enacts filial piety. Conclusion The findings of this study warrant further study to examine the influence of Confucianism among Korean American families. The three patterns of caregiving are strongly aligned with Confucian notion of family and family engagement. These patterns may help health providers to anticipate the needs of and provide individualized, culturally appropriate mental health care for patients with mental illness and their families of Korean origin. PMID:23256876

  11. Appraisal of the communication skills of residents in the Family Medicine Program in Central Saudi Arabia

    PubMed Central

    Alsaad, Saad M.; Alshammari, Sulaiman A.; Almogbel, Turki A.

    2016-01-01

    Objectives: To assess patients’ perceptions of the communication skills of family medicine residents. Methods: This is a cross-sectional study. Data were collected from patients, seeing 23 residents from 4 family medicine residency programs in Riyadh, Kingdom of Saudi Arabia namely, King Khalid University Hospital, Riyadh Military Hospital, Security Forces Hospital, and King Abdul-Aziz Medical City. The translated version of the Communication Assessment Tool (CAT) was used. Data were collected during January and February 2013. Results: A total of 350 patients completed the CAT, with an 87.5% response rate. Patients rated each resident differently, but the mean percentage of items, which residents rated as excellent was 71%. In general, male residents were rated higher 72.8 ± 27.2 than female residents 67.8 ± 32.2 with a significant difference; (p<0.005). Also, significant differences were found based on the gender of the residents, when each item of the CAT was compared. Comparing training centers, there were no significant differences found in the overall percentage of items rated as excellent or among items of the CAT. Conclusion: The study identified areas of strength and weaknesses that need to be addressed to improve communication skills of physicians. PMID:27381544

  12. 3 CFR 8448 - Proclamation 8448 of October 30, 2009. National Family Caregivers Month, 2009

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... caregivers selflessly devote their time and energy to the well-being of those they look after. During... from work without fear of losing their job or their income. We all have roles to play, including employers, by providing paid leave, flexible work arrangements, and other programs when feasible, to...

  13. The Caregiving Context in Institution-Reared and Family-Reared Infants and Toddlers in Romania

    ERIC Educational Resources Information Center

    Smyke, Anna T.; Koga, Sebastian F.; Johnson, Dana E.; Fox, Nathan A.; Marshall, Peter J.; Nelson, Charles A.; Zeanah, Charles H.

    2007-01-01

    Background: We assess individual differences in the caregiving environments of young children being raised in institutions in Romania in relation to developmental characteristics such as physical growth, cognitive development, emotional expression, and problem and competence behaviors. Method: Videotaped observations of the child and favorite…

  14. Health Profile of Aging Family Caregivers Supporting Adults with Intellectual and Developmental Disabilities at Home

    ERIC Educational Resources Information Center

    Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

    2009-01-01

    The health status of 206 female caregivers supporting adults with intellectual and developmental disabilities at home was investigated using objective (i.e., presence of chronic health conditions and activity limitations) and subjective (i.e., self-perceived health status) health measures compared with those of women in the general population in 2…

  15. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... training concerning the following core competencies: (1) Medication management; (2) Vital signs and pain... beneficiary travel under 38 CFR part 70. Respite care will be provided during the period of initial caregiver...; (7) Communication and cognition skills; (8) Behavior management skills; (9) Skin care; and...

  16. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... training concerning the following core competencies: (1) Medication management; (2) Vital signs and pain... beneficiary travel under 38 CFR part 70. Respite care will be provided during the period of initial caregiver...; (7) Communication and cognition skills; (8) Behavior management skills; (9) Skin care; and...

  17. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... training concerning the following core competencies: (1) Medication management; (2) Vital signs and pain... beneficiary travel under 38 CFR part 70. Respite care will be provided during the period of initial caregiver...; (7) Communication and cognition skills; (8) Behavior management skills; (9) Skin care; and...

  18. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... training concerning the following core competencies: (1) Medication management; (2) Vital signs and pain... beneficiary travel under 38 CFR part 70. Respite care will be provided during the period of initial caregiver...; (7) Communication and cognition skills; (8) Behavior management skills; (9) Skin care; and...

  19. The Impact of a Family Home-Learning Program on Levels of Parental/Caregiver Efficacy

    ERIC Educational Resources Information Center

    Morrison, Tomasine A.

