This paper focuses on the assessment of the unpaid informal family caregiver who takes care of her husband. For this paper and confidentiality of the caregiver, the paper will use a pseudo name of Arianna.' Arianna is 66 years old Hispanic woman who lives with her family in their home in Arlington City, in Texas, United States. They have been married for 35 years together with her husband and are blessed with four children comprising of two boys and two girls. At the time of this assessment, the children were not present, as Arianna explained that they are studying in some of the prestigious universities outside their home Arlington City, Texas. The initial information of my inquiry reveals that both Arianna and her husband were both employed as the nations civil servants, and were both working as university instructors. Arianna holds a Ph.D. degree from the University of Texas at Austin, while her husband worked as a clinical psychologist, having obtained a Ph.D. from the University of North Carolina at Greensboro. At the time of this assessment, Arianna mentions that both of them were not working and had resigned from their job because of her husband Dementia condition. For her, she says that she had to ask for a mandatory retirement to take care of her husband.
Social Functioning of the Caregiver
Our interview with Arianna began with the questions that sought to assess some of the essential social activities and aspects of social relationships with the person with Dementia. It was in addition to the inquiry about changes in social relations and actions of her husband, with respect to various aspects that include the timing of changes, and their effects. As part of her clarification, I found out through Arianna that due to the progression of her husbands condition, he began managing the finances of their business but Arianna felt that the man was now trying to make himself the sole owner of the business. Already, the husband had started avoiding his friends and relatives. Several weeks ago, the husband had held Arianna tightly in an angry way, and this over left her with a bruised face. At the moment, however, the man attends a day center where he used to play the table tennis. Unfortunately, he is unable to raise the bat and therefore cannot play any game. It is important to note that dementia is a long-lasting and progressive that affects the brain cells (Evans & Lee, 2014). The brain changes by decreasing and shrinking because of the death of some of the nerve connections established in early life (Aminzadeh et al., 2007).
Social and Support Systems
As part of the interview, I asked Arianna to respond to the question, Are there any social and support system available and what is your ability to participate within these systems? As a response from her, I was able to assess and determine that various social and support systems exist about the current situation of Arianna as well as her responsibilities towards husbands ailment. According to Arianna, the mental health professionals have primarily acted as their social supports. These include the psychiatrist and therapists who have profoundly helped her know the meaning and sense of suffering from Dementia as well as encouraging her to make good relationships with other professionals and people. Arianna further mentions that their children have been pivotal in supporting the ailments of their father.
To maintain mental health and avoid psychiatric hospitalizations, she mentions that their children have always encouraged her to make use of their relationship with the mental health professionals. For example, they have urged Arianna to be honest of their fathers mental health and conditions, in addition to their feelings, thoughts, and the change of their feelings over time. More specifically, she mentions that her elder son has always insisted to her that through sharing their thoughts and feelings can be sometimes uncomfortable or embarrassing, it is the best way through which their mental health professionals may use to diagnose and treat the disorders in the correctly.
A keen analysis of Ariannas assertions and explanations reveals that social support system is vital for maintaining her husbands mental health. It has affected the manner in which they think about and dealt with the challenges as well as the problems (Gaugler et al., 2010). In her view, having a healthy social support system has been the best way for them to support and maintain and build positive mental health. More specifically, the support systems have helped both Arianna and her husband to alleviate stress, increase their self-confidences and feelings of value and to reduce feelings of loneliness and isolation.
In a typical day for Arianna as her husbands caregiver, she wakes up early in the morning and prepares meals for her the family, before embarking on cleanliness activities. She ensures that the husband has well-prepared food and clean clothes by the time he wakes up. Later in the day, she ensures that the man has taken all the medication whenever he was supposed to do so. If necessary, she makes phone calls to their family mental health professional to inform him regarding the progress and response of her husband to the medication. In the afternoon, Arianna and husband join neighbours for social fulfillment and encouragement, but this only occurs if they have no visitor at their place. In the evening, she prepares the family meal and ensures that the husband eats early before retiring to bed by 9.00 Oclock latest.
Part 2: Assessment: The Interview
What types of tasks are involved in caring individuals with dementia and how often do you provide such care?
Are there any specific skills set necessary to provide the care such as in your case? Mention any if yes.
What are some of the additional responsibilities or stressors that affect care provision?
