The Manager Caregiver

Author(s):  
Elaine Wittenberg ◽  
Joy V. Goldsmith ◽  
Sandra L. Ragan ◽  
Terri Ann Parnell

As the Manager emerges from a communication climate of HIGH/WARM conformity (strong pull to share in similar values, attitudes, beliefs, and familial role expectations) and HIGH/COLD conversation (frequent and restricted communication contacts within the family system), the priority and commitment to family is prioritized. This priority can subvert the needs of this caregiver, and the Manager can find themselves protecting the care recipient and, at times, other family members from the challenges associated with understanding a diagnosis and its treatment. The Manager is drawn to professional help and support as well as health information, but this does not mean the Manager is sure about either—and they are strongly reliant on opinions of providers and professionals in their midst. The Manager employs similar approaches to all manner of pain (physical, emotional, social, psychological, spiritual) and because of the vigilance of the Manager, serving as the expert on the patient is a key-defining trait that is communicated via interactions with providers, family, patient, and other players. This trait positions the Manager to plan and activate care and advance the dynamics of the family system in which they live.

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2047-2057 ◽  
Author(s):  
Ingrid Hanssen ◽  
Phuong Thai Minh Tran

Background: If collectivistic-oriented family carers choose professional care for dependents with dementia, they risk being stigmatised as failing their obligation. This may influence dementia care choices. Research question: How may individualistic and collectivistic values influence choices in dementia care? Method: Qualitative design with in-depth interviews with a total of 29 nurses, 13 family members in Norway and the Balkans and 3 Norwegian dementia care coordinators. A hermeneutic content-focused analysis was used. Ethical considerations: Ethical approval was obtained from the Regional Ethics Committee for Research, South-Eastern Norway, and the nursing homes’ leadership. Findings: Family domain reasons why institutionalisation of dependents with dementia was seen as a last resort: obligation towards family members, particularly parents; worry about other family members’ reactions and inability to cope with the care for the person with dementia. Social domain reasons: feelings of shame and stigma regarding dementia, particularly in connection with institutionalisation of family members. Discussion: Children’s obligation towards their parents is an important aspect of the morality of collectivistic societies. Institutionalising parents with dementia may cause feelings of guilt and shame and worry about being stigmatised and ostracised. To avoid blame and rejection, caregiver(s) try to keep the fact that family members have dementia ‘in the family’. The decision to accept professional healthcare for dependents with severe dementia or have them admitted to a geriatric institution was postponed as long as possible. Conclusion: Family care morality may constitute a significant barrier against seeking professional help for persons with dementia, a barrier based on the expectation that the family will care for their old, even when suffering from severe dementia. Hence, stigma and shame may significantly affect the provision of care. Culturally tailored information may encourage family carers to seek professional help before the disruptive influence of the disease makes institutionalisation the only feasible option.


Author(s):  
Friday A. Eboiyehi

The continuous increase in the number of older people and the gradual erosion of the extended family system which used to cater to them are alarming. While older people in much of the developed countries have embraced old people's homes as an alternative, the same cannot be said of older people in Nigeria who still believed that it is the duty of the family to accommodate them. The chapter examined the perception of older people about living in old people's home in some selected local government areas in Osun State, Nigeria. The study showed that their perception about living in old people's home was poor as many of them still held on to the belief that it was the responsibility of their family members to house them as it was done in the olden days. Although a few of the interviewees (particularly those who are exposed to what is obtained in the Western world and those with some level of education) had accepted the idea, many preferred to live with their family rather than being dumped in “an isolated environment,” where they would not have access to their family members. Pragmatic policy options aimed at addressing this emerging social problem were highlighted.


2010 ◽  
Vol 41 (3) ◽  
pp. 113-121 ◽  
Author(s):  
Waldemar Świętochowski

Superficial and systemic diagnosis of family The distinction between two types of diagnosis of family was inspired by the concept of surface and source features of personality by R.B. Cattell. By means of existing psychological questionnaires we can only know the surface of consciously available mental phenomena. The same is true in the diagnosis of family. The McMaster model of family, systemic in its assumptions, developed research tools giving access only to the surface of the phenomena. Although they are divided into certain thematic categories they do not reveal what is really important in the family system. In this article, the author, after a detailed discussion of one of the tests based on the McMaster theoretical model, is attempting to identify the source features (here: unavailable for conscious cognition) of the family, hereinafter called systemic traits. In this research the exploration factor analysis was used. Three perspectives of the opinion of the family were maintained (like in the Family Assessment Measure). Factor analysis allowed identification of three factors for each perspective of the family assessment. Confirmative analysis proved a satisfactory match (using RMSEA, GFI and AGFI statistics). The accuracy of the identified systemic model was then tested by a confirmation study (confirmative factor analysis using Amos from SPSS). The authors also prepared a provisional questionnaire for measuring these systemic traits of the family. The tool proved to be promising and the work worth continuing. Incidentally, it turned out that the characteristics of the family system are relatively independent of personality traits of family members.