    2009-01-01

    This study sought to determine if participation in a home education learning program would impact the perceived levels of parental self-efficacy of parents/caregivers who participate in the completion of home-learning assignments and increase their levels of home-learning involvement practices. Also, the study examined the relationship between the…

  20. Identity Transformation and Family Caregiving: Narratives of African American Teen Mothers

    ERIC Educational Resources Information Center

    Brubaker, Sarah Jane; Wright, Christie

    2006-01-01

    This article explores connections between informal caregiving and identity transformation as experienced by pregnant teens. Based on in-depth interviews with 51 African American teen mothers, the article examines teens' pregnancy narratives as an example of narrative repair, illuminating how attending to processes that connect one's identity to…

  1. Modeling the Social Determinants of Caregiver Burden among Families of Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    McManus, Beth M.; Carle, Adam; Acevedo-Garcia, Dolores; Ganz, Michael; Hauser-Cram, Penny; McCormick, Marie

    2011-01-01

    This study described predictors of caregiver burden among parents of children with developmental disabilities. The sample, obtained from the 2005-2006 National Survey of Children With Special Health Care Needs, included 12,225 children, aged 5 to 17 years, with a developmental disability. Structural equation modeling assessed the relationships…

  2. More caregiving, less working: caregiving roles and gender difference.

    PubMed

    Lee, Yeonjung; Tang, Fengyan

    2015-06-01

    This study examined the relationship of caregiving roles to labor force participation using the nationally representative data from the Health and Retirement Study. The sample was composed of men and women aged 50 to 61 years (N = 5,119). Caregiving roles included caregiving for spouse, parents, and grandchildren; a summary of three caregiving roles was used to indicate multiple caregiving roles. Bivariate analysis using chi-square and t tests and binary logistic regression models were applied. Results show that women caregivers for parents and/or grandchildren were less likely to be in the labor force than non-caregivers and that caregiving responsibility was not related to labor force participation for the sample of men. Findings have implication for supporting family caregivers, especially women, to balance work and caregiving commitments.

  3. Geriatric medicine training for family practice residents in the 21st century: a report from the Residency Assistance Program/Harfford Geriatrics Initiative.

    PubMed

    Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy

    2003-01-01

    Increasing the quality and quantity of geriatric medicine training for family practice residents is a particular challenge for community-based programs. With support from the John A. Hartford Foundation of New York City, the American Academy of Family Physicians (AAFP) implemented in 1995 a multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. This report summarizes the initial results of the regional geriatric medicine curriculum retreats for residency directors. The goals of the retreats were to build recognition among the residency directors of the skills that future family physicians will require to be successful providers of primary care to older adults and to allow the residency directors to identify and develop solutions to barriers to improving geriatric medicine training for residents. Forty-six program directors participated in the three retreats between February 2000 and February 2001. The participants represented 52 programs and rural tracks in all geographic regions, small and large programs, and urban and rural settings. The program directors developed a consensus on the geriatric medicine knowledge, skills, and attitudes that should be expected of all family practice residency graduates; developed a list of basic, required educational resources for each family practice residency program; and proposed solutions to common obstacles to successful curriculum development.

  4. What is Family-Centered Care for Nursing Home Residents With Advanced Dementia?

    PubMed Central

    Lopez, Ruth Palan; Mazor, Kathleen M.; Mitchell, Susan L.; Givens, Jane L.

    2014-01-01

    To understand family members’ perspectives on person- and family-centered end-of-life care provided to nursing home (NH) residents with advanced dementia, we conducted a qualitative follow-up interview with 16 respondents who had participated in an earlier prospective study, Choices, Attitudes, and Strategies for Care of Advance Dementia at End of Life (CASCADE). Family members of NH residents (N = 16) with advanced dementia participated in semistructured qualitative interviews that inquired about overall NH experience, communication, surrogate decision making, emotional reaction, and recommendations for improvement. Analysis identified 5 areas considered important by family members: (1) providing basic care; (2) ensuring safety and security; (3) creating a sense of belonging and attachment; (4) fostering self-esteem and self-efficacy; and (5) coming to terms with the experience. These themes can provide a framework for creating and testing strategies to meet the goal of person- and family-centered care. PMID:24085250

  5. A qualitative descriptive study on the alignment of care goals between older persons with multi-morbidities, their family physicians and informal caregivers

    PubMed Central

    2013-01-01

    Background Goal setting is a recommended approach in clinical care that can help individuals with multi-morbidities and their caregivers manage chronic conditions. In this paper, the types of goals that were important for older persons with multi-morbidities were explored from the perspectives of patients, their caregivers and physicians. Comparisons of goals were made across each patient, caregiver and physician triad to determine alignment. Methods The study was a qualitative descriptive study facilitated through semi-structured one-on-one interviews. The study took place between May and October 2012 at a Family Health Team located in Ontario, Canada. The sample included 28 family medicine patients, their informal caregivers and family physicians. Socio-demographic data were analyzed via descriptive statistics in SPSS Version 17. Open ended questions pertaining to patient goals of care were analyzed thematically using NVivo9. Themes were derived on patient care goals for each of the participant groups (patients, caregivers and family physicians). Following this, alignment of goals across each of the triads was examined. Goal alignment was defined as concurrence on at least one goal by all three parties in a particular triad (i.e., patient, caregiver and family physician). Results Just over half of the patients were male (56%); they had an average age of 82.3 years and 4.61 health conditions. Most of the caregivers were female (82%); and 61% were a spouse of the care recipient. At the aggregate level, common goals expressed among patients, caregivers and family physicians were the maintenance of functional independence of patients and the management of their symptoms or functional challenges. Despite these common goals at the aggregate level, little alignment of goals was found when looking across patient-caregiver and physician triads. Lack of alignment tended to occur when patients had unstable or declining functional or cognitive health; when safety threats

