Caregiver Ebook

Caregiver Training Ebooks

The caregiver training e-book gives a training course on how to provideassistance to another person who is ill, disabled or needs help with daily activities. It can also serve as a useful guide to the individuals in the need of help. The product deals in physical, mental, social, and psychological needs and well-being of both the caregivers and the elderly person requiring care. Everyone needs a little help from time to time and while many seniors lean on the friends and family members for support, there may be some instances in which it's necessary to seek additional assistance or long-term care which was why this product was created by the author. This caregiver product is a practical guide created by the author who is an expert in the field. This product embeds in it several training sections in which each section gives detailed information on how to provide assistance to people who are ill, disabled, or aged. This product is a trusted and 100% guarantee to provide the necessary details needed in caring for the physically challenged, aged and ill individuals. The product is also an essential overview of issues from Alzheimer's to diabetes to strokes. More here...

Caregiver Training Ebooks Summary


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Caregiver Costs

Outside of the initial hospitalization, there has been a paucity of research on the out-of-pocket travel costs for caregivers associated with the incremental medical services provided to preterm infants. Productivity losses have also received scant attention (Zupancic, 2006), although such caregiver costs for disabling conditions can exceed the costs of care for the affected individuals themselves (Tilford et al., 2001). One recent study among large employers, in which mothers were both employed and the primary beneficiary on the company's health plan, found that mothers lost an estimated 1,513 in annual wages and benefits more in short-term disability following a preterm birth than after a term birth. The estimate was 2,766 when the synergies that are lost with coworkers when a worker needs to be replaced on short notice are modeled

Prevalence and Impact

A study done in 1998 revealed that African Americans and Latino Americans might have a higher overall risk of AD. Socioeconomic status, health care, level of education, and culture may also influence the diagnosis of AD. Another study in 1998 estimated that the annual economic burden created by the cost of caring for a patient with mild AD is 18,000, for a patient with moderate AD 30,000, and for a patient with severe AD 36,000. More than half of AD patients are cared for at home, with almost 75 percent of their care provided by family and friends. In 2002 the Alzheimer's Association estimated that approximately 33 billion is lost annually by American businesses as a result of AD. Time taken by caregivers of AD sufferers accounts for 26 billion, and 7 billion is spent for health issues and long-term care related to AD. Additionally, AD costs the United States more than 100 billion annually.

Sources for Further Study

Hamdy, Ronald, James Turnball, andJoellyn Edwards. Alzheimer's Disease A Handbook for Caregivers.New York Mosby, 1998. Causes, symptoms, stages, and treatment options for AD are discussed. Karlin, Nancy, J. Paul, A. Bell, andJody L. Noah. Long-Term Consequences of the Alzheimer's Caregiver Role A Qualitative Analysis. American Journal of Alzheimer's Disease (May June, 2001) 177-182. Examines caregivers' adaptation to the role of caregiver, caregiver burden and coping, social support issues, and positive and negative experiences created by unplanned changes brought on by AD. Leon, J., C. Cheng, and P. Neumann. Alzheimer's Disease Care Costs and Potential Savings. Health Affiliates (November December, 1998) 206216. Identifies the economic impact of caring for and treating those with AD. Mace, M., and P. Rabins. The Thirty-Six-Hour Day A Family Guide to Caring for Persons with Alzheimer Disease, Related Dementing Illnesses, and Memory Loss in Later Life. Baltimore Johns Hopkins...

The Social Component Of Mental Health Care

But due to demographic, social and cultural changes, the numbers of potential care-givers are declining in most countries. When family members are no longer available, expensive social and complementary services must take their place. Serious deficits in this respect are bound to lead to the destitution of the mentally ill as in medieval times, as shown, for example, by Fuller Torrey in 1980 for the USA 49 .

The People in Medication

Effective drug therapy requires three overlapping functions prescribing, which is the initiation of therapy based on medical problem assessment professional supervision or management of therapy by the prescriber or a co-therapist (e.g., pharmacist, nurse, or physician's assistant) and facilitation or actual administration of therapy, e.g., by the patient, a family caregiver, nurse, etc. These three primary functions of drug therapy are drawn inside the dotted line in Figure 4.1, each connected to the other by a two-headed arrow denoting communications in both directions. Today, dentists, clinical nurse practitioners, physician's assistants, pharmacists, and others have the authority to initiate therapy by prescribing prescription-only medicines, and patients and caregivers can initiate therapy with Likewise, a variety of occupations may act as co-therapists, providing professional knowledge and skill to help manage the use of medicines. Finally, most people administer their own...

