Impact of Alzheimer's on Family Members - Essay Example

Impact of Alzheimer's on Family Members Alzheimer’s disease occurs between the age of 40 and 90 with the greatest risk coming after the age of 65. More than half the patients are cared for at home and this results in the family and friends having to alter their lives to take on the responsibility of their loved ones (Juozapavicius & Weber, 2001). Recent studies suggest that the amount of strain family caregivers perceive is not correlated with the severity of Alzheimer’s symptoms (Wood & Parham, 1990). The concepts for this literature review are the impact of Alzheimer's on family members whose lives are deeply affected by the emotional, physical, social and financial burdens of care giving, effects of institutionalisation and support and assistance. Impact of Alzheimer's on family members Different studies have been conducted on the family caregivers and their responses to care giving to an Alzheimer patient. A cohort study with a comparison group was conducted by Baumgarten et al., (1994) in which there were 86 caregivers (family members with dementia patients) and 95 comparison participants (family members with cataract patients). This study suggests changing the hypothesis that prolonged exposure to stress affects well-being by depleting the caregiver's physical and psychological resources. Instead, the hypothesis should be that well-being declines linearly over time with continuing exposure to the stressful situation. However, Juozapavicius and Weber (2001) suggest that the caregivers too become victims of the diseases, as they themselves must struggle to survive it. It is a trying time for their physical and mental abilities and they feel that their mental reserves are exhausted. Exhaustion occurs due to increased stress levels. Sleep disturbances like getting to sleep, staying asleep and nighttime wandering causes problems for the family members and increases their stress levels (Blaszczyk & Mathys, 2007). According to Pratt et al., (1985) stress further leads to other complications. The family that gives care to the Alzheimer’s patients faces the prospect of social isolation, lack of time for the self, family and friends, career interruptions, financial drain and unrelieved physical labor. The family experiences sleep disorders, anxiety, chronic, fatigue, hypertension and cardio-vascular disease. This occurs because the family members do not get respite and time to eat right, relax, exercise or rest. They tend to lose sight of their own importance (Juozapavicius & Weber, 2001). Study by Juozapavicius and Weber suggests that the caregivers’ stress is increased because the patient is not in a position to express gratitude and on the hand may be aggressive, uncooperative and even violent. This can make the family even further frustrated, angry and resentful. The caregiver or the family has to come to terms with the fact that no words of gratitude or appreciation would be forthcoming from the Alzheimer’s patients as does in the case of other diseases (Juozapavicius & Weber, 2001). Study conducted by Baumgarten et al., (1994) was to examine the change in depression and physical symptoms during a one-year period and the participants were close family members. The study revealed that the caregivers experienced only a slight increase in depression and other physical symptoms from caregivers of cataract patients and the difference was small and not statistically significant. For physical symptoms the figures were statistically significant. The result demonstrated guilt and loneliness in the family of dementia especially after the patient was institutionalized. Support and assistance Retrospective research on the experience of the caregivers and their reflections of the caregiving experience conducted by Juozapavicius & Weber (2001) suggests that lack of support and assistance adds to the frustration of the caregivers. They find it frustrating as they did not who to turn for help. The family members also had lack of mental and emotional support from the family that lived away who did not realize the seriousness of the situation (Juozapavicius & Weber, 2001). They resort to institutionalizing the patient but this too does not relieve the caregiver of either the stress or the guilt. Institutionalizing also made the caregivers conscious of their own psychological state which according to the study perhaps made them more willing to discuss their depressed mood and physical health (Baumgarten et al., 1994). The study further suggests that increased health problems in the caregiver may be the cause rather than the consequence of the decision to admit the patient to an institution. A study by Pratt (1995) surveyed 240 subjects to examine the coping strategies used by the caregivers and the relationship that these strategies had with the caregivers’ subjective sense of burden such as Age, sex, income, residence and education did not affect the burden scores but the burden scores’ were related to the caregivers’ health status. The researchers state that the level of burden reported by caregivers in this study is similar to other studies. Effects of institutionalization Pratt (1995) demonstrated that institutionalizing does not reduce the burden of stress on the caregivers. It merely allows time to refocus their efforts on the emotional aspects of their relationship. Guilt is seen as a personal failure that arises when institutionalizing takes place after years of care giving. The caregivers express guilt even when they know that they were not physically and emotionally capable of taking care of the loved ones. An interview of the family members suggested that the caregivers tend to lose patience while many regretted that they had not understood the loved one. They reported feeling so overwhelmed at times that they lost patience and became irate with the patient (Juozapavicius & Weber, 2001). Some of them even regretted not having taken care of their own health and one of them said it took him four years to get back to normal life. Financial concerns also led to worry amongst the family members. Many even carried feelings of guilt even after the death of the patient. Wood and Parham (1990) conducted a study of 85 women to determine pattern of coping with the strain of providing care for an Alzheimer’s patient. The subjects identified themselves as primary caregivers of relatives diagnosed with Alzheimer’s disease. Only female were selected to avoid gender difference in stress and burden experiences. Subjects were selected based on race and residence. Socio-economic variables were controlled to ensure that results could be appropriately attributed to ethnic differences. The study revealed that urban residents and Whites use more action-oriented, problem-solving approaches to coping. It also demonstrated that race was not a significant predictor of the amount of strain that the caregivers experienced. The rural-Blacks seek information less frequently than do other groups. Conclusion Every caregiver’s situation is unique but still they do benefit from others’ experience. The disease not only steals the patient of the memory but also devastates the lives of the family members. This normally occurs due to lack of support and information available to the caregiver. Over a period, their health status declines and the caregivers become the first casualty of the disease. Further research is required to focus on prevention, which includes understanding whether certain drugs or lifestyle factors may exert a protective effect against Alzheimer's. Lastly research about care giving, including what types of educational programs are most effective and what types of support are most useful may assist the caregivers in leading a more meaningful life. . References: Baumgarten et al., (1994), Health of Family Members Caring for Elderly Persons with Dementia: A Longitudinal Study, Annals of Internatl medicine, 15 January 1994 | Volume 120 Issue 2 | Pages 126-132 Blaszczyk, A. T., & Mathys, M., (2007), Treatment of Cognitive Decline and Psychiatric Disturbances Associated With Alzheimer's Dementia, Journal of Pharmacy Practice 2007; 20; 13 Juozapavicius, K. P., & Weber, J. A., (2001), A reflective study of Alzheimer's caregivers, Am J Alzheimers Dis Other Demen 2001; 16; 11 Pratt et al., (1985), Burden and Coping Strategies of Caregivers to Alzheimer's Patients, Family Relations, Vol. 34, No. 1, The Family and Health Care. (Jan., 1985), pp. 27-33. Wood, J. B., & Parmar, I. A., (1990), Coping With Perceived Burden: Ethnic and Cultural Issues in Alzheimer’s Family Caregiving, The Journal of Applied Gerontology, Vol. 9 No. 3, September 1990 325-339 Read More