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[edit] Caring for an Aging Relative

Caring for an aging relative can have many unseen difficulties. It is helpful to know what to look out for. As someone ages, there are psychological factors such as depression, declining levels of trust and self-consciousness.[1] Physical factors such as stress cause many harmful effects on the body.[2] Finally, the changing of social roles and transitioning of relationships can alter the way an aging individual fits into their familiar social groups.[3] Each of these factors play an equal and important role on the quality of life of an aging relative.


[edit] Psychological

[edit] What is it?

As a person ages, there are many changes that they face. Many aspects of one's daily life must be altered to accommodate for this. Having to change the way an aging individual normally operates can have negative psychological effects. New health issues arise, daily tasks become difficult to perform, and independence is lost. These all affect psychological well- being, and therefore, the quality of life that is experienced.[4] Cumming and Henry (1961) [5] described the psychological effects of aging in their theory of disengagement[1]. They stated that older adults withdraw from personal relationships and society as they age. This has since been theorized as false, but there is a higher chance that someone may become withdrawn if their quality of life is not maintained as they age. Declines in memory, reaction time and intelligence indicate cognitive deterioration which can also contribute to a poorer quality of life [6]. As a person starts to lose the skills that were taken for granted, depression and self consciousness may take over.

[edit] Warning Signs and Signs for Intervention

There are several warning signs that indicate negative psychological effects are taking a toll on the aging individual. Depression, self consciousness and declining levels of trust are indications that quality of life is getting worse. [1] Caregivers should monitor for any changes in social and physical characteristics and intervene as soon as possible, if necessary. Older adults may become introverted and abandon efforts to participate in social opportunities.[4] Seniors have a valuable connection to their communities. This connection is stronger than that of younger citizens. [1] When an elderly person no longer participates in their regular community roles, this is another indication that they may be regressing psychologically.

[edit] Prevention & Treatment

There are preventative measures that can be taken to combat the negative influences of aging. Keeping the elderly happy and healthy is the key to success. This can be achieved by promoting the importance of active aging and maintaining a healthy lifestyle. [4] The American Geriatrics Society [2] is a great resource for a caregiver. The organization emphasizes the importance of keeping the caregiver informed about the psychological risks that accompany the aging process as well as other tips for healthy aging. There are many resources available to help decrease stress levels in both the elderly and the caregiver. This is important because a stressed caregiver is equally at risk for developing psychological issues from constant mental and physical stress. Providing opportunities for social involvement, goal setting and participation in activities significantly improve the quality of life for the aging individual. [6]

[edit] Adapting to the New Lifestyle

Finding ways to adapt to the many psychological changes that accompany the aging process are important. To decrease stress and improve quality of life, the elderly adult must focus on a smaller variety of tasks. Frequently, the elderly get depressed because they are no longer able to adequately perform the activities they once enjoyed. The American Geriatric Society suggests simplifying things. For example, a pianist could slow down the tempo and decrease their repertoire[6]


[edit] Physical

[edit] What is it?

With the increasing average age of the population comes an increasing need for more caregivers. Caring for an aging relative can pose serious health concerns for the caregiver [7][8]. Caregivers spend a significant amount of time caring for their aging relative, which causes large amounts of stress [9]. Adults who share a home with their ill parents experience the most stress [7]. Stress is increased especially with those who care for relatives with some form of cognitive impairment, such as Dementia [10]. Moreover, the need for adult care can arise suddenly, after a heart attack, fall, stroke or cancer. These events do not leave much time for preparation which can cause more stress than usual [7].

Stress can lead to a variety of other health-related problems, such as increased weight, compromised immune function and lower levels of overall physical health [8]. Furthermore, caregivers are less likely to exercise or follow a nutritious diet, get adequate sleep, take time to rest when ill, or remember to take their medications [8]. Not only do the caregivers experience elevated levels of stress, but caregiving can also lead to exhaustion, inability to concentrate, anxiety about future aging themselves and depression [7]. If the caregiver is not able to adequately take care of him or herself as well as their aging relative, it can lead to an overall decline in the caregiver's health.

[edit] Warning Signs and Signs for Intervention

Many people need caregivers as they age since there are normal cognitive declines associated with aging. However, relatives who acquire Dementia or other cognitive impairments will need the most care and will cause the most stress on their caregivers [10]. Early and accurate diagnosis of dementia can help the caregiver plan out how they are going to care for their relative, so it is very important for the older adult to go to the doctor on a regular basis [11]. Doctors will be able to spot the warning signs of dementia or other cognitive impairments and be able to work with the caregiver to plan strategies for coping.