Written Informed Consent

A clear statement that participation is voluntary and that there will be no repercussions, either in the patient's relationship with the investigator, or with the patient's other care-givers, should the patient decide not to take part in the study. 9. A clear statement that the patient may withdraw from the study at any time and for any reason, again without repercussions to his her relationship with any clinical care-giver.

Finding a Common Ground

In addition to making trade-offs, another classical approach would explicitly identify and emphasize common values among competing perspectives. For example, if a managed care organization knew that it would be obliged to pay for the consequences of ineffective treatment, there would be a large area of overlap among the interests of patients, caregivers, professionals, and payers. It should be possible to judge decisions according to this common interest. This approach might simplify the ethical analysis and lessen the pain of necessary trade-offs. An explicit agreed-upon objective is analogous to ethical policy, but might be more compatible with present market realities, and somewhat easier to develop. For example, a goal for a medications use system that partially unifies differing perspectives would be

Implications for Psychoanalysis Concluding Remarks

The neuroscience of prediction indicates that, in a similar way, what is learned with parents emotionally, in terms of being rejected, disappointed, shamed, or being made to feel inadequate, can also influence the individual for a lifetime. As a result of how the brain is organized, we predict from our experiences in early childhood (with important care-givers) what to expect from people in general. This biases us to experience current relationships as similar to past ones. It is not that current relationships are in fact identical to past ones, but that we subjectively experience them in this way.

Coping and adjustment

When skin disease leads to relationship strain, it is not uncommon for patients to feel guilty for demanding more resources from their partner or to harbour fears of being rejected. Taking on the role of caregiver or care-receiver and no longer that of lover or partner can quickly destroy a couple's relationship (Gottlieb & Wagner, 1991 Schmaling & Sher, 1997). Psychological distress may also affect appraisal of the relationship itself. Sufferers who are in an upset mood often shift perspective towards the negative, and this can extend to perceptions of their partners. Research shows that when one partner is depressed, couples display more interpersonal negativity,

Operant Conditioning

One major technique to teach new behavior is called shaping. Shaping refers to providing a consequence for successive approximations to a desired response. For example, to teach a child to tie shoelaces, a parent might start by crossing the laces, forming the loops and crossing them, and having the child do the last part of pulling the loops tight. The parent would then praise the child. The parent could then gradually have the child do more and more of the task, until the whole task is successfully completed from the start. This type of approach ensures that the task is never too far out of reach of the child's current capabilities. Shaping takes place when young children are learning language, too. At first, parents and other caregivers are overjoyed at any approximation of basic words. Over time, however, they require the sounds to be closer and closer to the final, precisely spoken performance. Shaping can be used to teach a wide variety of behaviors in humans and nonhumans. The...

The Need For A Clinical Neuropsychology Of Prospective Memory

Given the high prevalence of day-to-day prospective memory situations, it is evident that the lives of individuals with severely diminished prospective memory abilities may be compromised by a substantial loss of independence. For instance, persistent failures in prospective remembering may impede professional activities (e.g., incessantly forgetting about errands one is supposed to do at work), endanger the maintenance of intimate social relationships (e.g., chronically forgetting to keep promises to close friends), or even impose serious risks on physical well-being (e.g., failing to regularly take medication). In sum, the negative outcomes of prospective memory deficits may be highly embarrassing, frustrating, or even life-threatening, and can impose a substantial burden on the individuals' significant others or care-givers. Importantly, one source or amplifier of such difficulties with carrying out intended actions are disorders such as physical illness, injuries, or...

Etiology and Treatments

Because of the distressing yet fascinating nature of the symptoms, several theoretical positions have attempted to explain how obsessive-compulsive disorder develops. From an applied perspective, each theoretical position has evolved into a treatment or intervention strategy for eliminating the problems caused by obsessions and compulsions. According to psychoanalytic theory, as outlined by Sigmund Freud in 1909, obsessive-compulsive rituals are the product of overly harsh toilet training which leaves the patient with considerable unconscious hostility, primarily directed toward an authoritarian caregiver. In a sense, as uncomfortable and disconcerting as the obsessions and compulsive behaviors are, they are preferable to experiencing the intense emotions left from these childhood incidents. Obsessions and compulsions permit the patient to avoid experiencing these emotions. Furthermore, obsessive-compulsive symptoms force the patient to become preoccupied with anxiety-reduction...