Are there any formal services received?
How would you describe the values and preferences that exist between you as the caregiver and the patient that you are caring?
Do you believe that youre still able to continue with the care?
Are there any additional services needed other than what you presently provide? Mention any of yes please.
Personal Impressions and Assessment
Types of Tasks and Frequency
My interview with Arianna revealed information relating to various aspects of caregiving, which include the type of tasks and the frequency of care provision. From my assessment regarding the question on types of tasks and their frequency, I was able to note that both the pharmacological and non-pharmacological interventions are used in the care treatment and support of people with dementia.
Arianna explained to me that pharmacological interventions have been of great help towards her husbands conditions. Arianna explicitly knows that there is no cure for dementia nor are there any modifying drugs to combat the related diseases. One of her tasks, in this case, is to ensure that the drugs are administered to the patient by the doctors prescription. Such drugs do not treat but slow down the effects and symptoms of the disease. How these drugs function relates to the presence of Acetylcholine in the brain. Acetylcholine is a neurotransmitter and is a chemical needed to facilitate the communication between nerve cells in the brain. Throughout caregiving, Arianna has been involved in the provision of Exelon, Rimynl, and Aricept.
The effort was applied to maintain a sense of normality and sustaining a social life on the part of the patient. It was also an essential task for Arianna as the caregiver of the patient with dementia. From my assessment, I noted that family caregivers of those who have dementia are a vulnerable population based on the fact majority of them are advanced in age, under stress and live a sedentary lifestyle. The same applies to Arianna and therefore makes her potentially more vulnerable to increased mortality rate. As such, she mentions that there exist a set of skills needed. She spoke about being attentive, possessing interpersonal skills, stamina, and time management. All these are done to increase caregivers physical activities.
Formal Services offered
Promoting physical exercise in the patient was another crucial responsibility of Arianna. The physical activity has been shown to benefit people who have a cognitive impairment, as well as those who have Dementia. Individuals with dementia should always be encouraged to involve themselves in various forms of activities. In the interview, Arianna mentions that she has been widely engaged in activities and programs that ensure that her husband physical health is well maintained.
Overall Health Status
The overall Ariannas mental and physical health is impressive. Although many studies have shown that family caregivers who provide their services to mentally ill patients are likely to have their health affected, these were not evident in Arianna. Arianna mentions that the different and changing tasks that entail lines of work, and seemingly essential tasks could entail strong symbolic and moral meaning to her. She first accepted to be part of her husbands problem and vowed to help him sail and bring him out of it where possible.
My interview with Arianna significantly revealed many aspects of caregiving as offered by her. She explicitly provided the explanations of her tasks, skills necessary for her role, the regular services her patient receives and finally her overall mental and health status. This assessment, however, revealed many things still lacked and that several interventions were still needed to improve the quality and the effectiveness of the currently existing services. In my view, Arianna should consider integrating various possible interventions or services to address current concerns and problems. This move will consequently enhance the existing services to meet the needs of healthcare needs. I would suggest the following intervention programs:
Cognitive Stimulation Therapy (CST)
The Cognitive Stimulation Therapy (CST) refers to a form of non-pharmacological intervention used to support individuals with mild to moderate dementia (Farina, 2012). During the CST, an individual is invited to participate in various therapeutic sessions with experts who have skills in interpersonal communication, and dementia care. The skilled experts, in this case, can further integrate, initiate and hold discussions with the dementia patients in themes such as food, financial matters, family issues and current affairs experienced in the nation or city. In this case, the expert should support the CST through its fundamental principles such as centeredness, respect, involvement, inclusion and choice, reminiscence utilization and maximization of relationships.
Arianna should consider introducing the reminiscence therapy as part of the interventions used to improve the overall health status of the husband (Farina, 2012). Fundamentally, dementia as a mental health condition is often accompanied by impaired short-term memory. While it is evident that the patients long-term memory remains intact for sometimes, reminiscence therapy helps to tap the patients long-term memory and re-live past pleasurable experiences. This method is regarded as one of the significant non-pharmacological interventions that can benefit different parties including patients with dementia, their families, and health service professionals. In some cases, reminiscence helps improve quality of life, promote confidence, and boost the self-esteem of the patient.
In validation therapy, the practitioner attempts to communicate with an individual su...
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