[edit] Prevention & Treatment

In order to prevent the cargiver from experiencing such a high level of stress they can help the aging parent to prevent abnormal cognitive declines such as dementia. Some risk factors for dementia are diabetes, high cholesterol, heart disease and hypertension [8]. By going to see the doctor on a regular basis you can keep these factors under control and therefore they will be less likely to contribute to contracting dementia. Dementia can also be caused by smoking or a lack of vitamin B12; if you do not smoke and receive shots if you have low vitamin B12, it can prevent dementia [8]. Currently there is not a cure for dementia; however, there are medications which offer symptomatic relief. Aricept is a common drug to help with the Alzheimer’s form of dementia. It helps increase memory and learning, which normally would decrease without the drug [8]. If the caregiver helps the aging parent to prevent dementia early, the strain of caregiving would be greatly reduced.

[edit] Adapting to the New Lifestyle

Adapting to caring for an aging relative can be very stressful; however, there are steps that be taken in order to lessen the physical stress that is put on the body. To relieve the stress that is caused by caring for an aging relative, the caregiver can use effective coping strategies, such as delegating responsibilities to other family members or trying to reinterpret the situation in a positive way [7]. This can be effective in lessening the stress placed on the caregiver. Seeking social support, making use of community resources, or pressing for workplace and public policies that relieve the emotional and financial burdens of caring for an aging parent are also effective strategies that can be used by the caregiver [7]. Research on stress has shown that social support can also relieve stress [2]. Having people help with the care of the aging relative and increasing the frequency of these people helping are factors which can also found to reduce stress levels (Vitaliano, 1991). If caregivers have a good relationship with their practitioners, it can also reduce stress and in turn reduce negative physical symptoms associated with stress [9]. A tool called the Family Caregivers Support Agreement (FCSA) can be used to facilitate the relationship between caregivers and practitioners [9]. The FCSA is designed to address the needs and support services in order to meet the caregiver’s expectations [9]. It has been shown that a tool such as the FCSA enhances a partnership atmosphere, and as a result, decreases the stress on the caregiver [9].


[edit] Social

[edit] What is it?

There are multiple aspects included in the social perspective of caring for an aging relative. Throughout the stages of life, everyone experiences multiple changes to their social roles and relationships[7][8]. In elderly people, these changes can include the pruning of relationships down to a small group of people whom they are closest to and feel are most important in their life[7][8]. It can also include social role changes chosen by the elder such as becoming a volunteer or playing a more significant role in their grandchildren’s lives[8]. Or it may include role changes that are not so positive and not explicitly selected by the older adult, for example, being widowed or becoming a care receiver[8].

Different types of people will react to all of these social transitions in various ways. It is very important as a caregiver to recognize and be aware when an elderly adult is not adjusting well to these social changes.

[edit] Warning Signs and Signs for Intervention

There are several warning signs to look for when determining if an elderly relative is having difficulties adapting to the social changes in his or her life. Feelings of hopelessness and emptiness, withdrawal from close relationships, as well as unresponsive or depressive behaviours can be a sign of the need for social intervention[7][12][3]. The two most important warning signs that an aging relative needs social intervention are feelings of loneliness and social isolation[13].

Loneliness and social isolation in old age have been shown to have multiple consequences on one's overall health in various studies. Both have been linked to higher blood pressure, elevated risk for depression and poor mental health[13][3]. They have also been shown to be predictors of mortality, thoughts of suicide and suicide itself[13][3]. Therefore, it is extremely important to be aware of the risks and know how to implement treatment techniques to prevent further harm to the well being of an elderly relative.

[edit] Prevention & Treatment

In order for an older adult to stay mentally and physically stable in later life, they need to have strong social support from family members or friends. However, it is important to keep in mind that even if an elderly person has plenty of friends and family surrounding him or her, they can still be lonely. Loneliness is not to be confused with aloneness. One can still feel lonely even if they are surrounded by groups of people[3][13]. Loneliness is described as a painful and unpleasant experience that, as stated earlier, can lead to multiple consequences if it is not intervened[13]. Studies have shown that the quantity of relationships has little to do with feelings of loneliness and social isolation. However, the quality of relationships or perceived social support has a great effect on reducing feelings of social isolation and loneliness[7][13]. Emphasis should be put on trying to improve the quality of relationships between the older adult and their peers or relatives in order to prevent loneliness[13].

