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Sunday, October 17, 2010

Types of Services Needed for Caregivers - 2

By : Lamiaa Moustafa Elbosaty

Community Nursing Staff:

-         Community sister "district nurse". she provides nursing service for the sick elderly people at their own home.

Health visitors: They are specialized in care of elderly people. They also play a valuable role with regard to the following: Giving advice counseling, educating, identifying needs and liaisoning with other services.

-         Community psychiatric nurses: They support the patients and their carers as well as monitor progress and detect any deterioration (Bushy, 2002).

3: Allied Health Professional:

They provide an invaluable service to the elderly. They include: Physiotherapists, rehabilitation therapists, occupational therapists, speech therapists and pharmacologists (Lund & Wright, 2001).

4: Geriatricians:

These are consultant doctors who are specialized in the diseases and problems of aging and who are responsible for geriatric departments. They make home visits to advice in treatment.

5: Social Workers:

They can provide the vital link between the elderly person and the availability of any of the local services. The social worker is usually the key to obtaining extra financial help for an elderly person (Lund & Wright, 2001).

Tuesday, October 5, 2010

Alzheimer's Disease

By : Lamiaa Moustafa Elbosaty

Alzheimer's Disease : Is the most common cause of dementia in older adults, representing 60% to 80% of dementias. Subtypes of Alzheimer's disease are defined by age of onset; early onset Alzheimer's disease is used to define onset in age 65 or under, late onset Alzheimer's disease for onset after age 65. The late onset Alzheimer's disease is much more common than early onset Alzheimer's disease, but the early onset Alzheimer's disease has a more rapid progression" (NIH, 2004). The female to male ratio is approximately 2 to 1. It will become a greater public health problem as the society continues to grow (Sadock and Sadock, 2005).

Alzheimer's disease is a degenerative, progressive neuropsychiatric disorder that results in cognitive impairment, emotional and behavioral changes, physical and functional decline, and ultimately death. This disease robs its victims of every thing learning in life, so that they are unable to fall back on preserved intelligence (Boyd, 2005).

A simple way to describe the difference between normal forget- fullness of aging and Alzheimer's disease is seen in the behavior described below: With advancing age or with increased stress, an individual may say "where are my keys? Where I did place them? I can't find them anywhere?" After several stressful moments, the keys are usually found and events are over. However, if a person with Alzheimer's disease is handed a set of keys, he or she looks at them blankly, handles them awkwardly, and has no idea about what they are for or what to do with them (Allender, 2001).

Onset is gradual, and verbal memory is often affected first. Alzheimer's disease loses judgment and reasoning and safety becomes an issue early in the disease process. Victims of Alzheimer's disease may wander away from home and can't tell anyone exactly where they live, or they may forget that a stove can get hot and burn themselves while trying to cook. They neglect their health and are even unaware of whether they are experiencing major health problems (Mace & Rabins, 2001).

The client demonstrates depression, agitation, sleeplessness, and anxiety which upset the family normal routine. The motor activity increases in the evening (sundowning), aggression is common, both verbal and physical often takes the form of resistance to help with personal care. Serious physical violence to others is rare. Mood changes are common, and more than half suffers of depressive symptoms. Hallucinations occasionally occur in late stage of Alzheimer's disease .Client may under or over eat, with associated changes in weight and nutritional state. Changes in sexual behavior occur, usually with reduction in drive (Ritchie & Lovestone, 2002).

Thursday, September 23, 2010

AIM OF THE STUDY

By : Lamiaa Moustafa Elbosaty

This study aimed to assess problems and needs of family caregivers dealing with demented persons through:

1.     Assess knowledge, attitude and practice of the family caregiver about problems and needs of demented persons.

2.     Identify problems and needs of the family caregivers of demented persons.

3.     Signify role of the community health services in improving care of demented persons.

Research questions:

1.   What are the problems / needs of demented person?

2.   What are the problems / needs of caregivers of demented persons?

3.   How can caregivers deal with burdens when caring for demented person?   

Wednesday, September 22, 2010

Introduction To Dementia

By : Lamiaa Moustafa Elbosaty



Caregivers are a critical national health care resource, families often are a primary source of home care and support for older relatives, contributing services that would cost hundreds of billion of dollars annually if they had to be purchased (Adams, 2008). Caregivers need to talk about their experiences and to be listened to, and the presence of resources and support requirements. The caregivers said that their ability as caregivers was limited; many did not know what resources are available or how to locate new resources. Many caregivers are carrying out their role dutifully, but feel isolation, suggesting that there is a lack of social understanding and policies about informal caregivers (Zabalequi, et al., 2008).

