ISSUES AND CONCEPTS      IN AGINGCaring For the Frail Elderly        Chapter 12
A PROFILE OF CAREGIVING Approximately ____ million  people needed some assistance with daily  living Only ___ percent of...
FAMILY CARE               A PROFILE OF CAREGIVING   Activities of daily living (ADLs): questionnaire is    designed to me...
GENDER DIFFERENCESIN CAREGIVING     Primary caregivers: usually women;     Why?     tends to be the daughter who has fe...
WORK AND      CAREGIVING   __/__ of caregivers are no longer    working, __/__ are employed full-time or part-time.   Si...
THE CAREGIVER        BURDEN   The Cost of Being a Caregiver   Many caregivers are additionally stressed by financial    ...
HOW CAREGIVING AFFECTS FAMILY             RELATIONSHIPS   First research on caregiving focused on primary    caregiver in...
THE EFFECT ON PARENT-CHILDRELATIONSHIPS   Relationship between the caregiver and an elderly parent    can take many forms...
EFFECT ON SIBLING RELATIONSHIPS   Caregiving can generate tension between primary    caregivers and their siblings.   Wh...
CARFGIVING EFFECTS ON MARITALRELATIONSHIPS   The Bad          The Good                      © 2011 McGraw-Hill Higher Ed...
EFFECT ON MARITAL RELATIONSHIPS   Caregiving can reduce the time husbands and wives have    for each other.   Women may ...
EFFECT ONGRANDCHILDREN The Bad: Problems that arise: stress between grandparent  and grandchild, disruption of teen’s so...
EFFECT ONGRANDCHILDREN (CONT) The Good: Most grandchildren felt the caregiving situation  had a positive influence on fa...
HOME AND COMMUNITY-BASED SERVICES   Home and community-based services: most common    are:   Case management is provided...
INSTITUTIONAL CARE Nursing homes: the long-term care  option of last resort. Why is it the last resort? More than ___ p...
THE NURSING HOME INDUSTRY   People who reach age 65 have 40% chance of entering a    nursing home at some point during th...
STAFF TURNOVER IN LONG-TERM CARE   High turnover leads to _____ care, placing the    most vulnerable population group at ...
PROBLEMS IN ADJUSTING TO A NURSINGHOME   People who live independently in a community find the    transition to instituti...
PATIENT ABUSE INNURSING HOMES Patient abuse very/not very common;  may be ______ or ________ High turnover and high abse...
PATIENT ABUSE IN NURSING           HOMES (CONT)   More often abuse is more subtle and    psychological.   Federal govern...
FAMILIES OF THE INSTITUTIONALIZED                  ELDERLY   Caregiver stress often does not end after an aging parent   ...
NEXT WEEK Review for the final exam Student Learning Outcomes Quiz review Student Presentations                       ©...
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  • A.A Profile of CaregivingAccording to the General Accounting Office, approximately 12 million people needed some assistance with daily living in 1995. Only 9 percent of people aged 65 to 69 need help with activities of daily living (ADLs), while 43 percent of those older than 85 needed help. Children are most likely to provide care to aging parents, followed by a spouse. Caregiving generally lasts from five to seven years.
  • Home and community-based services: most common are: Personal care, such as bathing, dressing, feeding, and grooming.Housekeeping, including meal preparation and planning, grocery shopping, transportation to medical services, bill paying.Case management is provided by a social worker who assists frail elderly people and their families in obtaining the medical, social, and personal services needed.
  • High turnover leads to poor care, placing the most vulnerable population group at risk of bedsores, falls, and inadequate diet.
  • Patient abuse very/not very common; may be verbal or physicalHigh turnover and high absenteeism among staff creates situations that provoke abuse. Aides may use restraints to control patients, pinch or slap them. More often abuse is more subtle and psychological.Federal government and states have established vigilant rules in an attempt to protect patients.Greatest protection against abuse in nursing homes is presence of an “Ombudsman program”.Serve as watchdogs, monitor the quality of care in nursing homes by investigating complaints by families and residents against facilities.
