Chapter 28

Family
Caregiving
Good day!
Jeric Ursua
Ciarah Sumabong
Victor Steven
Touchchakorn Taranugan
“Family isn’t defined only by last names and by
blood; it’s defined by commitment and by love. It
means showing up when they need it most. It means
having each other’s backs. It means choosing to love
each other even on those days when you struggle to like
each other. It means never giving up on each other!”

—DAVE WILLIS
 TABLE OF CONTENTS

The Older Adult’s Nursing Strategies and

1 Family 3 Nursing Diagnosis
Family Members, Member Strategies, Contributing
Roles, Family Dynamic & Factors, Goal, &
Relationships Interventions
Scope of Family
2 Caregiving 4 Rewards of Family
Types of Assistance, Health Caregiving
Documents, Long-Distance
Caregiving
TERMINOLOGIES
Caregiver burden: stresses, challenges, and negative
consequences associated with providing assistance to a
person in need.
Elder abuse: the infliction of physical or emotional harm,
neglect, financial exploitation, sexual mistreatment, or
abandonment of an older adult.
Sandwich generation: middle-aged persons who are caring
for their own children and their parents.
Skipped-generation household: household in which
grandparent is raising minor grandchild with no parent
present.
 1
The Older Adult’s
Family
Family Members, Member Roles, Family
Dynamic & Relationships
The Older Adult’s Family
Older adults have a diversity of family structures,
including:
● Couples (married, unmarried, heterosexual, and
same sex)
● Couples with children (heterosexual, same sex,
married, and unmarried)
● Parent and child or children
● Siblings
● Groups of unrelated individuals
● Multi generations
The Older Adult’s Family
When interviewing older adults, it is important
to explore all persons who are “significant
others” to and individual and fulfil a family role,
regardless of whether they are unrelated or
reside in different households.
Remember: Persons beyond traditional
family members can serve significant
caregiver roles.
 Identification of
Family Members
Family functions are modified to address the special
needs of older persons and focus on the following:
• Ensuring fulfilment of physical needs
• Providing emotional support and comfort
• Maintaining connections with family and
community
• Handling financial affairs
• Instilling a sense of meaning to life
• Managing crises
 ASK
 Who checks on them regularly?
 Who shops with or for them?
 Who escorts them to the clinic or physician?
 Who assists with or manages their problems?
 Who takes care of them when they are ill?
 Who helps them make decisions?
 Who assists them with banking, paying bills,
and managing financial matters?
 Whom do they seek for emotional support?
 Family Member Roles
1 Decision-maker 2 Caregiver
The person who is The person who provides
granted or assumes direct services, looks after,
responsibility for making or assists with personal
important decisions or is care and home
called on in times of management of another
3crisis. Deviant family member.

The “problem child” or non-

conformist who has strayed from
 Family Member Roles
4 Dependent 5 Victim
An individual who A person who forfeits his
relies on the members or her legitimate rights and
of the family for may be physically,
economic or caregiving emotionally socially or
assistance. economically abused by
the family.
Remember: Even seemingly negative roles
can be fostered by and meet certain needs of
the family.
 Family Dynamics and
Relationships
• Learn as much as you can about your family
member's illness or disability and how to care for it.
The more you know, the less anxiety you'll feel
about your new role and the more effective you'll be.

• Seek out other caregivers. It helps to know you're

not alone. It's comforting to give and receive
support from others who understand exactly what
you're going through.
 Family Dynamics and
Relationships
• Trust your instincts. Remember, you know your
family member best. Don't ignore what doctors and
specialists tell you, but listen to your gut, too.

• Encourage your loved one's independence.

Caregiving does not mean doing everything for your
loved one. Be open to technologies and strategies that
allow your family member to remain as independent as
possible.
 Family Dynamics and
Relationships
• Know your limits. Be realistic about how much of your
time and yourself you can give. Set clear limits, and
communicate those limits to doctors, family members,
and other people involved.

Note: Grandparenting can be a positive experience for

older adults because they obtain enjoyment , affection, and a
sense of purpose from caring for their grandchildren without
the 24-hour stress of child-rearing responsibilities.
 2
Scope of Family
Caregiving
Types of Assistance, Health Documents, Long-Distance Caregiving
 Statistics

