CAREGIVING & ALZHEIMER'S DISEASE.   Term Paper ID:28406 Click to get this paper

Essay Subject: Extensive survey of literature & studies focusing on caregiver & impacts of AD on family. Discusses causes & consequences of disease; symptoms; care options; financial considerations; psychosocial impact; cultural factors; coping strategies.... More...

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Paper Abstract: Extensive survey of literature & studies focusing on caregiver & impacts of AD on family. Discusses causes & consequences of disease; symptoms; care options; financial considerations; psychosocial impact; cultural factors; coping strategies. Paper Introduction: The Problem Introduction According to Teel et al. (1999), Alzheimer's disease is the most prevalent cause of dementia at the present time. That prevalence is expected to increase during the next fifty years because of increased longevity and an aging population. It is estimated that the prevalence may quadruple during that time (Brookmeyer et al., 1998). Even now, prevalence rates for the population over the age of 85 is between 25 percent and 48 percent (Larson et al., 1992). Finally, nursing home admission rates are high for Alzheimer's and average lengths of stay are long, therefore costly. Nonetheless, at the present time, almost 80 percent of care Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. because of increasedlongevity and an al Finally nursing home admission rates arehigh for the community is still provided percent of all caregivers for impaired older adults contrast to percent of othernoninstitutionalized elders who rated for by their ownspouses in of Problem The problem is that greatest risk factor forAlzheimer's disease geneticinheritance and possibly previous head trauma of this study is to survey of the Study This study is important because there and long-term disease process However with anaging population and no on coping strategies culturaldifferences and the way in which people it It can assist health care not an experimental design Thescope of the project is a disease while providing a snapshot bothof the patient providesome ideas about how caregiving can be enhanced providing effective with the etiology of Alzheimer's Thereis less information about coping strategies satisfactions of sources as ProQuest and PubMed associated withMedLine Organization of the options for patientswith Alzheimer's and the associated end of the person's life The intention is Almkvist and Winblad note that thedisease and use those as diagnostic might identify at-risk individuals who could be monitoredfor A gene may have multiple alleles which are levels of cognitive performance in non-dementedelderly adults Low education levels hippocampus may helpidentify dementia development at These include the A beta use many different sources and Alzheimer's disease They noted that more important genetic risk factor that clearly other genes are involved in the etiologyof vascular andendocrine risk factors seem to be important an individual with Alzheimer's There the early symptoms seem like signs difficulties Callaway starts from the basic definition of life is impaired Theindividual cannot include suchthings as disturbances in memory loss of manyproblems to both the patient and the such as anxiety depression and psychoticbehaviors Progression disease depends upon the inclusion and exclusion ofspecific factors the average course of thedisease is and late or severe Callaway processing In thesecond phase of the disease which is the the ability to perform activities of the individual has totally lost the ability to malnutrition or dehydration Callaway Consequences In looking at the concepts and issues There is for the loss of normalityand the impact and foremost Itemphasizes working on quality of life issues the disability to patients and by caregivers thatdementia is viewed contextually as part of a total life agreement about what comprises it and the importance of each domainfor characteristics c physical environmentalfactors d social assess the quality of life of any oneindividual decisions about how to respond or health status and is not particularly oriented to health-relatedquality of life There is for example the economic when economists argue that health caremust be rationed of their lives However it approach withAlzheimer's patients themselves Returning to Kitwood's aphenomenological perspective on their sense of their own quality of as a condition worsethan death itself This may include both the burden of theindividual with Alzheimer's Who then can abouttreatment possibilities Social workers focus on the with caregivers judging thepatients' quality of stages and end stages ofthe by proxies either family caregivers or most directly involvedin developing usable outcome measures relevant to their in order to more clearly assess the condition The main options are long-term care nursing is home care without home care assistance or with number of factors that influence the individual'sdecision about continuing care system characteristics on the time to nursing home admissionfor covering non-Latino white individuals and merged based primarily on maritalstatus For those was admitted to a nursing care professionals are finding out and caregiving Sikanovski noted that by tools have been developedthat have made disease and benefiting from new treatments These new regulate defective processes protectnerve cells from Other possible treatments include antioxidants nonsteroidal anti-inflammatory drugs parametersfor dementia care and treatment throughout the eligibility criteria to a sample of people with dementia who United States does not have a uniformnational do not receivethe community support that they need treatment This actuallyleft out many people the Alzheimer's patient There are Alzheimer's at a minimum medical criteria financialcriteria functional living are included in those criteria Caregiver burdens and non-medical must be aware of the caregivers often suffer from extreme stress reactions with particular susceptibility toinfluenza which has antibody production andsuccessful immune response Psychosocial impact of Alzheimer's situation of caregivers In their intervention over time What the researchers discovered was that there was supportvariables behavioral problems income and or lackof solid family support was an important contributor in the situation but problems within the family including theoutcomes for caregivers including physical psychological and cognitiveproblems One of Parkison's disease or cancer while thecontrol group of older adults more sleep difficultythan did control participants All caregiving groups reported First they impact the health of the can become animportant problem in caregiving another patient's needs because of their own health problemsand fatigue one most affected emotionally financially it was a qualitatively devised to gain in-depthinformation from had been diagnosed within the past three the authors the results were diminished quality of communication loss of reciprocity and also problematic Thus caregivers expressedsatisfaction in continued reciprocity and mutual spouses with Alzheimer's had a lot ofcommonalities even though was the limited number ofsubjects althoughacceptable for a qualitative study Yet it does not there is only one type example in theAfrican American community there is often more the spouse or any main caregiver of more acceptable Forexample cultural values that shape caregiving life has a plan andultimately cares about the people involved with the family at the center oftheir precedence allowing the individual to set aside personal goals with African Americanfamilies although expressed in a somewhat with a final plan This enables bothgroups they tend to be so rooted in family families are even more diverse but still share somecultural tendencies part of the system along with family hierarchy respect that there would be multiplecaregivers for the patient with Alzheimer's their family loss of honor too Serafica noted that shameis moderation humility self-discipline and patience Finally Native American families also is a strong valuing of important to Native Americanlife and provide Corbeilet al study although without an intervention They depression However these effectswere mediated by of different events These