Formal and informal social support Flashcards
Types of Support
a) Emotional Support
- i. Reassurance, providing encouragement, expressing concern
- ii. Promotesself‐esteem and feelings of self‐worth
b) Informational Support
* i. Advice and access to new knowledge and skills
c) Instrumental Support
- i. Assisting with tasks (e.g. shopping, housework)
- ii. May include ‘personal care’ d) Social companionship
Sources of social support
- • Formal Care:
- Community care professions (since late 1950s)
- Social services
- Voluntary services
- • Informal Care:
- Partner
- Children
- Other relatives
- Friends/Neighbours
Informal network of social support
- Size of network: how many people do you see/know?
- Quality of network: how many supportive interactions do you have?
- Perceptions of support: how much support could you rely on if you needed it?
Religiosity
People with strong religious convictions tend to have better health and better health outcomes
- a) Proscriptions of harmful behaviours
- b) Support of religious community
- c) Belief in all‐powerful deity
Protective effects of support
- Reduces risk of illness following adverse life events e.g. bereavement, job loss
- Encourages professional help‐seeking
- Encourages recommended health actions e.g. taking medicine, diet
- Improves rates of recovery (symptom and QoL outcomes)
Negative effects of social ties
- may increase stress/anxiety
- may encourage smoking or poor diet
Stroke recovery
Aim to improve functional ability/performance:
- Standard outcome measure: Activities of Daily Living (ADL)
- Best outcomes likely to be facilitated by:
- Admission to Stroke Unit
- Specialist rehabilitation services (speech, language, physio)
- Ongoing rehabilitation post‐discharge
- variations in out outcomes achieved even with ‘best’ care
Impacts of stroke on social support
- Stroke may cause biographical disruption
- Disruption to taken for granted assumptions, behaviour, explanatory systems, self‐concept
- Loss of usual activities activities and roles
- Loss or change of roles within social network or close relationships
- Contributes to risk of depression (23‐63% pts)
- Contributes to poorer functioning and cognitive performance
Protective effects of support in stroke
Emotional support
- Confirm self‐worth, promote self‐esteem,
- Provide encouragement, sympathy, reassurance
- Helps task of adaptation and reconstruction of self‐ concept
- Reduce risk of depression
- Increase motivation to undertake rehabilitation
- Encourage realistic expectations
Happiness and health
Hypothesis:
- Emotional states are transmitted directly between individuals individuals ‐ ‘emotional emotional contagion contagion’
- Individuals can catch emotional states displayed by others (over seconds to weeks)
Conclusions
- People are embedded in social networks and the health and well‐being of one person affects the health and well‐being of others
- Affects neuroendocrine & autonomic function?
- Happiness
- lower cortisol output
- attenuated inflammatory responses
- patterns of heart rate indicative of healthy cardiac autonomic control
Informal carers
“People who look after a relative or friend who need support because of age, physical or learning disability, including mental illness”
- 80% of ‘ it community care’ is family care
- (Reluctance to identify ‘selves as carers)
- Estimated 20 – 50,000 young carers (aged under 18 yrs)
Changes in caring
• Increasing demands
– Elderly pop with chronic illnesses ‐ many yrs with considerable disability
• Increasing complexity of tasks
– fairly skilled nursing care
• Poorer health of working class groups
– greater needs for care at earlier stage
• Reduced family size and greater mobility among ethnic minorities
– may reduce availability of carers
Impact of caring
- Effects on activities/contacts/leisure time – Constant supervision
- Changes in roles/relationships – Notion of ‘equivalency’/ reciprocity built into friendships/relationships >> tensions
- Financial problems – Employment limits of cared for and carer, particularly significant in spousal caring
- Social isolation – Carer loss of own social networks on becoming a full‐time carer
- Dealing with uncertainty – Course of disease; future demands/plans?
• Coping with caring tasks: – Physically demanding (e.g. how to lift); dealing with personal care; emotional burden
Carer’s health
- Depression – 39% of spouses of stroke patients depressed compared to 12% control group
- Anxiety – Increased anxiety after caring for 6 months
- Stress – Higher stress associated with carer’s demanding behaviour, depression and need for constant supervision
- Physical health – Some problems e.g. fatigue, strain from lifting, associated with caring
Study of informal carers for cancer: 35% carers had long‐standing illness or disability of own (Thomas, 2000)
