Impacts Incidents On Both Patients

I chose to focus on the policy issue of family caregivers, who provide unpaid care to an ill or disabled loved one especially older adults. According to Gordon and Barrington (2016), there are almost 35 million Americans who provide care for adult family members and friends aged 50 or older with limited activities of daily living such as bathing; and instrumental activities of daily living such as preparing meal, and managing medications. Gordon and Barrington (2016) also mentioned that the family caregivers spend almost 40 hours per week to take care of their older relatives. Family members are the primary source of unpaid caregiving for older adults aging at their home.Impacts Incidents On Both Patients And Caregivers Essay

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Most people will, at some point in their life, help a family member or friend with a long-term health condition, disability or problems related to aging. Providing care has many benefits. In addition to reducing the social costs associated with health services and institutionalization, it also benefits the care receiver, allowing them to remain at home and maintain a better quality of life.

However, at times there can also be negative consequences, especially for caregivers. These include the impact on their physical and mental health and their participation in the labour force, pressures on their personal finances, and reduced time available for other activities.Note 1 Employers and governments may also be impacted, notably because of absenteeism, lost productivity and reduced tax revenues.

A number of Canadian studies have focused on family caregivers 45 years of age and over, particularly those providing care to aging parents.Note 2 However, fewer studies provide information about caregivers of all ages who help or provide long-term care to their spouse or partner (hereafter referred to as ‘spouse’), child, parent, extended family, or friend.Impacts Incidents On Both Patients And Caregivers Essay

This study uses new data to shed light on all family caregivers aged 15 and over in Canada. First, this article takes a brief look at family caregivers—particularly the intensity and type of care provided—based on their relationship to their care recipient.

Second, it examines data on the many consequences associated with caregiving responsibilities. Are some types of caregivers more likely than others to experience psychological, social or financial consequences? If so, why?Impacts Incidents On Both Patients And Caregivers Essay

Statistics Canada’s most recent source of information on family caregivers is the 2012 General Social Survey on Caregiving and Care Receiving (see Data source and definitions). Family caregivers are defined as people aged 15 and over who responded that they had, in the previous 12 months, either provided help or care to a person with a long-term health condition or a physical or mental disability, or with problems related to aging.

Nearly 3 in 10 people are family caregivers
In 2012, slightly more than 8 million Canadians, or 28% of people aged 15 and over, had provided help or care to a relative or friend with a chronic health problem (help for short-term sickness is excluded).Impacts Incidents On Both Patients And Caregivers Essay

Mental and Physical Health Effects of Family Caregiving
Since family caregiving became a widely studied topic in the early 1980s, most research has emphasized caregiving burden and the potential negative effects of caregiving stress on mental and physical health. Psychologists and others involved in clinical practice most often see caregivers who are seeking help because they are experiencing high levels of strain in the caregiving role, and these caregivers often report high levels of burden, stress and disruption of their own well-being and social activities.Impacts Incidents On Both Patients And Caregivers Essay

Strain Associated with Providing Caregiving Assistance
Multiple population-based studies indicate that many family caregivers report little strain associated with providing caregiving assistance. Schulz and Beach (1999) found that 44 percent of the spouse caregivers in their sample reported “no strain” in association with caregiving tasks. Using similar questions for both spouse and non-spouse caregivers, Roth and colleagues (2009) found that 33 percent of caregivers reported “no strain” and 50 percent reported “some strain,” while only 17 percent reported “a lot of strain.” A recent survey by the National Opinion Research Center (2014) found that 83 percent of caregivers viewed it as being a positive experience. Many caregivers experience both positive experiences and some strain simultaneously (Beach et al., 2000; Harmell et al., 2012). Lawton and colleagues’ (1991) two-factor model suggests that caregivers may experience both emotional distress and psychological satisfaction and growth, effects that are not incompatible.Impacts Incidents On Both Patients And Caregivers Essay