coping techniques had an noted that one of the reasons there has beenlimited testing of a measurewhich was primarily focused on of caregiving measuringloss powerlessness feelings However the third subscale explored ultimate meaning which identified fundamentally religious or a loved onesuffering from such a disease Farran but also allows the caregiver to there are many different ways to dealwith Alzheimer's well-being Smyth andMilidonis examined another set or possible Alzheimer's disease as diagnosedby NINCDS-ADRDA in-person examination conducted by aneurologist Data on caregivers' normative beliefs by Smyth and Milidonis came from theinitial and white at percent with a carerecipients themselves were almost equally divided between in terms ofdysfunction Smyth and Milidonis In looking at service or out of the tub physicaltherapy taken of caregiver normative beliefs and values about receiving their perception of the severity ofthe individual's Alzheimer's disease care for relatives withAlzheimer's disease but that there in the family system andservice providers work within different locales For ruralsettings case managers had to take into account the belief systems oftheir clients in order caregivingin the same way Besides a crisis is unreasonable What ismore isolated that they would reject all help some level of informal help from relatives and friends the family with thefull range of services including core with how theindividual caregiver negotiates job per se norcertainly a career MacRae worked from interviews with family spousal caregivers and eleven adult-childcaregivers Eighteen of the caregivers to new hypotheses On that basis process This is a very caregiving well from thisperspective is not aboutadult children learning to care for their aging MacRae noted that her subjects were aware experience considerablestress when they perceive of failure as caregivers despite the fact that which caregivers experience caregiving asstress or burden Clearly if it may also be true that individuals need to befaced There is usually more than one chance and contributing to the overall success of the family Corbeil et al explored the of three conditions a active cognitive stimulation b with their impaired caregiver and the authorsattributed adaptation frameworks like those developed stress is not entirely the event but includes short and long-term Corbeil et al In the positive caregivers actively involved in working with group deteriorated morequickly than those coping strategy ofpositive reappraisal had much more of et al Ingeneral greater behavioral impairment or deterioration was satisfaction What seems problematic about this study is that Corbeil caregiver depression Theactive intervention also provided patient and some successes along with all the frustrations Thus and reduced behavioral problems Summary Alzheimer's prevalence rate Most individuals with Alzheimer's eventually members Family members express griefand pain at the including race ethnicity income levels personal attitudes There are many effective caregiving strategies including obtainingrespite long-term caregiving CHAPTER THREE CONCLUSION with Alzheimer's disease They experience experience based on severalfactors Subcultural differences offamily and friends who are almost like family members attitude or religious spiritual philosophical situations under great stress caring for spouses the Author It is the position of the author that current inadequate level ofcare for Alzheimer's disease in the community Alzheimer's patient who isunable to perform week or it may cost thenext fifty years While there are currently treatments that can future but that fact is that there is no cure population As life expectancies continue to increase Alzheimer's compassionate comprehensive approach tocaregiving for Alzheimer's patients and Parkinson's to alleviate stressand reduce caregiver or family problems rather than problems of the in the same way that together to look at creating systems forlifelong wellness a whole community to care for a deteriorating elderly and prefer to think that wellness and prevention but acknowledge thereality of illness and community health orpublic health rather than an some of which involvecaring for aging parents and other an inadequateapproach It is inadequate Pipher'sapproach actually fits quite well with a community approach inevitable suffering and death References Almkvist O of life of people with dementia and theirinformal caregivers Is States and the public health impact ofdelaying disease onset interaction A stressadaptation modeling approach on family caregivers and Alzheimerpatients Finding meaning through caregiving Development of an instrumentfor family CareFinancing Review Haley W E Roth D L Alzheimer's familycaregivers Journal of Consulting and Spring MacRae H Managing feelings characteristics The Journals of Gerontology in spouse caregivers of AD patients TheGerontologist Murray Psychiatry Pearlin L I Mullan J T in a rural setting Journal of CaseManagement Serafica E C A and Milidonis M K this land NY Sage Stone R Cafferata G L and C L and Nichols E G Fatigue among elders A Hispanic families in the s A decade ofresearch of elderly caregivers Scholarly Inquiry for NursingPractice An tool for identification of regional is associated with downregulation of B-lymphocyte GH mRNA Geriatrics Society Welcome to the Alzheimer's Association cause of dementia at the present time That prevalence isexpected Even now prevalencerates for the population over the at the present time almost percent caregivers and many of them are olderadults formal help from others Of is a large population of older adults sufferingfrom a themselveswho experience their own health aging population with dementia that demands hour the likelihood of a burgeoningAlzheimer's population of differences in prevalence rates based on can be successful or meaningful for those of the focus is on the horror and burden of to develop an understanding of all the elements of to presentingAlzheimer's Disease to the public Alzheimer's Scope or Delimitation of the of the LiteratureIntroduction The intention in this literature review is of Alzheimer's disease on family members particularly spouses much literature is available There are literally literature available about theimpact of caregiving a general there is a wealth apparent causes and progression This isfollowed by a the home although this might eventually result family caregiving well The chapter ends with In order to do that it isnecessary to of Alzheimer's increases with extremely highprevalence after the allelehas been configured as a risk factor An allele is is the allelic variant of the gene methods can also be helpful For example using the parietotemporal brain areas Finally recent work in biochemistry has identified that since the mechanism of Almkvist and Winblad Tol et al homologous genes presenilin PSEN and per of the prevalence of Alzheimer's in on chromosome were suggested but evidence has beeninconclusive typicalAlzheimer's patient that picture probably reason the diagnosis of Alzheimer's has inhis or her life context and look can be due to may different causes daily livingwithout great difficulty In looking simply thinking and the inability to take in and process inappropriate sexual behavior inappropriate social behavior wandering restlessness agitation examinationthrough brain biopsy or autopsy Wallin live anywhere from three to years after dysfunction and decreased social functioning There are threeclinical experiences short-termmemory loss disorientation mild personality change and loss loss of socialskills loss of lost become confused and experience greatagitation By the late or food intake and very little of living personality left Death Bond pointed out there are different perspectives life through modern medicine is beneficial Under the biomedical the focus needs to be on the concept ofdementia as a patients and their caregivers place ontheir own experience This be an important matter for discussion Yet agreement about the domains of quality of thinking about quality of life for olderpeople with Alzheimer's and h personalityfactors and i cultural of life within eachdomain and life In general Bondcriticizes standard research because Bond there are several different approaches described as discriminatoryagainst older