Pathways To Homelessness For The Mentally

Homeless persons appear to have experienced considerable poverty in childhood. About one in five stated that their family was on welfare and that their primary caregiver was never or rarely employed. The mentally ill homeless did not differ significantly from the non-mentally-ill homeless in terms of childhood poverty. However, the mentally ill homeless did experience significantly more family and home instability. Of the mentally ill homeless sample, 60 had a primary caregiver who was either mentally ill or physically disabled, and more than one out of four were placed at least once in an institution or foster care. Furthermore, mentally ill homeless persons were also more likely to come from backgrounds marked by physical or sexual abuse. Compared with the non-mentally-ill homeless, twice as many mentally ill homeless (almost 40 of the sample) reported having lived in a household where violence or abuse took place regularly. One-third had actually been physically abused, while 5...

Pharmacist p Physician

Most often this is the patient himself, if able and permitted to participate in his own care. Other examples include family caregivers, practical nurses, and nursing aides. In an institutional setting (where patients are usually not permitted to participate in their own care), a professional medication nurse might provide facilitation functions when administering medications and also perform as co-therapist when assessing outcomes.

Pharmaceutical Care System

A PCS is a patient-level system in which the initial steps are the same as those in a drug therapy process. In addition, feedback about patients is planned and carried out. To do that, therapeutic objectives are essential. Furthermore, the objectives have to be documented by the practitioners (so that they will not be forgotten) and communicated to the facilitators (patient and caregiver) and co-therapists (e.g., pharmacists).

Gender Difference Research

Rachel Hare-Mustin and Jeanne Marecek claim that as knowledge in the social sciences is always incomplete, interpretation of events, including research findings, is always subject to bias. They suggest two forms of bias influence beliefs about gender differences. Alpha bias is the tendency to emphasize gender difference beta bias is the tendency to emphasize similarity. In beta bias, underemphasizing gender differences can lead to ignoring the different resources men and women need. In contrast, alpha bias, overestimating differences, can lead one to advocate different roles for men and women. If women are more caring, ought they to be the caregivers If men are more justice oriented, ought they to be judges If there is no difference in moral orientation between boys and girls, ought all children to be taught to use both principles Ought care and justice to be expected from all adults

Three Levels of Family Involvement

The burden experienced by family members varies based on their level of involvement with the member who is ill. Terkelson (1987a) proposed that there are three tiers of family involvement. In the immediate family, most often one individual, usually (but not always) a woman who is the mother, wife, sister, or daughter of the person with mental illness, assumes the role of principal caregiver. Much of her daily life becomes a series of illness-related occupations and preoccupations. She acknowledges the illness more than others and also suffers its impact more than others in this family. This individual, especially if she is the mother of the ill relative, may also feel responsible for the illness itself, an idea sometimes foisted on her by professionals. Terkelson (1987a) notes Often these implications are significant, asking a family to change its entire lifestyle, resulting in understandable resistance. Terkelson describes this sort of caregiver as living a life that is a stream of...

Drug Therapy Problems

Another necessary building block for a model of medications use is the concept of a drug therapy problem.* A drug therapy problem is any circumstance that a competent professional would judge to be inconsistent with achieving the objective of drug therapy. A DTP is overt, i.e., potentially detectable by a patient, caregiver, or professional, and is specific to a patient and time. In other words, DTPs are detectable in principle, although many may be undetected in fact. Despite the complexity of terms used in the literature and in Tables 3.2 and 3.3, there are relatively few types of DTPs. Bero et al. defined 14 types.19 Cipolle et al. have developed an exhaustive categorization of potential DTPs into eight types that are useful for practice and research.42 This will be described in more detail in Chapter 10. For purposes of modeling medications use and the genesis of DRM, we can think of DTPs as falling into three basic types. During the process of therapy, the patient, caregiver, or...

The Self Psychological Approach

Self-psychology is considered a descendent of Freudian psychoanalysis and was developed by, among others, Heinz Kohut. Richard Ulman and Doris Brothers (1988) present a treatment approach from the Kohutian self-psychology perspective. At the core of self-psychology is the notion that the structure of the self is created through relationships. Each of us possesses the psychic structure, the self-object, to refer to someone who is important in satisfying our basic, narcissistic-oriented needs. Self-objects are in the service of the self. The self is developed through the mirroring processes of the parents and primary caregivers. This sense of self develops and progresses from grandiosity and being the center of the world into a more healthy sense of self-esteem and ambition. Failures in mirroring result in an inadequate sense of self. In future relationships, the self-object is used to symbolize other people, and such people are expected to respond to you in a way that your...