  6. [Grieving among relatives and caregivers].

    PubMed

    Pascual, Angel María; Santamaría, Juan Luis

    2009-11-01

    This article provides a definition and description of grief, its characteristics, and the current explanatory models of this phenomenon (the stage model, task model, constructivist model and dual process model). The authors argue that a state of mourning in advance is produced in the process of dementia as a result of significant relational loss before death and describe the risk factors for complicated grief in caregivers: overload, lack of personal and material resources, delegation of care, and complex feelings such as guilt. The need for healthcare organizations to provide professional caregivers with the appropriate means to help with grief and to develop their own measures to prevent burnout is stressed. These measures could include protocols that provide bereavement intervention with the family, the primary caregiver, other patients and/or residents and the professional caregiving team. Finally, losses in persons with dementia must be taken into consideration, avoiding phenomena such as silencing and overprotection and encouraging acceptance and emotional support of their pain so that organic and emotional complications do not occur.

  7. Evaluation of the educational technology "Caring for dependent people" by family caregivers in changes and transfers of patients and tube feeding 1

    PubMed Central

    Landeiro, Maria José Lumini; Peres, Heloísa Helena Ciqueto; Martins, Teresa Vieira

    2016-01-01

    ABSTRACT Objective: to assess the contributions of interactive educational technology "Caring for Dependent People" in the development of knowledge to family caregivers of dependent people in a household context and their satisfaction in its use. Method: quasi-experimental study, not randomized, of the before and after type, with a convenience sample of 65 family caregivers, from two Medicine services of a hospital in Porto, Portugal. The Control Group consisted of 33 family caregivers and the Experimental Group of 32, identified by consecutive sampling. The experimental group had access to educational technology at home. Data were collected by socio-demographic, satisfaction and evaluation of knowledge questionnaire, about how to feed by nasogastric tube, positioning and transferring the dependent person. The assessment in both groups had two moments: initial, during hospitalization and one month after discharge. Results: the experimental group had a larger increase in knowledge related to the use of the educational technology. In the control group the knowledge did not differ in the two evaluation time points. Conclusion: these results confirm the improvement of interactive educational technologies and in the training of family caregivers to care for dependents. This technology successfully met the technical quality and learning needs of caregivers, and was considered easy and stimulating. PMID:27556879

  8. “I wouldn’t look at it as stress”: Conceptualizations of Caregiver Stress among Low-Income Families of Children with Asthma

    PubMed Central

    Sampson, Natalie R.; Parker, Edith A.; Cheezum, Rebecca R.; Lewis, Toby C.; O’Toole, Ashley; Zuniga, Adriana; Patton, Jean; Robbins, Thomas G.; Keirns, Carla C.

    2014-01-01

    Low-income caregivers of children with asthma experience multiple stressors, likely worsening family health. As part of Community Action Against Asthma’s community-based participatory research partnership, researchers conducted 40 qualitative semi-structured interviews and quantitative surveys with low-income caregivers of children with asthma in Detroit, Michigan. Participants described daily childhood asthma experiences and completed scales including the Peds Quality of Life Family Impact Module and Zarit Burden Caregiver Scale. Quantitative scale findings suggested participants are moderately stressed or affected by their child’s illness. While there was some accordance between qualitative and quantitative findings, qualitative findings additionally captured many relevant life stressors, seemingly overlooked or conflated in scale responses. Many participants described asthma as part of childrearing, rather than as a stressor or burden. Findings encourage improvement of clinical, psychometric assessments used to measure and address stressors that shape health for many families with children with asthma. PMID:23377734

  9. "I wouldn't look at it as stress": conceptualizations of caregiver stress among low-income families of children with asthma.

