Family and Carer Work for Serious Mental Illness, Essay Example

Impact on Family Caregivers

The development of a mental illness by a loved one gives a lot of burden to the family and informal caregivers. The caregivers sustain a lot of depressive symptoms and burden. The family caregivers are said to experience more mental and physical distress than those who are not giving any care. Those caregivers who are attending loved ones with dementia are said to experience resentment, loneliness, grief, and anger. It has been observed that the impact of caring for a loved one with mental illness subjects the caregiver to the risks of mental ill health, which comes in the form of clinical depression, depressive symptoms, and emotional stress. Most patients that have mental illness stay in their homes meaning that a family member cares for them. The caring process accorded to the individuals with mental illness can be very exhausting and taxing, especially in the case where the individual has a serious mental disorder. The provision of such long-term care has been found to be a source of great distress. Mental disorders are associated with behavioral problems which further heighten the caregiver’s stress levels, and this has significant impacts on the caregivers’ mental health. It is also observed that caring for loved ones with mental disorders result in negative effects on the quality of the caregiver’s life as well as the standard of care given. This being the case, the people with mental disorders need not be left to the family caregivers or informal caregivers alone. These caregivers need social support. Social support can help in bringing down the levels of stress being encountered by the family caregivers. Research findings reveal that the effects of social support on caregiver outcomes are quite profound. They reveal that by offering more social support to the family caregivers, there will be a lower perceived burden and less depressive symptoms. This is because caregiving is linked to a reduction in social support as well as withdrawal and increased isolation as explained by Bruce & Schultz (2001).

Dementia affects the mind of a person. Dementia cannot allow patients to perform their duties effectively because the disease weakens the patient besides leading to the loss of the cognitive ability (Clarke, 2011). Thus, the family caregivers should sit down and plan the way forward on how they are going to provide for their patient. Dementia begins with minor effects and then becomes worse as years go by. The disease that affects the neurons in the brain making them functionless causes it (Clarke, 2011). Therefore, there is a possibility of patient developing other health complications should the disease progress. This is because, as more brain cells become functionless, the body parts also become functionless and could be fatal. The patient should make the advanced directive regarding the illness when the illness has not reached its complex stage (Clarke, 2011). Thus, the patient needed to choose her health care provider and agent and chose her preferred mode of care, whether in-house or hospitalization.

There are various support services available for old patients mainly due to her age and health condition. It is normally the responsibility of the state to offer support services to patients with dementia to ensure that they live a peaceful life. This is because states understand that dementia patients have difficulties in coping with their daily lives. Dementia is a distressing disease to both the patients and their families. Thus, the state must engage itself in the disease through offering support services to the patients. People consider dementia a collective responsibility and they should, therefore, work hard to ensure that the lives of the patients are well taken care of. This has been through putting in place policies and programs that are necessary for providing this  as explained by Worden (2003).

Patient’s culture can have various impacts on the decisions of the patient’s family based on the decisions to be made concerning the treatment programs. When there is the lack of information on the efficiency of a particular mode of treatment, there is a possibility that the societal beliefs imposed on the patient’s family by the society will influence the medical decisions made. Also, the modes of treatment to be administered may also be influenced by culture (Worden, 2003). There are also some cultural beliefs on the causes of particular diseases, and this can play a major role in patient’s treatment.

Working with Family Members and Carers

Caregivers can get some positive associations with caregiving. Some of these associations include satisfaction with one’s competence, enhanced or improved closeness with the patient and fulfilled spousal responsibilities. Because of these perceived uplifts, caregiving can result in lower levels of caregiver depression and burden. The existence of informal support and high quality of informal relationships can lead to less deterioration on the caregiver’s emotional health and lower caregiver depression. If the caregiver is supported by someone who is empathic and understanding, the caregiver’s stress will be alleviated. However, caregiving exposes caregivers to high risk of an economic and social disadvantage as well as high risk of mental health challenges. This implies that there is a need for caregivers to have the opportunity of learning more effective techniques or ways of coping with stress. By learning new ways of coping, the caregivers can reduce their reliance on treatments and their anxiety. The behavioral skills of caregivers, as well as effective self-management training, lead to a lower chance of patient behavioral problems and improved mood of caregivers. A caregiver intervention has been designed to teach caregivers behavioral management skills for addressing problem behaviors that the people with dementia exhibit and also problem-solving strategies for increasing caregiver’s pleasant activities as enumerated by French, Smith and Shiers (2010).

