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COVID 19, MENTAL HEALTH AND CARE WORKERS

Article by Valencia InnoHub

Developed countries have been facing a demographic challenge for some years now; the increase in life expectancy and the decrease in the birth rate have generated an aging society.

This phenomenon has resulted in care needs for the elderly that have not had institutional backing in a lot of European countries. Up to that time, the market was the first to identify the growing need for elderly care and to develop services such as private nursing homes and home care.

Afterwards, with the implementation of different laws supporting caregiving, the private and public spheres worked together, giving rise to a wide network of protection for dependent persons. However, due to the familiarist tradition in some areas following the so called <<Mediterranean Welfare Model>>, the care of the elderly has been assumed by the family most of the times.

In addition, there has been a traditional gender bias since most caregivers, both family and external workers, were women. Other socioeconomic variables such as level of education also have played a role. This aspect was noticed by the different governments that incorporated special modalities in the Personal Income Tax or family caregivers, recognizing their work and insisting on the fact that many times being a caregiver is not chosen.

As we can appreciate, the issue of long-term care has had a long history and has experienced a transformation in various areas. However, it was not until the Covid 19 crisis that the psychological and emotional burden of caregiving came onstitute the focus of the debates.

On the one hand, the virus has particularly affected our elderly, making them an even more vulnerable sector. And, on the other hand, the various forms of lockdown have resulted in the elderly staying at home much longer with family members who at the same time act as caregivers. This fact has highlighted the psychological stress to which caregivers are subjected and afflictions such depression, anxiety, excessive worry and difficulties to manage stress. These symptoms are aggravated by the uncertainty to which the pandemic subjects us, at the professional, family and health levels.

Professionals recommend seeking psychological help to better manage anxiety, as well as finding time for oneself and being able to disconnect, since living and working in the same place and with the same person can be difficult. Soft skills are strongly recommended to deal with the anxiety caused by the pandemic situation.

From another point of view, we note how Covid 19 has increased the demand for nursing home and home care workers. This demand has had the same effects on these workers outside the family. They must cover a larger number of people and are under more pressure because they must follow a protocol. For example, in home care, other tasks are now added such as maintaining distance, ventilation, disinfection, etc.

Finally, there is the situation of relatives who have their elderly in residential care. The distance and the prohibition of visits, together with the fear that the elderly may become ill, have generated episodes of anxiety, sadness and worry. For this reason, the Governments have recommended that caregivers facilitate electronic contact between users and their relatives.

In conclusion, the history of caregiving has evolved and finally considered the mental health of caregivers as an important issue to take into account. But Covid 19 has accentuated the strong and urgent necessity to implement soft skills in the daily tools of the caregivers for them to be able to deal better with the emotions that usually arise in their daily activities. Thus, we must pay special attention to both family and professional caregivers and ensure that the mental and physical consequences of the pandemic are correctly treated with the adequate tools, applying always the prevention through proved tools and mechanisms based on soft skills.

References:

BBC News Mundo (January 2021). ‘Alguien el otro día vio morir a ocho o nueve personas en un turno’: la devastadora crisis de salud mental en el personal sanitario por la pandemia de coronavirus. BBC News. Online resource: https://www.bbc.com/mundo/noticias-55676579

Brión Insua, Rodrigo (January 2021). Cada euro bien invertido en Salud Mental nos puede ahorrar cuatro” indica el psicólogo Carlos Losada. Galiapress. Online resourse: https://www.galiciapress.es/texto-diario/mostrar/2265251/consecuencias-psicologicas-esta-crisis-podrian-manifestarse-persona-incluso-anos-despues-fin-pandemia

Fuente Robles, Yolanda María de la; González-López, Lucía; Guzmán-Tirado, Mercedes (2011). El desarrollo del sistema de atención a la dependencia y las personas cuidadoras en España: necesidades de atención y nuevas vías de apoyo. Universidad de Huelva. Online resource: http://rabida.uhu.es/dspace/handle/10272/4924

Guindo, Daniel and González Ramón (February 2021). Las otrac onsecuencias del coronavirus. Las Provincias. Online resource: https://www.lasprovincias.es/comunitat/consecuencias-coronavirus-20210206205725-nt.html

Limón, Raúl (January 2021). Las otras secuelas de la covid. El País. Online resource: https://elpais.com/ciencia/2021-01-29/las-otras-secuelas-de-la-covid.html

Tarricone, Rosana and Agis D. Tsouros (2008) Home Care in Europe. The solid Facts. Universià Commerciale Luigi Boccone.  World Health Organization. Online resource: https://www.euro.who.int/__data/assets/pdf_file/0005/96467/E91884.pdf

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Caregiver’s Stress Syndrome – causes, symptoms, prevention

Written by EURO LIDER organization

Caring for the elderly is a demanding job that is not only physically but also mentally demanding. What is the Caregiver’s Stress Syndrome? What body signals should make you more alert, how to deal with it and where to seek help?

