Caregivers Flashcards
What are the different categories of life-limiting conditions?
Life-threatening conditions which curative treatment may be feasible but can fail
Conditions where premature death is inevitable
Progressive conditions without curative treatment
Irreversible but non-progressive conditions causing severe disability leading to susceptible health
What are some figures for life-limiting conditions?
National prevalence in young adults increased in England
Increases with age, higher in females but male prevalence higher between 18-21yrs
Oncology predominates in all age groups
Prevalence & late diagnosis in black & south Asian populations significantly higher than white
Who is the caregiver?
Family caregivers provide complex support extending across physical, psychosocial, spiritual & emotional domains
More women than men become caregivers, most aged 55+ & most related to patient
Who are cancer carers in the UK?
700,000 young UK carers (18 or under)
7.6% live apart from person they support
22% perform healthcare tasks
53% haven’t received any information or training from professionals
50,000 cancer carers work full time while providing over 35hr of care a week
What are complex tasks at diagnosis?
Take active role in decision making relating to treatments
Integrate new medical information
Learn new illness related terminology
Enter new treatment setting
Find time to accompany patient to medical appointments
What are complex tasks during treatments?
Disagreements & conflict can complicate decision making, affect treatment & patient/ carer wellbeing
Excessive stress for both patient & caregiver, diminished QoL
Difficulties providing emotional support to patient while meeting ongoing obligations of home, work or family
How do people break bad news about diagnosis?
Great value on communication & medical decisions with family members
Approx 86% cancer patients are accompanied by caregiver to clinical visits
Different & conflicting needs
Family members may be as affected as patients
What is the emotional impact of diagnosis?
Emotional pain & physical suffering mirrored one another
Despair & helplessness
Not understanding medical terminology
Severity of bad news incongruent with expectations
Pre-death grief & silent suffering - anticipatory grief
What is the impact of diagnosis on family relationships?
Existential vacuum
Intimacy vs closeness
Relational crisis - don’t talk to protect themselves
What is anticipatory grief?
Feelings of loss before time of death & can be long lasting & multifaceted
Prolonged anticipatory grief doesn’t lessen feelings of grief at death
Can be experienced by patients & loved ones
What are symptoms of anticipatory grief?
Emotional - separation anxiety, denial, anger, resentment, depseration
Physical - sleep & appetite disturbances, headaches, nausea
Mental - forgetfulness, confusion, difficulty with decisions
What are Futterman et al (1972) processes of anticipatory grief?
Acknowledgement of inevitable death
Grieving - experiences & expressing emotional impact of loss
Reconciliation to child’s expected death
Detachment - withdraw emotional investment
Memorialisation - development of fixed representation of child
What is the impact not talking?
Self-defeating protection - don’t open up about painful experience
Self-blaming & guilt
Preserve relational homeostasis while inside worlds dominated by alienation and silent emotional pain
What would people not want to know?
Psychological illness minimisation
Reacting defensively & seek external reassurance
Distance from illness
What are complex tasks beyond treatment?
Poor adjustment over long-time due to strain in relationship between caregiver & patient, negative communication, less social support & role overload