    PubMed

    Sampson, Natalie R; Parker, Edith A; Cheezum, Rebecca R; Lewis, Toby C; O'Toole, Ashley; Zuniga, Adriana; Patton, Jean; Robbins, Thomas G; Keirns, Carla C

    2013-02-01

    Low-income caregivers of children with asthma experience multiple stressors, likely worsening family health. As part of Community Action Against Asthma's community-based participatory research partnership, researchers conducted 40 qualitative semi-structured interviews and quantitative surveys with low-income caregivers of children with asthma in Detroit, Michigan. Participants described daily childhood asthma experiences and completed scales including the Peds Quality of Life Family Impact Module and Zarit Burden Caregiver Scale. Quantitative scale findings suggested participants are moderately stressed or affected by their child's illness. While there was some accordance between qualitative and quantitative findings, qualitative findings additionally captured many relevant life stressors, seemingly overlooked or conflated in scale responses. Many participants described asthma as part of childrearing, rather than as a stressor or burden. Findings encourage improvement of clinical, psychometric assessments used to measure and address stressors that shape health for many families with children with asthma. PMID:23377734

  10. Advanced Practice Nursing: Meeting the Caregiving Challenges for Families of Persons with Frontotemporal Dementia

    PubMed Central

    Merrilees, Jennifer; Ketelle, Robin

    2010-01-01

    Frontotemporal dementia (FTD), once thought to be a rare cause for dementia, is now acknowledged to be the most common presenile (before age 65) cause of dementia (1). FTD is associated with profound changes in behavior, personality, emotions, and cognition. The purpose of this paper is to describe two cases of patients with FTD in order to illustrate salient aspects of the caregiving experience. Issues faced by caregivers are organized into 6 categories: diagnosis, behavioral symptoms, function, communication, long term management and care, and maintenance of the caregiver’s emotional and physical health. Examples of interventions directed by advanced practice nurses are described. We suggest that management of FTD requires expertise as scientific advances and discoveries about FTD continually change the landscape of care. PMID:20716977

  11. Spousal Caregiving in Late Mid-Life Versus Older Ages: Implications of Work and Family Obligations

    PubMed Central

    Lima, Julie C.; Allen, Susan M.; Goldscheider, Frances; Intrator, Orna

    2015-01-01

    Objectives This study examined life stage differences in the provision of care to spouses with functional impairment. Methods We examined 1218 married adults aged 52 and older from the 2000 wave of the Health and Retirement Study (HRS) who received impairment-related help with at least one activity of daily living. We examined the differential likelihood that spouses serve as primary caregiver and the hours of care provided by spousal primary caregivers by life stage. Results We found that late middle-aged care recipients were more likely than their older counterparts to receive the majority of their care from their spouse, but received fewer hours of spousal care, mostly when spouses worked full time. Competing demands of caring for children or parents did not affect the amount of care provided by a spouse. Discussion Late middle-aged adults with functional limitations are more likely than older groups to be married and cared for primarily by spouses; however they may be particularly vulnerable to unmet need for care. As the baby boom generation ages, retirement ages increase, and federal safety nets weaken, people with health problems at older ages may soon find themselves in the same caregiving predicament as those in late middle age. PMID:18689772

  12. Conversations about End of Life: Perspectives of Nursing Home Residents, Family, and Staff

    PubMed Central

    Hirschman, Karen B.; Madden, Connie

    2015-01-01

    Abstract Background: Care in nursing homes (NHs) often overlooks individual values and preferences. Residents' voices are critical to discussions about preferences, yet there remains limited research on conversations about the end of life (EOL) from the perspective of older adults who reside in NHs. Objective: The aim of this study was to describe the communication, content and process, related to EOL conversations among residents, family, and staff. Methods: We used semistructured interviews in this qualitative, descriptive study to describe conversations about EOL preferences. We examined participants' conversation, when it occurred, and what was discussed. We queried about barriers to and facilitators in discussing EOL care in the NH setting. We interviewed residents (n=16), family (n=12), and interdisciplinary staff (n=10) from four NHs. Results: The overarching theme—missed conversations—describes EOL-related communication. Residents, families, and staff rarely talked about EOL care preferences, nor did they pass along information about preferences or initiate conversations about EOL care with each other. Three categories explained missed conversations: inquiry (“No one asked”); assumptions (presence of an advance directive [AD], “They know me”); and conveying (lack of conveying information or wishes). Existing barriers and lacking facilitators resulted in missed opportunities to hold conversations about EOL preferences. Conclusions: Not all residents wanted to have conversations, but many wanted to be asked about their preferences. Missed conversations may adversely affect the quality of EOL care. Conversations with residents can be initiated by asking residents who they would like involved in the conversation and drawing upon the experience of others. PMID:25658608

  13. Cultural transition of international medical graduate residents into family practice in Canada

    PubMed Central

    Triscott, Jean A.C.; Waugh, Earle H.; Torti, Jacqueline M.I.; Barton, Martina

    2016-01-01

    Objectives To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. Methods This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Results Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths.  At the same time, IMG residents appeared to experience challenges in the areas of:  (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada’s health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning,  unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles.   Conclusions Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum.  IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning. PMID:27149322