Caring for the elderly is a job that is not the lightest. It often leads to burnout syndrome. As a result of exposure to chronic stress related to the responsibility for the health and life of the patient, the caregivers often develop depression and neurosis, experience anxiety, have problems with sleep, headaches, spine and heartaches, as well as gastric ailments such as stomach ulcers or indigestion. The most common syndrome of burnout, i.e. psychophysical exhaustion, affects caregivers who look after an elderly person alone. The situation in which the caregiver literally loses his strength may occur after 3-6 months of constant, intensive care for an elderly person.

It is worth knowing what to pay attention to and how to protect yourself from the consequences of overburdening yourself with obligations in the care of a caregiver, regardless of whether you provide professional care or look after a sick or elderly person in the family.

Caregiver Stress Syndrome – causes and symptoms

Caregivers for the elderly who devote themselves completely to their duties, giving up their lives and the right to rest, are at risk of developing the Caregiver Stress Syndrome (CSS). It is nothing more than a state of physical, emotional and mental exhaustion that occurs in people who are constantly caring for an elderly or chronically ill person. Round-the-clock care, assisting with almost all the daily activities of the senior, giving up one’s own social and professional life, and finally limiting the daily space only to the house or room of the sick person and loneliness in caring – this is a short path to frustration and fatigue, which with time worsen and turn into a series of ailments. What symptoms should make you alert?

Caregiver Stress Syndrome – emotional and mental symptoms:

• fear of being responsible for another person

• stress resulting from lack of knowledge about caring for an elderly / chronically ill person

• feeling powerless and lonely

• constant tension and nervousness

• apathy, deepening sadness

Caregiver’s Stress Syndrome – somatic symptoms: 

• physical exhaustion, chronic fatigue

• problems with sleep and concentration

• pain ailments (head, neck, spine, joints, heart)

• gastric discomfort

Exposure to chronic stress also weakens the immune system, and ignoring some disturbing symptoms can lead to the development of serious diseases, such as diabetes or high blood pressure.

How can I deal with Caregiver Stress Syndrome (CSS)??

First of all, make sure you have a balance between your duties and rest. Your rest, during which you regenerate your own strength, is just as important as the rest of your mentee.

Here are some tips on how to take care of yourself to minimize Caregiver Stress Syndrome (CSS)

  1. Don’t forget about yourself

When caring for the other person, remember that you also have needs and limitations, as well as good and bad days. To work efficiently, remember to rest and recuperate.

  • Eat well and stay hydrated

A balanced diet and the right amount of water are essential. Losing yourself in duties, it is easy to forget about your own meal or reaching for a glass of water. Try not to make it a habit. Eat regular meals, preferably every 2-3 hours, and drink water as often as possible

  •  Movement is healthy!

Physical activity has a positive effect on mood and well-being. You may think that movement is the last thing you are missing if you are constantly doing something every day, assisting the senior in most of their daily activities, but the point is to choose the form that is right for you, preferably outdoors. Even short but regular walks will improve your mood and relieve tension in muscles and joints. You don’t want to or can’t leave the house? Turn on YouTube and enjoy free exercise tutorials on the mat.

  •  Talk about the difficulties

Difficult times, bad days, feeling unwell – it happens to everyone. So that the depressed mood does not turn into anything more serious, try to talk about your difficulties on a regular basis. It may be someone close to you, but you can also always ask for help from specialists such as a psychologist or therapist. Take care of this especially if you work as a carer abroad – this is where the longing for your family comes in. A few minutes of talking to your loved ones will cheer you up and help relieve stress.

  • Learn, read and improve yourself as a caregiver according to the principle of more knowledge, less stress

Often the cause of the caregiver’s dissatisfaction is stress resulting from the lack of knowledge about how to deal with the charges’ ailments. If you work as a caregiver and travel abroad with a responsible employer, you can count on Nursing Support, but sometimes access to knowledge can be more difficult. Therefore, online courses and tools can come in handy, e.g. Here4U Erasmus+ Project.

