The impact of the marital relationship on the experience of caring for an elderly spouse with dementia

1998 ◽  
Vol 18 (2) ◽  
pp. 209-231 ◽  
Author(s):  
ROSE D. H. LEWIS

Husbands and wives constitute a large proportion of carers of those older people suffering dementia. Many older people with dementia have had a long history of personal relationships, often having lived with the same partner for most of their lives. Following the life course approach, this study explores the ways in which a couple's marital experiences impinge upon the challenges faced when a spouse develops dementia in late life and is cared for by his or her partner. I start by surveying the relevant literature. The second section outlines a study of nine couples and includes brief case vignettes. In the third section I seek to test out hypotheses extrapolated from the material, with the theme of how perceptions of the caring situation are related to perceptions of the pre-morbid marital relationship, drawing heavily upon the case material. No single discussion is exhaustive, as any of these hypotheses are worthy of intensive study in their own right. I conclude with a summary of the findings and a reflection on how professionals might put these findings into practice.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Afeez Hazzan

Abstract Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.


2017 ◽  
Vol 13 (1) ◽  
pp. 51-60
Author(s):  
Ahmad Berkah

Research in title “The impact of Sriwijaya Maritime Power toward the Entrance of Muslim Trade in Palembang in VII-IX Century” is based on the power of Sriwijaya maritime that dominated all of the International trade voyage path which was sailed by the foreign merchant including Arabic Muslim traders. The Arabic Muslim traders which sailed and traded to China must go across trade voyage paths of Sriwijaya, thus, the merchants stopped over in the Kingdom center of Sriwijaya located in Palembang. The objective of the study is to analyze the history of development of Sriwijaya’s maritime power, analyzing the sailing and trading path and the relationship of Sriwijaya and the foreign country, and the impact of Sriwijaya’s maritime power toward the entrance of Muslimtraders in Palembang in VII-IX century. This study is in the form of Qualitative research design which is library research., by analyzing thoroughly every single relevant literature. The approach of the research is by using historical method approach which are, heuristic, verification, interpretation, and historiograsion, and politicoligist and economologist scholarship. Moreover, the source of the data were primer and seconder data. Data collection technique as heuristic and verification. To analyze the data, it was used interpretation, then it was conducted the last step that was historyografy or a writing of history. This research concludes that the history of development of Sriwijaya appearing as the ruler of the largest maritime power in Nusantara was supported by their great army and a management of a strong and respected leader.Sriwijaya easily controlled strategic shipping paths, such as the Strait of Malacca, Bangka Strait, Sunda Strait, Karimata Strait, and all shipping lanes in the Nusantara.The condition of the shipping Routes initially frightened Muslim traders, because of the large number of pirates, having successfully controlled by Sriwijaya's maritime power, it became safe and comfortable to go through. And it was required to stop at the harbor or in the center of Sriwijaya Kingdom located in Palembang. In addition, Sriwijaya's relationships with foreign countries, namely Arab, India, China were carried out by Sriwijaya for the recognition of sovereignty and Sriwijaya's power strengthening in the trade shipping paths. Sriwijaya with its maritime power and cooperating with the Sea People to secure the cruise line to the center of Sriwijaya from pirates as well as increasing the confidence of Muslim traders both in trade and security guarantees on the way back from the center of Sriwijaya and access for Muslim traders in the process of Islamization through trade routes in the territory of Sriwijaya kingdom.


2011 ◽  
Vol 32 (5) ◽  
pp. 873-896 ◽  
Author(s):  
ANNE MCINTYRE ◽  
FRANCES REYNOLDS

ABSTRACTOlder people experiencing dementia are twice as likely to fall with consequences of serious injury, reduction in everyday activity, admission to long-term care and mortality. Carers of people with dementia are themselves at greater risk of physical and mental ill health, which increases as the dementia progresses. Unsurprisingly, carer burden also increases when a care-recipient falls. The aim of this study was to explore the experiences of falling of community-living older people with dementia and their carers. A qualitative approach was taken using interpretative phenomenological analysis. Nine older people with predominantly Alzheimer's disease and their ten carers were recruited from a large mental health National Health Service trust and participated in one-to-one and joint in-depth interviews. Three dyads participated in repeat interviews. Three focus groups were also carried out, with nine older people experiencing memory problems and 12 carers from a local Alzheimer's Society branch. The antecedents, falls events and consequences of falls were discussed. This paper reports specifically on the impact of falls on the caring relationship. Three themes emerged: ‘learning as you go’, ‘we're always together’, ‘nobody was interested’. The findings demonstrate how falling accentuates the impact of dementia on the dyad. Spouse-carers' discussion of their own falls emphasise the need for joint assessment of health and wellbeing to reduce carer burden and preserve the couplehood of the dyad.


