Health Science: Family Health - Essay Example

Health Science: Family Health The physiological and psychological aspects of a family with a grandmother with Alzheimer's Disease (AD Aspects that relate to family members, social aspects including the availability of social, medical, and community services and resources, legal, medical, or ethical aspects involved, other aspects of an issue derived from reading or the accounts of others. Disease Background Alzheimer's disease (AD) is a very common form of age-related dementia gradually starting with signs of forgetfulness of recent events, names or things and progresses to anxiousness and aggressiveness requiring full time care. Cognitive (intellectual) impairment extends to the domains of language (aphasia), coordinated movement (apraxia), recognition (agnosia). In the United States, many families experience at one time or another the devastating effects of Alzheimer's disease as about 100,000 Americans die of AD reportedly each year and about 4 million show some signs of the disease. McConnel (1990) reported that about seventy to eighty percent suffering from AD are being cared for in their homes by immediate family members like spouse adult children or both. Physiological Aspect of Family Caring for Patients with Alzheimer's Disease In consideration of the immediate family as the most probable caregiver for an AD patient, it is very likely that an elderly husband or wife between 50 to 90 years old or up to a capable old age may be the closest caregiver to an AD patient. Likewise, it is also probable that adult siblings, either married or not, or with family care for an elderly parent with AD, or both as provided for by the study conducted by McConnel (1990). Risk factors and clinical features must be well-established among caregiving family members. Since having a parent or a sibling with AD increases risk by up to three and a half times, it is also established that more AD patients in the family increases chance of developing the disease. Memory loss which progresses slowly from seemingly simple forgetfulness or fluctuating memory loss to a more pervasive loss of short term memory is often the indication of AD. Alzheimer's begins to damage the brain years before the symptoms occur although reason is still unclear among researchers. Age is the established biggest risk factor, lifestyle such as lack of exercise, diet and socialization were also suggested adding up to deterioration of body systems that contribute to the development of AD. Diagnosis is primary done with clinical observation as well as series of tests of memory and intellectual functioning over a period of weeks or months. This is to rule out alternative diagnoses. As of the research period, no medical tests are available to diagnose AD pre-mortem (Wikipedia, 2006). Interview with family, close relations and friends also account for the establishment of the presence of the disease, as well as establishment of the indicatory symptoms since patient is already suspect for consistency. Psychological Aspect of Family Caring for Patients with Alzheimer's Disease Fischer et al (1995) said that "Managing an older person with Alzheimer's disease (AD) in a community setting places considerable physical and psychological burdens on the primary caregiver and other family members." Fischer et al (1995) acknowledged that a single caregiver may deliver most patient care, spouse, adult offspring, offspring spouses, and other family members such as grandchildren, sibling are also involved in sharing care, emotional and financial support, or participating in various forms of family-based decision making. The report also added that multigeneration families affects day-to day care of frail older persons while Zarit et al (1980) also found out that familial emotional support has been shown to moderate the stresses of caregiving in some families. And Mortimer (1990) showed that a family's inability to accept the psychological loss of an ill older person, prevented the family from coping effectively with the chronic stresses of care. Shield (1992) also found that emotional support by family members lessened the caregiving spouse's depression, but criticism exacerbated spouse depression. Lieberman, et al (1995) reported that adult offspring and inlaws displayed variations of anxiety from depression, somatic symptoms, and well-being as a function of qualities of the family system. Their study further established that "qualities of the family system either exacerbated caregiving stressors or contained them from cascading through the family system to affect non-disease-related family roles." They suggested that the powerful and consistent role played by multigenerational family in response to caring an older person with AD are operative without respect to amount of direct caregiving provided by offspring to their ill parent. Nevertheless, Antonovsky and Sourani (1988) showed that family coherence was related to the ability of injured or chronically ill husbands and their wives to adapt to the stress of disease in the family. Doane and Diamond (1994) suggested that family patterns of criticalness, guilt induction, and intrusiveness are major predictors of the course and rate of relapse of major psychiatric disorders. The findings suggest that a basic set of family qualities are probably important for responding effectively to most demands for care, as experienced by family's life stage, other forms of stresses, and some of the unique characteristics of the disease (Rolland, 1994). England and Ganzer (1994) suggested that "A recurrent practice observation in practice and program evaluation (showed) that despite evidence of stress and strain, many of those who care for relatives with Alzheimer's seem to resist using support services." Nevertheless, further research and studies also found out varying variables and degree of care between family and the patient with AD that somehow provide interesting information about family relations, physiological and psychological aspects of caring for an elderly with AD. Giving support to a family member diagnosed with AD can be very difficult. The family member have to deal with her or his own fears, anxieties and guilt, or sadness and shock. In consideration to the fact that not all family member-caregivers have undergone formal or proper education about caring for people with chronic disease, Kennard (2006) suggested the following general attitude for family members with an AD patient: The family members or friends must arm themselves with knowledge. They have to understand about the condition of the patient. The better equipped they will be to support someone. Many institutional and government health brochures as well as websites provide a great way to learn about AD and caring for patients with AD and family members must be well-informed. Talking about the illness. Other people will soon know if a person wants to discuss something and this will show among family members carrying the burden of caring an elderly with AD. Others like neighbors, friends or close relations may help them by listening and showing that they want to support the person. Members might as well request their friends to listen, ask questions that enable them to continue with the conversation if they want to. The person must reassure others that it is alright for them to tell how they feel. The understanding, love and support from others is important. Ask open questions. It is proper that a person ask