The ability to relieve stress in the profession and the role of an elderly caregiver is an extremely important feature. Taking care of your own well-being and taking a distance sometimes costs a lot of effort, but allows you to function better, protects against dangerous ailments and ensures a healthy relationship with the person you care for.

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Personality changes in the elderly

An article by Fundacia EOS

People’s personality changes throughout their lives. Usually these are not major changes that occur over a very short period of time. People of all ages can experience mood swings, but deeper personality changes should be assessed by a doctor. Impulsiveness, paranoia, and social withdrawal are indicators of a larger potential problem.

As a caregiver for seniors, you should be able to identify which changes in behavior are normal and which are not so that you can get early help for those you care for.

Sudden changes in the behavior of an elderly person should be taken seriously.

Below are personality changes that are a normal part of the aging process, along with information on when to make an appointment with your doctor.

Sadness

An elderly person experiences many traumatic events. Loss of independence and the need for constant care, death of friends, often moving from a family home to a retirement home. As a result, she or he can react with deep sadness.

In our culture, it is difficult for people to express sadness. Anger is a more socially acceptable emotion. Therefore, an elderly person may express anger and aggression towards caregivers or loved ones, instead of expressing sadness by crying.

Be patient, be empathetic, and consider taking the elderly person to the doctor to rule out other possible health problems. A sadness that lasts for weeks or months can indicate depression. An elderly person may need therapy or medication to get back to normal life.

Memory Lapses

It is normal for the elderly to forget little things, such as the place where they put the keys or  names. This is due to the aging processes of the brain. It is important to be vigilant, however, as studies show that up to 10% of people over the age of 65 and 50% of people over the age of 85 will have dementia. Symptoms of dementia include memory loss, poor judgment, difficulties with language and concentration, and in some cases impaired visual perception. Memory loss in the elderly should be rare and brief. More significant memory loss (e.g., forgetting someone they have known for years) should alert the caregiver to the need to see a doctor.

Stroke

The risk of developing cognitive problems such as confusion, memory loss, decreased concentration of attention and difficulty in carrying out daily activities increases with age. The behavioral changes that occur as a result of a stroke depend on the area of ​​the brain that has been affected. In an elderly person after a stroke, personality changes can often be noticed. If you suspect a stroke, it is important to take the senior to the doctor for examination as soon as possible.

Dementia

‍Many caregivers who work with older people over the age of 50 help people with dementia or other cognitive impairments. Behavioral symptoms that may signal the development of dementia include apathy, mood, antisocial behavior, and language difficulties. If, as a caregiver, you notice that an elderly person has developed any of the above symptoms of dementia, it is important that you see the doctor as soon as possible.

Drug interactions

Polypharmacy or the use of more than one pharmacological drug to treat a wide variety of chronic diseases can lead to personality changes in older populations. If an elderly person is taking a wide range of medications on a daily basis, neurotoxicity can cause behavioral changes that imitate the signs and symptoms of dementia. If an elderly person has recently started taking new medications, drug interactions are important and should be reported to the doctor during the examination of the elderly person. 

Poor Sleep

As people get older, it may be difficult to sleep. In extreme cases, lack of sleep can lead to memory distortion, disorientation, depression and a reduction in the mental capacity of the individual. Sleep deprivation can cause dementia-like symptoms. Your doctor may prescribe sleeping pills to treat sleep disorders.

Risky Behavior

Risky behaviors that involve an imbalance between potential costs and rewards should be cause for concern. For example, seniors who suddenly gamble or drink alcohol excessively may actually show signs of dementia or depression.

Crankiness

Chronic pain, stress, and loneliness can lead to bad behaviours. Seniors who are inexplicably cruel or aggressive, may suffer from deeper problems such as physical pain, depression or dementia that need to be assessed by a doctor.

What are some examples of behavior changes?

Impulsive Behavior

Areas of the brain that normally control and manage behavior can become damaged as a result of aging processes, so that an elderly person cannot control his or her behavior. Impulsive, non-conforming behavior can include making rude, inappropriate comments or gestures, touching himself or herself or others inappropriately, and even behaviors such as cutting into the line or picking up someone else’s food. In old age, deterioration in brain function can lead to unusual behavior that needs to be assessed and treated by a doctor.

