By : Lamiaa Moustafa Elbosaty
A: Types of Services provided:
1- Adult Day Centers: They provide a place for individuals to socialize, exercise, and interact with others, they are generally geared to older adults and offer programs that are designed to promote services often tailored for individuals with cognitive impairments who might be in need of a safe place to be supervised or assisted in their activities of daily living. It provides a variety of mental, physical, and emotional services which benefit both the individual and their families. It offers transportation to and from their center, it also provides nutrition meals and snacks and can accommodate particular diets (e.g. diabetes). Adult day centers employ trained staff and volunteers who are able to assist with numerous aspects of daily living. (e.g., toileting, help with eating /drinking, assistance with walking) (Rose et al., 2000).
2- Adult Day Service: Users reported greater decrease in hours spent on behavior problems when compared to non users, even after controlling for baseline differences between two groups. They also reported decrease frequency of behavior problems in their relatives who attended adult day programs. Adult day services are effective in restructuring caregiving time and may offer potential benefits not only to family caregivers but also to community-residing older adult who have dementia well (Gauglar et al, 2003).
3- Special Geriatric Clinics: The goal of these clinics has been to offer coordinated medical and social services to the population of independent, working elderly to aid them in retaining their independence. In addition, they provide important diagnostic services to the elderly (Abido, 2000).
4 - Nursing Homes: There are many forms of these homes, however they could be roughly grouped into three categories. The first type is called the skilled nursing care home, in which residents receive a level of nursing care that requires professional nursing supervision. The second type could be called the personal care with nursing home, in which there may be substantial numbers of residents who require minimal or intermittent nursing and personal care assistance. The last type of homes is the residential homes, which the residents may need assistance with daily living activities but don't require nursing care (Abido, 2000).
5- Support Groups: Families caring for patients often find it helpful to share their experiences and thoughts in a group setting. Support groups provide an opportunity for family person to come together with others in similar situation. Strategies on providing care can be exchanged in a group, problems can be discussed, feelings can be aired and medical information or research on dementia can be discussed. More recently, support groups are also being offered for patients in the early stages of the illness (Haley, 2001).
The support groups are groups of people who have lived through the same difficult experiences and want to help themselves and others by sharing coping strategies. Mental health professionals strongly recommend that family caregivers take part in support groups (Rodring & Nestor, 2007).
There are several types of support groups such as the Alzheimer's association support groups which provide information about care receiver management, share coping strategies and provide support in discussion group with others caregivers. This type of support group may be more important to caregivers who are concerned about the future of their relatives who are in the later stage of Alzheimer's disease (Parks & Novielli, 2000).
In Egypt, Alzheimer's association address is Center for Psychiatric Hospitals, Ain Shams University - Cairo, Tel. +0223920074. Unfortunately, there are no institutions or qualified for care of those patients, which make up the psychological and physical burden on their families a great. Furthermore, there are a number of cases without detection, especially in the non-educated group of society and they will be having lack of patience and neglect for the treatment of their condition and requirement (Abyad et al., 2001).
Alternatively, educational support groups are self-limited and provide information to assist caregivers. This groups provide information about Alzheimer's disease; patient care; legal and financial resources; and available community services. Caregivers who have relatives in the early stages of Alzheimer's disease may be more in join to favor educational group rather than Alzheimer's association support group. Finally, stress management support group helps caregivers identify stresses, and develop strategies to cope with stresses of care giving. Nevertheless, caregivers in a stress management support group were shown to have used more effective coping skills at home, but have not reported reduced stress (Smyer & Qualls, 1999).
6- Home Care: It refers to health care and social services provided to individuals in their homes or in community and home like settings. Home care may include nursing rehabilitation, social work, home health, home care can unable elders to remain in their own homes for as long as possible, relieve the burden on hospitals and improve the quality of life for the elder and the caregiver. As well, home visiting nursing services can be used to good advantages especially when only part-time nursing care is needed such as physical therapy, home delivered meals and assistance in rending care (Jamieson, 2002)
7- Receipt Care Facilities: Provide overnight, weekend, and long stays for someone with Alzheimer's or related dementia, so a caregiver can have longer periods of time off. These facilities provide meals, help with activities of daily living, therapeutic activities to fit the need of residents, and a safe, supervised environment. Examples of such facilities include nursing homes, and residential care facilities (Lawton et al., 2001).
8- Emergency Respite: Is often offered in many nursing homes, residential care facilities, and assessed living facilities. It may be needed when a caregiver becomes ill or must go out of town unexpected by or if the care recipient is at risk of abuse or neglection (Rodring & Nestor, 2007).
9- Other services:
§ Transportation services
§ Social security services and protective services
§ Short-stay residential accommodation so that the caregiver of an elderly may go away on a holiday.
§ Leisure –time activities (recreational and educational programs).
§ Communication services "phones, emergency access to health care".
§ Visual services, out –patient clinic and dental care services.
§ Dietary guidance and food services
§ Exercise and fitness programs
§ Financial aid, counseling and social assistance services
Home repair and pest control(Lund & Wright, 2001).
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