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 Care of the Elderly and End‐of‐Life Care

Mary Briody Mahowald

in Bioethics and Women: Across the Lifespan

Cases illustrating variables that arise in the health care of elderly women and their caregivers, and care of the dying are presented. These include questions about ageism, competence to perform ... More

Cases illustrating variables that arise in the health care of elderly women and their caregivers, and care of the dying are presented. These include questions about ageism, competence to perform ordinary functions such as driving, possible loss of capacity for moral agency, advance directives, and decisions about forgoing or terminating life-support. For each topic, empirical and theoretical factors are discussed from an “egalitarian perspective” that imputes privileged status to the standpoint of women.Less

The Heart of the Matter: Religion and Spirituality at the End of Life

David E. Guinn

David E. Guinn (ed.)

in Handbook of Bioethics and Religion

Concerns about caregivers providing religious or spiritual care arise, in large part, out of a misunderstanding about religion and spirituality and what those terms really mean. Many people treat ... More

Concerns about caregivers providing religious or spiritual care arise, in large part, out of a misunderstanding about religion and spirituality and what those terms really mean. Many people treat religion and spirituality as special and unique. This chapter argues that religion and spirituality are basic human facts as inseparable from what it means to be human in the same way as our sex, our age, our ethnicity or the other social and cultural factors that caregivers routinely address. The chapter begins by offering a functionalist definition of religion and spirituality. It then examines research on the needs of patients at the end of life and suggests how these express religious and spiritual concerns. Finally, it offers guidelines as to how the caregiver may meet those needs of a patient.Less

Discipline and the Ethics of Care—Constructing Caregiver Discourses from an Urban Poor Area in Tanzania

Sofia Johnson Frankenberg

in Law and Childhood Studies: Current Legal Issues Volume 14

Most caregivers regard it as their responsibility to teach children to behave appropriately. What is appropriate behaviour and how to make children behave as they should varies according to the local ... More

Most caregivers regard it as their responsibility to teach children to behave appropriately. What is appropriate behaviour and how to make children behave as they should varies according to the local context. In Tanzania, although a signatory to the UN Convention on the Rights of the Child, corporal punishment is lawful in schools, in the penal system, in families, and in alternative care institutions. In a previous chapter, caregivers' conceptions of corporal punishment have been explored. This chapter takes point of departure in these findings and takes them a step further by investigating how they can be understood in the light of the caregiving relationship using the concepts zone of intimacy and ethics of care.Less

Expert Amateurs: Raising and Treating Children with Autism

Chloe Silverman

in Understanding Autism: Parents, Doctors, and the History of a Disorder

This chapter focuses on parents emerging from the experience of wide-ranging psychogenic theorizing about autism during the 1950s and 1960s, of which Bruno Bettelheim's work was but one well-known ... More

This chapter focuses on parents emerging from the experience of wide-ranging psychogenic theorizing about autism during the 1950s and 1960s, of which Bruno Bettelheim's work was but one well-known example. Parents' accounts of their work during a period when the diagnostic category of autism was in flux highlight their unique authority as caregivers and “amateur” therapists. These accounts of parents' treatment activities make clear that expert knowledge and private life have continually intersected in the families of autistic children. The chapter examines how love, through parental efforts to help their children by training themselves in treatment practices, has functioned as a form of practice or technique in interventions to address the syndrome of autism. In both the case of the Orthogenic School's milieu therapy and parental work in behavior modification techniques, the affective involvement of “semiprofessionals” was key to what was experienced as the success of the interventions.Less

Diverse Diagnoses And Special Populations

Harriet P. Lefley

in Family Psychoeducation for Serious Mental Illness

This chapter presents FPE models and research findings for various conditions, beginning with mental illness and substance abuse. Mueser and Fox's Family Intervention for Dual Disorders (FIDD) ... More

This chapter presents FPE models and research findings for various conditions, beginning with mental illness and substance abuse. Mueser and Fox's Family Intervention for Dual Disorders (FIDD) includes both single and multi-family formats. Programs for obsessive-compulsive disorder, borderline personality disorder, easting disorders, and brain and spinal cord injury are presented. Family psychoeducation (FPE) for specialized groups or different family members include families of veterans, spouses, young parents with mental illness and their children, and elderly caregivers. Research findings on the concerns of older parents, and the role of siblings in subsequent caregiving, are presented and discussed.Less

