Care for Loved Ones with Mental Illness - Report Example

Outlining the difficulties that informal carers experience when trying to care for loved ones with mental illness BY YOU YOUR SCHOOL INFO HERE HERE Outlining the difficulties that informal carers experience when trying to care for loved ones with mental illness Introduction Caring for a loved one with mental illness maintains a variety of negative outcomes on the informal carer. When acting as the caregiver for those with significant mental problems, common symptoms in the role of carer include insomnia, depression, stomach complaints and general physical fatigue. Medical practitioners have labelled this phenomenon as Caregiver Syndrome and the most common symptom is depression. It is estimated that 70 percent of all informal carers suffer from some degree of depression in the role of caregiver. This is a substantial statistic, indicating that being an informal carer for the mentally ill is a significant challenge and liability that has very negative and serious implications for the mental health of the carer. The aforementioned statistics on the high volume of caregivers suffering depression has significant implications for society. The role of caregiving creates substantial physical and emotional stress which can trickle down into other areas of the caregivers’ lives, including work relationships and family relationships (Schulz and Sherwood 2008). Why is this so important? In the UK, there are approximately 450,000 dementia patients who are receiving informal caring at home. Furthermore, a 2010 survey conducted by the National Alliance for Caregiving indicated that 68 percent of those who cared for war veterans with post-traumatic stress disorder had high measurable stress as an outcome of care and 50 percent actually experienced financial woes as a result of care (HNFS 2009). The government has been instrumental in attempting to create policies and establish committees to assist informal carers, however the extent to which these efforts have been successful is quite inefficient. It is primarily at the local level where support and funding is occurring today, due to sweeping welfare reforms that occurred after the 2008-2010 recession in an effort to curb governmental spending in key areas of public support. This report highlights the different challenges that informal carers receive during their caregiving activities with a supplemental analysis of contemporary government-sponsored policies which attempt to improve informal caregiving in today’s society. The implications of caregiving One outcome of being an informal caregiver for loved ones with mental illness is the onset of sleep disturbances (Phillips, Gallager, Hunt, Der and Carroll 2009). Long-term consequences of onset sleep disorders include irritability, a higher risk factor for heart disease and significant memory problems as well as an increased risk of sustaining an automobile accident (Zahn 2003). What this causes is a phenomenon referred to as daytime dysfunction (Kotronoulas, Wengstrom and Kearney 2013). Daytime dysfunction impacts many different aspects of the carer’s life including recreational lifestyle, social lifestyle and occupational factors thereby becoming a holistically invasive type of disease caused by the onset of sleep disorders. Wilson, Van Houtven, Stearns and Clipp (2007) further identified through a research study that the majority of individual informal caregivers would miss at least one day of work per month as a result of the depression and irritability that the strains of caregiving created. This has significant implications, especially for those with low income status that rely on maintaining a positive reputation in the workplace and ensuring they receive all compensatory benefits that maintaining a job provides. Missing work due to the burdens and demands of caregiving for the mentally ill could lead to increases in unemployment (due to job loss for absenteeism) or put more reliance on the national welfare system at a period where the country cannot afford significant government expenditures. In the United Kingdom, there is an under-developed and immature knowledge base in the medical and psychological community about assisting with sleep disorders. The Imperial College Healthcare Sleep Centre identifies that there is no structured training programs that provide support for sleep physicians and no adequate training ideologies for provision of sleep medications (Wollenberg 2008). Hence, in the UK, there is very little support in the medical community to assist those with sleep disorders as a result of caregiving, causing individuals facing this phenomenon to simply endure and attempt to cope with daytime dysfunction and insomnia. Clearly, this is an area where the government needs to intervene to create committees that can be responsible for training medical practitioners with knowledge in sleep medication and implementing treatment for this disorder. Research did not uncover any current government interventions or efforts to provide this important policy to assist carers facing chronic sleep disorders. Additionally, the most common outcome of informal caregiving for the mentally ill is depression. Depression, when onset, maintains a plethora of negative impacts on human physical and mental health. One outcome of depression is the tendency to overeat, which leads to higher cholesterol and provides more risk for heart disease. People with severe depression experience physical fatigue, an inability to concentrate and make important decisions, and may even contemplate committing suicide. Physical aches and pains alongside digestive issues are common outcomes of depressed individuals (Katon and Ciechanowski 2002). Though not all depression that occurs as a caregiver for the mentally ill is chronic and severe, it may lead to the individual requiring psychological counselling, thereby imposing yet another financial burden on the caregiver. Health Net Federal Services (2009) identified that nearly 50 percent of all caregivers experience financial problems. Hence, outside of the physical and emotional problems that depression causes, it has significant economic consequences on the low-income care provider that is already strained with the costs of providing care to their loved ones with mental illness. This is yet another reason why the government should be more involved and interactive in creating support and