The family caregiver needs educative support from the nurse on how to care for loved one, who can no longer meet his or her own physical needs or ADLs. Family caregivers assume an exhausting, 24 hours, and 7days a week job for someone who shows less and less appreciation for what they do and, with time, does not even recognize who they are (Ham, 2002).

Nurses can help family caregivers to identify their negative experience about caregiving and can help them reflect upon their coping strategies to find balance in their situation. Risk groups of caregivers may be identified, especially those with low perceived health and sense of coherence, for early intervention to reduce burden. Nurse should be providing emotional support and counseling and serving as a coordinator of available community resources, the nurse can significantly help to relieve the stress on the family caregivers (Signe & Sölve, 2008).

The nurse must assess the family and the client to determine their need for information and instruction about the illness, care of the clients, and support for the caregivers. The use of psycho-educational approaches has been demonstrated effective in enhancing family coping, and reducing caregiver depression and anger (Hepburn et al., 2003).

According to McIntyre and Cole (2008), the love stories is a spoken-word performance created from data gathered from family caregivers about their experiences of caring for a loved one with dementia. Loving care brings to the person with dementia opportunities for attachment, identity, inclusion, occupation and comfort.

Significance of the Study:

          Needs and problems due to caregiving of demented persons are a major source of caregiver's burden, and even burnout. Although 80% of caregiving is provided by family caregivers, there is deficit of support and services provided to them. Many international studies have defined the needs and problems of family caregiver dealing with demented person, yet there is a scarcity of local studies dealing with this problem.

Tuesday, September 21, 2010

Introduction To Dementia

By : Lamiaa Moustafa Elbosaty

 

Dementia is the seventh leading cause of all deaths in the United States and the fifth leading cause of death in Americans older than 65 years. Unfortunately, the main cause of dementia or the relationship to other brain abnormalities such as vascular disease and Lewy bodies is not known. There are also no good preventive or treatment strategies (Kuller & Lopez, 2008). Moreover, caring for a patient with dementia is more challenging than caring for a patient with physical disabilities alone. Peoples with dementia typically require more supervision, are less likely to express gratitude for the help they receive, and are more likely to be depressed. All of these factors have been linked to negative caregiver outcomes (Pinquart & Sorensen, 2007).

Caregiving has all the features of a chronic stress experiences; it creates physical and psychological strain over extended periods of time, is accompanied by high levels of unpredictability and uncontrollability, has the capacity to create secondary stress in multiple life domains such as work and family relationships, and frequently high levels of vigilance (Vitaliano, 2003).

Caring for a person with dementia can cause emotional, psychological and physical problems. In most cases of dementia, at least two individuals are affected; the person with condition and the caregiver. (Mannion, 2008).Carers are at high risk of mental health problems and that the comprehensive burden of caring has social, economic and health based elements. Dementia caregivers reported greater levels of physical burden and psychological distress than other caregivers (Kim & Schulz, 2008). Many problems can face the caregivers of people with dementia, which include the effective loss companionship and support of a life partner, social isolation and complex financial, legal and social decision-making. The burden of caring is financially, emotionally and physically significant (Thompson & Brigg, 2000).

Monday, September 20, 2010

INTRODUCTION

INTRODUCTION

By : Lamiaa Moustafa Elbosaty

Dementia is an umbrella term, when we hear that someone is diagnosed with dementia there is more to the story as a patient, family person, and the type of dementia. Each disease under the umbrella has different courses of illness, different symptoms and different challenges. The drugs' treatment and interventions may be different as well (Cooper, et al., 2007). Dementia is frequently associated with the elderly, and is often incorrectly assumed to be a part of the aging process. Actually, many elderly people retain their intellectual functioning into their eighties and nineties. Dementia becomes a public health issue facing the whole world in the next decades (Brierley, 2008).

 The number of persons with dementia was estimated at about 25 million persons worldwide (about 0.5% of the whole worldwide population), of which 59% were females, 52% live in less developed countries. The number of new cases of dementia in 2000 was estimated to be 4.6 million, and it is forecasted that by 2030, 63 million people will suffer from dementia. More than 5 million American are estimated to have dementia. In Europe there are 7.2 million persons have dementia and it will be 16.5 in 2050. In Africa, there are 1.3 million and it will be 6.3 million in 2050, while in the Arab world there are 1.5 million person suffering from dementia. In Egypt, there are about one million cases and it is expected to continue to increase in the coming decades (Ashour,2007). Significant cost implications related to dementia include an estimated $148 billion annually direct (Medicare/Medicaid) and indirect (e.g., caregiver lost wages and out-of-pocket expenses, decreased business productivity) costs (Alzheimer's Association, 2008).