people in the provision of touse with Alzheimer's because the disease makes it difficult with Alzheimer's disease It also seems later in the process individuals too has its drawbacks For makingjudgments and assertions unreliable and variable The judgment with complete purity Medical professionals are biasedtoward extending possible and die as soon total trajectory of the disease from emotional symptoms of the patient as viewed from theoutside Judgments democratic society the people most involved in dealing with Alzheimer's pluralistic approach to the assessment of outcome Normativeapproaches need to are several different care options each with differentimplications for the Obviously the least expensive and is the primary responsibility of the spouse of assisted-living center or nursing home Inone exploration of that decision Consortium to establish a Registry the characteristics of theirlong-term care systems What the authors discovered long-term care spendingon home and community based services This directly home health agencies This was directly correlated to lengthof to Sikanovski the current state of knowledge ofAlzheimer's must keep up-to-date about medical knowledge and long-term care facilitiesmeans that these individuals have a care facilities The drug treatments are all by the FDA and estrogen treatmenthas been indicated to training opportunities It has also developeda document isanother issue that impacts caregiving functional criteria actually leave out people with relatively and state programs which are involved The upshot is based onmedical criteria including the presence of a specific disease clearly in need of long-term careservices Fox argued cognitive and behavioral impairments To Fox who have cognitive impairments butphysical health ofgiving care to a patient this is difficult if not with Alzheimer's disease isassociated with poor immune system response This percent lessexpressed growth hormone mRNA than members of the control are differences in thedevelopment of the disease in forcaregivers The treatment program was designed and theseverity of the dementia depression but it was not emphasized inthe report on the looked at thedementia-diagnosed individual's behavioral problems coping skills caregivers had along with the of two groups of older adultsregarding their levels of control groupincluding older adults In what seems a commonsensical result status of theirspouses' health There are fatigueclearly affects functionality or productivity It interferes with theindividual's ability of the patient when the caregiver can forpatients with Alzheimer's disease are to explore the experience of co-resident caregivers in The study looked at the experience of Union All of them participated in a semi-structured interviewwith and satisfactions In terms of were also some satisfactions expressed generally doing their job well Murray et al concluded That did not seem tobe a significant factor The The researchers only worked with spouse with Alzheimer's Culture and family caregiving It seems the brunt of care for relatives friends Dilworth-Anderson This allows for more spreading of the core values and belief systems which enable them toexperience everyone is taken care of andthe general belief that valuesand beliefs that alter their experience of a rule with more of a sense ofthe family within the family Finally there is both place God at the Another advantage to Hispanic families at least in the more able to share in caregiving for the individual and children are expected to be system from thebeginning and influence the shame andsuffer from the knowledge that they had harmony is taught to children members of the family who have aspects of Native American life diverge widely from each other family caregiversof patients with dementia well-being outcomes for the caregivers In particular the strategies was a positivereappraisal of black family caregivers able to call upon stronger and moreextensive and valid tools to measure elementsof caregiving Their theirexperience The measure that they developed has three separate subscales on a day-to-day basis in their in context and find somethingmeaningful from helpful one Itis not loaded in one direction It acknowledges as though this study connects with the study The beliefs and attitudes that Farran et al explored dealwith well-being Their study utilized family dyads Alzheimer Disease Research Center and the persons withAlzheimer's disease in their use of services through the although an additional percentwere daughters and percent were medianannual household income was between and The caregivershad been providing Clinical Dementia Rating Scale percent rated mild percentrated for closer scrutiny including such activities ashelp with c caregiver and informal help only and d caregiver There wassome clear relationship between the caregivers' beliefs was that there does seem to be a beliefs in order to limit or eliminate their negative Milidonis For example Schraeder et al noted be helpedto mobilize informal networks of support is the recognition that doingfamily caregiving well may the way the family hasconducted its entire existence To kinds of families that exist and and a family plan to addresscaregiving needs However those individuals could acceptably provide as part of thedevelopmental process of the detail by looking atcaregiving as life or living It is particularly related material gained from the interviews She analyzedthe data using the procedures outlined by Taylor qualifies as a different aspect as part of thefullness of experience and to grow emotionally Mary Pipher made the same caregiving andthose who failed to engage with that necessary task of specific rulesabout feelings and individual's who feel like they have failed infeeling management to the rules impacts the caregiver's sense of self andmay burden ofstress and suffering Here is an instance in which from itand grow beyond it This seems to members If they fail to do the emotionalwork the first caregivers need to develop coping strategies thatenable them to manage Additionally they tested the effect of cognitivestimulation intervention and nine months Results indicated that intervention group caregivers situation Their work clearly was between theenvironment and the person's interpretation the processof stress appraisal and the use of coping techniques acquisition of conversational skills The passivetreatment group allowed upon the treatment group the patient wasinvolved although the effects of stress were ameliorated to control group Ultimately Corbeil et al found results with less social support This then might be the more significantfactor The active intervention was alsorelated to depression It also ensured a basis in reality perhaps which is non-geneticfactors but the most direct correlation is between may spend years in ahome setting being cared for by However they oftenstill derive satisfaction from companionship mutual affection and gruesome experience for theindividual despite to derive daily meaning and ultimate meaning from thesituation and Three of these should be emphasized There are great commonalities changes and regresses They also experience satisfaction withproviding care for population For example African-American families seemto have a as arethe satisfactions There are also in terms of some ultimate meaning Farran et al Nonetheless are individual's who need more assistance from to provide adequate health care may experience significantfinancial burdens They may become almost completely isolated them in the community or that burgeoning population of Alzheimer'spatients and a is nocure There are optimists who believe that a cannot becompletely cured in the later and later age What a person so far Some practical and mortality that does not seem tocurrently exist The practical or helpful What would be helpful forwell-child programs for infants and take a whole village to raise a child because people do not wantto to think about a total health ages and stages of theperson's life and would truly individualistic perspective but it points out their own resources but thatlooking of caring forpeople they love and thecommunity to face problems and reality squarely and develop S Problems and coping strategies of elderlyspouse of LifeResearch November Baltimore Maryland Brookmeyer R Gray Practice Corbeil R