Post on 08-Jul-2018
transcript
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 150
Annisa Wuri Kartika Annisa Wuri Kartika
Gerontological FamilyGerontological Family
NursingNursing
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 250
ObjectiveObjective
Aging and Aging Families Aging and Aging FamiliesTheories of agingTheories of aging
Geriatric SyndromeGeriatric SyndromeFamily CaregivingFamily Caregiving
Assessing and Su orting Assessing and Su ortingFamily CaregiversFamily Caregivers
Older Adults and Family Thera yOlder Adults and Family Thera y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 350
reambule reambule
Change in Social cultureChange in Social culture demogra hic$demogra hic$culture values$ medication technologyculture values$ medication technologyampn ()) life e ectancy +as - yearsampn ()) life e ectancy +as - yearsy (0) life e ectancy +as u to 123y (0) life e ectancy +as u to 123yearsyears3)) life e ectancy +as -2- years3)) life e ectancy +as -2- yearsampndonesiaampndonesia life e entancy +aslife e entancy +as
10$0 years 4(()5$10$0 years 4(()5$12 years 43)))5$12 years 43)))5$-$ years 43)3)5$-$ years 43)3)5$2 years 43)3052 years 43)305
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 450
Cont$Cont$ 46umlah lansia$ S546umlah lansia$ S5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 550
Aging Aging
Definition of aging is theDefinition of aging is the progressive loss of physiological progressive loss of physiologicalfunctions that increases thefunctions that increases the
probability of death probability of death (Goacutemez Rinessi et al 2000)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 650
Theories Of AgingTheories Of Aging
1 iologycal heories1 iologycal heoriesProgrammedProgrammedSenescenceSenescenceTheoryGenetic Clock TheoryGenetic Clock
Endocrine Theory Endocrine Theory Immunology Theory Immunology Theory
ear and Tearear and TearTheory Theory ateofiving Theory ateofiving Theory Crosslinking Theory Crosslinking Theory $ree adical Theory $ree adical Theory Error CatastropheError CatastropheTheory Theory
2 sychosocial2 sychosocialheoryheory
ctivity theory ctivity theory Continuity theory Continuity theory
DisengagementDisengagementtheory theory
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 750
Geriatric SyndromeGeriatric Syndrome
Conditions$ not diseasesConditions$ not diseasesCommon in the elderlyCommon in the elderly
Ty ically7Ty ically7
8ulti9factorial8ulti9factorialShare risk factorsShare risk factors
inked +ith functional decline$inked +ith functional decline$increasing frailty and oorincreasing frailty and oorhealth outcomeshealth outcomes
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 250
ObjectiveObjective
Aging and Aging Families Aging and Aging FamiliesTheories of agingTheories of aging
Geriatric SyndromeGeriatric SyndromeFamily CaregivingFamily Caregiving
Assessing and Su orting Assessing and Su ortingFamily CaregiversFamily Caregivers
Older Adults and Family Thera yOlder Adults and Family Thera y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 350
reambule reambule
Change in Social cultureChange in Social culture demogra hic$demogra hic$culture values$ medication technologyculture values$ medication technologyampn ()) life e ectancy +as - yearsampn ()) life e ectancy +as - yearsy (0) life e ectancy +as u to 123y (0) life e ectancy +as u to 123yearsyears3)) life e ectancy +as -2- years3)) life e ectancy +as -2- yearsampndonesiaampndonesia life e entancy +aslife e entancy +as
10$0 years 4(()5$10$0 years 4(()5$12 years 43)))5$12 years 43)))5$-$ years 43)3)5$-$ years 43)3)5$2 years 43)3052 years 43)305
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 450
Cont$Cont$ 46umlah lansia$ S546umlah lansia$ S5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 550
Aging Aging
Definition of aging is theDefinition of aging is the progressive loss of physiological progressive loss of physiologicalfunctions that increases thefunctions that increases the
probability of death probability of death (Goacutemez Rinessi et al 2000)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 650
Theories Of AgingTheories Of Aging
1 iologycal heories1 iologycal heoriesProgrammedProgrammedSenescenceSenescenceTheoryGenetic Clock TheoryGenetic Clock