The impact of skin disease on the motherchild relationship

It has often been assumed in the past that difficulties accepting a child with a skin condition may result in a disruption to the attachment of the child to his or her parent. Attachment is the normal process through which a young child forms a close relationship with their caregiver and which is thought to provide the basis for the development of subsequent relationships (Bowlby, 1980). This initial relationship provides the child with a secure base and enables the child to explore the world safely and confidently, and therefore increase independence. If the child feels upset or threatened, this important relationship acts as a secure base to which the child can return and be comforted. In order for the child to develop a secure attachment to the primary caregiver, the mother needs to be able to be sensitive to the child's needs and responsive to them.

Professional Self Care

Although it may seem obvious to some, why should STSD even be of concern As Shay (1995) states, what is the ethical standing of the needs of the trauma therapist (p. 253). When does the care of the caregiver become an important issue or an even more important issue than the care of the patient Shay shies away from taking a firm stance on this question, but I would propose that the answer to this question is that both parties involved have equal right to self-care, and, in fact, a professional who neglects his or her self-care regarding work with trauma sufferers is serving the best interest of no one. The simplest approach to take here is that an impaired professional is less likely to provide effective treatment and help.

Prospective Memory in Alzheimers Disease

Subsequent studies provided further evidence that dementia is associated with prospective memory impairments. In a questionnaire study, Smith, Della Sala, Logie, and Maylor (2000) found that Alzheimer's disease results in chronic prospective memory failures in everyday life. These failures were even reported to have a greater negative impact on caregivers' lives in comparison to patients' retrospective memory failures. Three further studies applying laboratory-based tasks supported the notion that prospective memory decline is a characteristic of dementia. Specifically, in a large-scale population-based study, participants with very mild dementia were almost unable to perform a prospective memory task

Patterns of Infant Mother Attachment

Instead, the child begins to move away from the mother, more carefully exploring objects and people. From time to time he or she returns to her, as if to check her whereabouts or to check in with her. If the mother moves away, however, or if the infant is frightened by some event, he or she will either approach the mother or will signal to bring the mother in closer proximity. For example, the infant often fusses, cries, and clings to the caregiver at the first sign of the caregiver's possible departure, a response known as separation protest. At about the same time, infants begin to express stranger anxiety or stranger wariness by fussing and crying when an unfamiliar person enters the room or approaches. This strange situation, therefore, exposes a child to three potentially upsetting experiences separation from the caregiver, contact with a stranger, and unfamiliar surroundings. The episodes are arranged in such a way that they present a series of...

Piagets stages of cognitive development

One of the central development tasks of these first two years of life is the acquisition of an understanding of the concept Piaget called object permanence. This involves the ability to form a mental representation of an object that will enable the child to realize that the object still exists, even if it is out of view. It is generally not before nine months of age that the baby can understand the concept of object permanence. One clue indicating acquisition of this skill is the characteristic high-chair game where the child delights in dropping objects from the tray to the floor and then repeating the action, over and over, after the item is returned by the caregiver. Peek-a-boo is also a favorite game at this stage of development. The child now understands that a face can disappear and will reappear. It is not lost forever. She may also begin to display the distressing emotions of separation anxiety. The child now realizes that the person that is out of sight still exists, and she...

Impact Of Preterm Birth On Families

Furthermore, different factors predict family stress at different ages (Beckman and Pokorni, 1988). When the neonate born prematurely was 3 months of age, it was found that informal support, the number of siblings, and the family's socioeconomic condition were the most important factors at 6 months of age, gestational age at birth, home environment, caregiving demands, and the number of parents in the home were the most important at 12 months of age, race, home environment, and scores on the Bayley scales of infant development were the most important and at 24 months of age, birth weight at birth, informal social support, temperament, caregiving demands, and race were the most important (Beckman and Pokorni, 1988). Future studies could advance knowledge in this area by developing a measure that would capture the particular health and functional health challenges that these families and the children born preterm face. In a recent review of functional health outcomes of preterm...