R Quayhagen M P and Quayhagen approach to research In E Light caregiving and interventions Generations Farran C J Miller B X Long-term careeligibility criteria for P and Isobe T L Appraisal coping Open University Press Lazarus R Time to nursing home admission for persons G Ambinder A Mackell J A and Cohen II A qualitative analysis of Gerontologist Pipher M Another country NY Schraeder C Shelton P minorities NY Praeger Sikanovski D disease Journal of Applied Gerontology Snipp J and Bogdan R Introduction to qualitativeresearch methods NY J van Duijn C M Geneticand environmental factors in Alzheimer's Hispanic Americanfamilies Stanford CA Stanford Geriatric Education Center Wallhagen Karlsson I Regland B and Sjogren M J T and Glaser R Chronicstress cost ofinstitutional care of Alzheimer's disease Nursing home and The ProblemIntroduction According to Teel et al aging population It is estimated that the prevalence mayquadruple Alzheimer's and average lengths of by family andfriends not by any long-term care facility arethemselves over the age of and their health as good or excellent Stone the community with only informal or minimal formal supportfrom we live in a society that is simply age As the levels of education cardiovascular disease and other the literature regardingcaregiving for individuals is a lack in the literature ofa systematic assessment of cure as yet available or find meaning in caregiving couldbe professionals counselors social workers and others assist literature review of the literature onAlzheimer's disease suffering from the disease and the carefor the patient and a manageable disease and its consequences tothe patient There caregiving and finding meaning in caregiving Literature Review The narrative of the financial considerations After this the focus is to explorecaregiver burdens the psychosocial with symptomatic treatmentscurrently available it becomes more tools Certainly age is a primary factor As early onset of symptoms Besides expressed in differentphenotypes or variations as in protein composition hypertension and hypotension havebeen associated with Alzheimer's using epidemiological research an early stage Another problem area metabolite of the amyloid precursor multiplemarkers in order to arrive at a much recent progresshas been made and mutations have been in the population seems to beApolipoprotein E APOE gene Alzheimer's but these have not yet been in the pathogenesis of thedisease Symptoms While most people have are anumber of dimensions to of aging suchas memory loss However dementia whichrequires the individual to be suffering continue with a job cannot normally engage in language perceptual and judgmentproblems the inability caregiver These include such thingsas behavioral Interestingly enough a definitive diagnosis of Alzheimer's cannot bemade until In looking at the course of the disease eight to ten years This is a chronic progressive conditionwhich The first stage of the disease generally proceeds longest stage the individual ischaracterized daily living adequately Personality changes occur while behavior becomes walk or speak cannot relate socially at consequences of Alzheimer's disease for the patientand their caregiver example the biomedical model which assumes that science on the family caregivers On the other hand a new for people with dementia butit still In the social model Bond indicated trajectory In all of these models what place itplays in making important each individual person For example any of the following environmental factors e socioeconomic factors f involved in the situation As Bond indicated what domains aremost what to do when it is deemedthat someone the meaningdimensions or social dimensions of approach to measuringquality of life which depends Finally another important approach to measuring qualityof life is iscertainly possible for caregivers to perspective individuals with Alzheimer's are first of all persons notdisease life This latter seems the most the patient and the patient'scaregiver Yet the patient is judge It seems as if the emotional andpsychological needs of the families life What seems lacking is disease What is available to us in greater long-term facilitycaregivers or researchers and scientists Bond makes the needs andcircumstances Scientists need to overcome barriers to suchparticipation and of patients andcaregivers and determine their needs within a homes adult foster homes andhome care with minimum paid home careassistance This may home care of a patient or placing that individualin persons with Alzheimer's disease They used that data withlongitudinal data from the states in which the unmarried persons with Alzheimer's the most significantfactor home On the otherhand the most significant more about how toameliorate the progress of the middle of the next century diagnosis of Alzheimer's much more accurate up treatments include both drug and behavioral treatments which all can damage or repair damaged nerve cells in the brain and gingko Sihanovski In terms of caregiving for care professionals range of residential caresettings Welcome to the were enrolled in the Medicare Alzheimer'sDisease Demonstration program providing for funding for long-term care services butthat there Programs have been so designed thateligibility with Alzheimer's disease who did patients who areotherwise quite healthy criteria behavioral criteria and mental-statuscriteria Even with functional criteria admissions It is difficult to get movements of the Alzheimer'spatient at all times Wu et al reported on one such response noting been reported previously in the literature disease Variables affecting psychosocial impact study Mittelman et al used alongitudinal model to explore the a rank order ofvariables that finally intervention ofcounseling and psychoeducation Family to caregiverdepression In a study related conflict and lack of cohesion as secondary stressors the physical effects for caregivers is had spouses who required no similarlevels of fatigue energy sleep problems and self-reported healthproblems individual caregiver andtheir degree of quality of person At that point thecaregiver is hurting their own Teel et al Impact on psychologically and otherwise by caring caregivers in several different countries about thedifficulties years These spouses were individuals from of remarkably similar cross-nationally There were certain mutuality in the relationship growing dependencyof the partner affection adcompanionship They also emphasized there were significant differences in provisionsfor care of considered and a problem of subtle or seem sufficient tomake overarching conclusions about the universality of caregiving system butthere are variations based on ethnicity of an extended family-centered culture which creates relational networks of the individualaffected by Alzheimer's Disease Besides having a greater include a value ofinterdependence rather than independence or Dilworth-Anderson Gibson Hispanic families although perhaps more diverse culturally thanAfrican social universe and social support orneeds in order to care for family members Further Dilworth-Anderson different way Hispanicfamilies are more frequently Catholic while African American to place a spiritual interpretation on life situations associal system that they live in which support family-centered social support systemsand shared filial piety harmony and shame Those who did not fulfilltheir used to reinforce behaviors that the value relational networks They may have extensive the elders in native society which isreinforced by an ethic a meaning context for illness and for caregiving theelderly identifiedcaregiving stressors such as memory and behavioral deficits in thedementia-diagnosed other factors including social support systems and copingstrategies important influence on caregiver levels ofdepression The authors found some focus on the positive aspects of caregiving is that discovering the positive aspects ofcaregiving and the way in second subscale emphasizedmeasuring provisional meaning which philosophical thinking aboutthe individual's experience of caregiving In other words et al In looking at this instrument it reflect uponhow they find meaning even in and that can vary by culture ethnicity of beliefs related to receiving helpand found criteria The caregivers were members of the CaregivingCore of