  • Patient abuse very/not very common; may be verbal or physicalHigh turnover and high absenteeism among staff creates situations that provoke abuse. Aides may use restraints to control patients, pinch or slap them. More often abuse is more subtle and psychological.Federal government and states have established vigilant rules in an attempt to protect patients.Greatest protection against abuse in nursing homes is presence of an “Ombudsman program”.Serve as watchdogs, monitor the quality of care in nursing homes by investigating complaints by families and residents against facilities.
  • Ch12 caring for the frail elderly rev 11 11

    1. 1. ISSUES AND CONCEPTS IN AGINGCaring For the Frail Elderly Chapter 12
    2. 2. A PROFILE OF CAREGIVING Approximately ____ million people needed some assistance with daily living Only ___ percent of people aged 65 to 69 need help with activities of daily living. While ___ percent of those older than 85 needed help _______ are most likely to provide care to aging parents. followed by a __________ © 2011 McGraw-Hill Higher Education. All rights reserved.
    3. 3. FAMILY CARE A PROFILE OF CAREGIVING Activities of daily living (ADLs): questionnaire is designed to measure the capability of elderly living on their own. Instrumental activities of daily living (IADLs): keeping track of money, doing light housework, taking medicine, running errands. Long-term care: a range of services designed to help people with chronic conditions compensate for limitations in their ability to function independently. © 2011 McGraw-Hill Higher Education. All rights reserved.
    4. 4. GENDER DIFFERENCESIN CAREGIVING  Primary caregivers: usually women;  Why?  tends to be the daughter who has fewer competing obligations.  Usually one who is not working or is unmarried – many daughters take on the caregiving role regardless of their other responsibilities.  Gender differences in the caregiving experience may reflect that daughters perform more intimate tasks for their elderly parents than sons do and that they spend many more hours providing care. © 2011 McGraw-Hill Higher Education. All rights reserved.
    5. 5. WORK AND CAREGIVING __/__ of caregivers are no longer working, __/__ are employed full-time or part-time. Since 1970, there has been a substantial increase in paid employment among women. Why would Caregivers experience greater job stress and more work/family conflicts than non-caregivers? Employer concerns over caregiving Employers often recognize that caregiving affects the job performance of caregivers. © 2011 McGraw-Hill Higher Education. All rights reserved.
    6. 6. THE CAREGIVER BURDEN The Cost of Being a Caregiver Many caregivers are additionally stressed by financial worry associated with paying for home care services, health care, nursing home care. Caregiver burden: management of the tasks. Coping Skills Caregiver stress: the strain felt by the caregiver.  The degree of stress felt by a caregiver depends partly on the coping skills she or he may have developed to deal with other life events, and partly on the kind of social support available. © 2011 McGraw-Hill Higher Education. All rights reserved.
    7. 7. HOW CAREGIVING AFFECTS FAMILY RELATIONSHIPS First research on caregiving focused on primary caregiver in isolation from other family members. New research suggests that caregiving not only affects the emotional well-being of the caregiver but reverberates across other family relationships. Caregiving can also be a positive influence on the family relationship by bringing kin together to accomplish a shared goal. © 2011 McGraw-Hill Higher Education. All rights reserved.
    8. 8. THE EFFECT ON PARENT-CHILDRELATIONSHIPS Relationship between the caregiver and an elderly parent can take many forms. Mutuality: both mother and daughter describing a rewarding relationship characterized by joint activities and minimal conflicts. Ambivalent: mothers and daughters had relationships where there were rewards and costs; relationships were sometimes tense. Conflicted: few rewards and frequent costs. (“She’s generous and compassionate to others, but not to me”.) Stress can increase role reversal. The parent becomes the dependent one. © 2011 McGraw-Hill Higher Education. All rights reserved.
    9. 9. EFFECT ON SIBLING RELATIONSHIPS Caregiving can generate tension between primary caregivers and their siblings. Why? One study found that greatest source of stress for women caring for parent with Alzheimer’s was siblings. Different types of sibling conflict create different responses on the part of caregivers. Disagreements over how to care for a parent may lead to depression. © 2011 McGraw-Hill Higher Education. All rights reserved.
    10. 10. CARFGIVING EFFECTS ON MARITALRELATIONSHIPS The Bad  The Good © 2011 McGraw-Hill Higher Education. All rights reserved.