Author(s):  
Bryan D. Carter ◽  
William G. Kronenberger ◽  
Eric L. Scott ◽  
Christine E. Brady

Session 8 is again focused primarily on family communication and dynamics for the purposes of identifying and addressing parenting behaviors and parent–teen dynamics that may unwittingly undermining teen confidence in becoming more independent in managing their illness and lifestyle. The clinician engages the family in a discussion of parental and teen roles within the family system and an examination of the impact of the teen’s illness on family members’ roles. Behavioral family systems concepts of “misguided support” and “strong beliefs” that family members hold, but that inadvertently may be serving to maintain a dependent or even overprotective/enmeshed family dynamic, are introduced and applied to the family situation, along with strategies for moving these dynamics in a more independence-engendering direction.


2016 ◽  
Vol 33 (S1) ◽  
pp. S570-S570
Author(s):  
M. Kékes Szabó

Family organization has arguably a determinative role in our healthy social-emotional and cognitive development, although we may have different perceptions of this system. Its background is in connection with the family members’ different experience, knowledge and beliefs about the world. Furthermore, we are also prone to imagine others’ mental representations that can help us to understand them better. Sometimes these meta-representations may be more accurate, while other times they may be incorrect. Although theories of mind tasks are well-known tools to explore (meta-) representations, the use of Gehring's (2010) Family System Test (FAST) in this way is less tested. The aim of this study was to compare the family members’ perceptions of the family with one another. Children's and parents’ family images were explored. In line with Smith, Myron-Wilson and Sutton's (2010) previous findings, my results confirmed the parents’ increased ability to assess the children's perceptions. Finally, growing theory of mind abilities may also be in the background of the results above (Happe, Winner and Bownell, 1998). Subsequent studies have to broaden the focus and involve more methods, age groups in the investigations to know more about human cognitive processes.Disclosure of interestThe author has not supplied his/her declaration of competing interest.


Author(s):  
Tatyana Yu. Fadeeva ◽  

The study of parental burnout of fathers as well as mothers is relevant, since it may be the source of family trouble in general. The purpose of the study is to identify the factors of parental burnout of fathers and mothers. It is assumed that there are multidirectional correlations between the intensity of parental burnout components and parental sets, the attitude of spouses to the family role, and the consistency of the family functions of fathers and mothers. The study was carried out on a sample of parents of full families in Saratov, raising biological children (N = 61, 40 women (aged M = 32), 21 men (M = 33.9)). The applied methods include the questionnaires "Parental Burnout" (I. N. Efimova); "Role Expectations and Claims in Marriage" (N. A. Volkova), "Parental Attitude Research Instrument " (E. S. Schaefer and R. K. Bell, adapted by T. V. Nescheret and T. V. Arkhireeva), the questionnaire on marital satisfaction (V. V. Stolin, T. L. Romanova, G. P. Butenko). The largest number of correlations between the parameters of parental burnout and parental sets, the attitude of spouses to the family role and family functions have been revealed in the sample of mothers. It has been found out that in both samples the level of "emotional exhaustion" is interrelated with the parental predisposition to excessive strictness towards the child. However, the emotional exhaustion of mothers is more mediated by their dependence on the family and low self-assessment as a parent, whereas fathers’ burnout is due to the focus on the child and the desire to accelerate their development. The level of "depersonalization" in the sample of mothers correlates with the level of their concentration on the child, the consistency of family functions ("emotional and psychotherapeutic", "social activity", "physical attractiveness of the partner"), and marital satisfaction. In the sample of fathers, it correlates with the scales related to the sphere of marital relations (physical attractiveness of the partner, the degree of the father’s involvement in family affairs and marital satisfaction). The degree of the "parental achievements reduction" in the sample of mothers is associated with the balance of "intimacyseparateness" or its lack in the family system; in the sample of fathers it is connected with the availability or lack of verbal contact with the child and the father's acceptance of the child’s natural development. The applied aspect of the problem under study consists of the possibility of using the results in the practice of advisory services.