Endocrine Theory Endocrine Theory Immunology Theory Immunology Theory
ear and Tearear and TearTheory Theory ateofiving Theory ateofiving Theory Crosslinking Theory Crosslinking Theory $ree adical Theory $ree adical Theory Error CatastropheError CatastropheTheory Theory
2 sychosocial2 sychosocialheoryheory
ctivity theory ctivity theory Continuity theory Continuity theory
DisengagementDisengagementtheory theory
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 750
Geriatric SyndromeGeriatric Syndrome
Conditions$ not diseasesConditions$ not diseasesCommon in the elderlyCommon in the elderly
Ty ically7Ty ically7
8ulti9factorial8ulti9factorialShare risk factorsShare risk factors
inked +ith functional decline$inked +ith functional decline$increasing frailty and oorincreasing frailty and oorhealth outcomeshealth outcomes
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 350
reambule reambule
Change in Social cultureChange in Social culture demogra hic$demogra hic$culture values$ medication technologyculture values$ medication technologyampn ()) life e ectancy +as - yearsampn ()) life e ectancy +as - yearsy (0) life e ectancy +as u to 123y (0) life e ectancy +as u to 123yearsyears3)) life e ectancy +as -2- years3)) life e ectancy +as -2- yearsampndonesiaampndonesia life e entancy +aslife e entancy +as
10$0 years 4(()5$10$0 years 4(()5$12 years 43)))5$12 years 43)))5$-$ years 43)3)5$-$ years 43)3)5$2 years 43)3052 years 43)305
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 450
Cont$Cont$ 46umlah lansia$ S546umlah lansia$ S5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 550
Aging Aging
Definition of aging is theDefinition of aging is the progressive loss of physiological progressive loss of physiologicalfunctions that increases thefunctions that increases the
probability of death probability of death (Goacutemez Rinessi et al 2000)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 650
Theories Of AgingTheories Of Aging
1 iologycal heories1 iologycal heoriesProgrammedProgrammedSenescenceSenescenceTheoryGenetic Clock TheoryGenetic Clock
Endocrine Theory Endocrine Theory Immunology Theory Immunology Theory
ear and Tearear and TearTheory Theory ateofiving Theory ateofiving Theory Crosslinking Theory Crosslinking Theory $ree adical Theory $ree adical Theory Error CatastropheError CatastropheTheory Theory
2 sychosocial2 sychosocialheoryheory
ctivity theory ctivity theory Continuity theory Continuity theory
DisengagementDisengagementtheory theory
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 750
Geriatric SyndromeGeriatric Syndrome
Conditions$ not diseasesConditions$ not diseasesCommon in the elderlyCommon in the elderly
Ty ically7Ty ically7
8ulti9factorial8ulti9factorialShare risk factorsShare risk factors
inked +ith functional decline$inked +ith functional decline$increasing frailty and oorincreasing frailty and oorhealth outcomeshealth outcomes
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 450
Cont$Cont$ 46umlah lansia$ S546umlah lansia$ S5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 550
Aging Aging
Definition of aging is theDefinition of aging is the progressive loss of physiological progressive loss of physiologicalfunctions that increases thefunctions that increases the
probability of death probability of death (Goacutemez Rinessi et al 2000)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 650
Theories Of AgingTheories Of Aging
1 iologycal heories1 iologycal heoriesProgrammedProgrammedSenescenceSenescenceTheoryGenetic Clock TheoryGenetic Clock
Endocrine Theory Endocrine Theory Immunology Theory Immunology Theory
ear and Tearear and TearTheory Theory ateofiving Theory ateofiving Theory Crosslinking Theory Crosslinking Theory $ree adical Theory $ree adical Theory Error CatastropheError CatastropheTheory Theory
2 sychosocial2 sychosocialheoryheory
ctivity theory ctivity theory Continuity theory Continuity theory
DisengagementDisengagementtheory theory
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 750
Geriatric SyndromeGeriatric Syndrome
Conditions$ not diseasesConditions$ not diseasesCommon in the elderlyCommon in the elderly
Ty ically7Ty ically7
8ulti9factorial8ulti9factorialShare risk factorsShare risk factors
inked +ith functional decline$inked +ith functional decline$increasing frailty and oorincreasing frailty and oorhealth outcomeshealth outcomes