Caregiver Depression, Mental Health Service Use, and Child Outcomes

Barbara J. Burns, Sarah A. Mustillo, Elizabeth M.Z. Farmer, David J. Kolko, Julie McCrae, Anne M. Libby, and Mary Bruce Webb

in Child Welfare and Child Well-Being: New Perspectives From the National Survey of Child and Adolescent Well-Being

This chapter analyzes the mental health care needs and service use for caregivers involved with the child welfare system, who experience symptoms of depression warranting a psychiatric diagnosis. ... More

This chapter analyzes the mental health care needs and service use for caregivers involved with the child welfare system, who experience symptoms of depression warranting a psychiatric diagnosis. Noteworthy findings include the high rate of caregiver depression, a 40% rate that greatly exceeds both the rate of depression in the general population and the rate for female welfare recipients; and the large gap between need for mental health care and reported use of such care for serious depression. An unusual feature of the chapter is the highly innovative use of NSCAW longitudinal data to group depressed caregivers into the categories early recovery, recovered and relapsed, and delayed recovery, in order that these caregivers' use of mental health services may be compared. It also reports a number of sobering consequences of caregivers' depressive illnesses for children and the role that mental health services may play in affecting those consequences. The chapter provides a model discussion of clinical and practice implications emerging from these empirical findings.Less

Older Adults as Caregivers to Persons With Developmental Disabilities

Philip Mccallion

in Handbook of Social Work in Health and Aging

The success that the aging of persons with developmental disabilities (DD) represents also means challenges for families who must provide longer term and new forms of care. In addition, traditional ... More

The success that the aging of persons with developmental disabilities (DD) represents also means challenges for families who must provide longer term and new forms of care. In addition, traditional views of family caregivers, particularly older parents as caregivers, must be expanded to include other relatives, such as siblings and grandparents. The aging of persons with DD and their caregivers requires all social workers to renew perspectives, tools, and approaches. The increasing complexity of life history and experiences, health needs, and life transitions also require that a holistic and multidisciplinary perspective be embraced. Drawing on the related research and practice literatures, this chapter outlines key demographic issues for adults with DD and their families, and describes changing family caregiving constellations. Suggestions are offered for the assessment and management of life transitions, and of grief and bereavement issues that are increasingly a feature of the older years of both caregivers and persons with DD.Less

Family carers and social difference

Kelli I. Stajduhar

in Death, Dying, and Social Differences

The rising number of people facing old age makes it likely that serious chronic and life-limiting illness will be a dominant challenge for health care delivery in the next half-century. Family carers ... More

The rising number of people facing old age makes it likely that serious chronic and life-limiting illness will be a dominant challenge for health care delivery in the next half-century. Family carers will continue to play a major role in the provision of support and care. This chapter briefly summarizes what is known about family carers to lay the foundation to engage in discussions of difference. Specifically, it discusses ‘social differences’ that receive relatively little attention in the literature in relation to family care work: cultural and religious difference, and social class difference. The chapter uses examples to illustrate how these differences can challenge that which we have learned about carers and will suggest supportive interventions that take into account such difference.Less

Restorative Justice and Aging: Promise for Integrated Practice

Alexandra Lee Crampton and Nancy P. Kropf

in Social Work and Restorative Justice: Skills for Dialogue, Peacemaking, and Reconciliation

This chapter focuses on an important shared concern in gerontological social work and restorative justice: helping older adults who become frail, dependent, and vulnerable. It explores the benefits ... More

This chapter focuses on an important shared concern in gerontological social work and restorative justice: helping older adults who become frail, dependent, and vulnerable. It explores the benefits and limitations of social work and restorative practice approaches when working with older adults. It explores a basic contrast between the two disciplines in that gerontological social work focuses on the care of individual older adults, while restorative justice focuses on harm caused to individuals, families, and the community. Social work outcomes focus on preserving or enhancing the older adult's autonomy and dignity, while restorative outcomes focus on healing injury and repairing relationships.Less

Social Sources of Information

Sharon B. Berlin

in Clinical Social Work Practice: A Cognitive-Integrative Perspective

In this chapter, the focus shifts from explaining the role of the memory system in creating meaning and meaning change to explaining the contributions of the physical and social environments to ... More

In this chapter, the focus shifts from explaining the role of the memory system in creating meaning and meaning change to explaining the contributions of the physical and social environments to personal meanings. It considers the role of culture, social structures and institutions, and family life in shaping memories of the self, others, and the larger world. Current information from environmental sources may variously signal that things are just as they always have been or that things are now different from what one had thought or felt. The chapter also explores how chronic threats and deprivations narrow attention and interfere with optimal learning and problem solving. In addition, it considers the influence of early child-caregiver interactions on self-schema development and how lingering effects of problematic interactions might be buffered as a function of subsequent different experiences. Throughout the chapter, steps that practitioners might take to create and highlight environmental discrepancies (opportunities) are highlighted.Less