Disorders of Swallowing

Nasopharyngeal Penetration

Maintained sitting in the true lateral position, best accomplished in an infant feeding seat. Participation of the parents and caregivers helps to reassure the child, and recreates some aspect of daily feeding. The child's own speech therapist or feeding therapist should optimally be present during the examination to witness the events. The therapist can observe the optimal food volume and consistency and compensatory maneuvers that assist swallowing (FerNbAcH 1994). Boluses of different consistencies are fed. Young children are given liquids, though the density of various liquids may vary. The examination in older children begins with thin liquid barium, proceeding to feeds with a mixture of barium thickened with pudding or pureed food, and finally with more solid food such as barium-coated crackers. Barium density influences the swallowing mechanism. High-density barium has a slower transit time, causing the upper esophageal sphincter to open later, to remain open for longer and to...

Health Related Quality of Life

The challenge in pediatrics is that children are constantly developing and changing and their personal values may also evolve over time (Rosenbaum and Saigal, 1996). Traditionally, parents or caregivers have been accepted as reliable proxy respondents on behalf of younger children or those with severe disabilities. However, there is evidence that proxy responses by parents correlate poorly with the perceptions of children. Parents have more consistent agreement with children for observable functioning (physical health), than for emotional and social functioning. Overall, parents are generally more negative, and their responses may be influenced by the burden of caregiving (Eiser and Morse, 2001). Also, health professionals have limited abilities to judge patients' HRQL, and their values may differ from those of children and their parents (Saigal et al 1999). Further work is required to understand how the characteristics of patient proxy responses influence agreement. However, it is...

Economic Evaluation Of Interventions To Reduce Preterm Birth And Its Consequences

To date, there have been limited analyses of the cost-benefit or the cost-effectiveness associated with interventions for preterm birth. One global cost-benefit analysis of the reduction in mortality and morbidity associated with LBW due to advances in neonatal intensive care technology between 1950 and 1990 found that the net societal return was not only high but also outweighed that of several other widely used technologies in health care (Cutler and Meara, 2000). Although the historical advances in neonatal intensive care technology have been vast, as have the increases in the associated costs, the analysis was based on limited available data on the extent of and the quality of life associated with the developmental disabilities associated with LBW. It also ignored the effects of LBW on the quality of life of the family and caregivers and

Costofillness Methodology Applied To Preterm Birth

The relevant costs included are not conceptually restricted to those associated with the affected individual. Maternal, caregiver, and family costs are also relevant. Maternal costs include the incremental costs of prenatal care and delivery services, the costs of any extended care associated with maternal morbidity arising from the pregnancy, and the costs of added precautionary care in subsequent pregnancies, even if the subsequent birth goes to term. Caregiver costs appropriately include travel expenses for extended care of the preterm infant, in addition to the incremental value of time devoted to caring for the infant or child born preterm.

Review Of Developmental Research On Prospective Memory

The earliest age at which prospective memory skills can be observed has so far been addressed only in a naturalistic study of Somerville et al. (1983). In this study, 2-, 3, and 4-year-old children were assigned to eight different reminding tasks by their usual caregivers (mothers) over a period of 2 weeks. These tasks varied in the level of motivation, like Remind me to buy candy at the store tomorrow morning (high interest) or Remind me to bring in the wash after the nap (low interest), and in the length of delay between receiving these instructions and the opportunity to carry them out (5-10 minutes vs. several hours).

Repression the Unconscious Mind and Unconsciousness

It is suggested that It is the emotional availability of the caregiver in intimacy which seems to be the most central growth-promoting feature of the early rearing experience 57 , and where this availability appears not to have been there, it is likely that there will be a need in the patient for more emotional memory communications repressed contents communications including transference interpretations will seem to be more helpful where the patient's mental life is predominantly depressive rather than paranoid-schizoid.

TABLE 151 Studies Applying RBMT Prospective Memory Items

Relationships among a comprehensive range of neuropsychological tests, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS Randolph, 1998), everyday functional skills measured using the Direct Assessment of Functional Status (DAFS Loewenstein et al., 1989), measures of prospective memory from the RBMT, and self-and caregiver reports of functional memory skills were evaluated.