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 550
Aging Aging
Definition of aging is theDefinition of aging is the progressive loss of physiological progressive loss of physiologicalfunctions that increases thefunctions that increases the
probability of death probability of death (Goacutemez Rinessi et al 2000)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 650
Theories Of AgingTheories Of Aging
1 iologycal heories1 iologycal heoriesProgrammedProgrammedSenescenceSenescenceTheoryGenetic Clock TheoryGenetic Clock
Endocrine Theory Endocrine Theory Immunology Theory Immunology Theory
ear and Tearear and TearTheory Theory ateofiving Theory ateofiving Theory Crosslinking Theory Crosslinking Theory $ree adical Theory $ree adical Theory Error CatastropheError CatastropheTheory Theory
2 sychosocial2 sychosocialheoryheory
ctivity theory ctivity theory Continuity theory Continuity theory
DisengagementDisengagementtheory theory
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 750
Geriatric SyndromeGeriatric Syndrome
Conditions$ not diseasesConditions$ not diseasesCommon in the elderlyCommon in the elderly
Ty ically7Ty ically7
8ulti9factorial8ulti9factorialShare risk factorsShare risk factors
inked +ith functional decline$inked +ith functional decline$increasing frailty and oorincreasing frailty and oorhealth outcomeshealth outcomes
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 650
Theories Of AgingTheories Of Aging
1 iologycal heories1 iologycal heoriesProgrammedProgrammedSenescenceSenescenceTheoryGenetic Clock TheoryGenetic Clock
Endocrine Theory Endocrine Theory Immunology Theory Immunology Theory
ear and Tearear and TearTheory Theory ateofiving Theory ateofiving Theory Crosslinking Theory Crosslinking Theory $ree adical Theory $ree adical Theory Error CatastropheError CatastropheTheory Theory
2 sychosocial2 sychosocialheoryheory
ctivity theory ctivity theory Continuity theory Continuity theory
DisengagementDisengagementtheory theory
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 750
Geriatric SyndromeGeriatric Syndrome
Conditions$ not diseasesConditions$ not diseasesCommon in the elderlyCommon in the elderly
Ty ically7Ty ically7
8ulti9factorial8ulti9factorialShare risk factorsShare risk factors
inked +ith functional decline$inked +ith functional decline$increasing frailty and oorincreasing frailty and oorhealth outcomeshealth outcomes
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 750
Geriatric SyndromeGeriatric Syndrome
Conditions$ not diseasesConditions$ not diseasesCommon in the elderlyCommon in the elderly
Ty ically7Ty ically7
8ulti9factorial8ulti9factorialShare risk factorsShare risk factors
inked +ith functional decline$inked +ith functional decline$increasing frailty and oorincreasing frailty and oorhealth outcomeshealth outcomes
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 850
Cont$ 4geriatric syndrome5Cont$ 4geriatric syndrome5
Share$ Ris ampactorsShare$ Ris ampactorsOlder age 4efine old5Older age 4efine old5Functional ampm airmentFunctional ampm airment
Cognitive ampm airmentCognitive ampm airmentampm aired mobility 4ampnouye et al 3))-5ampm aired mobility 4ampnouye et al 3))-5
hysical social functioning andhysical social functioning anddisabilitydisability
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 950
Geriatric GiantGeriatric Giant
mmo ilitynsta ilityncontinence (urinary ali)ntellectual im+airment ( C -ementia)nampection (neumonia etc)m+airment oamp hearing isionm+action (consti+ation)solation ($e+ression)nanition (malnutrition)
m+ecunity (+oerty)nsomniammune $eampiciencym+otence Kane Ouslander Abrass (from
Solomon 1988) Essentials of
Clinical Geriatrics2 1$ 1
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1050
Aging Families Aging Families
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1150
8arital Status And Aging
ampn the community -0lt of men over 10 arelikely to be married and living +ith theirs ouselt of +omen over 10 are married andliving +ith their s ouse-lt of +omen over 10 are +ido+slt of men over 10 are +ido+ers
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1250
iving Arrangementiving Arrangement
ikelihood of living alone increasesikelihood of living alone increases+ith aging+ith agingO tions for livingO tions for living
