Ambiguous loss and shared leisure barriers of family caregivers

2009 ◽  
Vol 8 (2) ◽  
pp. 23-30
Author(s):  
Leandra A. Bedini, PhD, LRT/CTRS ◽  
Nancy J. Gladwell, ReD, CPRP

Ambiguous loss is a concept that describes the loss of a significant other through illness or disabling condition rather than death. With regard to leisure, ambiguous loss is experienced when one’s loved one has a physical or mental disability that prevents him or her from being actively involved in shared leisure experiences with his or her spouse/partner. For many family caregivers, ambiguous loss creates an additional constraint to their leisure pursuits because of the importance placed on participating with their leisure partners. In addition, these dyads often lack information and strategies to negotiate this barrier. This article addresses specific ways that therapeutic recreation professionals can reduce the sense of loss and increase access to satisfying leisure experiences for both the family caregiver and their care-recipient.

Author(s):  
Robert Holda

One of the most misunderstood and unappreciated segments of society in relation to medical tourism is the family caregiver; those caring for a loved one who sacrifice their own employment schedule, their personal time for relaxing and recreation, and often and importantly their own health. The purpose of this chapter is to raise awareness of the plight of family caregivers as an issue for medical tourism, the effects of stress and burnout, and the essential need for respite of body, mind, and spirit for these central assistants in the matter of healthcare for patients. Though healthcare and its subset, medical tourism, are frequently perceived as focused on a “patient”, they also encompass many other individuals and organizations. As addressed here, the focus is on the family member caring for a loved one. The intent is to link the concept of medical tourism as an avenue for relaxation and respite to enhance the wellness of this specific target market.


Dementia ◽  
2018 ◽  
Vol 19 (5) ◽  
pp. 1712-1731 ◽  
Author(s):  
Jill-Marit Moholt ◽  
Oddgeir Friborg ◽  
Bodil H Blix ◽  
Nils Henriksen

BackgroundFamily caregivers contribute substantially to the care for older home-dwelling people with dementia, although community healthcare services tend to be underutilized. In this study, we aimed to explore the use and predictors of use of home-based and out-of-home respite care services available to older home-dwelling persons with dementia, as reported by the family caregivers.MethodA cross-sectional survey was administered to family caregivers ( n = 430) in Northern Norway during April to November 2016. The use of healthcare services was categorized into two types according to principal component analysis: home-based services and out-of-home respite care services ( R2= 44.1%). Predictors of service use were examined with bivariate correlation, multiple linear regression, and Poisson regression analyses.ResultsThe use of home-based services among persons with dementia was significantly higher for persons with advanced age, persons living in urban areas, persons living in an assisted living facility, persons living alone, and persons able to manage being alone for a short period of time. Among the family caregiver variables, higher age, status as a daughter, son, or other family member, higher educational level, and full-time employment also predicted greater use of home-based services. Same ethnicity was associated with use of fewer home-based services. The use of out-of-home respite care services was significantly higher among male persons with dementia and among those living in urban areas. In addition, fewer out-of-home respite care services were used by male caregivers or daughters of the care recipient, while the use was higher when the caregivers experienced more caregiving demands or had provided care for longer periods of time.ConclusionsThese results indicate areas that policymakers and healthcare providers should consider to identify families who underutilize healthcare services and to achieve a more equal and efficient allocation of services in accordance with families' needs.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S979-S979
Author(s):  
Patricia Egan

Abstract Dementia family caregivers are routinely enlisted as proxy assessors of care recipients’ quality of life (QOL). This study explored whether prompts to change perspective during QOL assessment could elicit an intra-proxy gap. The intra-proxy gap was hypothesized to be any difference between those assessments made from the caregiver’s own perspective and those made from the adopted perspective of the care recipient, as the care giver imagined it to be (Pickard and Knight, 2005). Thirty-six dementia family caregivers were recruited from senior service agencies. Subjects completed the Quality of Life-Alzheimer Disease (QOL-AD), Caregiver Version under two conditions: First, from an unprompted perspective and second, from the adopted perspective of the care recipient, as the family caregiver imagined it to be. T-testing indicated intra-proxy gaps emerged for eleven of the QOL-AD’s thirteen domains. For these domains, QOL scores were higher when assessed from the care recipient’s perspective, as the family caregiver imagined it to be. The sample was then repeatedly bisected using caregivers’ personal, relational, and health factors. T-testing indicated that family caregivers’ personal factors were associated with intra-proxy gaps across more QOL-AD domains than their relational or health factors were. Three personal factors, being of older age, having more empathetic concern, and having more empathetic distress, were associated with intra-proxy gaps more frequently than other personal factors were. Findings suggest that clinicians should be alert for perspective employed by proxy assessors and for the possibility of intra-proxy gaps. Recognition of these gaps could help improve interpretation of QOL scores.


