Sandwich Generation Caregivers: Ethical Legacies Throughout Generations

Research Topic This critical hermeneutic research study explores ethical meanings during a time of dual-generation care and how these interpretations may affect one\u27s view of family life across generations. The research participants in this study were adults situated between young children and dependent elders, who are also termed the sandwich generation (Brody 1981; Soldo 1996). By reexamining notions of self and others through narrative, one may see life anew from an ontological perspective not considered beforehand. Through narrative about moments of familial care, new understandings about personal meanings emerge which may or may not have changed over time. From this study\u27s conversations, participants came to see how carrying out an ethical life may be seen as part of a broader family legacy, influenced by their ethnic background, culture, faith tradition, or entirely new personal interpretations. Theory and Protocol Critical hermeneutic theory of Paul Ricoeur (1984; 1988; 1992; 2005) formed the basis of the theory applied to this study with emphasis upon areas related to temporality, ethics, and recognition. This field research followed an interpretive anthropological approach outlined by Herda (1999) that includes protocol for the study\u27s data analysis using three theoretical categories used to bring forth findings and implications. Research Categories In this study, guiding questions related to three critical hermeneutic categories brought forth data for analysis. The mimesis category fostered remembrances of the family from the past, as well as present actions, and future hopes. The theory area of ethical aim drew data about how one\u27s key ethics may influence actions of care, whether with children or elders. The final category, recognition, created or renewed the caregivers respect for their role, and that of others in society with a similar plight. Findings Caregivers recounted stories and were often unaware of the underlying ethics that informed their actions. The telling of their story with distance and proximity of their lived experience enabled the caregivers to reinterpret their own notion of a good life. The following findings came forth from participant conversations: (1) Caregiving often means retracing the past in the present; actions of care are part of a larger pattern a family passes on; (2) Caregivers may be able to move from overwhelmed to seeing new capabilities; and (3) Recognition and support for caregivers helps multi-generational families. Moments of dual-generation care may be challenging, yet may also render new interpretations of ethics that offer resilience in difficult times

ROLE OF FAMILY IN ELDERLY CARE

Family is an integral part of everyone’s life. The purpose of thesis is to explore the roles of family and significance of their participation in elderly care. The aims are to increase awareness of nursing students, nurses and families regarding involvement of family members in elderly care and to find out experience of elderly residents when family members visit them. Research method used in this thesis is quantitative research in which questionnaires were used to collect data from elderly people. Mainly questions were about family visit and its importance, loneliness and involvement of family members in their care. Data was collected from two different elderly homes in Oulu. The research questions were: - How do elderly feel about loneliness at elderly home? How are family visits implemented? What effects do family visits have on the elderly? What expectations do the elderly have on family visits? The study included two elderly homes of Oulu and the sample of 68 residents. The findings of the research showed that most of the elderly feels loneliness in elderly home. However, there were also elderly residents who mentioned that they do not feel loneliness at all. It was identified that the difference in loneliness feelings among elderly was greatly influenced by the number of family visit and support received by them. Further, this study helps to determine that elderly preferred to be visited by their family members as frequently as possible and they think that family visit is important for their happiness and well- being. This research will help health care students, nurses and family members to understand value of regular family visit in elderly home, family roles and support needed to maintain the quality of life of elderly residents. In addition, nurses will involve family members in elderly care as well as family will be encouraged and motivated to participate actively

Aging Well

This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults

Aging Well

This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Compiles peer-reviewed research and literature reviews on issues regarding patient safety and quality of care, ranging from evidence-based practice, patient-centered care, and nurses' working conditions to critical opportunities and tools for improvement

Evolutionary Service Composition and Personalization Ecosystem for Elderly Care

Current demographic trends suggest that people are living longer, while the ageing process entails many necessities, calling for care services tailored to the individual senior’s needs and life style. Personalized provision of care services usually involves a number of stakeholders, including relatives, friends, caregivers, professional assistance organizations, enterprises, and other support entities. Traditional Information and Communication Technology based care and assistance services for the elderly have been mainly focused on the development of isolated and generic services, considering a single service provider, and excessively featuring a techno-centric approach. In contrast, advances on collaborative networks for elderly care suggest the integration of services from multiple providers, encouraging collaboration as a way to provide better personalized services. This approach requires a support system to manage the personalization process and allow ranking the {service, provider} pairs. An additional issue is the problem of service evolution, as individual’s care needs are not static over time. Consequently, the care services need to evolve accordingly to keep the elderly’s requirements satisfied. In accordance with these requirements, an Elderly Care Ecosystem (ECE) framework, a Service Composition and Personalization Environment (SCoPE), and a Service Evolution Environment (SEvol) are proposed. The ECE framework provides the context for the personalization and evolution methods. The SCoPE method is based on the match between the customer´s profile and the available {service, provider} pairs to identify suitable services and corresponding providers to attend the needs. SEvol is a method to build an adaptive and evolutionary system based on the MAPE-K methodology supporting the solution evolution to cope with the elderly's new life stages. To demonstrate the feasibility, utility and applicability of SCoPE and SEvol, a number of methods and algorithms are presented, and illustrative scenarios are introduced in which {service, provider} pairs are ranked based on a multidimensional assessment method. Composition strategies are based on customer’s profile and requirements, and the evolutionary solution is determined considering customer’s inputs and evolution plans. For the ECE evaluation process the following steps are adopted: (i) feature selection and software prototype development; (ii) detailing the ECE framework validation based on applicability and utility parameters; (iii) development of a case study illustrating a typical scenario involving an elderly and her care needs; and (iv) performing a survey based on a modified version of the technology acceptance model (TAM), considering three contexts: Technological, Organizational and Collaborative environment

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference

Stigmas of Alzheimer\u27s Disease and Help Seeking for Alzheimer\u27s Disease Among African Americans

AbstractThe purpose of this study was to examine how the perceptions of stigma of Alzheimer’s disease (AD) affected the help-seeking behaviors of African American caregivers. Data used in this study were collected using semistructured interviews with 11 African American caregivers caring for loved ones diagnosed with AD. The conceptual framework of this study was guided by the stigma theory and the sociocultural health belief model. The four types of social stigmas used to assess the effects of the stigma of AD were public, self, courtesy, and structural stigma. Data were analyzed using the Thematic Content Analysis (TCA). Results provided support that the various stigmas of AD are prevalent in the lives of African American caregivers. Results suggested that stigmas of AD are major contributors to delaying help-seeking among African Americans. Stigmas associated with AD were found to be a perceptible issue in the everyday reality of African American caregivers. Being culturally aware and culturally competent on the effects of AD in African American communities has been shown to be vital to social change. Findings suggested that the stigma of AD deeply influenced the help-seeking behaviors of African American caregivers and revealed that there is a need to work on the negative issues of stigma of AD for significant change. The findings also showed that various factors of stigma of AD should be considered when planning to reduce stigmatic beliefs and behaviors associated with AD in African American communities. The results provided information beneficial to healthcare and human service practitioners, and other professionals on how the stigmas of AD affect the help-seeking behaviors for AD among African American caregivers