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If an elderly relative experiences pain form social isolation and loneliness, there are a few ways to intervene. The first class of interventions are aimed at the individual level. These would involve things such as increasing one-on-one contact, whether it be via phone or visits with family or professionals[13]. The next class of interventions are aimed at the group level. These could include programs where the older adult gets together with other peole their age over something they all enjoy, for example, a knitting class or social lunches [13]. The third class is aimed at the environmental level. These interventions could include teaching the older adult how to use a computer or online video chat programs, which would enable them to connect with friends and relatives that may not live close by. The environmental level could also include providing transport to remove the common obstacle for elderly adults of not being able to get around[13]. Out of all of these intervention types, it has been suggested that group level interventions are the most effective, particularly group interventions that facilitate educational and social support[12].


[edit] Adapting to the New Lifestyle

The best way to help an elderly relative adjust to their lifestyle and keep them socially involved would be to implement the day programs, classes or social activities. There are many opportunities in the Niagara area for an elderly adult to get involved. The Niagara Region website[14] has a list of locations and activities that older people can potentially participate in[3]. They also provide a lot of information about long-term programs for elderly adults as well as social and mental supports available for the caregiver[4].


[edit] Notes and References

  1. ↑ 1.0 1.1 1.2 Statistics Canada. (2006). A Portrait of Seniors in Canada. Retrieved from http://www.statcan.gc.ca/access_acces/alternative_alternatif.action?l=eng&loc=http://www.statcan.gc.ca/pub/89-519-x/89-519-x2006001-eng.pdf&t=A%20Portrait%20of%20Seniors%20in%20Canada.
  2. ↑ 2.0 2.1 Vitaliano, P.P., Russo, J., Young, H.M., Teri, L., & Maiuro, R.D. (1991). Predictors of burden in spouse caregivers of individuals with Alzheimer's disease. Psychology and Aging, 6 (3), 392-402.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 Routassalo, P., & Pitkala, K. H. (2003). Loneliness among older people. Reviews in Clinical Gerontology, 13, 303-311.
  4. ↑ 4.0 4.1 4.2 Bowling, A. (2007). Enhancing later life: How older people perceive active aging? Aging & Mental Health. Vol. 12, No. 3, May 2008, 293–301
  5. ↑ Cumming, E., & Henry, W.E. (1961). Growing old, the process of disengagement. New York: Basic Books.
  6. ↑ 6.0 6.1 6.2 The AGS Foundation for Health in Aging. (2005). Psychological and Social Issues. Retrieved from http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=3.
  7. ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 Berk, L. E. (2010). Exploring lifespan development (2nd ed.). Boston, MA: Allyn & Bacon.
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 Bjorklund, B. R. (2011). The journey of adulthood (7th ed.). Upper Saddle River, NJ: Prentice Hall.
  9. ↑ 9.0 9.1 9.2 9.3 9.4 Levesque, L., Ducharme, F., Caron, C., Hansen, E., Magnusson, L., Nolan, J., & Nolan M. (2010). A partnership approach to service needs assessment with family caregivers of an aging relative living at home: A qualitative analysis of the experiences of caregivers and practitioners. International Journey of Nursing Studies, 47 (7), 876-887.
  10. ↑ 10.0 10.1 Fisher, G.G., Franks, M.M., Plassman, B.L., Brown, S.L., Potter, G.G., Llewellyn, D., Rogers, M.A.M, & Langa, K.M. (2011). Caring for individuals with Dementia and Cognitive Impairment, Not Dementia: Findings from the aging, demographics, and memory study. Journal of the American Geriatrics Society, 59 (3), 488-494.
  11. ↑ Milne, A.J., Woolford, H.H. Mason, J., & Hatzidimitriadou, E. (2000). Early diagnosis of Dementia by GPs: An exploratory study of attitudes. Aging and Mental Health, 4 (4), 292-300.
  12. ↑ 12.0 12.1 Cattan, M., White, M., Bond, J. & Learmouth, A. (2005). Preventing social isolation and loneliness among older people: A systematic review of health promotion interventions. Ageing & Society, 25, 41-67.
  13. ↑ 13.0 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 Shiovitz-Ezra, S. & Leitsch, S. A. (2010). The role of social relationships in predicting loneliness: The national social life, health, and aging project. Social Work Research, 34, 157-167.
  14. ↑ Niagara Region 2011, Seniors. Community programs for seniors. Retrieved from http://www.regional.niagara.on.ca/living/seniors/programs/default.aspx

Kr09an 14:49, 1 December 2011 (EST) Cv09sq 22:22, 2 November 2011 (EST) Rl09ah 12:08, 1 December 2011 (EST)

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