Apathy

‍This is one of the most common behavioral changes associated with dementia. Apathy can be defined as a lack of enthusiasm, interest or indifference and passivity. Familiarizing yourself and understanding apathy can allow the caregiver to learn to adjust his or her expectations so as to have a beneficial relationship with the elder.

Aggressive/Threatening Behavior

‍When an elderly person with dementia shows aggressive or threatening behavior, it can be dangerous for the caregiver. In most cases, when a senior starts to behave aggressively, a trigger appears that initiates the behavior. It may be, for example, the psychosocial environment of the elderly. If something in the environment has caused them strong emotions, aggressive behavior may be a normal reaction.

Contact your doctor if you feel that an elderly person is a threat. Learn about techniques and methods to deal with aggressive behavior in dementia patients and don’t be afraid to ask for help.

Anxiety

‍Anxiety is a common behavioral change in the elderly, especially in those individuals who have dementia. Individuals who have memory loss or suffer from some kind of illness may struggle to manage their emotions and self-control, and will look outward to their caretakers for help with managing feelings. Impaired memory in particular can lead to anxiety because it can be frightening to elderly individuals to lose memory or be confused for no apparent reason. When this happens, anxiety can set in and cause a variety of other personality and behavior changes.

In some cases, because many elderly people with dementia or impaired brain function require the help of their caregivers to manage their emotions, the individual may walk around looking for their caregiver and get lost due to an inability to remember where they are. One of the key things to do to help the individual with anxiety is to provide them with a clean, clutter-free space and to be available to them to help them remember things when needed.

Compulsive Behavior

Some elderly individuals may start to express compulsive behaviors, such as checking locks multiple times, obsessive organization or cleaning practices, frequent visits to the bathroom, unusual collections or dramatic changes in eating habits. Often, compulsive behaviors are not done on purpose and are driven by anxiety or memory loss. The best way to help is to be supportive and determine if there is perhaps a need that is not being met for the individual.

Remember that if the compulsive behavior is not interfering with their daily life or yours, it may sometimes be best to avoid talking about this behavior. Sometimes, bringing awareness to a compulsive behavior can cause more anxiety and can be counterproductive. However, offering the elderly person a different activity or identifying the potential cause of their anxiety may eliminate the compulsive behavior entirely.

How you can deal with personality changes in an elderly patient:

● If the elderly person shows signs of apathy, encourage him or her to do things with you that he or she previously liked. Offer a controlled, organized environment in which you can perform these activities, and choose something that is justified in his or her specific situation and interests.

● Elderly people with anxiety or anxiety-related compulsive behaviors benefit from having an appropriate environment. Make sure their space (as well as surroundings, if possible) is well organized and calm.

● A sudden drop in empathy can be hard to deal with, but it can often be controlled by expressing your feelings about the older person’s actions. Thank them and express gratitude as they act and speak appropriately, and explain your feelings when they behave or speak inappropriately.

● If your elderly patient exhibits aggressive or threatening behavior, the first most important thing to do is to make sure that both you and the patient are physically safe. If you or your patient are in any danger, get help immediately.

The article was prepared based on:

https://www.freedomcareny.com/posts/personality-changes-in-the-elderly#toc-what-causes-personality-changes-in-the-elderly-

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Taking care of the elderly during COVID 19 Pandemic

The greatest of all learnings during this pandemic has been the lost respect for human lives. Amidst this chaos, there is the peace that some of us are there with our families to fight it together.

The age-old mantra- “prevention is better than cure” is the solution in hand and is especially important for those who taught us the same, the senior citizens of our society.

The elderly is at a greater risk against COVID 19, and those with pre-existing problems are all the more vulnerable. This pandemic poses a greater challenge in taking care of them, and with the on-going lockdown, it becomes more difficult to reach out to those who live far away. Wherever we are, we can help them and reassure them that they are not alone.

Take care of elders in COVID19
Image soure – Freepik

Here are certain ways to support them and make sure the elderly around you are safe

Social engagement can happen with social distance

Older people would be missing out on their walks, chats sessions, and evening tea talks during this time. This could be a big problem for them, as it is their daily routine. Teach them to engage socially via technology. Set up group chat sessions online, live exercises, and even spiritual classes for them. It’s time for them to know about the new normal of society.