Family Psychoeducation An Evidence Based Practice

As this chapter has pointed out, families are often the principal support providers for people with severe mental illness. Effectively educating and supporting these families has been shown to have very positive effects for the family member with mental illness as well as the entire family. For many years, under the influence of psychodynamic thinking, parents were blamed for contributing to their child's illness (e.g., the schizophrenogenic mother). Later professionals reawakened to the fact that families were important caregivers with the ability to affect the course of the illness. A number of different family psychoeducation and support strategies have been employed (e.g., Anderson, Reiss, & Hogarty, 1986 Falloon, Boyd, & McGill, 1984). This has produced a sufficient body of research to be considered an EBP. Problem solving Families are taught problem-solving strategies that they role-play and practice on a regular basis. Besides improving the family's response to crisis, this...

Conclusion Looking Forward to Systematic Medications Use Management

The analysis leads us away from simple cause-and-effect explanations. It leads toward a systems model of drug therapy that includes organized patient monitoring and cooperative actions by patients, caregivers, physicians, nurses, pharmacists, and others. 4. This process often attempts to educate the patient or caregiver at psychologically the worst moment when he or she may be tired and ill at the end of an episode of care. 5. From the time outpatients or family caregivers receive the prescription, they are in charge of their drug therapy. This authority may actually begin when they leave the physician's office, because patients can decide whether to obtain the medicine. For many patients, following doctor's orders may not withstand the first subjective experience of a side effect, regardless of whether actually caused by the medicine. 6. This process lacks an effective feedback loop for patient outcomes. It may isolate the patient's or caregiver's opportunity to observe the immediate...

Attachment in Nonhuman Primates

This research provided the impetus for the development of Bowlby's ethological account of attachment. Since that time, research by Mary Ainsworth and Alan Sroufe, as well as many others, has provided important information for the continuing development of understanding of the complex relationship between caregivers and infants.

Psychosocial and Alternative Models

With trauma, our sense of basic safety is significantly challenged. Herman reminds us that our sense of basic trust is initially established in our interactions with our primary caregiver, a la Erik Erikson's work on basic trust versus mistrust. Our basic sense of trust enables us to engage the world. Herman (1992) states, the original experience of care makes it possible for human beings to envisage a world in which they belong, a world hospitable to human life (p. 51). Trauma challenges this and leads to an experiencing of relationships as alien and fraught with abandonment. In keeping with her psychoanalytic roots and similar to the work of Freud, Herman states that trauma reactivates old psychodynamic conflicts and our struggles related to autonomy, initiative, competence, identity, and intimacy. As our autonomy fails to triumph over the powerful traumatic stimulus, our ability to self-regulate our emotions and levels of arousal breaks down. Trauma, with its invasiveness,...

Attachment and Bonding in Infancy and Childhood

Bonding and attachment are two theoretical constructs that psychologists have used to describe and explain the intense emotional tie that develops between a caregiver and child. Research has helped psychologists to explain the development of several common social behaviors in infancy and to use individual differences in infant behavior to predict aspects of later development.

Psychological Adjustment

Sique may make them feel conspicuous and awkward, while at the same time they may be popular with boys and experience more dating opportunities. They also may have to deal with parents and other caregivers who have reacted to their early sexual development by being overly restrictive. The beauty ideal for women in American society, as portrayed by the media, is that of a prepubescent female. Changes in body fat related to puberty thus may lead to body image problems, as entry into puberty increases the distance from the beauty ideal just as girls become most interested in it. As with boys, the consequences of early and late maturation decrease over time. However, either early or late start of menarche seems significantly more difficult to deal with than if more typical.

Brief Overview

In brief, attachment theory is based on the concept that all infants have a fundamental need to develop a close relationship, or attachment, to their mother (or primary caregiver). They initiate attempts at attachment through attachment behaviors such as smiling at, hugging, and moving toward their care-giver. If the mother or caregiver answers consistently and appropriately with sensitive and responsive behavior such as comforting, holding, hugging, and stroking, the attachment bond is strengthened and secure. When responses are inconsistent, insensitive, or inappropriate, an insecure attachment is formed.