2019 ◽  
Vol 13 (1) ◽  
pp. 48-67 ◽  
Author(s):  
Dimitra Xidous ◽  
Tom Grey ◽  
S. P. Kennelly ◽  
Cathy McHale ◽  
Desmond O’Neill

Objectives: Research was conducted to investigate the impact of the hospital environment on older people including patients with dementia and their accompanying persons (APs). The article presents key research findings in the case study hospital. Background: For many patients, the hospital is challenging due to the busy, unfamiliar, and stressful nature of the environment. For a person with dementia, the hospital experience can be exacerbated by cognitive impairment and behavioral or psychological symptoms and can therefore prove to be a frightening, distressing, and disorientating place. Method: The findings are based on a stakeholder engagement process where the research team spent approximately 150 hr observing within the hospital, administered 95 questionnaires to patients and/or APs, and conducted 12 structured interviews with patients and APs. A thematic analysis was employed to analyze and generate key themes emerging from the process. Results: Themes were grouped into overarching issues and design issues across spatial scales. Conclusion: This research confirms the negative impact of the acute hospital setting on older people with cognitive impairments including dementia and delirium. The multiple perspectives captured in this study, including most importantly people with dementia, ensure that stakeholder needs can be used to inform the design of the hospital environment. The research points to the value of understanding the lived experience of the person with dementia and APs. The voices of patients, particularly persons with dementia and their APs, are a crucial element in helping hospitals to fulfill their role as caregiving and healing facilities.


2017 ◽  
Vol 18 (4) ◽  
pp. 246-253 ◽  
Author(s):  
Vari M. Drennan ◽  
Jill Manthorpe ◽  
Steve Ilifffe

Purpose The purpose of this paper is to discuss the question of how to meet the needs of older people living at home with dementia who have problems with continence. The paper is focused on social care practice in community settings. Design/methodology/approach This paper is practice focused and draws on the authors’ research and experiences in clinical care, workforce development and service improvement. Findings This paper summarises research on incontinence and its negative effects on quality of life and care relationships. It describes the impact of incontinence in terms of social embarrassment, restricted social activity, extra work (such as laundry) and costs, but also distress. It links research with care practice, with a focus on people with dementia who may be at particular risk of both continence problems and of assumptions that nothing can be done to assist them. Social implications This paper provides questions that could be addressed in commissioning and provision of services and argues that they need to be informed by care practitioners’ experiences. It provides details of sources of support that are available at national and local levels. Originality/value This paper draws together research on continence and social care practice to provide a series of self-assessment questions for local services. It focuses on social care workers who are at the frontline of practice including personal assistants and carers.


2013 ◽  
Vol 25 (7) ◽  
pp. 1107-1114 ◽  
Author(s):  
Sylwia Górska ◽  
Kirsty Forsyth ◽  
Linda Irvine ◽  
Donald Maciver ◽  
Susan Prior ◽  
...  

ABSTRACTBackground: Dementia is a major cause of disability among older people and constitutes one of the greatest challenges currently facing families and health and social care services in the developed world. In response to trends in dementia prevalence and the impact the condition has on peoples’ lives, dementia care has been placed high on the public and political agenda in the United Kingdom. However, despite significant public resources being allocated to combat the impact of the disease, recent evidence indicates that numerous challenges in relation to service provision remain. This study aimed to develop a deeper understanding of the lived experience of people with dementia regarding their service-related needs.Method: The study made use of data gathered through individual semi-structured, narrative interviews conducted with persons with experience of dementia and their unpaid carers.Results: Although participants were generally satisfied with the services they received, a number of unmet needs related to service provision were identified. In terms of diagnostic procedures the findings of this study indicate the need for early diagnosis delivered through a comprehensive assessment package. The participants also highlighted the need for well-coordinated post-diagnostic support, greater continuity of care concerning the personnel involved, and enhanced access to non-pharmacological interventions to support identity and social engagement.Conclusion: This study contributes to a better understanding of service-related needs of people with dementia in relation to diagnostic procedures and post-diagnostic support.


2005 ◽  
Vol 11 (4) ◽  
pp. 345-357 ◽  
Author(s):  
HEATHER G. BELANGER ◽  
RODNEY D. VANDERPLOEG

There is increasing interest in the potential neuropsychological impact of sports-related concussion. A meta-analysis of the relevant literature was conducted to determine the impact of sports-related concussion across six cognitive domains. The analysis was based on 21 studies involving 790 cases of concussion and 2014 control cases. The overall effect of concussion (d= 0.49) was comparable to the effect found in the non-sports-related mild traumatic brain injury population (d= 0.54; Belanger et al., 2005). Using sports-concussed participants with a history of prior head injury appears to inflate the effect sizes associated with the current sports-related concussion. Acute effects (within 24 hr of injury) of concussion were greatest for delayed memory, memory acquisition, and global cognitive functioning (d= 1.00, 1.03, and 1.42, respectively). However, no residual neuropsychological impairments were found when testing was completed beyond 7 days postinjury. These findings were moderated by cognitive domain and comparison group (control groupversuspreconcussion self-control). Specifically, delayed memory in studies utilizing a control group remained problematic at 7 days. The implications and limitations of these findings are discussed. (JINS, 2005,11, 345–357.)


2009 ◽  
Vol 16 (2) ◽  
pp. 262-267 ◽  
Author(s):  
HEATHER G. BELANGER ◽  
ERIC SPIEGEL ◽  
RODNEY D. VANDERPLOEG

AbstractDebate continues about the long-term neuropsychological impact of multiple mild traumatic brain injuries (MTBI). A meta-analysis of the relevant literature was conducted to determine the impact of having a history of more than one self-reported MTBI (versus just one MTBI) across seven cognitive domains, as well as symptom complaints. The analysis was based on 8 studies, all conducted with athletes, involving 614 cases of multiple MTBI and 926 control cases of a single MTBI. The overall effect of multiple MTBI on neuropsychological functioning was minimal and not significant (d = 0.06). However, follow-up analyses revealed that multiple self-reported MTBI was associated with poorer performance on measures of delayed memory and executive functioning. The implications and limitations of these findings are discussed. (JINS, 2010, 16, 262–267.)


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