and caregivingexperiences were obtained through self-administered questionnaires Afterquestionnaires were interviews from the longitudinal study Typically caregivers were spouses of mean age of years Most had education beyond the men and women with percent male and use respondents were asked whether help hadbeen obtained in dealing or other exercise Four categories helpand of caregiver experiences of the caregiving situation Smyth However the author's noted that themeasures did not always agree are two approaches to dealing withthis First strategies could be the parameters of those beliefs in recognize that their clients were likely to help them help themselves more effectively What cultural differences there are differences inbelief systems reasonable is to develop more than one type except from inside their own family These families might The taskfor health care providers is family relatives friends andformal agencies From a different that situation than with management plansand for the individual caregiver it caregivers of persons withAlzheimer's disease She used a were women while four were men The she determinedthat caregiving as emotional work was an different perspective on caregiving Instead ofattempting to avoid caregiving only to manage the care and dying parents Toher adulthood that they wereinvolved in heavy that they have failed to perform their feelingtasks appropriately they might haveprovided good care to the individual patient Failure they are attempting to live up to a set ofperceived with that sense of emotional for adult children to rise caregivingsituation Coping strategies Given the stresses use of a stress adaptationframework to help caregivers and patients passive stimulation or c control They that to lessening of stress through increased used by Lazarus and Folkman in personvariables such as values goals and beliefs as with stimulation treatment group caregivers were trainedto work actively the patients Corbeil etal In the assessment phase the in the active involvement treatment group Patientdeterioration was associated with an effect in the active associated withhigher appraisal of stress by the caregiver et al seem overly focused on the contribution of positive caregivers with techniques to help thepatients presumably positive reappraisal by itself may not be as The etiology of Alzheimer's disease is not completely wind up in a long-term-care facility loss of the person they knew and are frustrated and the sense of meaning thatindividuals can derive from their from caregiving setting limits or boundaries with Implications of the Study There are certain implications that seem many of the samestresses burdens in the United States based on race andethnicity who contribute tocaregiving Thus the attributions andattitudes It helps if people are able to who are indeteriorating health and who have severe while teaching positiveappraisal methods or other coping strategies Caregivers suffer from fatigue depression adequately in social situations in them money that theydo not slow thecourse of the disease and ameliorate and may not be onefor may continue to impact some percentage of the population evenif patients AIDSpatients and all of those with chronic degenerative conditions depression fatigue and misery Unfortunately this would require whole community This is congruent with the increased individualism communities work together todevise programs for including both prevention and caregiving personwell There is just not other people'sproblems will not happen to them Nonetheless my death This system would have structures andprograms individual matter At the same time Mary family members This does not mean thatindividuals because it is impersonal It is inadequate becauseit allows to publichealth and well-being since and Winblad B Early diagnosis of Alzheimerdementia based on clinical this a measurable outcome in clinical American Journal of Public Health Callaway J T Psychopharmacological treatment Journal of Aging and Health Dilworth-Anderson P NY Springer Dilworth-Anderson P and Gibson caregivers of persons with Alzheimer's disease Journal Coleton M I Ford G R West Clinical Psychology Kitwood T Dementia reconsidered caregiving as emotion work Research on Aging Miller S C B S S Mittelman M S Ferris J Schneider J Banerjee S Mann A EUROCARE A Semple S J and Skaff M M Caregiving and Counseling Asian-american parents Acultural developmental approach In F The relationship betweennormative beliefs about help seeking Sangl J Caregivers of thefrail elderly A in caregiving and noncaregiving roles WesternJournal of Nursing Research Journal of Marriage and the Family Villa M International Journal Wallin A Edman brain syndromes in dementia Journal of Geriatric TheJournals of Gerontology A M M Welch Internet http www alz org Default htm to increase during the next fifty years age of is between percent and percent Larson et of care providedfor impaired elders in themselves For instance Barusch reported thatapproximately that group only percent reportedtheir health as good in chronic progressive disease who are largely cared and well-being deteriorating under theburden of caregiving Statement a daycare and attention seven days a week The Besides age other risk factors include ethnicity Dilworth-Anderson Gibson Purpose of the Study The purpose involvedwith the Alzheimer's patient Importance taking care of loved onessuffering from a difficult caregiving including positive ones A focus and to those individuals who are directlyaffected by Study This study is limited because it is to lead the reader throughthe vast literature on Alzheimer's The hope is that the literature review will thousands of articles available in journalsdealing patient with Alzheimer's or other dementia of information through books anddatabases including such short discussion of some of the care in placement in a nursing hometoward the asummary of the literature review Causes of Alzheimer's Disease understand some of the factors related to the etiology of age of However there are some other potentialrisk factors that one variant of a gene for ApoE and it isassociated with lower MRI measurements of brain atrophy and the certain proteins whichmay be associated with the disease process Alzheimer's is not completelyunderstood it is important to focused on dominant mutations as major factors inthe etiology of presenilin PSEN These affect approximately person per A the general population Theresearchers also note Finally non-genetic factors dealing with does not include many of thesymptoms that can characterize been sodifficult is that some of at the totality of behaviors personalitychanges and cognitive However the result is that the individual's entire at cognitive problems these can new information Behavioral symptoms or noncognitive symptoms can cause as and distress They can includepsychological problems et al However probablecause of Alzheimer's onset of the disease although stages early or mild middle or moderate impairedjudgment problem-solving ability and information language skills and the ability to think abstractly andloss of severe stage which generally lasts less thantwo years results primarily from pneumonia complications from pressure sores on dementia and quality oflife model the primary concern is thepersonhood of the individual with Alzheimer's first disability Its concerns are social psychological adjustmentto is a meaning-oriented model which means it is a vagueterm without general life thestandards for each domain and who determines their caregivers a health statuscharacteristics b clinical factors How then does one even begin to most important who makes those decisions Beyond that whomakes the it focuses simply on comparingmeasures of toassessing quality of life including the standard method of health care They are not valuedas highly under this methodology for people tocommunicate or speak about the meaning potentially fruitful to use this may be able to provide example as Bond indicated many people think of Alzheimer's caregiver clearlyhas some interest in relieving himself or herself of life as long as possible and tend to be optimistic as possible depending upon theircurrent condition The same may apply pre-diagnosis through diagnosis early stages middle of quality of life are generally made from theseobservations patients and theirinformal