questions that require a sentence rather than a yes or no answer to enhance sharing and opening up. Studies have shown that mental and social activities retards or slows progression of memory loss among older person. Do not avoid the person. Alzheimer's is a slow progressive disease and people do not change overnight. To cut them off or suddenly reduce contact will make a friend or relative feel even worse. Avoidance makes it harder to contact people later as one would feel embarrassed and a bit guilty for not having been able to visit. If one simply cannot visit, use the telephone to talk with the friend or family member. Arrange a date and time to visit and fulfill it. Longer Term Support. As much as possible, help the person have as fulfilling life. Continue with the activities one have always done together. Support and help them out with things they find confusing or difficult. Choose an activity that stretches them but is not demeaning or likely to undermine their confidence. Expect change. One's approach had to change as the family member, relative or friend's physical and mental abilities decrease. Their ability to understand, process information, express themselves and their ability to concentrate on tasks will change. Stay Cool. People with Alzheimer's easily become frustrated and angry although they would not be able to articulate why. The attitude is more of an overwhelming sense of irritation mixed with confusion prevalent among patients. These are all signs of the condition so that family caregivers are well-advised never to take the irritation personally and try not to react in kind as it will simply raise the issue yet solve nothing. Look after yourself. The main caregiver may easily fall into the trap of giving everything over to care and forgetting about themselves. But this is not advisable good for the family member or the patient. It is best to find out about short-term support locally and then get involved with support groups simultaneously. Little things help even if the idea seems alien. One should make contingency plans in case the caregiver becomes ill or incapacitated. Don't take over. The caregiving family member must remember that not because someone has Alzheimer's disease does not mean that people have to take over decision making, choices and responsibility from the patient. Let the patient have a share of voluntary deeds as long as the acts are not harmful to the family. An elderly man featured in Reader's Digest showed his capacity to care for his toddler grandson that bewildered his caregiving daughter. As you would like to be treated. See the person first and not the illness. Know that the help, love, understanding, attention and support are invaluable for the patient. Social, Medical, Legal and Community Services While Texas has established a legislative mandate providing information and support to Alzheimer's patients, their families and long-term care providers as early as 1987, HEALTHvision, a leading healthcare Internet company recently announced the first nationally accessible internet-based support network for families coping with AD called the Alzheimer's Caregivers Internet Support System (ACISS). It is a "one-stop shopping" service designed to support the medical, social and psychological needs of family caregivers in the United States. ACISS provides innovative information, support and advice and features include on-line support group, tele-counseling, a reference library and message center. It also offers behavior management tools that caregivers can access from the convenience of their own homes any time they would need it. With video-conferencing secure messaging and streaming media available, this is the closest thing to 911 for families caring for AD patients (Eure, 2006). The United Kingdom through the National Health Service (Alzheimer's Society, 2004) provide community care assessment through the social services department and that the local authority has a duty to ensure the provision of the necessary services under the NHS and Community Care Act 1990. The local authority social services department are responsible for assessing the needs of people in need of care services that will enable them to carry on living at home as normal or even productive individuals. Care support is imperative for the needy person. Services which may be provided directly by social services or arranged through other agencies such as health or housing departments or through voluntary and private organizations. These services often include: Equipment and adaptations Meals on wheels Home care Respite care Day care Care in a care home. The family or immediate relative involved in caring for the AD patient usually expects the following when assessment takes place: An explanation from the carer or patient of any worries as well as their own point of view no matter the difference of opinions; that the patient or carer should make clear what types of services they would need and how the services may be conveniently delivered or provided. The UK's health care provisions are of importance that services may be provided right away since 2004, although situation may vary dependent on assessment although "reasonable" charges apply that may depend on the capability of patient or immediate family, although the charges may be waived. Conclusion The abovementioned research have provided necessary data in deliverance of care for elderly patients with Alzheimer's disease in relation to family's physiological and psychological aspects. Likewise, it is of note that governments are now more than ever alert and concerned about individual and family care for patients with AD with much support from the private and public sector. With a continued support and information dissemination, it is very likely that families with elderly patients with AD can cope better than the previous generations that struggled in discovery alone of the nature of AD, existing facilities for cure and caring, among other necessary coping mechanism. With more health and care professionals armed properly of knowledge, skill and community support not only to care for patients but to properly educate and deal with the families of patients, who in turn, badly need and require proper information and support, AD patients are becoming less threatening for families that intend to care and support their parents or siblings. Reference: Alzheimer's Society. (2004). "After the Diagnosis." January, from http://www.alzheimers.org.uk/After_diagnosis/Getting_support/info_communityassessment.htm England, S. and C. Ganzer. (1994) "Alzheimer care and service utilization: Generating practice concept from empirical findings and narratives." Health and Social Work vol.19. Eure, M. (2006) "Service launched to Reach Potential Families of Four Million Alzheimer's Patients." About.com. Fischer, L. and M Lieberman. (1995). "The Effects of family Context on Adult Offspring of Patients with Alzheimer's Disease: A Longitudinal Study. Journal of Family Psychology, Vol. 10. Kennard, C. "Caregiver's guide to the Alzheimer's Brain." About.com. 2006. McConnel, S. (1990, June) The impact of the Pepper Commission on the long-term care needs of Alzheimer's patients and families. Statement before a hearing of the Health and Environment Subcommittee of the House Energy and Commerce Committee. Wikipedia. (2006.) "Alzheimer's disease." Wikipedia. 2006. Zarit, S.H., Reever, E. and Bach-Peterson. (1980). "Relatives of the impaired elderly." Gerontologist. Read More