Author(s):  
Robert Holda

One of the most misunderstood and unappreciated segments of society in relation to medical tourism is the family caregiver; those caring for a loved one who sacrifice their own employment schedule, their personal time for relaxing and recreation, and often and importantly their own health. The purpose of this chapter is to raise awareness of the plight of family caregivers as an issue for medical tourism, the effects of stress and burnout, and the essential need for respite of body, mind, and spirit for these central assistants in the matter of healthcare for patients. Though healthcare and its subset, medical tourism, are frequently perceived as focused on a “patient”, they also encompass many other individuals and organizations. As addressed here, the focus is on the family member caring for a loved one. The intent is to link the concept of medical tourism as an avenue for relaxation and respite to enhance the wellness of this specific target market.


2020 ◽  
Author(s):  
Tebogo Pule ◽  
King Costa

Introduction: In most cases chronically-ill patients, the disabled and old persons are discharged from healthcare facilities to their families who have inadequate knowledge and skill. They may not be familiar with the kind of care expected to provide. The healthcare system does not provide continuity of care, especially to the family caregiver. The family caregiver is left to attend to the physical, economical, psychological needs of the patient with limited to no support from the healthcare system. This poses a huge challenge and increases the burden for the family caregiver which ends up becoming unbearable to the point where the process is no longer a healthy or viable option for both the caregiver and care recipient. The role of the caregiver in a patient’s health is often overlooked or underestimated in the South African health system, as a result, the caregiver is not recognized as part of the health system policy and financial inclusions. The aim of this study is to conduct a Qualitative Systematic Review of the conditions of service for family caregivers across four dimensions namely: Problems/challenges, burden, intervention and outcome, in South Africa. Method: A Qualitative Systematic Review was conducted, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) methodology on Google Scholar database, and retrieved articles from 1994 to 2020. Following Boolean operators, words “AND”, “OR” and “NOT”, were used, to search key terms “family caregiving in South Africa”, “primary caregiving” or “informal caregiving”. Rigor was determined and documented throughout in order to allow readers to access its completeness. Inclusion and exclusion criteria were clearly outlined. Criteria for evaluating primary studies were clearly defined at the beginning of undertaking research. A total of 1810 articles, reports and dissertations were retrieved and only 85 studies were included in the review. Findings and Discussion: Studies were critically appraised using WebQDA software, whereby 198 comments emerged. Both the burden and challenges of caregiving experienced were categorized as problems, which came out 82 times (68%) compounding the role that they play. Other categories that emerged from the studies were Intervention and outcome which came out 53 and 13 times respectively. Interventions and outcome were also consolidated into one group, implying that interventions would have an impact on improving or declining outcome and these were only 32%. Four final themes emerged out of this research.


2017 ◽  
Vol 99 (905) ◽  
pp. 519-534 ◽  
Author(s):  
Pauline Boss

AbstractFamilies of the missing often have no facts to clarify whether their loved one is alive or dead, or if dead, where the remains are located. Such loss is called “ambiguous loss”, and those suffering from it will usually resist change and will continue to hope that the missing person will return. As this article will endeavour to explain, our goal as professionals working with the families of the missing is to help them shift to another way of thinking that allows them to live well despite ambiguous loss. To do this, we must acknowledge that the source of suffering – the ambiguity – lies outside the family. The article offers a psychosocial model with six guidelines focusing on meaning, mastery, identity, ambivalence, attachment, and finding new hope.


2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Lucimar Aparecida dos Santos ◽  
Patrícia Peres de Oliveira ◽  
Edilene Aparecida Araújo da Silveira ◽  
Elaine Cristina Rodrigues Gesteira ◽  
Deborah Franscielle da Fonseca ◽  
...  