legislative policies to assist the caregiver: to remove the financial burdens that are correlated and inter-dependent with depressive health outcomes. Between 2005 and 2007, the government piloted a cash-for-care scheme to attempt to alleviate the financial burdens caused by a variety of factors in caregiving (Moran, et al. 2012). However, this was prior to the 2008 recession that caused government to cut a variety of programs in order to satisfy a strained budget during this period. Today, the cash-for-care scheme is no longer part of the recent welfare reforms designed to consolidate government spending and there is no support for caregivers for the mentally ill to ensure reimbursement of financial expenditures in the caregiving process. This is something that requires more government scrutiny to re-implement as the consequences to businesses and society are substantial as associated with the economic costs of recurring depression symptoms for informal caregivers. Cash-for-care would put much less burden and reliance on the country’s medical network which is already over-burdened and the NHS is unable to free up beds in many of the country’s urban hospital centres. The cash-for-care program, if re-implemented, would provide substantial support for those who must incur high expenditures of care and could alleviate potential mental health issues of the carer who is already anxious about their financial state as a result of providing important care to the mentally ill. Elderly caregivers are especially at risk when caring for their loved ones with dementia. Prolonged stress and the physical demands of caring increase the mortality rate in older informal carers. A 1999 study utilising a sample population of 392 caregivers who provided care whilst living with their ill spouses indicated that 12.6 percent of participants died whilst providing care over a four-year period. Mortality risks in the caregiving group were 63 percent higher than a non-caregiving control group (Schulz and Beach 1999). These are rather startling and overwhelming statistics offering support that elderly caregivers caring for loved ones with mental illness in the home environment could face serious morbidity problems as a result of their caring activities. Research did not uncover any government policies or strategies aimed at reducing the risks to elderly health and mortality, despite the statistics indicating that older caregivers are at significantly higher risk of death as a result of caring for the mentally ill. In fact, the only legislation available today is government support for development of care facilities for those with dementia and strategies for improving collaboration between nursing home staff and the medical community (Qazi 2011; Innes 2011). The government is lax in creating policies that could better enhance informal care practice and knowledge which is likely a contributor to the growing instances of caregiver mortality. Even though the government is concerned about the facility developments to improve dementia care, there is little consideration for the needs of at-home informal caregivers that continue to have their life spans cut short as a result of caring for mentally ill family members. In terms of young carers, those between five and 18 years of age, there are many consequences of caring for mentally ill loved ones. A 2004 study involving a sample group of 6,178 young carers indicated that 27 percent of secondary school-aged carers were experiencing problems in education and that a whopping four out of 10 young carers abuse alcohol and drugs as a means of coping with caregiving (Dearden and Becker 2004). During adolescent years, the child’s brain is still developing cognitive capabilities and moral centres that will dictate positive adjustment and learning comprehension well into adulthood. The portion of the brain that controls impulsive behaviours has not yet developed until the child has reached adulthood (Dryden-Edwards 2014). This has many serious implications for society and the educational network in the country as children who must rely on drugs and alcohol as a means of coping with the challenges of caring for the mentally ill could have long-lasting repercussions on psychological and cognitive adjustment into adulthood. Fortunately, however, there are a variety of government-sponsored organisations that assist young carers in adjusting to their caregiving roles. Kent Young Carers, an organisation affiliated with the government of Kent, provides education, counselling support and a variety of social activities with other young carers to help them better adjust to a care position. Groups known as Chill Clubs allow children to socialise with other young carers and the organisation invites these children on a variety of different trips and sponsored events throughout the year (Kent Young Carers 2013). For young carers, it is becoming commonplace for local governments to sponsor or subsidise programs and organisations that provide support for young carers. Children, in the role of caring for the mentally ill, are expected to take on the responsibilities and emotional growth that is required of adults in a caregiver role, something that young brains have not yet developed. Hence, coping with these pressures at a young age becomes a monumental tasks. The development and launch of such organisations and programs throughout the UK provide a diverse organisational model that includes a range of services from better social support to counselling as a means of alleviating some of the concerns and problems that young carers experience. It is estimated that there are approximately 700,000 young carers in the United Kingdom today, of which 13,000 must provide care at an astonishing rate of 50 hours or more per week (Carers Trust 2012). Young carers between the ages of 16 and 18 are twice as likely to not be involved in training programs, employment or education, suggesting that being a carer for the mentally ill strips the young carer of multiple opportunities that are generally afforded to their non-caregiving peers in the country. There is no evidence, however, that the government has intervened in providing new educational and career training opportunities that are relevant for a flexible schedule that is demanded of youth caregivers. This is an oversight at the Parliamentary level and it requires more attention considering that today’s youths are tomorrow’s