ampnde endent +ith or +ithout assistanceampnde endent +ith or +ithout assistance=etirement communities=etirement communitiesFoster careFoster care
Assisted living Assisted living
ong9term careong9term caregtursing homegtursing home
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1350
SSSSNG N- S RNGSSSSNG N- S RNG
F 3 C RG4RSF 3 C RG4RS
Family Care-givingFamily Care-giving
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1450
Family Care9givingFamily Care9giving
Family life is characteried by echanges ofFamily life is characteried by echanges ofhel and su ort throughout the life coursehel and su ort throughout the life courseGrand arents are a freuent source ofGrand arents are a freuent source ofchildcare for grandchildren$ articularly in theirchildcare for grandchildren$ articularly in their
first three years 4 andell$ 8cCartney$ O+en$first three years 4 andell$ 8cCartney$ O+en$ooth$ Clarke9Ste+art$ 3))5ooth$ Clarke9Ste+art$ 3))5 their adulttheir adultchildren +ork or are unable to care for theirchildren +ork or are unable to care for theirchildrenchildren
Grand arents also are often a source of stabilityGrand arents also are often a source of stability
+hen arents divorce$ and gro+ing numbers of+hen arents divorce$ and gro+ing numbers ofgrand arents are filling arenting roles forgrand arents are filling arenting roles forgrandchildren because their arents are unablegrandchildren because their arents are unableor un+illing to fulfill their arental obligationsor un+illing to fulfill their arental obligations4Baysli Kaminski$ 3))054Baysli Kaminski$ 3))05
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1550
Family CaregivingFamily Caregiving
For many older adults$ the health crisis increase de endence or inability to livealone The majority 400lt5 receive care intheir o+n home (most caregiers 5ill e ampamilymem ers 5 4gtational Alliance for Caregiving
and AA=$ 3))5Caregiving may sim ly mean ee+ing aneye on D an older adult to monitor +ell9being 48essecar$ 3))25
Walker$ ratt$ and Eddy 4((05 note that a$ult$aughters do similar things for de endentmothers including running errands$ re aringmeals$ and assisting +ith house+ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1650
Cont$Cont$
ampncreasingly$ roviding care to an older adult isampncreasingly$ roviding care to an older adult isbecoming art of the normative life e erience inbecoming art of the normative life e erience infamiliesfamilies -0lt of adults +ill e erience caring for-0lt of adults +ill e erience caring forfamily member at least once in their lifetimefamily member at least once in their lifetimee ending on the family caregiver s circumstances$e ending on the family caregiver s circumstances$caring for relativescaring for relatives can e a 6oy or the care can e acan e a 6oy or the care can e a
source oamp an7ietysource oamp an7iety8ost caregivers are middle aged or older8ost caregivers are middle aged or older8ost care is rovided by +ives and daughters$8ost care is rovided by +ives and daughters$=esearch has consistently sho+n that=esearch has consistently sho+n that
8omen8omen rovide more ersonal care$ more hours ofrovide more ersonal care$ more hours of
care9giving$ and more housekee ing$care9giving$ and more housekee ing$enen more ty ically rovide financial assistancemore ty ically rovide financial assistance4such as money management5$ make4such as money management5$ makearrangements for formal care$ and do home andarrangements for formal care$ and do home andyard maintenance +orkyard maintenance +ork
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1750
=ole of Caregiver =ole of Caregiver
ampncreasing de endency reuires careampncreasing de endency reuires cares ecific to A$ +hich involves intimate$s ecific to A$ +hich involves intimate$
ersonal care related to bathing$ dressing$ersonal care related to bathing$ dressing$eating$ toileting$ transferring$ and mobilityeating$ toileting$ transferring$ and mobility4Wallace Shelkey$ 3))-54Wallace Shelkey$ 3))-5
Su ort ampA$ +hich consist of functionsSu ort ampA$ +hich consist of functionsrelated to laundry$ housekee ing$related to laundry$ housekee ing$trans ortation$ food re aration$ sho ing$trans ortation$ food re aration$ sho ing$handling finances$ using the hone$ andhandling finances$ using the hone$ andmedication management 4Graf$ 3))-5medication management 4Graf$ 3))-5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1850
