The Psychosocial Aspect of Caregiving

The Psychosocial Aspect of Caregiving

Caregiving of the elderly or bedridden takes various forms:physical care home chores financial support emotional support Caregiving of the elderly or bedridden can take various forms such as: The actual physical care Less direct work such as cleaning the house and running errandsGiving financial support, regular visits and phone calls If all this is done by one carer over a prolonged period, there will be great physical and emotional strain. Shared tasks among family members are not easy to arrange especially if there are pre-existing relationship problems. 

Caregiving is made more difficult when the elderly person has depression, fatigue, frustration and anger. It is important for the family to understand the illness, and its impact on the elderly, the family and the carer.

 Illness impact 
While the elderly is in hospital, the family should keep in close contact with the staff to understand the illness and how it affects the elderly person. They are encouraged to participate in the rehabilitation programme. It is traumatic when the onset of illness is sudden; especially when it affects his mobility and the ability to take care of personal hygiene. The person is often shocked to find himself having to be fed and having his personal hygiene and toilet needs attended to by others. He can be confused, even angry and very often depressed when recovery is slow or not noticeable. There will be anxiety about eventual recovery and he will not be able to respond enthusiastically to rehabilitation. A lot of support will be needed in coming to terms with his illness and reduced functional ability. Sometimes, the person cannot appreciate the goals of rehabilitation. Usually he is very anxious to start walking again. It will therefore be useful for the relative to understand and help to encourage him.  Understanding the person The family is usually very protective towards the elderly person sometimes even to the extent of restricting the elderly person’s freedom. It is a question of how much to let go and allow the elderly to have self determination versus how much care and control the carers should exercise on them. Instructions to the elderly not to walk around in the house when no one is at home because of your fear of falls can have a debilitating effect on him. In many instances, the elderly person becomes fearful and refuses to walk when he actually can. Yet the risk of a fall is real if the elderly is allowed to walk on his own. The decisions made can be painful and are often fraught with feelings of guilt, fear, anxiety and frustration. Until you have come to terms with these emotional conflicts, it will be difficult for you to manage the elderly at home.  Effect of the illness
On the family 

The sudden onset of illness is a crisis to the family and can often cause disruption to family life and daily routine. Prior to the hospitalization, the elderly might have been performing one or multiple roles as housekeeper, childminder, income earner, helpmate and companion to his spouse. With the illness and the resultant disability, he can no longer perform these functions. Far worse, he becomes an additional burden to the family. Before you have adjusted to the changes and vacuum that the elderly leaves, you are required to assume care of the elderly.If all family members are working, there will be no one at home to care for the elderly. It may not be feasible for a family member to give up a job to look after the elderly as it can mean substantial lowering of standard of living or experiencing acute financial pressure.If you are caring for your parent, Remember your parent is always your parent – providing care for a mother or father does not mean you have reversed roles, and the adult child has become the parents’ parent. Neither has your parent become your child and should not be treated like one. The responsibility of care may change, however. For example as your parent ages, you may need to care for him in contrast to his caring for you as you grew up. It is helpful to understand these changes, and the effects they have on you and your family. On One’s Life And Feelings 
These changes can sometimes make you feel helpless, angry, guilty, or depressed about the loss of what is familiar. Painful questions arise: Should the person live with you? Should you resign or employ a maid? Should you take full responsibility? How will it affect your own life? You can control your response to these changes. Know yourself, your values, strengths, limitations and goals.The next step is to learn coping skills. These include evaluating yourself and your situation, setting goals, getting support, listing opportunities, and taking action. Have a positive attitude. Understanding your elderly relative and his needs, learning specific skills and developing positive attitude. On The Family’s Resources 
Even if the person is unable to talk, he will still benefit from the company of family members. Being there with the elderly person, providing physical care or bringing food and continuing to give pocket money are ways of showing care and concern. He is bound to experience moments of depression and despair. At such times, encouragement and patience are most required.Members of the family can perform different roles and functions.This will relieve the carer as well as meet the physical, social, emotional and even spiritual needs of the elderly person.Family members who are cooperative and supportive of one another ensure continuous and good care of the elderly person.  Appreciating your own needs
Caring for an elderly person can place considerable restriction on the carer’s social life. The carer may worry about leaving the elderly alone and may choose to remain at home with him. This usually ends in isolation and loneliness. Carers must know their limits and stop before they reach burnout. You cannot take good care of him unless you take care of yourself first. Carers must seek help and support from other family members, as well as from professionals. Family members can relieve the carer so that she can take regular breaks. It is very important that the carer is aware of all available sources of help and knows how to make use of them.  Care arrangements
The family needs to understand what the person can do and what assistance he will need on discharge. Care arrangements need to be made. Foreign maids 
It is not uncommon for families to employ foreign maids. Employing a maid is cheaper than paying for a nursing home. It also has the added advantage, of having the elderly person remain in the comfort of the home and having someone to do household chores. Day care 
The elderly person can attend a day care centre. He can benefit from the mental, physical and social stimulation that the activities at the centre provide and the carer can have a break when the elderly is away at the centre. Community hospital 
The elderly person can benefit from a stay in a community hospital for rehabilitation or convalescence. It also gives time for the family to work out the care plan when the elderly is finally discharged. Nursing homes 
Admission to a Home is another option. On entering a Home however, the individual begins to lose his or her identity and becomes an inmate in an institution. Often, accommodation is in shared rooms or in a large dormitory style ward. There is also the feeling of being abandoned. This is made worse if the carers feel guilty and avoid visiting the elderly at the Home. Intermittent respite care is an alternative care arrangement that provides an elderly person with either day care or a short-stay in a Home or community hospital. It can help the carers by giving them a break for a short while. 

It will be useful for the family to discuss care arrangements among themselves. They can also discuss these issues with the doctors, nurses, therapists or medical social workers in the hospital. 

Relatives’ Support Group

Join a relatives’ support group or get to know other carers. The group gives each of the carers an opportunity to share their feelings and experiences with others in the same position and having similar problems. Through this group you may find the answers to the problems you encounter. Sometimes the group can invite professionals who can inform and advise on the various aspects of the illness and the services available to you.Community Resources

We have a list of services according to zones which you may find useful. We hope you and your family can have a rewarding experience of caring for your elderly relative and that the elderly can have a dignified life. Inpatient Services 
These are the hospitals providing medical, nursing, rehabilitation and respite care and for patients who are chronically ill.   
Other related subjects:
Personal Hygiene & NutritionIncontinenceWound Care 
Exercise & MobilityThe Psychosocial Aspect of Caregiving
Medical Care 
Safe Use of MedicineDying  
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2 Simei Street 3, Republic of Singapore 529889 
Tel: (65) 6788 8833 Fax: (65) 6788 0933 Reg No 198904226R

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