Thematic analysis of the experience of making a decision to place a family member with Alzheimer's disease in a special care unit.

The purpose of this study was to provide an in-depth description of the experience of making the decision to place a family member in a special care unit among a diverse sample of family caregivers. To achieve purposive maximum variation of the sample, the sample of 30 family caregivers was chosen from an original study of 256 family caregivers. The sample was randomly stratified according to ethnicity, gender, and relationship to the care receiver. Three independent researchers used Luborsky's method of thematic analysis to analyze the interviews. After mutual consensus, 1565 themes (descriptive statements) were identified and synthesized into 21 topics. The topics were then synthesized into four patterns describing the decision-making experience: moving toward the unavoidable decision, struggling with the decision, seeking reassurance, and remaining connected.

The experience of caring for a family member with Alzheimer's disease.

The purpose of this phenomenological study was to describe the experience of caring for a family member with Alzheimer's disease or related disorder (ADRD) living at home among a diverse sample of 103 family caregivers. The study involved secondary analysis of in-depth transcribed interview data using van Kaam's rigorous four phase, 12-step psychophenomenological method. A total of 2,115 descriptive expressions were categorized into 38 preliminary structural elements. Eight essential structural elements emerged from an analysis of the preliminary structural elements. The eight elements were then synthesized to form the following synthetic structural definition: Caring for a family member living at home with ADRD was experienced as "being immersed in caregiving; enduring stress and frustration; suffering through the losses; integrating ADRD into our lives and preserving integrity; gathering support; moving with continuous change; and finding meaning and joy."

The 20th century. Looking back at the ambiance of aging from the perspective of age-specific journals and periodicals.

The word "aging" is fraught with nuance, both positive and negative. The purpose of this article is to describe the results of a preliminary exploration of the ambiance of the concept of aging in the United States as seen from the perspective of periodical literature from the past century. A convenience sample of professional journals and lay periodicals concerned with aging and the issues of aging was selected as the focus for this investigation. Specifically, volume one, number one of the selected journals was examined with regard to the date of the first publication, the table of contents, and the first issue editorial or articles in the first volume describing the motivation for the introduction of the journal. Findings indicated that as the century progressed and the study of aging took form, the focus shifted from how to manage the problems of aging to: (a) how to promote healthier young adult lifestyles to increase the chances of a healthy old age, (b) how to continue to maintain older adults' health and therefore, increase the life expectancy for those people older than age 65, and (c) how older adults contribute to the well-being of society. The longevity of the human species, as well as the increasing size of the aging population is a new phenomenon, the ramifications of which are difficult to predict. However, as the emotional tone of the journals in the latter quarter of the century gradually became more positive, it was apparent that consideration was being given to the idea that this phenomenon could be a positive force in the collective growth of humanity.

Redefinition: coping with normal results from predictive gene testing for neurodegenerative disorders.

The purpose of this qualitative study was to describe the psychosocial impact and coping processes of normal (negative) results from predictive testing for an inherited neurodegenerative disease. Ten adults with normal results of predictive testing for the Huntington disease (HD) or the Pallido-Ponto-Nigral Degeneration (PPND) gene mutation participated in semi-structured interviews 1 month after receiving results, and seven of these participants were interviewed 6 months later. The major theme of Redefinition was derived using Knafl and Webster's analysis method (1988). People who received normal gene results experienced loss of former beliefs about themselves and developed new self definitions, relationships with family, and roles in society. This coping process evolved from a personal focus at 1 month to a broader future perspective at 6 months after testing. Identifying components of the redefinition process may be an important consideration in planning interventions to promote coping with normal gene results in persons within at-risk families.

Psychosocial impact of predictive testing for Huntington disease on support persons.

Although a support person is required by many centers during the predictive testing protocol for Huntington disease (HD), little is known about the psychosocial impact of predictive testing on persons serving in this role. Eighteen adults who were support persons during predictive HD testing in one HD testing center completed a semi-structured interview to describe their experiences. Participants also completed the Impact of Events Scale (IES) to assess perceptions of emotional distress regarding predictive testing and the State Anxiety Scale of the State Trait Anxiety Inventory (STAI) to assess anxiety regarding the interview. State anxiety scores were similar to normative values for working adults. Although support persons for individuals with a positive gene test scored higher on all measures of the IES than those who were support persons for persons with negative gene mutation results, these differences were not statistically significant. Support persons identified aspects of the protocol that did not fit their needs, perceived the testing process as extending into subsequent caregiving responsibilities when the test was positive, and were uninformed regarding specific caregiving issues for family members with the gene mutation. The impact of the testing experience appeared to be most intense for those support persons who were at-risk offspring of probands. Findings suggest that individual assessment of support person needs may allow more focused counseling of support persons during predictive genetic HD testing. Collaboration with health care providers may facilitate symptom management following testing.

Our parents, our children, ourselves: a therapy group to facilitate understanding of intergenerational behavior patterns and to promote family healing.

1. The parent-child relationship is one of the most influential in a person's life, forming the conscious and unconscious reality out of which the person functions for the rest of his or her life. 2. Because all families are imperfect, painful behavior patterns can be passed from one generation to another. 3. Through understanding the history of their own growth and development and that of the families they produced through marriage, these parents learned how to change their part in painful interactions with their children, thus opening the possibility of healing between generations.