ABSTRACT
Families now provide most of the care received by older people in the United States. Proposed changes in the health care system will mean that families must take an even greater role in delivering health care. It is crucial that nurses practicing in a variety of settings be prepared to establish partnerships with family caregivers in order to attend to the long-term care needs of older people.
Subject(s)
Caregivers/psychology , Home Nursing/psychology , Professional-Family Relations , Aged , Geriatric Nursing , Health Knowledge, Attitudes, Practice , Humans , United StatesABSTRACT
The PREP system of nursing interventions, designed to increase preparedness (PR), enrichment (E), and predictability (P) in families providing care to older people, was pilot tested for acceptability and preliminary effectiveness. Eleven family units were assigned to the PREP group and 11 to a standard home health control group. The PREP group scored approximately one SD higher than the control group (p < .05) on the Care Effectiveness Scale, indicating greater preparedness, enrichment, and predictability. Further, on a rating of overall usefulness, the PREP group rated their assistance from PREP nurses (M = 9.75) as significantly higher (p < .01) than the control group rated assistance from the home health nurse or physical therapist (M = 6.57). Although not statistically significant, mean hospital costs for the PREP group ($2,775) were lower than for the control group ($6,929). Results provided support for a full intervention trial.
Subject(s)
Caregivers , Home Care Services , Home Nursing , Aged , Aged, 80 and over , Caregivers/psychology , Caregivers/statistics & numerical data , Clinical Nursing Research/statistics & numerical data , Depression/prevention & control , Female , Frail Elderly , Health Maintenance Organizations , Home Care Services/statistics & numerical data , Home Nursing/statistics & numerical data , Humans , Male , Middle Aged , Pilot Projects , Program Evaluation/statistics & numerical data , Random Allocation , RewardABSTRACT
In both Alzheimer's disease (AD) and AIDS, family members vary in their perceptions of the individual's ability to control his or her cognitive or behavioral functioning. Family members who believe that the behaviors are unintentional generally experience less distress than do family members who believe that the individual has control over his or her thoughts or behaviors. The manifestations of intellectual and cognitive dysfunction of AD and AIDS are strikingly similar. Impairments of memory, concentration, and abstract thinking; confusion and disorientation; and slowed mental capacities are among the shared symptomatology, and may eventually become the catalysts for family caregiving. It is imperative that clinicians and researchers collaborate in further investigation in order to ease the burden on family caregivers and facilitate adaptations of caregiving methods.
Subject(s)
AIDS Dementia Complex/nursing , Acquired Immunodeficiency Syndrome/nursing , Alzheimer Disease/nursing , AIDS Dementia Complex/psychology , Acquired Immunodeficiency Syndrome/psychology , Adult , Aged , Aged, 80 and over , Alzheimer Disease/psychology , Caregivers/psychology , Cost of Illness , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Nursing AssessmentABSTRACT
1. The concepts of local and cosmopolitan knowledge may be used by gerontological nurses in creating partnerships with family caregivers to frail older people. 2. Local knowledge is the understanding and skills that the family brings to the caregiving situation; cosmopolitan knowledge is the understanding and skills that the gerontological nurse brings to the situation. 3. Four nursing interventions are guided by the conceptualization of local and cosmopolitan knowledge: acknowledging and affirming local knowledge when it is adequate; developing or enhancing local knowledge when it is inadequate; assisting family caregivers to apply local knowledge to problem solving; and blending local and cosmopolitan knowledge.
Subject(s)
Caregivers/psychology , Family/psychology , Frail Elderly , Geriatric Nursing , Professional-Family Relations , Aged , HumansABSTRACT
The purposes of this study were to explore family caregiver perceptions and interpretations of dementia-related behavior problems, and describe how these perceptions and interpretations influenced the caregivers' experiences managing these behavior problems. Using intensive interviewing techniques, family caregivers to persons with dementia (N = 10; all women) were asked to describe their experiences managing behavior problems. The results suggest that the caregiver's interpretation of the nature and cause of the behavior and her perception of the care receiver's ability to control it influence the way in which the caregiver manages the behavior problems, and the degree to which she experiences negative consequences. These results may have important implications for the way in which health professionals intervene to assist family caregivers in managing problem behaviors related to dementia.