Build Physical Immunity with Mental Health

The pandemic has taken a toll on the mental health of a lot of people, and for those who live alone it is a cause of worry. Talk to them and connect with them to see if they are okay, their mental wellness is what will keep them going during this time.

Also, aged people might find it difficult to approach their doctors for regular check-ups. Get them in touch with physicians’ online or make them speak to doctors so that they can be sure of their health conditions.

Offer a Helping Hand

It is not safe for anyone to step outside, and for the old, it is a challenging task. Offer them to get groceries, medicines, and essential items. Teach the art of online shopping and payment so that they don’t have to feel dependent on anyone. It’s a way to ensure that they stay indoors and stay safe.

Take care of elders in COVID19
Image soure – Freepik

Practice and preach the safety measures

Make sure that you are well sanitized and follow all the necessary steps before you approach an elderly person to help. Try and talk to them about Corona, ensure that they have access to all the right information about COVID 19 and the precautions that need to be taken. Speak to them about the importance of lockdown and social distancing.

Stay in Touch

The biggest fear during this lockdown is to be left alone. Take timely updates from them, and talk to them about how are they doing during this quarantine. If they are away from family and friends, keep their families posted about. The people who need a caretaker can use some extra help during this time, only if we plan to take out some time for them.

These could be some ways to remain connected with the elderly, to make them feel that they are a valuable part of our lives and our societies.

Senior citizens are a reflection of how we see ourselves in the future. We might find it difficult to manage this while juggling with work and household responsibilities, but a casual interaction or a phone call will reassure them that they have the support and a helping hand at bay. It is time to be a responsible citizen, neighbor and a friend to all.

Source: https://www.resmed.com/in/en/consumer/blogs/taking-care-of-elderly-during-COVID19-Pandemic.html

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Need for redefining needs

People often claim to have a variety of needs which they sometimes struggle to meet. The more we understand our fundamental needs, the better we are equipped to live well.

The American psychologist, Abraham Maslow, conducted a research on the complexity of needs. In his 1943 paper “A theory of Human Motivation”, he developed a motivational theory called the hierarchy of needs. According to Maslow, people have five categories of needs: physiological, safety, love and belonging, esteem, and self-actualization.

No matter the age, our needs are important to our wellbeing as individuals. The needs of elderly people might be different when comparing to young people but are no less important. The difference is that, as we age, our healthcare needs are intertwined with social needs.

Let’s explore the needs of elderly people based on Maslow’s hierarchy of needs!

  • At the age of emerging elderhood, the needs of individuals often need to be redefined. A needs assessment analysis based on age stages indicates that physiological functions decline with age; hence, addressing those needs is of primary importance.
  • Aging is associated with an increase in regards to seniors’ safety needs. Seniors are capable of being independent but sometimes they need assistance to remain safe. Caregivers can create a safe living environment for them by ensuring that the place they live is adequately equipped with daily care facilities and accommodates their everyday needs.
  • Sense of belonging is a central need in old age. Providing a senior with a sense of belonging is pivotal for that person’s wellbeing. Elder people are often afraid to lose their independence and being alone, so it is important for them to feel supported and cared for. What can caregivers do to alleviate their fear of social isolation and loneliness? Encouraging seniors to remain active in their interests and providing them with opportunities to participate in group activities can promote their active social life and eliminate their feelings of loneliness.
  • Studies have shown that self-esteem begins to decline as people get older. Expected life changes can affect people’s feeling of emotional confidence due to the change of their socioeconomic status, social roles, and/or physical abilities. This might affect one’s self love and appreciation. To boost the self-esteem of the elderly, caregivers should constantly show them that they are respected and appreciated especially for the knowledge, experiences, and wisdom they have and share. The caregivers also need to deconstruct the negative images around aging by challenging the negative developmental pattern of self-esteem. This will lead elder people to have a more balanced view of themselves and thus, improve their self-respect and sense of accomplishment.
  • Aging is strongly related to self-actualization! Older people have the need to feel fulfilled and accomplished. Caregivers can encourage elders in their journey towards self-actualisation and support their exploration towards new variations and meanings in life. For example, they can inspire elders to venture into new creative activities. A continual discovery of one’s self, fulfils the need of self-actualization. Creativity thus, can be an important tool to boost elderly people’s feelings of completeness, as this is skill is often associated with how creative one can be.
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Family Caregivers

Photo by eberhard grossgasteiger on Unsplash

Family caregivers play an important role supporting their relatives with advanced progressive disease to live at home. Caring for an older family member often requires teamwork.