E erience of care9givingE erience of care9giving
S ouses are generally the first line ofS ouses are generally the first line ofcaregiverscaregivers +omen live longer than men$+omen live longer than men$+ives are more likely than husbands to+ives are more likely than husbands tobecome caregiversbecome caregivers care9giving s ousescare9giving s ouseshave a 1lt greater mortality rate than othershave a 1lt greater mortality rate than others
their age +ho are not caregiverstheir age +ho are not caregiversThose +ho care for someone +ith dementiaThose +ho care for someone +ith dementiaare at increased risk for de ression$ greaterare at increased risk for de ression$ greaterlevels of stress$ and lo+er levels of subjectivelevels of stress$ and lo+er levels of subjective+ell9being 4inuart Sorensen$ 3))15+ell9being 4inuart Sorensen$ 3))15
8ost have to make a range of adjustments at +ork8ost have to make a range of adjustments at +ork4going in late or leaving early$ cutting do+n on4going in late or leaving early$ cutting do+n onhours +orked$ or leaving the labor force entirely5hours +orked$ or leaving the labor force entirely5
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 1950
Family Focus
ach Family is uni9ueCase Stu$y8rs Endang$ age -0$ has lived +ith herolder daughter for 0 years She hasthree adult children$ t+o daughters and ason$ +ho rovide assistance +ithtrans ortation$ bathing$ and medicationmanagementThey have been doing thissuccessfully together for the ast years
ntil no+$ 8rs Endang s children havefelt able to handle most situations and+ere able to obtain the resources neededto continue to manage their o+n lives andhel their mother
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2050
Cont$
8rs Endang s older daughter has had a close relationshi +ithher mother They both enjoy cooking and listening old musictogether The other t+o children enjoy talking +ith their mother8rs Endang looks for+ard to their freuent visitsThe older daughter feels that$ des ite some hel from herbrother and sister$ most of the burden of organiing hermother s care falls to her She has gladly acce ted thisres onsibility in the ast
Bo+ever$ she no+ has t+o children in college and t+oteenagers at home As a result$ she has had to go to full9timestatus at +ork Ber stress level continues to increase and she isbeginning to resent her mother s needsrom tampe scenario ampat is our assessment of tampis famil
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2150
Caregier Com+etence
Research sho5s
ampigher level of skill in providing care for afamily member is associated ith loercaregiver role strain(
-eampinition The com etence and skill ofthe caregiver4s5 and thefamily in roviding care to afamily member or loved one
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2250
=elationshi s and =e+ards
Research sho5s
higher )uality relationship beteen acaregiver and a care recipient is associatedith loer caregiver strain(
-eampinition ampnteractionsbet+een the caregiver and thecare reci ient based on love$
shared activities$ and sharedvalues
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2350
Caregiver =ole Strain
Caregiver role strain is defined asthe felt difficulties in erforming thecaregiver role
Caregiver role strain can come from7roviding direct careTension and +orryEconomic burdenCommunication roblemsack of su ort or resources
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2450
Caregiver Em o+erment
8odel
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2550
Su ort Family Caregivers
e family focusedrovide systematic assessmentampndividualie family strategiesBel the family recognie health
roblems and roblematictransitions earlyWork together +ith the caregiver
to blend family and nursingkno+ledge
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2650
Eam les of Cross9isci linary Com etencies S++O - G A0 CA EG 3E S
merican ournal oamp Nursing
ssessmentgtursing Social Work
Assess family kno+ledge of skillsnecessary to deliver care to olderadults
Assess caregivers needs andlevel of stress
Family $ucation