Multiple-Family Psychoeducational Group for the Parents of Persons with Schizophrenia

Joseph Walsh

in Clinical Applications of Evidence-Based Family Interventions

This chapter discusses multiple family psychoeducational group interventions and their rationale for use with the family members of persons who have schizophrenia. Psychoeducation offered in multiple ... More

This chapter discusses multiple family psychoeducational group interventions and their rationale for use with the family members of persons who have schizophrenia. Psychoeducation offered in multiple family groups (MFGs) for schizophrenia can be helpful in decreasing stress to family caregivers of people with severe mental illness and preventing relapse and hospitalization. Common group topics include theories of schizophrenia, its course, the positive and adverse effects of medications, the relationship between stress and symptoms, available resources for persons with schizophrenia and their families, the nature of professional interventions, managing family emotional responses to the illness, and mobilizing strengths for improved family functioning. The group process, as exemplified through a case study, is intended to help families experience less burden and stress, reduce their sense of stigma, help them assist each other with parenting, and normalize their communications.Less

Ethics Education Competencies for Health Care Professionals Caring for Patients Facing Decisions about Life-Sustaining Treatment or Approaching the End of Life

Nancy Berlinger, Bruce Jennings, and Susan M. Wolf

in The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life: Revised and Expanded Second Edition

This section presents nine practical, skills-based ethics competencies to support the use of these Guidelines among professionals who care for patients facing decisions about life-sustaining ... More

This section presents nine practical, skills-based ethics competencies to support the use of these Guidelines among professionals who care for patients facing decisions about life-sustaining treatment or nearing the end of life. These patients rely on many different professionals, so responsibility for good care should be shared among professions, specialties, and care settings.Less

Public health in the economics of child labour

Eric V. Edmonds

in Child Labour: A Public Health Perspective

Public health is important in the child labour discussion for more reasons than just the consequences of child labour. The morbidity and mortality of caregivers and earners may be central in ... More

Public health is important in the child labour discussion for more reasons than just the consequences of child labour. The morbidity and mortality of caregivers and earners may be central in understanding how children end up in dangerous or exploitive conditions. This chapter outlines how public health issues enter into the economics of child labour. It examines both how public health influences child labour and how child labour influences child health. It begins by reviewing the state of economic research on why children work.Less

The Place of Carers

Jonathan Herring

in Law and Bioethics: Current Legal Issues Volume 11

This chapter focuses on the legal treatment of carers. It develops the claim that an individualized approach to caring relationships is inappropriate. It then considers in more detail two specific ... More

This chapter focuses on the legal treatment of carers. It develops the claim that an individualized approach to caring relationships is inappropriate. It then considers in more detail two specific issues which demonstrate this issue. The first is the relevance of carers when issues of rationing health care resources. The second is the relevance of the interests of carers when decisions are made concerning people who lack capacity.Less

Building Bridges: The Protestant Perspective

Christina M. Puchalski

in A Time for Listening and Caring: Spirituality and the Care of the Chronically Ill and Dying

This chapter provides an overview of Protestant approaches to end-of-life care. It presents stories of the dying and their caregivers which show how different people approach the impending dying ... More

This chapter provides an overview of Protestant approaches to end-of-life care. It presents stories of the dying and their caregivers which show how different people approach the impending dying process and issues that attend death. The chapter describes the Protestant practice in attending to the dying and planning for pre-death and post-death, and also presents the text of prayers for a person near death, litany at the time of death, and a commendation at the time of death.Less

Spirituality in Palliative Care: An Ethical Imperative

Christina M. Puchalski

in A Time for Listening and Caring: Spirituality and the Care of the Chronically Ill and Dying

This chapter examines the ethical aspects of spirituality in palliative care. It provides a roadmap for describing key spiritual interests in healthcare, the source of those interests, and the way ... More

This chapter examines the ethical aspects of spirituality in palliative care. It provides a roadmap for describing key spiritual interests in healthcare, the source of those interests, and the way they find concrete expressions in the lives of patients, their caregivers, and families. The chapter also identifies and clarifies the moral warrants or the scope and grounds of the ethical obligation to address spirituality in the palliative care setting.Less