Counseling Caregivers: Building Resiliency Through Advocacy
Gregory A. Dawson Ph.D.
This 1 hour workshop will include lecture, answer/discussion. The focus will be on familial and non-familial caregivers for elderly and terminally ill patients.
The presenter is a therapist and haa been a caregiver to family members providing
a unique perspective.
Goals 1.Attendees will become familiar with the literature about the issues facing caregivers of elderly and terminally ill patients, both family member and non-family member caregivers.
Goal 2 To provide participants with a time for discussion and questions related to counseling caregivers.
Summary Abstract
In order to understand care-giving it is necessary to organize and distinguish the relationships, responsibilities, and multiple meanings within a caregiver network (Sims-Gould & Martin-Matthews, 2008). Due to the lack of emphasis on the interpersonal nature of arrangements in these networks, little is known about how to support and advocate for caregivers. Improvements in programs, services, and research can only be achieved if themes in family care-giving are better understood. These unique and common themes include the presence and importance of absentee helpers, having to care for multiple parties, the participation of males in care-giving, having a balance of assistive and direct help, and the presence of paid care-givers within a network.
The need for counseling and support for care-givers stems from the significant amount of burden and distress that they experience. Once they take on the care-giving role, these individuals often struggle with negative effects in their health, finances, psychological well-being, and relationships (del-Pino-Casado, Frias-Osuna, Palomino-Moral, & Pancorbo-Hidalgo, 2011). Research suggests that problem-focused, emotion-focused, approach, and avoidance coping strategies are all related to subjective burden and health outcomes of care-givers. Counseling should be used as an opportunity to teach and reinforce healthy coping skills in this population. Excessive guilt is another factor that frequently leads to psychological disorders and dysfunctional experiences in care-givers (Gonyea, Paris, & de Saxe Zerden, 2008). Mental health professionals are challenged in helping care-givers that are ridden with guilt to learn from their mistakes, identify reparations, accept disappointments, and engage in self-forgiveness.
A care-giving network is usually comprised of family as well as non-family helpers. Non-family caregivers of elderly persons in long-term care should be offered training programs so that they are better equipped to approach families and their loved ones (Tisher, Dean, & Tisher, 2009). Psycho-educational approaches offer coping skills to manage illness, behaviors that are adverse, and help the family feel comfortable with dealing with shame, guilt, depression, and societal biases (Lefley, 2012). Caregivers need counseling to deal with negative consequences that can be psychologically and physically damaging (Marquez-Gonzalez, Losada, Izal, Perez-Rojo & Montorio, 2007).
The cognitive restructuring model has components that assist caregivers in identifying and changing dysfunctional beliefs. Telephone interventions are another method shown to be useful to caregivers. Since the process of taking care of an elderly family can be tedious, this method can prove to be less time consuming (Toseland, Naccarato, & Wray, 2007). Another benefit of telephone counseling is the elimination of distractions. Clients are more likely to self-disclose without hesitation for the lack of non-verbal responses usually observed.
Counseling is sometimes perceived as non-essential when caring for the elderly. Therefore, families are more inclined to reject the services. Understanding themes in care-giving can lead to improvements in programs, service and research. Research indicates that restructuring the negative thought process of caregivers is most effective, (Marquez-Gonzalez, Losada, Izal, Perez-Rojo & Montorio, 2007). A group that has the most difficulty with changing their mind set is the Baby Boomers (Holtzman & Lynda, 2012). Caregivers are frequently unprepared for their role and become overwhelmed by the complexity of stress their duties entail. The development of family education programs could minimize their frustrations (Leftly, 2010). Unfortunately, our country does not perceive this population as an important societal or political issue (Sims-Gould Martin-Matthews, 2008).
Multicultural and diversity issues must also be considered in regards to the physical and emotional burdens of caregivers. In Africa, HIV prevalence is rapidly increasing and resources for care are limited (Abasiubong, Bassey, Ogunsemi, & Udobang, 2011). The responsibility of care for the HIV population has shifted from formal to in-home family care. Counselors must advocate for caregivers of diverse backgrounds.
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