The choice to place a loved one in
a long-term care facility is never an easy decision. However, culture, poor
caregiver physical health, and complex emotions, grief and perceptions can
complicate the decision. This post examines the ways in which these
complications affect the decision to place the care recipient in long-term
care.
Traditionally, family members have
cared for elder family members. However, Western societies have been
increasingly utilizing long-term care for elders. Culture plays a role in
deciding to place an elder in long-term care because of the cultural
expectations associated with the decision. In many Asian cultures, filial
responsibility (the responsibility to provide care to loved ones at home) is
expected (Ting & Woo, 2009). Anecdotally, this is the case with many
members of Hispanic and African-American populations as well. However, filial
responsibility can vary within cultures greatly. The decision to place a loved
one in long-term care can be affected by the expectations and perceptions of
the culture in which the caregiver and care recipient reside.
Caregivers are more likely to have depression,
heart disease and diabetes than their non-caregiver counterparts (Family
Caregiver Alliance, 2006). Caregivers report poor physical health more often
than non-caregivers (Family Caregiver Alliance, 2006). The decision to place
the care recipient in long-term care can be affected due to caregiver declining
health.
Lastly, complex emotions, grief and
perceptions can affect the decision to place in long-term care. Emotions such
as guilt, anger, and shame are powerful. Grief, especially if complicated can
serve to hinder the decision to place a loved one for long-term care. Further,
the caregiver may perceive that the care recipient would not want to be in a
long-term care facility or that they would somehow let down their family if
they decide to use long-term care.
Caregivers would benefit from an
intervention that helped to navigate difficult decision making such as placing
the care recipient in long-term care. Ultimately, caregivers must be given
tools and resources that guide their decision and have an outlet for
complicated issues that may dissuade them from making the appropriate choice to
place. Health educators are uniquely suited to provide decision-making tools
and resources while improving physical health outcomes at the same time.
References:
Family Caregiver
Alliance. (2006). Caregiver health: A
population at risk. Retrieved from https://caregiver.org/caregiver-health
Ting, G., &
Woo, J. (2009). Elder care: Is legislation of family responsibility the
solution? Asian Journal of Gerontology
& Geriatrics, 4, 72-75.
Hi, Lauren, What a great post! This is such a relevant issue, especially as more and more of us have parents that are reaching their 80s and beyond. Fortunately, my parents are in good health and still independent. But I know that someday I may have to make these difficult decisions. I think other factors in these decisions are the personal relationship between the elderly parent and adult child, as well as where the adult child resides and what type of career he or she has. As you noted in the article, these are difficult decisions that really require professional help to navigate. Keeping an elderly parent at home may be the best decision for some, but not for everyone, or the need for long-term care may change over time. Also, you never know just when you will be thrust into the role of caretaker. My son's Sunday school teacher was recently hospitalized with diabetic sores on her foot. Her husband is really having to scramble to handle all the caregiving responsibilities which he did not expect. Thanks for talking about an important issue! --Liz
ReplyDeleteThis is great information, Laura! To be honest, before your topic selection, I have not thought much about this simply because I have never needed to be a caregiver for another adult. Of course, it could happen at any time so I am fortunate that you have raised awareness on this issue for me. I find it interesting how filial responsibility varies among cultures and races. When I did clinicals in a rest home, I very rarely saw a Hispanic or African American patient.
ReplyDeleteLooking at all of the negative health effects on caregivers, it is obvious that more resources should be made available to these individuals. If there were more resources, I believe it would not be such a devastation to their health (both emotionally and physically). Even though great rewards can accompany caring for a close family member, there are of course times when a more permanent option is needed as you pointed out. Overall, great post!
-Mimi
Hey Laura, your post brought back memories - some good, some bad. I worked in a long-term care facility for ten years. I have to admit that experience had some life-changing effects on me. Overall, I learned that long-term care is needed for those with very difficult health problems, problems like alzheimer's, where families often can't provide adequate care for the patient. Also, I learned that long-term care (like a hospital) is good care, but it's best when a family member comes to visit often. Those with family coming by often, received the best care. I guess it's like "the squeaky wheel get's the grease".
ReplyDeleteYour idea of having tools and resources to guide the families decision is a good one. I would suggest that the Social Worker of a particular LTC facility is a resource that may be under utilized. Furthermore, while the decision of whether to put a loved one in a nursing home is difficult, something that might help is having the social worker of the LTC facility organize a family support group. This might provide some much needed support and encouragement for the families. Thanks for an interesting post!