First of all, it is important to define the caregiving responsibilities, for example by setting up a family meeting and, if it makes sense, include the care recipient in the discussion. This is best done when there is not an emergency. A calm conversation about what kind of care is wanted and needed now, and what might be needed in the future, can help avoid a lot of confusion.

Decide who will be responsible for which tasks. Many families find the best first step is to name a primary caregiver, even if one is not needed immediately. That way the primary caregiver can step in if there is a crisis. Agree in advance how each of your efforts can complement one another so that you can be an effective team. Ideally, each of you will be able to take on tasks best suited to your skills or interests.

Consider Your Strengths When Sharing Caregiving Responsibilities

When thinking about who should be responsible for what, start with your strengths. Consider what you are particularly good at and how those skills might help in the current situation:

  • Are you good at finding information, keeping people up-to-date on changing conditions, and offering cheer, whether on the phone or with a computer?
  • Are you good at supervising and leading others?
  • Are you comfortable speaking with medical staff and interpreting what they say to others?
  • Is your strongest suit doing the numbers – paying bills, keeping track of bank statements, and reviewing insurance policies and reimbursement reports?
  • Are you the one in the family who can fix anything, while no one else knows the difference between pliers and a wrench?

Consider Your Limits When Sharing Caregiving Responsibilities

When thinking about who should be responsible for what, consider your limits. Ask yourself the following:

  • How often, both mentally and financially, can you afford to travel?
  • Are you emotionally prepared to take on what may feel like a reversal of roles between you and your parent – taking care of your parent instead of your parent taking care of you? Can you continue to respect your parent’s independence?
  • Can you be both calm and assertive when communicating from a distance?
  • How will your decision to take on caregiving responsibilities affect your work and home life?

Be realistic about how much you can do and what you are willing to do. Think about your schedule and how it might be adapted to give respite to a primary caregiver. For example, you might try to coordinate holiday and vacation times. Remember that over time, responsibilities may need to be revised to reflect changes in the situation, your care recipient’s needs, and each family member’s abilities and limitations.

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Soft Skills in the job of caregiver

by Eurolider

Being the caregiver of seniors requires a specific set of skills. Some of them can slightly differ depending on what type of caregiving job one is doing – whether it is a job in the hospital, senior house, rehabilitation centre or any other one that involves working with seniors. Similarly, working with one specific senior for a longer time will be different than working with many of them every day. Finally, activities you do in your work are not always the same as the ones other caregivers do. However, there are still some universal skills that you can improve and tips that you can listen to in order to become a better caregiver and to make your job easier and more enjoyable. These are usually described as the soft skills being a mix of personality traits involving most often communication, acting in a group and management.

Our Here4U project’s soft skills pack consists of skills like:

  • Communication – the process of exchange of information, making emotions or ideas known to someone
  • Problem solving  – the capability of a person to face one or several issues and find the best possible solution to fit all its needs
  • Keen observation – activity involving attention to detail, focus, analysis, reasoning and memory
  • Empathy – the ability to empathize with someone else’s emotional states, putting yourself in someone’s place and understanding their way of thinking, being able to accept the way others think and look at the reality from their perspective
  • Patience – the state of endurance under difficult circumstances
  • Stress management – undertaking correct actions adequate to current situation in order to cope with difficult, unpleasant, undesirable events occurring in life that cause unpleasant emotions such as anxiety, feeling of lack of control over the situation.
  • Creativity – a skill connected with how we develop, understand and communicate specific ideas.
  • Being able to empower and motivate – spreading motivation, a process that occurs in human consciousness (sometimes also in the subconscious mind), as a result of which there is a desire to do something
  • Assertiveness – a social and communicative skill that consists in expressing your own thoughts and ideas in an effective way, sharing your point of view with other people without underestimating theirs
  • Thick skin – ability to adapt to stressful circumstances and adverse events and deal with unfounded criticism

You can find out more about them in our diagnostic tool and soon in our MOOCS. However, this does not mean that these are the only soft skills worth knowing and improving in. Some more of them are also interconnected within the ones above.