  14. Impact of a family medicine resident wellness curriculum: a feasibility study

    PubMed Central

    Runyan, Christine; Savageau, Judith A.; Potts, Stacy; Weinreb, Linda

    2016-01-01

    Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction. PMID:27282276

  15. Resident and faculty perceptions of effective clinical teaching in family practice.

    PubMed

    Gjerde, C L; Coble, R J

    1982-02-01

    Increasing interest in clinical teaching has led to the realization that the unique subset of skills which characterizes effective clinical teaching needs to be identified. Such identification will lead to development of these skills and improvement in the quality of clinical teaching. Family practice faculty are vitally concerned with improving their clinical teaching skills, since clinical teaching is the core of education in family medicine and since many family physicians who become preceptors have had no formal training as teachers. In this investigation of effective clinical teaching behaviors, faculty and residents generally agree in their perceptions of the helpfulness of 58 clinical teaching behaviors. Neither group felt that emphasis on references and research is as important a factor in effective clinical teaching as are residents' active participation in the learning situation and positive preceptor attitudes toward teaching and residents. It was perceived that the ineffective clinical teacher has a negative attitude toward residents, is inaccessible, and lacks skills in providing feedback, while the effective clinical teacher has skills in two-way communication, creates an educational environment that facilitates learning, and provides constructive feedback to residents.

  16. "We Have No Rights, We Get No Help:" The Legal and Policy Dilemmas Facing Grandparent Caregivers

    ERIC Educational Resources Information Center

    Letiecq, Bethany L.; Bailey, Sandra J.; Porterfield, Fonda

    2008-01-01

    Guided by an ecological perspective on family policy, this qualitative study used family life history interviews to document the legal and policy dilemmas faced by 26 grandparent caregivers residing in Montana. Most grandparents (n = 18) were caring for their grandchildren in informal or private care arrangements. Findings revealed four legal or…

  17. Long Distance Caregiving

    MedlinePlus

    ... life, working women with their own major family responsibilities remain our primary caregivers, more and more men are becoming caregivers. However, anyone anywhere can give care—regardless of gender, income, age, social status, and employment. No matter how great the ...

  18. Effectiveness of a Three-Month Training Program in Psychotherapeutic Intervention for Family Practice Residents.

    ERIC Educational Resources Information Center

    Gagnon, Robert J.; And Others

    1994-01-01

    A study among medical residents (n=50) at the University of Montreal and Laval University (Quebec) found that a structured series of 12 seminars dedicated to psychotherapeutic interventions by family doctors was effective in raising students' knowledge levels, perceived skills, and attitudes. Skills of the "how-to" type improved more than did…

  19. Modeling the hydrologic and economic efficacy of stormwater utility credit programs for US single family residences

    EPA Science Inventory

    As regulatory pressure to reduce the environmental impact of urban stormwater intensifies, U.S. municipalities increasingly seek a dedicated source of funding for stormwater programs, such as a stormwater utility. In rare instances, single family residences are eligible for utili...

  20. Referral Rates of Senior Family Practice Residents in an Ambulatory Care Clinic.

    ERIC Educational Resources Information Center

    Lawler, Frank H.

    1987-01-01

    A study of patterns in second- and third-year family practice residents' requests for referrals found higher rates for the senior students, suggesting possible differences in approach to case management, lack of experience in referral among younger students, and differences in case mix. (MSE)

  1. Clinical Poems and Clinical Conversations: Some Thoughts on Working with Family Medicine Residents

    ERIC Educational Resources Information Center

    Stein, Howard F.

    2006-01-01

    This paper describes an experiment in which Family Medicine residents composed, read, and discussed their poems as a way of bringing to life their often complex relationships with patients. It argues that this approach mobilizes the physicians' own creativity in the service of reflective practice and improved doctor-patient relationships. This…

  2. A National Survey on the Current Status of Family Practice Residency Education in Geriatric Medicine.

    ERIC Educational Resources Information Center

    Li, Ina; Arenson, Christine; Warshaw, Gregg; Bragg, Elizabeth; Shaull, Ruth; Counsell, Steven R.

    2003-01-01

    A survey of family practice residency directors found that 92 percent have a required geriatrics curriculum; nursing homes, assisted living facilities, and home care are the predominant training sites; the mean number of geriatrics faculty is 2.6 per program; and conflicting time demands with other curricula was ranked as the most significant…

  3. Family medicine residents' beliefs, attitudes and performance with problem drinkers: a survey and simulated patient study.