    11. 11. EFFECT ON MARITAL RELATIONSHIPS Caregiving can reduce the time husbands and wives have for each other. Women may be too worn out from performing caregiving duties to spend quality time with their husbands and may worry about whether caregiving demands are harming their marriage. The most stressful caregiving situation occurs with Alzheimer’s disease. © 2011 McGraw-Hill Higher Education. All rights reserved.
    12. 12. EFFECT ONGRANDCHILDREN The Bad: Problems that arise: stress between grandparent and grandchild, disruption of teen’s social life, resentment of their mother’s caregiver burden. Children may have to compete with their grandparents for their parent’s attention. Despite such potential strains, several studies have found that family caregiving may also have positive consequences for grandchildren. © 2011 McGraw-Hill Higher Education. All rights reserved.
    13. 13. EFFECT ONGRANDCHILDREN (CONT) The Good: Most grandchildren felt the caregiving situation had a positive influence on family relationships. Another positive effect: it made the young people more empathetic toward other adults and their grandparents. The adolescents repeatedly described feeling closer to their mothers, who were nearly always primary caregivers. © 2011 McGraw-Hill Higher Education. All rights reserved.
    14. 14. HOME AND COMMUNITY-BASED SERVICES Home and community-based services: most common are: Case management is provided by a social worker who assists frail elderly people and their families in obtaining the medical, social, and personal services needed. © 2011 McGraw-Hill Higher Education. All rights reserved.
    15. 15. INSTITUTIONAL CARE Nursing homes: the long-term care option of last resort. Why is it the last resort? More than ___ percent of Americans who turned 65 in 1990 will spend some time in a nursing home. © 2011 McGraw-Hill Higher Education. All rights reserved.
    16. 16. THE NURSING HOME INDUSTRY People who reach age 65 have 40% chance of entering a nursing home at some point during their lives. Problems: Although many nursing homes provide adequate and, in some cases, exceptional care, poor-quality care is a continuing problem. Among the problems documented were untrained staff, poor health care, unsanitary conditions, poor food, and unenforced safety regulations. © 2011 McGraw-Hill Higher Education. All rights reserved.
    17. 17. STAFF TURNOVER IN LONG-TERM CARE High turnover leads to _____ care, placing the most vulnerable population group at risk of __________, falls, and inadequate _______. © 2011 McGraw-Hill Higher Education. All rights reserved.
    18. 18. PROBLEMS IN ADJUSTING TO A NURSINGHOME People who live independently in a community find the transition to institutional life difficult. People sometimes wept recalling a cherished piece of furniture or a comforting daily routine. Older Hispanics or other immigrants who enter nursing homes face unique obstacles in adjusting to institutionalization, including language and cultural differences. © 2011 McGraw-Hill Higher Education. All rights reserved.
    19. 19. PATIENT ABUSE INNURSING HOMES Patient abuse very/not very common; may be ______ or ________ High turnover and high absenteeism among staff creates situations that provoke abuse. Aides may use _________s to control patients, pinch or slap them. © 2011 McGraw-Hill Higher Education. All rights reserved.
    20. 20. PATIENT ABUSE IN NURSING HOMES (CONT) More often abuse is more subtle and psychological. Federal government and states have established vigilant rules in an attempt to protect patients. Greatest protection against abuse in nursing homes is presence of an “Ombudsman program”.  Serve as watchdogs, monitor the quality of care in nursing homes by investigating complaints by families and residents against facilities. © 2011 McGraw-Hill Higher Education. All rights reserved.
    21. 21. FAMILIES OF THE INSTITUTIONALIZED ELDERLY Caregiver stress often does not end after an aging parent or spouse is admitted to a nursing home. Constant conflict with the staff adds to the stress, as caregivers who formerly attended to every need of their loved ones now find they are at the mercy of strangers. Highest levels of stress and depression occur among caregivers of patients with severe behavioral problems and memory loss. © 2011 McGraw-Hill Higher Education. All rights reserved.
    22. 22. NEXT WEEK Review for the final exam Student Learning Outcomes Quiz review Student Presentations © 2011 McGraw-Hill Higher Education. All rights reserved.
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