For patients with early dementia, psychotherapy may have some benefits for patients who have early dementia. However, because of cognitive loss, it is important to involve the caregivers. There are significant benefits of cognitive-behavioral family care in caregivers of patients who have dementia. The cognitive-behavioral family care also has a positive effect on patient behaviors as described by Rose, Mallinson and Gerson (2006).

Role of Psycho-education

As part of our group exercise, the role-playing was a very useful tool for me to understand different roles in the family and the complexity of being a carer or family member of a mentally ill relative. I could conclude that the role of our psycho-education and interventions used is very much the key to our result for working with family and friends. Eliminating stigma, focusing on solutions, not on the problem itself, proved to work much better than a leaflet or signposting. Families and carers need solutions and psycho-education to understand the illness first, and then they need to know they are not alone. My future role as a mental health nurse working with dementia diagnosed older adults and their family will not be an ordinary responsibility but will entail great attention and commitment to educating family and carers of how to support their loved ones. I will be doing that by organizing small psycho-education groups or by simply discussing the illness with the family members and signpost them to the support groups available for dementia and Alzheimers. If necessary, I will arrange a package of care for the family member(s) to enable respite for a few weeks and perhaps additional support (for instance carer’s stress vulnerability assessment). In this regard, I will find a way to ease off the tension, stress, challenges and strain that can be put on someone caring for their loved one as explained by Lafond (2002).

Using Psycho-education Approaches

Psychoeducational family work refers to a technique or an approach that is used for working with families who have a member suffering from psychosis. The goals of the psychoeducation approaches are to improve the quality and outcome of life and to reduce family strain and stress. The psycho-education has a single-family or a multi-family format. The approach consists of three stages. The first stage is called the joining in the period. The second stage is called the survival skills workshop, and the last stage is called the meetings stage. The meetings are normally held twice per week, and for single-family approach, they last for 45 minutes while for multi-family intervention, the meetings last for 90 minutes as argued by Rose, Mallinson and Gerson (2006).

One of the psycho-education approaches that can be used for patients suffering from Alzheimer and dementia is called face-to-face interventions. In this case, it is suggested that when caregivers are taught coping strategies, the caregiver burden can be effectively relieved. It is also observed that face-to-face teaching is more effective intervention than group sessions. One-to-one teaching interventions that have proven most successful are those based on educational sessions together with psychosocial training. These face-to-face interventions cover a wide range of areas, which include practical advice to cope with Alzheimer and Dementia, information about the disease, skills training for tackling or handling the patient’s behavioral problems, the organization of care, teaching on decision-making skills, advice about self-care and emotional consequences of being a caregiver. Psychosocial interventions for caregivers combined with cholinesterase inhibitor therapy administered to the patient have been proven successful for lowering caregiver depression. Therefore, combined psychosocial approaches and drug use in the management of patients who have Alzheimer and Dementia are very effective in reducing caregiver burden as explained by Reed, Peters and Banks (2010).

During psycho-education, the motivation of the participant and the skills and experience of the health professional constitute essential elements during the recruitment of the participants. Information has to be communicated in an understandable and an easy way, especially during behavioral family therapy. During the early stage of Alzheimer and Dementia, there are some essential factors that the psych-education providers need to consider. Some of these factors include the provision of education about the mental illness, provision of guidance through treatment, identification and supporting of the personal strengths of the patient and focusing on the individual and not on the illness. The health professionals need to establish quality relationships with the patients and caregivers during the recruitment phase as argued by Rose, Mallinson and Gerson (2006).

References

Bruce, E. J., & Schultz, C. L. (2001). Nonfinite Loss and Grief: A Psychoeducational Approach. Baltimore, P. H. Brookes.

Clarke, C. L. (2011). Risk Assessment and Management For Living Well With Dementia. London: Jessica Kingsley Publishers.

French, P., Smith, J., & Shiers, D. (2010). Promoting Recovery in Early Psychosis: A Practice Manual. Chichester, John Wiley & Sons. http://www.123library.org/book_details/?id=5152

Lafond, V. (2002). Grieving Mental Illness: A Guide For Patients And Their Caregivers. Toronto, University of Toronto Press.

Reed M, Peters S; Banks L (2010). Sharing Care with families In: French. P; Smith J; Shiers D; Reed M; Rayne M Promoting Recovery in Early Psychosis – A Practice Manual. Chichester Wiley-Blackwell.

Rose, L. E., Mallinson, K. and Gerson, L.D. (2006). Mastery, burden and areas of concern among caregivers of mentally ill persons. Archives of Psychiatric Nursing 20 (1) 41-51

Worden, J. W. (2003). Grief Counselling and Grief Therapy 3rd Edition – A Handbook for the Mental Health Practitioner. London Brunner-Routledge