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Providing care to elders can be a complex process; the more challenging the patients’ needs, the more complex, demanding, and stressful the caregiver’s role might be (Darer, Hwang, Pham, Bass & Anderson 2004). At the same time, it is important to consider obstacles and challenges of taking care of elderly people in order to work effectively with different generations and cultures. Elderly people consist a heterogeneous group, for which implementing a single management plan proves difficult to achieve. Caregiving can be stressful for the carers due to the demands emerging from the care receiver’s mental and physical deterioration. More precisely, the care recipient’s mental state and behavior are associated with caregiver’s emotional overwhelm, anxiety and depression.

However, the caregiving relationship, by definition, is made up of two people. Caregiving is a dyadic process involving the interactions between a care recipient and a caregiver in their relationship. These patterns of interaction can be both positive and negative. The relationship between the caregiver and the receiver consists of the cognitions, emotions, internalized expectations, and qualifications that the relationship partners construct as a result of their interactions with each other. In this respect, competences in caregiving relationships appear to require the ability of both people involved to find the balance.

The well-being of both the elder and the caregiver has an impact on the well-being of the other member of the dyad (Lyons et al. 2002). According to relevant theory and research, stress is frequently observed as a result of the caregiving relationship on both parties (Pinquart and Sorensen 2003). In other words, one party’s psychological condition mirrors the condition of the other and that distress of one party precipitates problems for the other (Mitrani et al. 2006). Moreover, caregiving dyads seem to be affected by any change related to the social and familial environment that they belong. 

The ways a caregiver alleviates stress is likely to influence the impact of the stressors on themselves and the dyad. The caregiver may experience burnout and become susceptible to mental and emotional distress as well as physical health challenges. This might affect their ability to make a correct assessment of the physical needs and health care status of the care recipient (Long et al., 1998). In addition, caregivers who feel being emotionally overextended may perceive the care recipient to be more impaired than they are. This may result in a negative and emotionally charged atmosphere which can induce a negative effect on everyone’s mood and behaviour and thus, alter the relationships between the variables.

In contrast, when the caregiving relationship is built on acceptance and emotional support, the likelihood of psychological morbidity reduces, and negative symptoms such as anxiety and depression can be decreased (Cooper et al. 2008). Caregivers need to apply different methods in order to cope with tension and meet the caregiving requirements. If their methods are not effective, they may experience what is frequently described as a ‘negative psychological load’ which can influence the quality of their services and their psychological state in general.

According to Isobel Menzies (1960), the working model of nursing and caregiving care, is the model that divides work into tasks, distributes the responsibilities for the care and reduces the emotional relationship with the patients, and thereby reduces the sources of work stress. To this extent, workplace culture adopts a medical-centric paradigm, and care becomes more impersonal and based on routine activities. The lack of an intimate relationship might give rise to feelings of boredom, exclusion, and social marginality. Consistent with this, emotional loneliness and social loneliness have been shown to have distinctive effects on psychological wellbeing in younger (Russell, 1982) as well as in older people (Green, Ericsson, &Winblad, 2001; Holmén, Richardson, Lago, & Schatten-Jones, 2000). Therefore, this working model reflects negative on the psychological state of the elderly and creates a negative circular journey.

In the case that the caregivers adopt a person-centred philosophy then they finally develop relationship-based interactions with the elders. In order to be able to develop and maintain good working relationships with the receivers, it is fundamental to this model for the caregiver to develop mechanisms to deal with a set of negative factors such as work-related stressors, the severity of the recipient’s condition, the role of a caregiver in general, and possible stressors of their private lives. However, this is something that requires time and experience processing.

In conclusion, the relationship established between the two parts of the duo should further be explored to understand the dynamics behind this dyadic interaction. Learning how to deal with this situation and applying the propitious models can be beneficial for both the caregivers and the care receivers. Creating high quality in these relationships will eventually provide benefits which might help sustain the caring aspect of caregiving.

Reference List:

Cooper Claudia, Cornelius Katona and Gill Livingston. (2008). Validity and reliability of the brief cope in carers of people with Dementia. The Journal of Nervous and Mental Disease, 196 (11): 838-843.

Darer JD, Hwang W, Pham HH, Bass EB, Anderson G. (2004). More training needed in chronic care: a survey of US physicians. Acad Med.; 79 (1): 32-40

Green, L. R., Richardson, D. S., Lago, T., & Schatten-Jones, E. C. (2001). Network correlates of social and emotional loneliness in young and older adults. Personality and Social Psychology Bulletin, 27, 281-288. doi:10.1177/0146167201273002

Long, K., Sudha, S., & Mutran, E. J. (1998). Elder-proxy agreement concerning the functional status and medical history of the older person: The impact of caregiver burden and depressive symptomatology. Journal of the American Geriatrics Society, 46: 1103–1111.

Lyons, K. S., Zarit, S. H., Sayer, A. G., & Whitlatch, C. J. (2002). Caregiving as a dyadic process: Perspectives from caregiver and receiver. Journal of Gerontology: Psychological Sciences, 57B: 195–204.

Menzies IEP. (1960). A case study in the functioning of social systems as a defence against anxiety. Hum Relat, 13: 95–121

Mitrani Victoria B., John E. Lewis, Daniel J. Feaster, Sara J. Czaja, Carl Eisdorfer, Richard Schulz, Jose Szapocznik. (2006). The Role of Family Functioning in the Stress Process of Dementia Caregivers: A Structural Family Framework. The Gerontologist, Volume 46, Issue 1; 97–105.

Pinquart, M. & So Rensen, S. (2003a). Predictors of caregiver burden and depressive mood: a meta-analysis. Journal of Gerontology, Psychological Sciences, 58: 112–128

Russell, D. (1982). The measurement of loneliness. In Peplau L. A. & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy. New York, NY: Wiley. 81-104.

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