Analyses of Mental and Physical Health Effects
Meta-analyses of the physical and mental health effects of caregiving have shown higher levels of depression and physical health problems in caregivers when compared with noncaregivers (Pinquart & Sorensen, 2003; Vitaliano, Zhang & Scanlon, 2003). In Pinquart and Sorensen’s review, effect sizes (differences between caregivers and noncaregivers) for all studies were .58 Standard Deviation Units (SDUs) for measures of depression and .18 SDUs for measures of physical health, with caregivers having higher depression and worse health. Most of these studies used nonrepresentative samples of caregivers and noncaregivers drawn from clinics, support groups and recruitment of volunteers. These effect sizes were considerably smaller for studies that used representative community samples (e.g. from population based studies), with these effect sizes being .26 SDUs for depression and .09 SDUs for physical health. A recent study of 5,159 caregivers and 37,940 demographically equated noncaregivers found effect sizes of only .13 SDUs for caregiver depression and .01 SDUs for physical health. This study also found that caregivers who reported no strain (33 percent of caregivers) had lower depression than noncaregivers, and that only the 18 percent of caregivers reporting high strain had elevated depression compared with noncaregivers (Roth et al., 2009). These highly strained caregivers had depression scores over twice as high as noncaregivers (Roth et al., 2009), highlighting the importance of examining caregivers’ subjective experiences of strain. Thus while caregivers report more distress than noncaregivers, the extent of these differences depends on the populations studied.Impacts Incidents On Both Patients And Caregivers Essay

A widely cited, landmark population based study of caregiving (Schulz & Beach, 1999) reported that spouse caregivers who reported strain were at risk for premature mortality. This study has been cited incorrectly by many scholars, policy groups and on caregiver web sites to suggest that all caregivers are at risk for heightened mortality (Brown & Brown, 2014; Roth et al., in press). Five more recent population based studies of caregiving and mortality, all with larger sample sizes than Schulz & Beach (2009), have reported the opposite effect, with caregivers living longer than noncaregivers (See Roth et al. in press for a review). Biomarker studies comparing caregivers and noncaregivers (see Lovell & Wetherell, 2011 for a review) often report that caregivers have abnormalities in measures of endocrine and immune system function, but nearly all of these studies have used small convenience samples and focused on dementia caregivers (Roth et al., in press). Thus evidence is currently mixed as to whether caregiving has generally negative effects on objective indicators of health.Impacts Incidents On Both Patients And Caregivers Essay

Highly Strained Caregivers: Older Adults and Women
This does not minimize the importance of examining possible negative health effects on highly strained caregivers. Older adults in caregiver roles may be particularly vulnerable because caregiving demands may tax their health and physical abilities and compromise their immune response systems, and the stress associated with caregiving can exacerbate existing chronic health conditions (Navaie-Waliser et al., 2002). Older caregivers may also be at increased risk for unintentional injuries such as falls, cuts, scrapes and bruises that can range from minor to serious (Hartke et al., 2006). There is also evidence that women take on more caregiving tasks, report more care recipient problems and experience more distress due to caregiving than male caregivers (Pinquart & Sorensen, 2005; Yee & Schulz, 2000). Due to the demands on their time, caregivers may be less likely to engage in preventive health behaviors than non-caregivers and thus neglect their own health (Schulz, 1997) and may be at increased risk for medication use (Vitaliano, Zhang & Scanlon, 2003). Dementia caregivers report more stress and depression than other caregivers (Ory et al., 1999). There is also evidence that family caregivers in certain caregiving scenarios — for example, those caring for a loved one with a brain injury — may be more likely to encounter verbal abuse from the care recipient or a family member (Erosa, Elliott, Berry & Grant, 2010; Stern, 2004).Impacts Incidents On Both Patients And Caregivers Essay

Beyond Mental and Physical Health Effects
The potential negative effects on caregivers can also extend well beyond mental and physical health effects. Caregivers, particularly younger caregivers, often experience disruptions to their education, putting school on hold or dropping out entirely, which can impact their future career and earnings (National Alliance on Caregiving, 2005). Caregiving can also result in considerable financial strain, and can cause difficulties in other roles such as marriage and employment (National Alliance for Caregiving, 2009; National Opinion Research Center, 2014).

In summary, population based studies show that many caregivers do not report high levels of strain, cope successfully with caregiving, report many psychological benefits from caregiving, and may even experience improved health and reduced mortality because of their caregiving experience. However there are clearly subgroups of caregivers that report high levels of strain, experience heightened depression, and who may show negative health effects from caregiving. Caregiving strain is often worsened by certain kinds of caregiving demands (dementia and end-of-life care) and in circumstances where caregivers do not have enough resources (knowledge, skills, social support, respite, and community services) and can be overwhelmed. Clinicians in many settings are most likely to see these highly strained caregivers, and should be prepared to address their considerable psychological, social, and health needs, while also understanding that caregivers may feel pride, a sense of purpose, and other benefits from their caregiving activities. Impacts Incidents On Both Patients And Caregivers Essay

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