Damron-Rodriguez JA (2008) Developing competence for nurses and social workers evidence-based approaches to education American Journal of Nursing Vol 108 No 9 40-46
ampnvolve$ educate$ and$ +hena ro riate$ su ervise family$friends$ and assistive ersonnel
in im lementing best racticesfor older adults
se educational strategies torovide older ersons and
their families +ith informationfor +ellness and diseasemanagement
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2750
Systematic Assessment
ltel+ i$entiampy ampamily strengths an$ ampamily care issuesy
istening to the family caregiver and care reci ient
Asking the family caregiver +hat hisHher concerns areSharing nursing kno+ledge and skill in building thecaregiver s com etence in care9givingSu orting the family in enjoyable activities ordiscovering ne+ +ays of relationshi building
roviding information and su ort through care9givingtransitionsEncouraging the caregiver to take care of hisHher o+nhealth
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2850
ssessment ssues
Family FunctioningI Family assessment informs the bio9 sycho9social
functioning of the elder
I Assessment of the larger family system in relationto the rimary adult caregiver can mitigate stress
46anen$ et al$ 3))15Relationshi+s
I Assessment of the relationshi bet+een adultchildren and their arents is likely to be reflective ofthe relationshi s eistent during the develo mentalstages of the adult children s lives 46anen$ et al$3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 2950
ssessment ssues
Caregiing rrangementsI 8ost elderly receive care from only one caregiver$
most often their s ouse if married 4Cha ell$
((5I S ouses caring for aging artners face multi le
adjustments 4ustbader Booyman$ ((5I Elders receive four and one half years care on
average in American families 4gtational Alliancefor Care9giving AA=$ ((-5
I Caregiing is a +ositie e7+erience ampor many+articularly 5hen caring ampor those 5ho oncecare$ ampor them 4Flori$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3050
ssessment ssues
Role ReersalI escribes the shift of rotector and rovider role from
arent to adult child
I Adult children +ith de endent children of their o+nmay be stressed by dual care9giving role
46anen$ et al$ 3))15
Conamplicts an$ -isagreements
I 8ay eist from lack of informationHunderstandingI Social +orker can facilitate im roved information sharing
I 8ediation bet+een aging arents and care9givingchildren can avoid breakdo+ns
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3150
ssessment ssues
Role oamp the S+ouseI =elationshi roblems bet+een an adult child
and their s ouse may be com ounded byaddition of res onsibility for elderly arentHs
I S ouse s relationshi +ith elder arentHs maysu ort or com licate care9giving
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3250
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3350
ssessment ssues
ssessment oolsI Tools are available to measure memory and behavior
roblems$ caregiver distress$ as +ell as ecoma s ands iritual genograms
I e ression and aniety measures are also useful Geriatric e ression Scale Geriatric Aniety Scale
I The role of culture cannot be overlooked in assessingcaregiver erce tions and stress
I Cultural a+areness is vital to tailoring interventionstrategies acce table to families
46anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3450
ampndividualied Family
StrategiesStrategies shoul$ ein$ii$ualize$ 5ithconsi$eration oamp
Family referencesWhat family has tried or nottried beforeEducational levelCulture and ethnicityBealth care rovider orhealth care system su ort
Family Strategies $o not come in one sie fits allD
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3550
ampdentifying Bealth roblems androblematic Transitions Early
ransitions can occur ampormany reasons 7
Changes in health
condition of care reci ientor caregiver =elocationeath
Family relationshi sChange in health caresystem or rovider
gtursing su ort of thefamily during transitions
may need to be redefined tomeet the family s changing
needs
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3650
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3750
Working Together to lend Familyand gtursing Kno+ledge
Working on family care concerns isfacilitated by families and nurseslistening to each other and utting