    PubMed

    Kahan, Meldon; Wilson, Lynn; Liu, Eleanor; Borsoi, Diane; Brewster, Joan M; Sobell, Linda C; Sobell, Mark B

    2004-03-01

    Fifty-six second-year family medicine residents completed a survey on their knowledge and beliefs about problem drinkers. Most residents felt responsible for screening and counseling, were confident in their clinical skills in these areas, and scored well on related knowledge questions. However, only 18% felt that problem drinkers would often respond to brief counseling sessions with physicians while 36% felt that moderate drinking was a reasonable goal for patients with severe alcohol dependence. Residents were then visited by unannounced simulated patients (SPs) presenting with alcohol-induced hypertension or insomnia. Residents detected the SP in 45 out of 104 visits. In the 59 undetected SP visits, residents asked about alcohol consumption in 47 visits (80%), discussed the relationship between alcohol use and the presenting complaint in 37 visits (63%), and recommended a specific weekly consumption in 35 visits (59%). Only 31% offered reduced drinking strategies, and most did not ask about features of alcohol dependence. These results suggest that residents have the fundamental clinical skills required to manage the problem drinker who gives a clear history and is receptive to advice. Educational efforts with residents should focus on the importance of systematic screening, taking an alcohol history under more challenging conditions, identifying the subtler presentations of alcohol problems, counselling the less receptive patient at an earlier stage of change, distinguishing the problem drinker from the alcohol-dependent patient, and offering specific behavioral strategies for the problem drinker.

  4. 76 FR 26147 - Caregivers Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-05

    ... for a caregiver. It would not be rational to decouple the concepts such that, for example, a veteran... of the eligible veteran's and caregiver's physical and emotional states, observing for signs of abuse... offered to Primary and Secondary Family Caregivers to include individual and group therapy, counseling...

  5. Cybersupport: empowering asthma caregivers.

    PubMed

    Sullivan, Claire E

    2008-01-01

    In the United States, an estimated 6.5 million children have asthma (Akinbami, 2005). Due to the chronic and unpredictable nature of asthma, the condition places excessive demands on the primary caregiver. The complexity of asthma management has required parents to take increased responsibility for the assessment and treatment of their child's asthma (Dickinson & Dignam, 2002). Many families are turning to the Internet for information and support. The purpose of this study was to gain insight into the "lived" experiences of an online asthma caregivers support group. Archived messages posted to an online discussion list were analyzed using phenomenological thematic analysis. Five themes emerged providing insight into the meaning of caregiving and the provision of social support. Online support narratives provide a unique way to gain insight and understanding of the experiences of mother's enacting the caregiver role. Understanding the everyday lives of asthma caregivers can help nurses and other health care providers better meet caregiver needs.

  6. Caregiver Depression

    MedlinePlus

    ... will not sell or share your name. Caregiver Depression Tweet Bookmark this page | Email | Print Many caregivers ... depression See your doctor Treatment Coping Symptoms of depression Caregiving is hard — and can lead to feelings ...

  7. Psychosocial functioning among HIV-affected youth and their caregivers in Haiti: implications for family-focused service provision in high HIV burden settings.

    PubMed

    Smith Fawzi, Mary C; Eustache, Eddy; Oswald, Catherine; Surkan, Pamela; Louis, Ermaze; Scanlan, Fiona; Wong, Richard; Li, Michelle; Mukherjee, Joia

    2010-03-01

    The study is an analysis of baseline data from a pilot psychosocial support intervention for HIV-affected youth and their caregivers in Haiti. Six sites in Haiti's Central Department affiliated with Partners In Health/Zanmi Lasante (PIH/ZL) and the Haitian Ministry of Health were included. Participants were recruited from a list of HIV-positive patients receiving care at PIH/ZL. The baseline questionnaire was administered from February 2006 to January 2007 with HIV-affected youth (n = 492), ages 10-17, and their caregivers (n = 330). According to findings at baseline, the youth reported high levels of anxiety, including constant fidgeting (86%), restlessness (83%), and worrying a lot (56%). Their parents/caregivers also reported a high level of depressive symptoms, such as low energy (73%), feeling everything is an effort (71%), and sadness (69%). Parents' depressive symptoms were positively associated with their children's psychological symptoms (odds ratio [OR] =1.6-2.4) and psychosocial functioning (OR =1.6 according to parental report). The significant levels of anxiety and depression observed among HIV-affected youth and their caregivers suggest that psychosocial interventions are needed among HIV-affected families in central Haiti and other high HIV burden areas. The results suggest that a family-focused approach to service provision may be beneficial, possibly improving quality of life, as well as psychosocial and physical health-related outcomes among HIV-affected youth and their caregivers, particularly HIV-positive parents. PMID:20214482

  8. "How Long Are We Able to Go on?" Issues Faced by Older Family Caregivers of Adults with Disabilities