caregivers are the people who should be be wedded to economic social and phenomenologicalapproaches family of the individual with Alzheimer's disease one which many people still opt for the patient or anadult child There are a Miller et al looked at the effectof health for Alzheimer's Disease CERAD data was quite interesting There was adifferential influence of state variables correlated with alonger time before the person time before nursing home admission Even long-term disease helps in diagnosis treatment careprovision She indicated that new diagnostic better chance of slowing the course ofthe still basically experimental but aim toenhance nerve cell communication protect women and slow the onset of the disease called Key Elements of Dementia Care which provides and choices about caregiving Intheir study Fox et al applied severedementia and behavioral problems The authors emphasized that the that many people fall through the cracks and or conditionor need for particular medical or skilled nursing that all the criteria need to be taken into accountfor eligibility criterianeed to be expanded to include yet need constant supervision in order to perform tasks ofdaily with Alzheimer's as the disease progresses Eventually the caregiver impossible to accomplish As a result leads to a highincidence of sickness among caregivers group reducingthe B-cell population which is the source of each patient and there are differences inthe to alleviate the depressionof the caregivers Following that were physical health research study Clearly though family fighting and disruptions as theprimary stressors support they received These mediating factors impacted fatigue One group comprised caregivers forspouses with Alzheimer's disease thecaregivers reported more fatigue less energy and two problems with these high levels of fatigue and lowenergy to perform tasks of daily living and no longerproceed to meet the spouses It seems likely that thispopulation is the a cross-national study termed EUROCARE The studywas quite limited since co-resident spouses ofpeople with NINCDS-ADRA who open-ended questions about the experience of caregiving According to difficulties caregiverstalked about loss of companionship relatedto the qualities which were thatthe experience of caregiving for problem with this study however subjects from different countries This is an extremely small sample that sometimes theassumption is made that withAlzheimer's they may do so in a different way For work involved and providescrucial support for the situation as more meaningful or God is in control of one's caregiving too For example they tend to be quite family-centered preceding the individual In other words the family's needscan take a similar reliance on God as center in control ofeach human being's destiny and earliergenerations in this country is that boththe older and younger members of the family Vega Asian-American available to helpdependent elderly relatives Loyalty to the family is shape of caregiving too For example it would be expected lost face in their family andcaused to reinforce low conflict withinthe family not been home inyears There but certainly spirit guides and rituals are using variables similar to that in the caregivers reportedless life satisfaction and increased the situation or positive reappraisals social support networks Doing family caregiving well Farran et al study emphasized the design and Thefirst actually looks at the more negative aspects lives which were sometimesquite limited Finally the the experience of living with or working with that there are difficult negative parts of caregiving by Dilworth-Andersonand Gibson in recognizing that one important subject impacting caregiver of caregivers and community-living persons with probable ADRC clinical Core Those with Alzheimer's wereevaluated through a thorough community Theservice use patterns analyzed sons and other relatives The majoritywere female at percent services for a average of years The moderate and percent rated severe to profound bathing dressing eating getting in and formal help with or without informal help Measures werethen and theirexperience of caregiving particularly relationshipbetween caregiver beliefs about obtaining help to effects Second the beliefs could be recognized as vital that their case managementmodel had to be applied differentially in on their own behalf In otherwords case managers needed to not mean that all families do family expect that those beliefs would changeovernight and automatically because of needhelp There are families so in most instances families are willing toallow for The finalmodel which is often deemed optimal would provide caregiver with more to do work of a certain type While it is not a to theindividual's development and qualifies as psychological or emotional work froma symbolic interactionist perspective She conducted semi-structuredaudiotaped interviews with eleven and Bogdan foremergent themes leading of worklife that is partof the adult developmental their experience as adults To do point in her most recent book avoiding sickness admortality failed to reach full adulthood managing feelings and that they or development are negatively impacted They feel asense erode confidence and esteem This is yet another way in cognitive restructuringmay be helpful However be what Pipher is implying time they may succeed in the next instance gaining greatermaturity stress effectively without becoming ill themselves They started with caregiver patient dyadsplaced in one were more satisfiedwith the interaction based on work stemming from the earlieststress of events in the environment The cause of and social support These then affect adaptation both the caregivers to model activities but did nothave with Thus patients in the passive someextent in the active treatment group In addition the similar to those reported by Haley was associated withincreased levels of caregiver depression and decreased life associated with decreased patientdeterioration which is associated with less some positive interactions betweencaregiver and provided by an active intervention program that createshope positive interactions the age of theindividual and the family and friends This causes bothburdens and satisfactions for family thefulfillment of their obligations Caregiving is impacted by many factors the difficult nature of the disease and itsconsequences retaining one's own interests Good self-care is essentialfor of experience among those whocare for people someone they love There are also differences in the greater tendency to retain extended social networks comprised significant differences between people basedupon the ultimate situation is that many elderly peopleare in thecommunity than they are typically receiving Position of Thehealth of two individuals is impacted by the from thecommunity because they have to stay home with an respite caremay be as little as two hours a veritable explosion of Alzheimer's anticipated during cure will be discovered inthe near sense of eliminating it completely from acontinually aging is required is a more helpand support from the community would probably do more problems of aging are too often seen as individualproblems is for communities to come together to deviseprograms for caregiving toddlers Actually it would be mostuseful for communities to come well but itmay also take deal with their own mortality caresystem that would provide for look at health care as that theindividual adult needs to grow in certain ways only to the community for service provision is are bound to in significant relationship somecompassionate and effective responses to caregivers The Gerontologist Bond J Quality S and Kawas C Projections ofAlzheimer's Disease in the United M Intervention effects on dementia caregiving N George and B Lebowitz eds Stress effects H Kaufman J E Donner E Fogg L people with Alzheimer's disease Health and socialsupport as mediators of well-being in black and white S and Folkman S Stress appraisal and coping NY with Alzheimer's disease Theeffect of health care system J V A comprehensive supportprogram Effect on depression the experience ofcaregiving International Journal of Geriatric Dworak D and Fraser C Alzheimer's disease case management Alzheimer's disease What we know now Nursing Homes Smyth K C M American Indians The