10M+ 45 %

More than 10 million 65 years or

Involvedpeople
in parent care, older in this
No. of caregivers
approximately half of whom specific age.
provide care on a regular basis.
 Types Of Assistance
 Maintaining and cleaning the appointments, and take
home actions.
 Managing finances
 Transporting  Monitoring and
 Explaining administering medications
 Reassuring  Supervising
 Accompanying to  Protecting
physician’s office and  Bathing and dressing
hospital  Feeding
 Cooking and providing meals Toileting
 Health Documents
 Birth Certificate
 Social security and  Deeds
medicare numbers  Military discharge
 Insurance policies records
 Durable power of  Source of income
attorney  Bank accounts
 Wills  Prepaid funeral
arrangements, cemetery
plots
Long Distance Caregiving
A long distance caregiver:
 Is very difficult
 Finds it challenging to identify and evaluate local
resources
 Often feels guilty about not being nearby or more
involved
 Has burden of travel
Remember: Maintaining
Should review a file
telephone callsof information that can be
requested by health care providers and facilities, as well as
that will be needed at the time of death of the relative, is an
important task that all caregivers-near and long-distance can
fulfill.
Protecting the Health of the Older Adult and Caregiver
● Effective gerontological nursing
recognizes that the health of all
family members must be maintained
and promoted.
● Maintenance of independence
facilitates normality in family
relationships.
● Health practices through disease and
disability prevention.
● Aggressive attention to avoid
Protecting the Health of the Older Adult and Caregiver
● Interventions such as environmental
modifications, financial aid, home-
delivered meals, etc. can supplement
deficits and strengthen the older
person’s reserves for independent
living.
● The physical, emotional, and social
health of the caregivers must be
evaluated periodically to ensure that
they are competent to provide the
required services and are not
 Caregiver’s TLC
T L C
Training Leaving Caring
training in care leaving the care caring for themselves via
techniques, safe situation periodically to adequate sleep, rest,
medications use, obtain respite and exercise, nutrition,
recognition of relaxation and maintain socialization, solitude,
abnormalities, and their normal living support, financial aid,
available resources. needs. stress reduction, and
health management.
 Gerontological nurses
should review the TLC
needs of caregivers during
every contact to ensure their
continued effectiveness.

Remember: Family
caregiver are often senior
citizens themselves. Even if
they are younger children of
an older adult, they are often
60 years of age of older.
 3
Nursing Strategies and
Nursing Diagnosis
Strategies, Contributing Factors, Goal, &
Interventions
 NURSING STRATEGIES TO ASSIST
FAMILY CAREGIVERS
01 02
Guide the Provide
family to view information that
the situation can assist in
realistically anticipating needs
03 04
Assess and monitor Introduce and
the impact of the promote a review of
caregivers on the care options
total family unit
 Nursing Diagnosis
Altered Family Processes
An alteration in family processes exists when
Overview the family’s normal functions are changed due
to a transition, crisis, or uncertainly, or
uncertainly of outcome.
Illness or injury of family member, change in
dependency level of member, change in role or
function of family member, additional or loss of Factors
family member, relocation, reduced income,
added expenses, social or sexual deviance by
family member, break in religious or cultural
Nursing Diagnosis
Altered Family Processes

The family will demonstrate support and

assistance to members in their fulfilment of
Goal physical, emotional, and socioeconomic needs;
the family will seek and accept assistance from
external sources as appropriate.
 Interventions
o Collect a comprehensive family history that includes profile
of family.
o Identify factors related to family dysfunction and plan
appropriate interventions.
o Facilitate open, honest communication among family
members.
o When a member is receiving health services, explain care
activities and expected outcomes.
o Provide caregiver education and support.
o Make the family aware of support and self-help groups that
Family Dysfunction and Abuse
Dysfunctio
nal family
A family that Elder
encounters
conflict, Abuse
An intentional act
that creates a risk of
misbehavior, and
harm to an older
often child
adult.
neglect or abuse.
Dysfunctional family
Less able to fulfill the physical, emotional, socio-
economic, and spiritual needs of their members.
Rigid in roles, responsibilities, and opinions.
Unable or unwilling to obtain and use help from
others.
Composed of members with psychopathology or
behavioral disorders.
Inexperienced or ineffective at managing crises.
Ineffective or inappropriate with their
 Forms of Abuse
Infliction of pain or injury.
Withholding of food,Sexual abuse.
money, medications orVerbal or emotional abuse.
care. Neglect.
Confinement, physical orAbandonment
chemical (drug) restraint.
Theft or intentional
mismanagement of assets.
Remember: Both the actual commission of a harmful
act and the threat of committing it are considered abuse.
 4
Rewards of Family
Caregiving
Rewards
The love and richness of experience offered
by older persons add a unique depth and
meaning to the family.

Caregiving experiences provide opportunities for

relatives to learn more about each other as
individuals and to obtain gratification in the young
giving something back to the aged who may have
sacrificed for them.
THANKS!
Do you have any questions?

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