ABSTRACT Objective: To unveil the resilience process in family caregivers of people with malignant neoplasia. Method: Descriptive and qualitative research performed between September and November of 2017 in a Brazilian Unit of High Complexity Care in Oncology. Individual interviews and four focus groups were conducted with 29 family caregivers. Socio-constructivist methodology was used under Vygotsky's perspective, the theoretical framework of the construction of the resilience processes, besides the hybrid model of thematic analysis. Results: Three thematic categories emerged: "feelings revealed through colors"; "practice of care and communication in the process of resilience" and "faith and hope in the process of resilience". The family caregivers organized themselves to provide support to their family member with malignant neoplasia and they faced, in a more consolidated way, the overwhelming transformations imposed by the disease. Conclusion and implications for practice: The guidelines made by health professionals were paramount in the process of family caregivers' resilience, in addition to emotional support and spirituality. The communication with health professionals is essential in the coping of family caregivers when dealing with problems or conflicts, since there is better conduction in the process of illness of the loved one, when there is greater knowledge and understanding of the disease.


2013 ◽  
Author(s):  
Laura A. Scudellari ◽  
Bethany A. Pecora-Sanefski ◽  
Andrew Muschel ◽  
Jane R. Piesman ◽  
Thomas P. Demaria

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemisi Okikiade Oyegbile ◽  
Petra Brysiewicz

Family caregivers of patients with end-stage renal disease (ESRD) play a significant role in providing substantial care for a prolonged period for their sick relatives, often with very limited resources, making it a difficult environment. Government support for family caregivers of patients with ESRD is lacking in Nigeria, increasing their vulnerability to caregiver burden and its consequences. An action research study using a complimentary mixed-method approach was used to develop the intervention model for managing caregiver burden. Quantitative data were collected to measure the extent of caregiver burden using a Zarit Burden Interview questionnaire for 96 family caregivers, while individual in-depth interviews with 15 participants provided the qualitative data. Integrating the quantitative and qualitative data led to the identification of four moderators to manage the caregiver burden in this study. The model for managing caregiver burden was developed from the findings, using stressors and associated moderators of caregiving, and the role played by culture and finance in this context. An implementation checklist was developed, which was used by registered nurses to implement the concepts in the model with the family caregivers during the model implementation phase. Family caregivers of patients with ESRD need to be supported by nurses during the caregiving process. Nurses can increase caregivers’ identity and knowledge of the disease as a way of preventing the family caregivers from being overwhelmed by their caregiving role.


2018 ◽  
Author(s):  
Abu Sikder ◽  
Francis Yang ◽  
Rhiana Schafer ◽  
Glenna A. Dowling ◽  
Lara Traeger ◽  
...  

Objectives: Due to psychological and physical strain, family caregivers of patients with Alzheimer’s disease and related dementias are at high risk for depression and stress related disorders. We investigated the feasibility of a mobile application (App) intervention delivering Mentalizing Imagery Therapy (MIT), which incorporates guided imagery and mindfulness, to facilitate self-regulation and increase perspective on the mental life of self and others. Method: A 4-week pilot trial of an MIT App for family caregivers of people with dementia was conducted to assess feasibility of use, mood and depression symptom benefit, and relationship changes. Semi-structured interviews were conducted at the study’s conclusion to characterize participants’ perceived benefits. Results: 80% of 21 consented participants downloaded the App, utilized it at least once, and were further analyzed. Of these participants, average usage of audio recordings was 14 ± 10 (SD) days out of 28 possible, and 29 ± 28 individual sessions. Acute improvement in mood from before to after completion of exercises was uniformly observed (p < .001), and after four weeks there was a significant increase in positive affect and a reduction in negative affect. Participants with severe levels of depression (n=3) at baseline exhibited an improvement in symptoms at 4 weeks averaging 30% (p < .05). Semi-structured interviews revealed an increase in the ability to remain “centered" despite caregiving challenges, take the perspective of the loved one, and positively reframe the caregiver experience.Conclusion: App delivery of MIT is feasible for family dementia caregivers. Results showed moderate to high usage of the app for a majority of the users, and promising improvements in mood and depression. These data provide justification for larger, controlled trials.


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