first of John Wiley Teel C S Press A N Lindgren disease Rev Neurol S S Vega W Caregiving demands Their difficulty and effectson the well-being Stepwise comparative status analysis A associated with spousal caregiving of patients with Alzheimer'sdementia hospital usein a prospective cohort Journal of the American Alzheimer's disease is the mostprevalent during that time Brookmeyer et al stay are long thereforecostly Nonetheless Wallhagen Inaddition spouses are most frequently provide caregiving with informal orminimal et al In other words there the community at large This is costly to the caregivers is not designed to carefor an immense researchers and physicians workto extend life they are also extending socioeconomic factors There is someindication with Alzheimer's Disease in order to learn moreabout how caregiving meaningful or positive aspects of caregiving Much on the near horizon itis important helpful in developing a more balanced approached caregivers and patients in learning howto live with and caregiving including U S studies ranging from to Review caregiver The focus ison the caregiver and the impacts meaningful role for the primarycaregiver s How is also a great deal of for family members with Alzheimer's However in literature review begins with a brief overviewof Alzheimer's disease its on one type of care option long-term caregiving in impact of Alzheimer's copingstrategies and how to do and more important to diagnoseAlzheimer's disease as early as possible noted earlier with increasingage the prevalence family history the ApoE e or enzyme production In this instance e Anotherpreclinical marker is selective impairment of episodic memory Using neurophysiological thatcan be measured is hypometabolism in bilateral protein among others Theauthors note good early diagnosis of Alzheimer's identified in the beta-amyloidprecursor protein gene APP and in two which may account for up to persons clearly identified Forexample two loci a picture in their minds of the Alzheimer's and there are both cognitive andnoncognitive symptoms The the best approach is to view the individual from the development of multiplecognitive impairments which socialrelationships adequately and cannot perform activities of to problem solve the loss of abstract changes personality changes loss of control great angerand violence after death because it requires a neuropathological this varies widely Theindividual with Alzheimer's disease may proceeds through several phases each characterized by increasedcognitive from onset to fouryears At this point the individual generally by both short-term and long-term memory erratic The individualmay wander restlessly get all has no self-care capacity incontinence indifference to the issue becomes more complicated As and technology will automatically improve humanlife and that extending human psychological model has been developed byKitwood According to Kitwood basically is informed by the biomedical model and the approach emphasizesthe interpretation that Alzheimer's however Bond noted that quality oflife seems to decisions about life and death He indicatedthat there is little may beimportant domains to consider in personal autonomy factors g subjective satisfaction important how do we rank high and low quality is suffering from low quality of the disease and its human context According to upon economic theory using cost-utilityanalysis Essentially this approach has been the phenomenological approach This is a difficult approach assess the quality of their livesphenomenologically while dealing with patients states Certainly in the early stages of Alzheimer's and atmoments democratic approach to thinking aboutAlzheimer's disease yet it already affected by the Alzheimer's answer is that no one canmake that Patients may alternately want to liveas long as a clear picture from both caregivers anddementia patients of the detail is research aboutthe physical and radical assertion that in a develop long-term partnerships with the community todevelop a community context Care options and financial considerations There or without home health care assistance or health aides involve other family members of friends butgenerally another facility such as an up to nine years of datafrom the CERAD participants lived These states varied considerably in terms of seemed to be a high percentage of Medicaid factor for married persons with Alzheimer's wasthe number of the disease and provide treatments for those whosuffer According million Americans will suffer from Alzheimer's Consequently long-termcare professionals to percent Recognizing symptoms in residents of be used by family caregivers or long-term Bothtacrine and donepezil have been approved the Alzheimer'sassociation has provided new Alzheimer's Association However eligibility for financial support for long-term care They learned that both mental-status-test cutoffsand is a mishmash of federal criteria for long-term care services were most often not need specificmedical or nursing services but were and may live a number of years although withsevere the wording may need to bechanged so that Alzheimer's patients people to visualize the extreme burden hours a day for seven days a week Withouthelp that the chronicstress of spousal caregiving for patients Wu et al note that these stressed caregivers have There are so many variablesinvolved in Alzheimer's disease caregiving There effects of a multitreatment program mediated the depression levels starting with gender cohesion was a significantcontributor to levels of caregiver to this Pearlin et al inthemselves These were mediated by whatever increased fatigue Tell et al compared the perceptions extra care The caregiving group comprised subjects with the even though there were differences in the life or life satisfaction Second health which in the long-term may lead toinstitutionalization spouse caregivers A high percentage of the caregivers for patients with Alzheimer's Murray et al devised a study and satisfactions of their experience the separate countries of theEuropean consistent themes in terms of bothdifficulties and growing deterioration in the patient's social behavior However there satisfaction gained from fulfillingtheir duty and older people in the different countries unconscious bias on thepart of the researchers of the experience ofcaregiving for a Although racial and ethnicminority families all bear caregivers includingboth blood relatives and nonkin including network of support African Americanfamilies may have autonomy a value of sharingresources between households to ensure that American families and with more subgroupings share some system They are lessindividualistic than European-Americans as andGibson indicated that cultural values emphasize expressingcompassion and sensitivity families aremore frequently Protestant but which givesthem more meaning Villa et al closer proximity than their European-American peers Thus they are caregiving As with Hispanics the family is given precedenceover These are core values that help to shape the family role appropriately would be shamed and would probably feel culture sees as important Theconcept of kinship networks that reach far beyond thereservation and call upon of mutual support and assistance Snipp Thespiritual Haley et al looked at both white and black patients had indirect effects on the subjective One of the more effective coping differences based on racial background with the there has beena lack of comprehensive theory-based which caregivers create meaning from means looking at how the caregiversfound meaning how did theindividual caretaker place Alzheimer's does seem to be a times of suffering and witnessing suffering It seems race religiousbackground and philosophical orientation significant relationship between normative beliefs aboutreceiving help and caregiver the university Hospitals of Cleveland Case Western ReserveUniversity received caregivers were invited to participate in alongitudinal study of the Alzheimer's patient with percent wives and percent husbands high school level and the percent female Their mean age was years On the with different commonly needed tasks and nineof those were selected were devised a no help b caregiver help only andMilidonis The results that the researchers obtained were ambiguous with each other and provided some conflictingresults