Lesson 21: Family, Caregiver, and Residential Care


Attention

Caring for the elderly at home can create a lot of strain on families...planning for the care of both the client and the needs of the family are essential.


Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • MHRT Outcome: Knowledge of generic community resources including available natural supports

Teaching

Without a doubt, the care and welfare of the elderly depends greatly upon the availability of family members to serve as caregivers. The degree to which family members take on these responsibilities is highly influenced by the cultural expectations of the family.

Families, however, are increasingly dispersed and "busy" with jobs, childcare, and other responsibilities. While home-based care options are available, they fall short of the 24/7 that family members alone can provide.

As Mental Health workers we know that the families of our clients can be available to meet diverse needs that exceed what agencies and funding provides. It behooves us to support the FAMILY members as much as we support the CLIENT. In fact, it might be more important to support the family member if that family member is all that stands between the client and institutionalization.

When working with families it is important to asses characteristics of the family that will determine its ability to provide care and support:

  • Organization and disorganization in the family
  • Medical and psychological sophistication of the family
  • Degree of disruption the client's needs have on the family
  • Patterns of conflict (current and old)
  • Psychiatric and medical illnesses in other family members
  • Marriage and family dynamics
  • Racial, ethnic, and cultural beliefs and practices
  • Recent traumatic events
  • Family members' perceptions of the patient
  • Age of caregivers
  • Needs of youth

Phases of Family Caregiving

  • To recognize and prioritize problems
  • To overcome denial
  • To manage emotions
  • To build a collaborative relationship with family and professionals
  • To balance needs and resources
  • To move on after the patient has died

Specific Factors related to Caregivers

  • Gender
  • Relationship to the patient
  • Racial group / ethnicity
  • Cultural adaptation
  • Patient's behavioral and emotional challenges
  • ADL impairment (activities of daily living)
  • Levels of religiosity
  • Caregivers coping style
  • Family / psychosocial support
  • Use of community services
  • Caregiver's psychiatric history
  • Alcohol misuse / abuse

When we recognize barriers that might exist to good care in the home, we may be able to intervene and help the caregivers understand what is happening. This takes relationship building with the family members.

Changes in where the elderly live often entail a "downsizing"...explore these commercial resources related to "Aging in Place" and "Downsizing"

Article on "Aging in Place" submitted by Debra Poli

Website for Simply Sized Home: Downsizing Made Easy

 


Assessment

Lesson 21 Discussion

Pick one or more of the characteristics of families listed in the Lesson Plan and describe a personal experience with a family that would be challenged to provide good care to an older client. Discuss potential interventions based upon your reading.

Lesson 21 Assignment

You are working with an client who is older and has just moved in to live her daughter and son-in-law. They live in Portland, ME. Using only web-based resources, create a cheat-sheet of all the CAREGIVER resources that might be available to this family. Be sure to include both formal (agencies and services) and informal (church, support groups, etc.) supports.

Your document should include your name at the top and a TABLE that lists the resource name and contact information and a brief description of what that resource might be used for.

Here is an example and you may use these as starting points for your own table:

Southern Maine Agency on Aging
1-800-427-7411

Possible services:

  • Meals on Wheels
  • Family Caregiver Support Program

METRO Greater Portland Transit District
http://gpmetrobus.net

Possible services:

  • Bus transportation around Portland and local ares