2021 ◽  
Author(s):  
Joyce T. Shatilwe ◽  
Khumbulani Hlongwana ◽  
Tivani P. Mashamba-Thompson

Abstract Background The reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child health information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health. Method Data for this study were collected using semi-structured in-depth interviews. These were conducted with 12 adolescent pregnant girls between the ages of 15 and 19 and eight nurses from four different health centres in the Ohangwena Region of Namibia. The study was conducted over the period of three months (December 2018 to March 2019). The data was grouped into clusters aided by NVivo computer software version 12. Data were organized and condensed in small units, prior to being coded, categorized, and finally grouped into main themes and sub-themes. Results Results revealed that long travel hours to reach the nearest clinics was amongst the leading challenges affecting accessibility and utilization of MCHI for pregnant adolescent girls. This was exacerbated by poor support with transport fare, poor road infrastructure and non-availability of transport, and these factors were key barriers to accessibility and utilization of clinic services. Other barriers pertained to the family dynamics, such as disclosing the pregnancy to the family members prior to commencing antenatal care (ANC) visits and harsh treatment from family members after the disclosure. Conclusion The pregnant adolescent girls were concerned about their inability to access and utilize MCHI. The challenges identified made them susceptible to maternal complications, hence their inability to access relevant MCHI to prepare them for pregnancy. Health educational interventions should prioritize both the adolescent girls and their families for proper support, especially since the reactions of families on the pregnancy of their adolescent girls often negatively affect accessibility and utilization of maternal and child health services. Moreover, further research on adolescents' needs during pregnancy should be expanded to include their parents, in order to better inform policymakers.


Author(s):  
Galina Beiger

Dysfunctional families are families that fail to fulfill the protective and educational function of their children. They are conflicted, affected by addictions, unadapted to life, inefficient in education. The situation of these families is a challenge for the Polish social assistance system. As part of social work with these families, a number of different methods are used, among others empowerment, interdisciplinary work model, work with family assistants, psychological therapies, school for parents, Family Group Conference and day support facilities. The work methods used involve family members based on their resources and aim to ensure that families use their strengths and acquire appropriate care and upbringing skills, achieve balance and gain greater independence in functioning, and regain control over their own lives. Сhanges that take place in social life cause weakening of social ties and the role of the family as a basic environment of human upbringing. Many Polish families are unable to perform the protective, educational, economic, preventative functions of their members, including children. Particularly disadvantaged families - affected by addictions, illnesses, disorders, unadapted to life and ineffective in education - pose a serious threat to the development of children, but also a great challenge for the social assistance system. For many years, social assistance institutions have usually been a source of financial resources to support these families. The current development of the family support system tends to develop effective methods of working with families, these pedagogical tools can be used by social workers and family assistants. Their essence is to influence the restoration of relationships between family members, the improvement of relations and communication, the desire for family reintegration. To this end, actions are taken based on the developed procedures based on the resources inherent in the family to make changes in the functioning of the family system through the forces of its members. The effectiveness of social work with disadvantaged families is enhanced by interdisciplinary activities that involve the use of the knowledge, experience and professional skills of various institutions and non-governmental organizations. Nowadays, the best way to work with such a family is to involve the so-called human factor, which embodies the professionalism and effectiveness of the assistance provided. A crisis family is increasingly perceived as an entity responsible for their own destiny. Working with the family using the above mentioned methods takes into account not only the deficiency of its functioning, but above all its strengths and potentials, which allows it to gradually regain balance, stability and take control of their life.


Author(s):  
Stanisław Chrobak

t. The family is the first and the most important educational environment of man. In the family system, all of its members influence each other, and therefore one of the most important components of the overall relationship between family members are parental attitudes. Both the personal and pedagogical culture of family members as well as the culture of family life determines the „culture of joy”. Experiencing joy in the family is done in the course of everyday life. Hope is born in this activity. The experience of joy and the testimony of hope also arise from various life situations, which are usually unique and unexpected. Hope mobilizes to fight the hardships of everyday life. Hope is the power to change life.


2005 ◽  
Vol 51 (4) ◽  
pp. 301-321 ◽  
Author(s):  
Sidney Z. Moss ◽  
Miriam S. Moss ◽  
Helen K. Black ◽  
Robert L. Rubinstein

Living and dying are inextricably associated in nursing homes. It is not unusual for old nursing home residents to express a wish to die. This article examines interwoven patterns of family responses to resident's wish to die. As part of a multi-site ethnographic study of bereavement in long-term care, we analyzed themes in audio-transcribed in-depth qualitative interviews with 20 family members in two religiously and culturally diverse nursing homes. Rooted in the contexts of the nursing home, the family system, and the socio-cultural milieu, three patterns of family responses emerged: avoidance, disconfirmation, and acceptance of the wish to die. The family members' responses reflect their efforts to make meaning of the resident's wish both for the resident and for themselves. Rather than viewing the wish to die as a symptom of mental health problems, they perceive it as reflecting the existential situation of the resident.


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