business leaders and adult community contributors. Missed opportunities as a result of adult caregiving should be given more government sponsorship and funding to provide programs that would be relevant and valuable to youth caregivers. A call for further policy support The government is, in some fashion, supporting assistance for young carers. The Education Welfare Services organisation, Home School Liaisons and Inclusion Officers have been established in the country to support the family and assist in finding additional support services for young carers. These organisations have been able to procure grants for further support program development for young carers and the government also works with school administration to create a more inclusive and rewarding educational environment for young carers (PRTC 2006). Furthermore, Children’s Society (2013), created through the work of the Include Project sponsored by the government, the government has implemented many programs designed to improve the young carer position. Young Carers in Focus identified 200 different young carers across the country that would serve as champions that interact via social media on the Internet with other youth carers in an effort to create a safe social haven for youth carers. Other local government-sponsored activities include the production of a newsletter titled Purple News that describes best practice in providing support for young carers, making educational films, and identifying opportunities for trips and events to support stressed youth carers. Even a DVD was produced that featured young people referred to as Undercover Heroes that provided interactive education and entertainment regarding local support services, games and general information to inspire young carers to better cope with their difficult responsibilities of providing care. However, there is clearly a disparity between government support for adult carers for the mentally ill and the focus that emphasises more support for youth carers. Therefore, local governments and independent agencies are taking a lead role in attempting to provide support for caregivers for the mentally ill. The Carers Rights Movement was launched with the objective of addressing social exclusion, low income problems, and general lack of recognition that adult informal carers receive in the country. Supplementing this movement is the 2004 launch of The International Alliance of Carers Organisation that intends to increase the social visibility of carers, promote knowledge exchanges of best practices associated with caregiving programs, and encouraging national government (rather than local) support for the needs of caregivers. This organisation is headquartered in London, UK and involves representation from Australia, The Netherlands, United States, the UK and Sweden in an effort to internationalise support services and promotion of caregiver needs throughout the world. The only notable effort of government that is still in effect today is the Work and Families Act of 2006 that allows carers to request flexible working hours to accommodate their mentally ill family member. It is the only legislation created prior to the 2008-2010 recession that did not get removed from the welfare reforms that took place during the recessionary environment in the country. This piece of legislation enacted by Parliament ensures non-discrimination for those in the workplace that request flexible working hours, thus bonding employers to provide provisions in the event of a caregiving situation. The aforementioned Work and Families Act of 2006, however, is not sufficient for dealing with the psychological and physical problems that caregivers for the mentally ill must endure. This is why local governments are taking the initiative because government simply is not fulfilling their obligations and responsibilities for providing support and counselling services to caregivers. The Derby City Council, in partnership with the Southern Derbyshire Clinical Commissioning Group, managed to procure funding to provide this support to troubled caregivers. This effort will provide transportation for carers and provide training to assist in informal caregiving techniques. Clearly, it is local level government interventions that are providing the majority of support for stressed and anxious caregivers who must regularly work with the mentally ill in the caregiving role. Conclusion As indicated by the research, there are many serious and sometimes debilitating outcomes of being an informal carer forced to care for the mentally ill loved one. Depression, physical health problems, sleeping disorders, and recurring fatigue were identified as the most common outcomes of being a caregiver. The consistent financial expenditures of care, also, works as a catalyst for the aforesaid symptoms of caregiving, showing a sort of vicious circle that makes it difficult to be an effective caregiver. Goverment, at the national Parliamentary level, however, is not creating enough legislation or policy development in order to provide important support and counselling services to adult informal carers. There is, though, a considerable effort at the national and local level to provide support for children who are forced into care roles and who must put forth considerable time and effort to provide care to the mentally ill. This has positive benefits, at least, in one sector of the national population. More support, clearly, is needed for adult informal caregivers since the symptoms of caregiving for the mentally ill are substantial and have implications for the national economy and overall human well-being at the social level. Government absolutely needs to be more interactive and proactive in identifying the needs of caregivers that must provide support for mentally ill loved ones in today’s society. Local government, however, should be applauded for taking the initiative and building partnerships with various organisations to raise funding and public awareness of the challenges of being a caregiver. Local government across the country has been the most instrumental in creating support services and publicly promoting the needs of caregivers manifesting symptoms of depression, sleep disorder development, and a wide range of potential negative outcomes of caregiving for the mentally ill. References Carers Trust. (2012). Key facts about carers. 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