For example, another important skills and potentially connected with caregiving are connected with working with people. These are leadership and teamwork skills. It is likely that as a caregiver you might need to cooperate with others doing the same work. These skills are beneficial because together you can better accomplish your goals and deliver good job. Moreover, there is a high chance of needing to work with flexibility and adaptability in order to react to sudden changes in the field. These also goes hand in hand with time management and organization useful in any job. An organized caregiver who manages time well will be able to achieve more in a shorter time and additionally they will be seen as more professional. Lastly, initiative is also a useful soft skill, connected with creativity. Caregivers need to be proactive in their work and should engage in many fun and interesting activities – the Here4U project will provide you with the “Box of Ideas” where you will find many of those.

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Delaying aging processes

Aging is a biological process that involves backward changes, and thus limiting the ability of cells and organs to self-repair. The decrease in the function of the nervous and endocrine systems gradually reduces metabolism, reducing muscle strength and the speed of conduction of nerve impulses. There are many methods used to delay aging, including geriatric rehabilitation and  neurorehabilitation.

Geriatric rehabilitation

One of the roles that carers of the elderly play in relation to the people most dependent on the others help is to care for and work on improving the functioning of the elderly in their own home. The goal of geriatric rehabilitation is to improve mobility of the elderly and transform the aging process, which is often accompanied by disability and dependence on other people, into optimal aging, i.e. as long as possible to maintain the ability to function in many areas – physical, cognitive, emotional, social and spiritual despite occurring complaints.

Geriatric rehabilitation should be based on a comprehensive geriatric assessment – determining health, psychosocial problems and the functional capacity of an elderly person, and then choosing the most important goals.

Health-related activity of the elderly should mainly concern everyday activities, such as e.g. using kitchen appliances, cleaning, lifting something off the floor, exercises improving the ability to change position from sitting to standing, learning how to rise after a possible fall, improving walking. It should include walking at a slower and faster pace, changing direction, climbing up and down the step.

A very important role in the physical activity of the elderly is played by aerobic training programs, which are indicated for people who are unable to continue a given activity for a long period of time. Marching, nordic walking, hiking, running, cycling, swimming, aerobics are examples of trainings that improve cardiovascular and respiratory fitness, increase muscle endurance and general mobility.

As people grow old, the length of many muscles is shortened, which can lead to pain in certain positions, loss of function, and abnormal movement patterns, which is why stretching exercises are also recommended in this group.

Another important group for older people are exercises to improve balance and prevent falls. These exercises should affect static and dynamic balance, muscle strength and also include assessment and changes in the environment as well as assessment and correction of vision. An example is tai-chi exercises, which can be included in an exercise program for the elderly.

Rehabilitation programs for the elderly should be characterized by an individual approach to class participants. They can be carried out individually or in groups, the focus should be on simple and medium-difficult forms of physical activity. Physical exertion should preferably be made daily for 30 minutes or at least 3 times a week for 40 minutes. Exercises are also to be relaxing and enjoyable.

Neurorehabilitation

As people grow old, both the weight and volume of the brain decreases, and significant brain atrophy begins after the age of 60. Brain aging can be:

– optimal – without any symptoms of cognitive decline,

– physiological, with a slight impairment of cognitive functions,

– mild cognitive impairment – subjective and objective cognitive impairment with normal daily functioning,

– dementia – pronounced cognitive impairment affecting daily functioning.

The consequence of brain aging is, among others, deterioration of working memory and information processing speed.

Counteracting and / or delaying the effects of brain aging processes is possible because the brain has the ability to make plastic changes (neuroplasticity), thanks to which it can remodel connections between individual centers and rebuild lost functions. Neurorehabilitation uses technological achievements to restore, develop or improve the patient’s functioning in the area of:

  • cognitive (e.g. memory, concentration, perceptiveness, attention),
  • motor (e.g. motor coordination, correct reaction time, precision of movements).

Knowledge of brain neuroplasticity is used in cognitive therapies.