    ERIC Educational Resources Information Center

    Dillenburger, Karola; McKerr, Lyn

    2011-01-01

    Research-informed policy and practice is needed for older caregivers of adult sons/daughters with disabilities. These caregivers are often under tremendous stress because of failing health, financial pressures, bereavement and worry about the future of their sons/daughters. Twenty-nine older parents/caregivers of 27 adults with intellectual and/or…

  9. Predicting Desire for Institutional Placement among Racially Diverse Dementia Family Caregivers: The Role of Quality of Care

    ERIC Educational Resources Information Center

    Sun, Fei; Durkin, Daniel W.; Hilgeman, Michelle M.; Harris, Grant; Gaugler, Joseph E.; Wardian, Jana; Allen, Rebecca S.; Burgio, Louis D.

    2013-01-01

    Purpose: Literature on institutionalization of patients with dementia has not considered the role of caregivers' quality of care, which encompasses caregivers' exemplary care (EC) behaviors and caregivers' potentially harmful behaviors (PHBs) toward care recipients. This study sought to understand the role of quality of care in mediating between…

  10. Does empowering resident families or nursing home employees in decision making improve service quality?

    PubMed

    Hamann, Darla J

    2014-08-01

    This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. PMID:24652909

  11. Does empowering resident families or nursing home employees in decision making improve service quality?

    PubMed

    Hamann, Darla J

    2014-08-01

    This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses.

  12. Child, Caregiver, and Family Characteristics Associated with Emergency Department Use by Children Who Remain at Home after a Child Protective Services Investigation

    ERIC Educational Resources Information Center

    Schneiderman, Janet U.; Hurlburt, Michael S.; Leslie, Laurel K.; Zhang, Jinjin; Horwitz, Sarah McCue

    2012-01-01

    Objectives: To examine emergency department (ED) use among children involved with child protective services (CPS) in the US but who remain at home, and to determine if ED use is related to child, caregiver and family characteristics as well as receipt of CPS services. Method: We analyzed data on 4,001 children in the National Survey of Child and…

  13. The cancer caregiving experience of caregivers of Mexican ancestry.

    PubMed

    Juarez, Gloria; Branin, Joan J; Rosales, Monica

    2014-01-01

    The act of providing care may be the same in all ethnic groups, but the way caregiving is defined by family members is influenced by cultural values and beliefs. This study describes the caregiving experience and challenges of caregivers of Mexican ancestry. Qualitative interviews of 20 family caregivers and thematic analysis of transcribed audiotapes identified four themes that characterized their caregiving experience. These themes include an emphasis on family values, a strong commitment to care, difficulties dealing with everyday life realities, and a reliance on spirituality, all of which added to the meaningfulness and burden of caregiving. Further investigation within a cultural context is warranted in the development of interventions and programs to better assist caregivers in coping with the challenges of providing cancer care.

  14. Depression and caregiver burden among rural elder caregivers.

    PubMed

    Butler, Sandra S; Turner, Winston; Kaye, Lenard W; Ruffin, Leah; Downey, Roberta

    2005-01-01

    Family caregivers of older adults frequently experience feelings of burden and depression though they may not come to the attention to health and service providers until they are at a point of crisis. Through a simple screening tool, the Maine Primary Partners in Caring (MPPC) project identified individuals providing care to older adults through rural primary care practices, in order to provide upstream interventions before caregivers were in crisis. This paper describes a sample (n=62) of rural family caregivers identified through their physicians' offices. High levels of caregiver burden and depression were reported. Family support and knowledge of caregiver tasks predicted decreased caregiver burden and depression, while isolation predicted increased caregiver burden. Implications of these results for gerontological social workers are outlined.

  15. THE ASSESSMENT OF CAREGIVER BURDEN IN CAREGIVERS OF HEMODIALYSIS PATIENTS

    PubMed Central

    Mashayekhi, Fatemeh; Pilevarzadeh, Motahareh; Rafati, Foozieh

    2015-01-01

    Background: Chronic renal failure is among the chronic disease which due to persistence of the disease and long treatment process has various effects on the physiological, psychological, functional ability, lifestyle changes, and independence status of the patient and his family. This may result in the burden feeling in caregivers. According to the importance of the subject, this study is to assess the level of caregiver burden in caregivers of hemodialysis patients. Methods: This is a cross-sectional analytical descriptive study that was conducted in 2014 on the caregivers of hemodialysis patients. Research instruments were consisted of two parts: demographic data check list and caregiver burden questionnaire. Data were analyzed by SPSS statistical software and Pearson correlation coefficient tests. A p value of less than 0.05 was considered statistically significant. Results: In this study, 72.5% of caregivers reported moderate to severe levels of caregiver burden. A significant relationship was observed between gender of the patient with caregiver burden score of (p=0.031) and type of the income with caregiver burden score of (p=0.000). Caregivers of male patients and patients with inadequate income had a higher caregiver burden score. Conclusions: Our results showed that more than half of the caregivers of hemodialysis patients had moderate to severe levels of caregiver burden, therefore it is worthy that health officials and nurses pay special attention to this issue by communicating with these patients and their caregivers. PMID:26622201