John Bowlby was born in 1907, and followed his surgeon father's footsteps towards a career in the sciences, studying medicine at Cambridge University and eventually graduating in 1928 with a Ph.D. in psychology. His early work with young boys led him to conclude that it was a child's early experiences with (or without) caregivers that most profoundly affected their character, and he decided on a career as a child psychiatrist. Attachment theory was coming into its own in the 1960s and '70s, coinciding with the women's liberation movement. Ainsworth and Bowlby both faced criticism on their emphasis of mother as primary caregiver from those who believed that women had been relegated to that role for far too long. Ainsworth herself had this to say about the theoretical impact of her work on the women's movement


The principal goal of treatment is to slow AD progression, provide a safe environment, maintain function as long as possible, and provide emotional support for the patient and family through social services and support groups. However, the treatment of dementia varies according to the stage of the disease and is focused on management of symptoms because no cure exists. It is of utmost importance to educate the patient and family about AD, its course, ramifications, and treatment options. Treatment includes both patient and caregivers. In early stages of AD, patients and their families may need counseling to deal with a sense of loss be made aware of support groups, respite care, and other social services that are available to them and be introduced to legal considerations in making decisions about future care needs such as medical and financial powers of attorney and a living will. As more supervision is required, caregivers need to be aware of physical dangers that can result from...

Stranger anxiety

Bonding refers to the development of an emotional tie of the mother to the infant. This biologically based process is believed to occur in mothers shortly after the birth of an infant, a time period during which the mother's intense emotional response is triggered by contact with her newborn. The existence of such a bond is then evidenced in the mother's behavior. Attachment, on the other hand, refers to a relationship between the caregiver and infant that develops over the infant's first year of life the quality of the attachment is apparent in the behavior of the infant. The work of British psychiatrist John Bowlby played an important role in the acceptance and understanding of the notion of mother-infant attachment. Bowlby argued that the behaviors of infants are not random and that, in fact, some of the behaviors exhibited most commonly by infants actually serve a single goal. Specifically, he argued that the infant behaviors of crying, babbling, smiling, clinging, non-nutritional...

Personal Objectives

Some people take medicines mainly to follow doctor's orders. This applies not only to a patient in a paternalistic relationship, in which the patient may take his medicines regularly regardless of their desirable or undesirable effects, but also to some caregivers, nurses, and pharmacists who carry out doctors' orders without questioning the effect of the medicine on a patient.


Competence is the ability to use personal and environmental resources to reach one's objectives. Professional competence includes scientific knowledge, skill (e.g., problem-solving and communications), and attitudes of painstaking attention and commitment to the client's interests.8111415 It includes teaching patients or caregivers the spectrum of options and consequences, and helping them to make informed choices.


In contrast to paternalism, the idea that patients should be in control of their care sounds very attractive. However, patients should never become consumers of health care. They need valid explanations of disease (as far as possible), respect for their attempts to understand that which is mysterious, advice about how to care for themselves, and loyalty to their interests. A professional who seeks more than a clinical outcome for his patients will often need active cooperation from patients and family caregivers. Many patients will not easily yield their autonomy to claims of professional authority. However, they may willingly cooperate in a therapeutic relationship in which the common objective is to achieve clinical outcomes that improve quality of life.

The Functions

With this complex response pattern, infants (1) may keep or restore the well-functioning, and thus well-being, by restoring the homeostatic values to within their functional levels (2) are able to communicate these effects to the caretakers, and invite them to care for the well-being, i.e., for the needed degree of cooperativity and (3) can initiate the molecular mechanisms of learning and memory, the brain functions that create biography. These functions translate the effects of the human-specific experiences as well as the effects of the caregivers' behavior on innate knowledge about what supports well-being and what disturbs well-being into autobiographical memory. These learning and memory functions have been studied as the experience-dependent neuronal plasticity of the neo-cortex, as the neuronal mechanisms that extract personal meaning out of the interaction of individuals with their environments and translate them into the neural architectures of the cortico-cortical...

Attachment styles

Originally attachment theory explained emotional bonds between infants and caregivers. Bowlby (1969-1980) believed attachment was a vital part of the human experience 'from the cradle to the grave' and that it played a powerful role in the emotional lives of adults. Hazan and Shaver (1987), developed Bowlby's theory further and noted that the major attachment styles described in the infant literature by Ainsworth et al. (1978) namely secure, avoidant and anxious- ambivalent were similar to how adults related in intimate relationships. Moreover, comparable behaviours became activated when adults were physically or perceived themselves to be psychologically separated from their partner. Romantic love can thus be conceptualized as an attachment process, but unlike infant attachment, it includes reciprocal behavioural systems of caregiving and sex (Shaver & Hazan, 1988).