their kno+ledge and skill together to7define +hat the care9giving issues aregenerate strategies that can be tried toim rove or solve issues of concern
Educational materials +hich accommodated theirdifferent learning styles$ =esource materials about long9term care o tions$ in9home care$ and cost +ere rovided
A family care conference +as scheduled at the hos ital
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3850
Family Assessment andSu ort
Goals7ampncrease family andcaregiver com etency in
roviding careStrengthen relationshi s andthe re+ards of caregiverampncrease redictability and
stability in family caresituations
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 3950
Family hera+y
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4050
erson-irecte$ Care
A hiloso hy of erson irected Care45 strives to im lement and su ort thechoices that the erson being assistedmakes and to kee all decision9makingas close to them as ossible
The literature references +ersoncentere$ and +erson$irecte$ care
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4150
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4250
FamilyCentere$ Geriatric Resource Nurse(FCGRN) o$el
The FCC 8odel$ reviouslyused for +orking +ithchronically ill children$ +asada ted for care ofhos italied older adultsThe focus is on assessment ofthe family$ as +ell as theindividual older adult 4Salinas$
O Connor$ Weinstein$ ee$ Fit atrick$ 3))35
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4350
Cont$ (FCGRN)
SampCES
S lee disorder The ittsburgh Slee Juality ampnde
oor nutrition 8ini gtutritional Assessment
ampncontinence
Confusion Confusion Assessment Scale
Evidence of falling 8orse Fall Scale
S kin breakdo+n raden Scale
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4450
Cont$ (FCGRN)
FA8amp
Family involvement
ssistance neededembers needs
ntegration into care lan
inks to community su ort
3 our intervention
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4550
sychoe$ucationThe a roach includes the follo+ing ste s7
6oining +ith the family$ develo ing ra ort and em athyroviding an e lanation of the sycho9educational a roachEducation on dementia and management of behavioral
sym toms associated +ith agingampnformation on caregiver stress and co ing strategiesEducation on de ression and cognitive9behavioral strategiesampnformation on community resources for in9home and long9term care including nursing home lacement4Gleason9Wynn$ 3)) in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4650
SolutionFocuse$ hera+y
Four underlying assum tions guidesolution9focused thera y sessions 7
Every client is uniue
Clients have the strength and resources to findsolutionsChange is constantL small changes can lead tobigger onesSince it is not ossible to change the ast$concentrate on the resent and future4i chik$ 3))3 in 6anen$ et al$ 3))15
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4750
reatment anuals 7am+le amp Ste+s
Solution9Focused Thera y ty ical first sessionractitionerHclient conversation about client slifeGather a brief descri tion and contet of the
roblem Ask relationshi uestionsL M+hat +ould your+ife sayN
Track ece tions to the roblemL M+hat +asha ening +hen the roblem could haveha ened but didn tN
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4850
Scale the roblemL Mrating the roblem on a scalefrom ) to ) +ith ) being the +orstHlo+est and )being the bestHhighest
se co ing uestionsL Mask clients ho+ they havebeen able to co e +ith a roblem reviously Ask the miracle uestion to develo solutionsL M+hat+ould your life be like if the roblem disa earedNgtegotiate the goal for changeTake a session break
4Franklin 8oore$ ((( in 6anen$ et al$ 3))15
Treatment Manuals Example OfSteps (cont)
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 4950
R -NG
Anak kemarin menjadi orang tua sekarang danmenjadi kakekHnenek di masa mendatang
alita sehat akan menjadi de+asa yangroduktif dan akan menjadi lanjut usia yangsehat$ aktif dan mandirienduduk negara maju menjadi kaya sebelum
tua$ sementara enduduk negara berkembangmenjadi tua sebelum kaya
Kalacampe 4 Keller 2
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050
8192019 Gerontological Family Nursing
httpslidepdfcomreaderfullgerontological-family-nursing 5050