  16. Aggressive behavior directed at nursing home personnel by residents' family members.

    PubMed

    Vinton, L; Mazza, N

    1994-08-01

    Anecdotal evidence suggests there is a significant amount of aggressive behavior directed at nursing home personnel by residents' family members. This exploratory study describes a random sample survey of 70 Florida nursing homes. Administrators reported 1,193 acts of verbal aggression and 13 acts of physical aggression for a 6-month period. Dissatisfaction over how the specific and overall care needs of residents were being met was most frequently cited as the contributing factor. Social work staff and directors of nursing were most often called on to resolve these conflicts. The authors conclude with recommendations for research and conflict resolution. PMID:7959112

  17. The significance of losing things for nursing home residents with dementia and their families.

    PubMed

    Powers, Bethel Ann

    2003-11-01

    This article examines the significance of losing things as part of an individual's whole experience with the material aspects of life. The data on which this report is based were drawn from a broader ethnographic study of everyday ethics affecting nursing home residents with dementia. Combined anthropological methods of participant observation and in-depth interviewing were used to gather information about ordinary daily issues for residents, family members, and nursing home staff. Findings are described as themes related to personal possessions and concerns surrounding them. Discussion comprises an interpretive analysis of meanings drawn from the research and represented as ethical considerations and practice implications--general principles and strategies. PMID:14619317

  18. The significance of losing things for nursing home residents with dementia and their families.

    PubMed

    Powers, Bethel Ann

    2003-11-01

    This article examines the significance of losing things as part of an individual's whole experience with the material aspects of life. The data on which this report is based were drawn from a broader ethnographic study of everyday ethics affecting nursing home residents with dementia. Combined anthropological methods of participant observation and in-depth interviewing were used to gather information about ordinary daily issues for residents, family members, and nursing home staff. Findings are described as themes related to personal possessions and concerns surrounding them. Discussion comprises an interpretive analysis of meanings drawn from the research and represented as ethical considerations and practice implications--general principles and strategies.

  19. Family routines within the ecological niche: an analysis of the psychological well-being of U.S. caregivers of children with disabilities

    PubMed Central

    Larson, Elizabeth; Miller-Bishoff, Thomas

    2014-01-01

    Using mixed methods, this study examined the relationship of caregivers of children with disabilities’ psychological well-being (PWB) and their orchestration of daily routines within their ecological niche. Thirty-nine U.S. caregivers completed in-depth interviews, PWB Scales, and Family Time and Routines Index (FTRI). We used a multi-step analysis. Interview data was coded and vignettes created without knowledge of PWB and FTRI ratings. Next, the relationship of quantitative measures was analyzed. Four groups were created using FTRI-extent and PWB means: (1) low routine-low PWB, (2) low routine-high PWB, (3) high routine-low PWB, and (4) high routine-high PWB. We examined qualitative differences in key features between groups. Findings: Total PWB and FTRI scores were not significantly correlated, PWB Purpose in Life and FTRI-extent scores were moderately positively correlated, and PWB Environmental Mastery and FTRI-extent correlation approached significance. Qualitative findings describe caregivers’ structuring of routines, intensity of oversight, support in routines, management of dinner, paid work, and needs for respite. The four groups differed in paid work, household support, degree the child could self-occupy, Environmental Mastery, and opportunities to recuperate. Caregivers with higher levels of well-being and more regular routines did paid work, had supportive spouses, had children who more often could follow routines, had higher Environmental Mastery, could orchestrate a family meal, and had breaks from care in either work or leisure. All Native American caregivers and Mexican American caregivers with spouses were in the high routine-high PWB group. Insight into this complex negotiation between family members within daily routines may provide practitioners a better understanding of how to work within family circles to foster therapeutic alliances, identify focused intervention targets, and promote positive family wide outcomes. PMID:24910625

  20. ‘No matter what the cost’: A qualitative study of the financial costs faced by family and whānau caregivers within a palliative care context

    PubMed Central

    Allen, Ruth; Moeke-Maxwell, Tess; Gardiner, Clare; Robinson, Jackie

    2015-01-01

    Background: There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life. Aim: To explore the nature and range of financial costs incurred by family caregiving within a palliative care context. Design: In-depth qualitative interviews were conducted with 30 family/whānau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels. Setting: Auckland, New Zealand. Findings: Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited. Conclusion: Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and whānau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings. PMID:25680378