Patients who are terminally ill greatly affect the family caregivers. Therefore, family intervention is very crucial in the care of patients. Family intervention strategies are very useful, but they generally ignore the primary stressor for the family caregivers. The provision of family care has been very detrimental to the lives of the caregivers and the patients. Due to this fact, there has been a proliferation of various intervention programs aimed at improving family care and the wellbeing of caregivers.
Family interventions in providing care to patients who are terminally ill are relatively uncommon and mostly underdeveloped. Family intervention is necessary to assist caregivers to cope with the physical and emotional demands of providing care and to minimize the work of caregiving. As the health of an individual deteriorates, there is a gradual change that occurs towards the end of a patient’s life; hence the focus of care should change to palliation.
Moreover, the interventions that focus on the relief of the suffering patient have rarely been tested. In support of this view, the priority problems or the needs of the family caregivers may be experiencing will be identified, and the family-centered, measurable, and achievable outcomes that will focus on the family problems or needs from a nursing perspective and conclude with the intervention that would be recommended and the appropriate health care professional.
This paper focuses on the family care required to assist Mr. W who fell down basement steps and sustained serious injuries on the left tibia/fibula structure. The family members need to take care of him. However, there are many limitations in the activity that may prevent the W’s from undertaking their daily activities. Mr. W should be provided care by his family members. Family care should focus on assisting with daily chores, coordinating care or treatment among various physicians, and providing medicare (Cannuscio, 2009).
In this case, Mrs. W spends a lot of time weekly when attending to her husband. Thus, various activities emphasize the role of family caregivers in taking care of their loved ones who are seriously sick. Depression is the main cause of suffering to Mr. W and he appears to be withdrawn. Depression affects patients as well as their family members (Chitty & Black, 2010).
In most cases, the support of family caregivers has been a focal ideology of palliative care for many years, and few of these interventions have been developed for caregivers of terminally ill patients. The present interventions are not appropriate in addressing the main source of family caregivers’ distress of their loved family member suffering (Purnell & Paulanka, 2008).
Many problems are encountered by Mr. W’s family. The most important is the time that they spent in providing care to Mr. W. Even though, family caregiving may take little time in a day, in most cases it may be an equivalent of a full-time job. Mrs. W spent most of her time taking care of her husband. She even switched from a part-time job to a full-time job to meet her family’s needs. However, the sense of her responsibility to her husband was never-ending. Other family members are also faced with numerous challenges, for instance, the 15-year-old daughter has to babysit the younger child after school every day since their mother switched to a full-time job to sustain the family.
The family members are not able to predict the length of Mr. W’s illness hence, they are faced with numerous logistical needs since they must coordinate numerous medications, attend to clinical and social services, and the requirements to support the family. Mr. W’s family is also affected by the emotional burden and mental health risks because of the deteriorating health conditions of Mr. W. They bear a huge emotional burden for the work they do.
Even though some of them may be privileged and enjoy their role, mostly they suffer from sadness, resentment, anger as well as a sense of inadequacy. Mrs. W is greatly affected emotionally by exhaustion, disruption of daily activities, financial strain; she is subjected to mental health retardation that encompasses depression and anxiety. According to Purnell and Paulanka (2008) wives tend to be more likely to have depression than husbands.
The effectiveness of family care is evident in Mr. W’s family because family care provides them with the caregivers’ satisfaction. The subjective measures of the family experience include the satisfaction of their services and quality of the measures taken when providing care to Mr. W. These instruments assess focused aspects of family care that are very crucial in proving the effectiveness of interventions.
Satisfaction measures are very specific and correspond to the purposes of intervention such as communication, improved caregiving, management of pain, and convenient support. Other relationships to these measurable outcomes are supported qualitatively such as spiritual support. The family of Mr. W believes that religion is central to their lives and their religious beliefs assist in forming their family values. Hence, it is important to demonstrate the link between these aspects of giving care to the patient and the satisfaction that is related to spiritual support as a possible intervention.
The most appropriate intervention to assist the family of Mr. W in achieving the outcomes or addressing the problems of needs identified may involve teaching the family caregivers new knowledge or skills on how to provide effective care. These may include educational or training programs (Sherman, (2004). The other effective intervention program is to assist the family caregiver in appropriate ways to cope with the physical and emotional demands of providing care. This may take the form of support groups or counseling of family members on the most effective way to take care of a terminally ill patient.
It is important to reduce the work of caregivers so that they may develop emotionally and psychologically. It is also important to provide psychological services to family members and the community since the family the W.’s have close friendships with their neighbors. The community and the family members should be given psychological services that include home care services. However, effective treatment of family caregivers should have a psychological approach that is more effective than other approaches such as educational or multidimensional approaches. A psychological intervention applies general information to a specific situation by practicing new skills and allows the development of new plans to apply the skills in any condition they may encounter (Matzo, 2004).
The educational interventions rely on the assumption that obtaining new skills and information leads to acquiring new behavior hence, providing the caregiver’s little opportunity to translate the new skills into action during the process of intervention. A psychoeducational intervention allows the caregivers to apply techniques that are largely enhancing behavior change, for instance, the behaviors of children and their attitude towards their sick father. A multidimensional approach is vital to address various risk factors and stressors that may have negative effects on the caregivers’ wellbeing (Edleman & Mandle, 2010).
Health Care Professionals
To improve the services offered by family members to Mr. W, it is necessary to involve health professionals who are skilled enough to address the family problems. For instance, the family of the W’s may require the services of home care providers who are certified in medicare. These professionals are skilled to assist the family members in taking care of Mr. W. These professionals provide a diagnosis too seriously ill patients at home. In addition, they provide services that are highly controlled and supervised. The services of hospice caregivers may vital because they provide a broad range of services such as psychological, spiritual support.
Spiritual care is very essential to Mr. W because it reduces despair. The hospice caregivers also provide support to family members in providing care to a patient. They also provide related medication, medical supplies, and equipment that are based primarily in the home hence providing an opportunity to the family members to stay close to one another. The hospice care providers are available throughout the day and provide services that ensure that the patient’s needs are met and keep them comfortable and honored and to feel free from suffering. Moreover, Homecare Aid Agencies may also be required to assist in feeding the patient, bathing, dressing, and engaging in various activities in the home such as housekeeping (Clark, 2008).
Family members are involved in providing care to a seriously ill patient. Mental disorders reverberate the entire family with moderate rates of psychological and social mobility. In the recent past, a lot of awareness has been put in place on the importance of family care in maintaining continuity of care to patients.
Family intervention is very important to sustain patients’ who are seriously ill. Family care is very necessary for enhancing the spiritual and emotional well-being of a terminally ill patient. Moreover, family members may face enormous burdens as a result of caregiving. The major reason for family care is to relieve Mr. W from pain. This forms the major reason for family intervention; however, the intervention programs to provide care for patients who are critically ill may be complex because they may advance beyond visible symptoms to include mental disorders which may occur due to the past, present, and future concerns of the patient’s and caregivers’ wellbeing (Pitorak, 2003).
Family care often comes at the expense of the wellbeing of the caregiver; however, in reducing patient suffering, physical, psychological, and spiritual, it is necessary to improve the wellbeing of the family caregivers.
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Edleman, C. L., & Mandle, C.L. (2010). Health promotion throughout the lifespan (7th ed.). St. Louis: Elsevier Mosby.
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Purnell, L. D., & Paulanka, B. J. (2008). Transcultural health care: A culturally competent approach (3rd ed.). Philadelphia: F. A. Davis.
Sherman, D. W., et al. (2004). Teaching symptom management in end-of-life care. Journal for Nurses in Staff Development, 20(3), 103-115.