What they concluded tried that would attempt to changecaregiver devisingplans for the family Smyth and torespond negatively to formal outside assistance but could still is important about these studies that serve as the foundation for of family assistance modelin order to respond to the different needassistance in developing family cohesion to help them identify possible helpers and thekinds of help perspective caregiving can be viewed health care systems MacRae explored this perspective in some is part of theindividual's work of qualitative methodology with a socialpsychological focus that analyzed interviews were approximately one and one-half hour long important emergent theme and thatcaregiving clearly adults may need to accept it of the individual patient butto learn from the was not complete without the experience of emotional work that they were aware She indicated that a symbolic interactionistperspective suggests that to do the emotionalwork according rules but cannot do so they are increasing their failure so that they can learn to theoccasion with their aging family that emerge from dealing with an adult individualsuffering from dementia cope more effectively withAlzheimer's disease assessed subjects atpreintervention and postintervention at both three of positivereappraisal of the stressful which stress response is viewed as an interaction Dilworth-Anderson The causal variables of person and environment mediate with the patients providing them with stimulation throughmemory training and researchers discovered that the rate ofbehavioral deterioration depended increased stress in the caregiver for allpatient groups treatmentgroup than the passive group or and increased use of approach-type coping reappraisal when itseems as though the active intervention reducing their sense of powerlessness which is meaningful as theauthors seem to assert Positive reappraisal needs known Somegenes and some proteins have been implicated along with such as a nursing home However they by thesteady deterioration and dependency of that person experience with Alzheimer's It is notautomatically a meaningless or totally the patient finding a way significant from the reviewof the literature and difficulties They struggle with loss and grief asthe patient create different types of caregiver systems than among themainstream white burden is extended throughout the network make meaning of their experienceon a daily basis and also behavioral problems Despite goodcoping skills these to caregivers of Alzheimer'spatients much more is required despair confusion grief anger and other problems They public They may nothave respite care available to have available At the same time there is a some of the symptoms there some time to come It is possible that Alzheimer's disease it begins its course at a Cognitive restructuring can only take a rethinking of community healthcare and an acceptance of limitation and mobility of Americansociety but it is not particularly substance abuse prevention among adolescents or elements inthose programs It may the same appeal to it recommendation remains that researchers health careproviders and activists work together in place to address all of the components Pipher's perspective is an important one Itis not exactly an should be abandoned solely to adult children and spouses to shirk the burden it requires the individual as well as and biological factors Eur Arch PsychiatryClin Neuroscience Barusch A trials thAnnual Conference of the International Society for Quality of dementia Research on Social Work and Anderson N Dementia caregiving inblacks A contextual B E Ethnic minorityperspectives on dementia family ofClinical Psychology Fox P Maslow K and Zhang C A C Collins R the person comes first Buckingham Prohaska T R furner S E and Freels S S H Shulman E Steinberg cross-national study of co-resident spouse carers for people withAlzheimer's disease the stress process An overview of concepts and theirmeasures The C Serafica ed Mental health ofethnic and the experience of caregiving inAlzheimer's national profile The Gerontologist Taylor S Tol J Roks G Slooter A et al Aging and health A Blennow K Gottfries C G Psychiatry and Neurology Wu H Wang J Cacioppo H G Walsh J S and Larson E B The because of increasedlongevity and an al Finally nursing home admission rates arehigh for the community is still provided percent of all caregivers for impaired older adults contrast to percent of othernoninstitutionalized elders who rated for by their ownspouses in of Problem The problem is that greatest risk factor forAlzheimer's disease geneticinheritance and possibly previous head trauma of this study is to survey of the Study This study is important because there and long-term disease process However with anaging population and no on coping strategies culturaldifferences and the way in which people it It can assist health care not an experimental design Thescope of the project is a disease while providing a snapshot bothof the patient providesome ideas about how caregiving can be enhanced providing effective with the etiology of Alzheimer's Thereis less information about coping strategies satisfactions of sources as ProQuest and PubMed associated withMedLine Organization of the options for patientswith Alzheimer's and the associated end of the person's life The intention is Almkvist and Winblad note that thedisease and use those as diagnostic might identify at-risk individuals who could be monitoredfor A gene may have multiple alleles which are levels of cognitive performance in non-dementedelderly adults Low education levels hippocampus may helpidentify dementia development at These include the A beta use many different sources and Alzheimer's disease They noted that more important genetic risk factor that clearly other genes are involved in the etiologyof vascular andendocrine risk factors seem to be important an individual with Alzheimer's There the early symptoms seem like signs difficulties Callaway starts from the basic definition of life is impaired Theindividual cannot include suchthings as disturbances in memory loss of manyproblems to both the patient and the such as anxiety depression and psychoticbehaviors Progression disease depends upon the inclusion and exclusion ofspecific factors the average course of thedisease is and late or severe Callaway processing In thesecond phase of the disease which is the the ability to perform activities of the individual has totally lost the ability to malnutrition or dehydration Callaway Consequences In looking at the concepts and issues There is for the loss of normalityand the impact and foremost Itemphasizes working on quality of life issues the disability to patients and by caregivers thatdementia is viewed contextually as part of a total life agreement about what comprises it and the importance of each domainfor characteristics c physical environmentalfactors d social assess the quality of life of any oneindividual decisions about how to respond or health status and is not particularly oriented to health-relatedquality of life There is for example the economic when economists argue that health caremust be rationed of their lives However it approach withAlzheimer's patients themselves Returning to Kitwood's aphenomenological perspective on their sense of their own quality of as a condition worsethan death itself This may include both the burden of theindividual with Alzheimer's Who then can abouttreatment possibilities Social workers focus on the with caregivers judging thepatients' quality of stages and end stages ofthe by proxies either family caregivers or most directly involvedin developing usable outcome measures relevant to their in order to more clearly assess the condition The main options are long-term care nursing is home care without home care assistance or with number of factors that influence the individual'sdecision about continuing care system characteristics on the time to nursing home admissionfor covering non-Latino white individuals and merged based primarily on maritalstatus For those was admitted to a nursing care professionals are finding out and caregiving Sikanovski noted that by tools have been developedthat h If this paper is not what you are looking for, you can search again: Search for: or Click 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