Interest in cognitive remediation techniques in elderly have increased with a growing understanding of the impact of cognitive impairment on loss of independence in day to day function. In recent years, several studies have assessed the efficacy of different cognitive interventions in the elderly and reported beneficial effects, even in advanced age, which could be maintained for a considerable period of time beyond training. The focus of interventions in these studies was memory and related functions. Multifaceted training that combines three relatively diverse strands of therapy: A form of counseling/behavior therapy to target psychosocial variables (self-efficacy beliefs, feelings of control, and optimism), CT to target cognitive functions and complimentary physical activity, appears to have some benefit in maintaining a higher level of cognitive function over time. Targeted cognitive interventions, especially memory training interventions, have been widely used. Memory training including stress management, health promotion, and memory self-efficacy support has been tested in older adults in retirement residences. Memory training for healthy older adults typically includes mnemonic strategies, concentration and attention, relaxation, personal insight, self-monitoring, motivation, feedback, and problem-solving, succeeded in improving memory performance. With memory training classes, elders improve their performance on cognitive tasks including perceptual discrimination, visual search, recognition, recall, and spatial perception

The review of research evaluating the effect of cognitively stimulating lifestyles on cognitive function of older adults suggests that overall research findings support positive effects of cognitive and physical activity, social engagement, and therapeutic nutrition in optimizing cognitive aging.

In summary, the available data suggest that cognitive remediation therapies have great promise for improving cognition and quality of life of elderly.

Reference List

Żak M., Rehabilitacja geriatryczna (2020). Medycyna Praktyczna dla pacjentów, Retrieved May 31, 2020 from

https://www.mp.pl/pacjent/rehabilitacja/rehabilitacja-medyczna/128935,rehabilitacja-geriatryczna

Sharma I., Srivastava J., Kumar A.,  SharmaR., Cognitive remediation therapy for older adults (2016). Journal Geriatric of Mental Heatlh, Retrieved May 31, 2020 from

http://www.jgmh.org/article.asp?issn=2348-9995;year=2016;volume=3;issue=1;spage=57;epage=65;aulast=Sharma

Carr, JH, & Shepherd, RB. (2006). The changing face of neurological rehabilitation. Brazilian Journal of Physical Therapy, 10(2), 147-156. Retrieved May 31, 2020 from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552006000200003&lng=en&tlng=en. 10.1590/S1413-35552006000200003

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The diagnostic tool

Introduction.

Being the technical partner in the Here4U project we wanted to create a diagnostic tool for our caregivers working with seniors target group. Using this diagnostic tool the caregivers are able to assess the current state of their own personal soft skills. We based our tool on ten different soft skills, namely empathy, assertiveness, the ability to empower and motivate other people, general problem solving, stress management, creativity, patience, communication skills, observation skills, and thickness of skin, as was discussed and studied with the other partners in the project. The goal was to create an MVP or Minimum Viable Product of this tool and start testing it in order to later improve. In other words, the current version of the diagnostic tool is a psychometric tool and the goal is to provide the user of an automatic feedback report and their assessment results after completion of the questionnaire.

How it works. 

When first navigating to the tool using the link: https://here4u-9e425.firebaseapp.com/, the user is asked how they wish to sign in. The tool asks you to sign in, in order for it to keep track of your previous scores. Users are able to sign up using their Google account or create an account using their email address. Once they created an account and they are signed in, the user is allowed to take the assessment test. This test is made up out of a series of fifty statements all related to one of the ten soft skills listed before. From the pool of all questions, five are selected from every soft skill and they are then randomized in order. The user then needs to indicate to what extent each of the fifty statements applies to them by using a Likert scale, ranging from “Strongly disagree” to “Strongly agree”. Finally upon finishing the questionnaire, the user is provided with a small report on how they fared for each of the examined skills. Further development of the platform will use these scores to suggest training materials and track personal development in these soft skills.

Each of the statements in the tool was carefully selected and thought on in cooperation with experts of the field. In this preliminary study it was also decided to provide each of the skills with respective “inverted” statements which can be raised throughout the test in order to really make the user thinks about their answers.

Future.

The next steps we are undertaking is adding  the feedback report to the final screen where the user is able to view their score. This feedback will be based on the score for each soft skill.

Then, following the development of this assessment tool, we will build a e-learning platform for the caregivers to extend the resulting toolset of this project for our target group. By creating this platform we will allow senior’s caregivers to not only assess their current skills but also improve or refine them. The users of the platform will be able to follow online courses using media like video tutorials in order to improve on those soft skills they currently seem to lack in or refine skills they already own and excel in them.

Hope you are all as excited as we are!
The Odisee team.

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CAREGIVING RELATIONSHIP: A DYADIC PROCESS

Photo by Freepik

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.

PINQUART,M.&So¨RENSEN, S. (2003a). Predictors of

caregiver burden and depressive mood: a meta-analysis.

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