Informed Consent

In general, the principles are no different with the elderly than with other adult persons the elderly are just as subject to the relationship to the researcher if the clinician and researcher are one and the same. Not wishing to offend (by refusal) is very strong in the elderly, and also they are also subject to 'therapeutic fallacy', i.e. they find it hard to accept that, despite repeated descriptions of risks and possible benefits, the treating physician could be really offering them treatment of uncertain benefit or risk. The elderly are more likely to have cognitive impairment or mild dementia, and to be living alone, in poverty, or under institutional care. They are also vulnerable to caregiver abuse, often because of indifference, anger, or physical abuse triggered by the patients' behavior and difficulties derived from their disease.

Other Support Groups

Not all support groups are for addicts. Support groups exist for adoptive parents, people who were adopted when they were children, people with acquired immunodeficiency syndrome (AIDS), caregivers for patients with Support groups may not be sufficient in and of themselves to solve individual problems. They are probably most effective as a part of an integrated plan for addressing the challenge in the individual's life that involves other resources as appropriate. For example, the caregiver of a person with Alzheimer's disease may also need social services support, adult day care or respite care facilities, medical assistance for control of problem behaviors, and home health services to deal successfully with the day-to-day challenges of dealing with the patient. The support group can facilitate access to these other resources in addition to serving as an important stress reducer and support system for the caregiver.

Burden and Stigma

Objective burden deals with specifically identifiable, observable problems associated with the person's mental illness. The objective burdens of families in which a member has a chronic developmental, mental, or physical disability have a degree of commonality. Objective burden includes financial hardships due to medical bills, the cost of the consumer's economic dependence, disruptions in household functioning, restriction of social activities, and altered relationships because of the demands of caregiving. There is often a significant time commitment to the mental health consumer's needs at the expense of other family activities. Individual members of the family, particularly the primary caregiver, may often need to change their role in the family, often at the expense of their own careers. Subjective burden refers to the psychological distress borne by family members, which is engendered by the illness. Subjective burden is related to objective burden, but not always directly. A...


The interface between psychiatry and dermatology is multidimensional and begins in early development. The skin is a vital organ of communication and the earliest social interactions between the infant and its caregivers occur via the body, especially through touch. A disruption in tactile nurturance, for example, as a result of a skin disorder during infancy or due to childhood abuse and or neglect can be associated with serious psychiatric morbidity in later life including major depressive disorder, body image pathologies, a tendency to self-injure and dissociative states when there is significant psychological trauma present in association with the neglect. The importance of the skin in social communication is further exemplified during adolescence when the development of a cosmetically disfiguring skin disorder such as acne can be associated with depression, suicidal ideation and body image disorders including eating disorders. The role of the skin as an organ of communication...

Further Analysis

Until he was about 10 months old, he accepted his mother's departures in the morning, but then began to protest them. In the strange situation, the moment his mother got up to go at the end of Episode 3 he was undone. Ganda infants . . . showed more intense distress in everyday separation situations at home than did the American babies of our Sample 1. Most of them had been left with other caregivers every day for four hours or more while their mothers worked in the garden, whereas when the mother was at home she tended to take the baby with her as she moved from room to room. It would seem that when the Ganda mother did leave the baby behind, this signified to him a much longer absence than that expected by most of our American sample babies when the mother left the room. Similarly, we found . . . that children in full-time day care, having been previously home reared, showed significantly more distress in the separation episodes of the strange situation than home-reared...

Anna Freud

When Anna Freud was 23 years old, she underwent psychoanalysis with her father as analyst, which was unusual, even at that time. This analysis continued for several years, and Anna seemed to form a dependence on her father from which she never broke free until his later years. In 1923, when her father had the first of many operations on his jaw to remove cancer growths, Anna felt it was her duty to care for him because he was ill. She remained his constant companion and primary caregiver until his death many years later.

The baby box

In 1944, near the end of the Second World War, Skinner and Yvonne decided to have a second child. Knowing that Yvonne found the first two years of caregiving for a child arduous, Skinner suggested they simplify the care of the baby. This suggestion evolved into an invention that would later become known as the baby box, or baby tender, as Skinner called it. The baby box was intended to be a superior alternative for the traditional baby crib. Skinner's baby box consisted of a thermostatically controlled enclosed crib with safety glass on the front and a stretched-canvas floor. It provided restraint and protection for the infant while also allowing great freedom of movement for the child. This baby box would be the sleeping space for their second daughter, Deborah, for the next two-and-a-half years. Skinner reported his invention and its use with his daughter in an article he submitted to Ladies Home Journal during that time period. As a result of this exposure, hundreds of other babies...

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