Lacking a healthy attachment to a caregiver and having in-utero methamphetamine exposure have been linked to a variety of cognitive delays, developmental delays, and mental health issues throughout a person's lifespan. It is unknown if there is a relationship between in-utero methamphetamine exposure and the ability to build a healthy attachment to a caregiver. The purpose of this generic qualitative study was to improve understanding of the perceptions of caregivers about attachment efforts for foster children under the age of 3, who have had in-utero methamphetamine exposure. This study was guided by attachment theory. Purposeful sampling was used to select 7 participants who had provided care to foster children with in-utero methamphetamine exposure within the last year. Data were collected through the use of semistructured interviews, which were conducted in-person, audiotaped, and then transcribed. Data was analyzed through text searches of themes, axial coding, and repetitive words. Trustworthiness was obtained through member checking and generating a rich description of the participants' experiences. The findings revealed that many of the participants feel that these children do not respond to their efforts to build a healthy attachment to them. They also felt that the foster children did not process stimuli, such as touch, in the same way as other children; that the foster children found such interactions to be aversive. The findings of this study have the potential to impact social change by assisting therapists, caseworkers, and foster parents better understand the needs of foster children and to create a foundation for interventions to better serve foster children with in-utero methamphetamine exposure.

本研究目的係為探索中年未婚女性畢業照顧者之生活經驗，以瞭解其生活調適情形與對未來生活的規劃，促使社會工作者對畢業照顧者有更深層的認識，並作為未來擬定處遇計畫及支持性福利措施或方案的參考。本研究採用質性研究中的深度訪談法，以立意取樣選取8位符合研究條件（照顧失能家人之時間至少需達1年以上；且被照顧者已逝世，照顧者脫離照顧身份時間已達6個月以上）之受訪者。主要研究結果分述如下： 一、成為「畢業照顧者」的心情包含：卸下重擔的輕鬆感、感傷自己孤獨一人、慢慢釋放的壓力等三種類型，因應受訪者的照顧年資、畢業年限、被照顧者的自我意識是否清楚，以及自身適應能力等差異，呈現出迥然不同的情緒反應。 二、中年未婚女性畢業照顧者之生活重心移轉情形，依「程度」劃分出：頓失生活重心、摸索生活重心、重拾生活重心等三類，並將「場域」劃分為：職場工作、志工、社交與休閒娛樂等。呈現出畢業照顧者的生活重心由「逝者」漸轉移至「生者」，進而開始重視自身需求的情形。現階段遇到的挑戰包含：（1）不易重返職場；（2）孤獨與寂寞；（3）處理內心解不開的結。 三、對於老年生活的規劃，研究結果指出：（1）理想居住型態有二，以與單身未婚的朋友共居為主，進住養老院為輔；（2）為降低個人在晚年生活的風險，體認保健、保險與儲蓄的重要性。（3）作好面對死亡的準備，包括預立遺囑、遺產分配、接受安寧療護的意願釐清，以及身後歸屬與處理方式等。本研究彙集了受訪者分享「當照顧已成往事」的心得，有感於畢業照顧者淬鍊過後的人生智慧益發顯得寶貴，本研究歸納出：重拾原有的夢想和興趣、把握當下與志工生活，以及注重生命品質等三項重點作分享。 根據研究結果進一步討論發現：（1）中年未婚女性畢業照顧者面臨喪親時的調適方式與一般人相去不遠，相異之處在於照顧工作帶給她們身體、心靈、社交活動上的影響，導致畢業照顧者容易出現「筋骨酸痛」、「失落又解脫的矛盾心情」與「不易重返職場」等特殊需求，進而需要「職能治療與復健」、「專業心理諮商」以及「提供友善政策以支持重返職場」等專業服務或福利政策；（2）畢業照顧者因提前接觸老年與臨終生活，彷彿替自己預習了老年生活與死亡的課程，這種經驗將有助於自身面對老年生活的態度與適應；（3）中年單身者擔憂未來失去生活自理能力後的照顧問題，我們必須正視此一中高齡單身族群的照顧議題，文末並依結果分析提出對社工實務、政策與未來研究之建議。 / The purpose of this study was to explore the life experience that former caregivers which were unmarried middle-aged female, to understand the life adjusting and future planning, and to promote social workers to get deeper understanding for the former caregivers in order to help draft the action plans and supporting welfare measures or projects. This research employed qualitative methods. The researcher conducted semi-structural interview with eight former caregivers individually, and collected in-depth data. 8 interviewees who conform to research conditions (time of taking care of disabled family members is at least more than 1 year; if care receiver passed away, the time that caregiver loses care-giving status has been more than 6 months) are selected by purposive sampling. The study findings after data analyzed are listed below： First, the feelings of became former caregivers were three types： The relaxation of unloading the heavy responsibility, loneliness and strain was slow down. Research results demonstrate totally different emotional responses according to differences, including interviewee’s care-giving seniority, years of graduation, whether care receiver’s self awareness is clear or not, and self adaption ability. Second, As for middle-aged single female former caregiver’s life center shift condition, it can be divided according to “level”: three kinds including losing life center, exploring life center, and regaining life center. In addition, it can also be divided according to “field”: workplace, volunteer, social and leisure entertainment. The conditions that former caregiver’s life center gradually shifts from “dead” to “living”, and begins to attach importance to self requirements are demonstrated. The challenges in current stage include:（1）Not easy to go back to workplace,（2）solitude and loneliness, and（3）dealing with the untied knot in heart. Third, Concerning the planning of old age life, research results indicate that:（1） There are two ideal living styles, which is mainly living together with single friend supplemented with living in House for the Aged,（2）in order to reduce individual risk in old age life, and realize the importance of health care, insurance, and saving.（3） Prepare for facing death, including living will, estate distribution, clarification of willingness to accept hospice care, after-death ownership and disposal method. This study summarizes interviewees’ experiences of sharing “when care giving has become bygones”. Realizing that former caregiver’s life wisdom is valuable, it is summarized in this study: Sharing the three points including regaining the original dream and interest, seizing the moment and volunteer life, and focusing on life quality. Based on the findings of this research, the researcher finds three points：（1）middle-aged single female former caregiver’s adjustment method when facing bereavement is quite similar to general people. The difference is the effect of care giving work on their body, mind, and social activity, which easily induces former caregiver’s special requirements including “aching muscles”, “ambivalence of loss and relief”, and “not easy to go back to workplace”, and then professional service or welfare policy including “occupational therapy and rehabilitation”, “professional psychological counseling” and “providing friendly policy to support going back to workplace” are required.（2）Former caregivers contacts old age and death life earlier, so it is just like to preview the lesson of old age life and death for themselves. This kind of experience will be helpful for the attitude and adjustment of facing old age life.（3）Middle-aged single people worry about the care giving problem when they lose life providing ability in the future, and we must face the care giving issue of this elderly single group. The outcome could be the suggestions for the social work practice, social policy and future research.

<p>Fear among caregivers in mental health care has always existed. Fear is a basic feeling that will protect us from dangerous situations and it makes itself constantly reminded in the care of mentally ill patients. The feeling makes the carer distanced in the relationship. A distancemean consequences for the patient. When the caregiver don´t relieve the patients suffering, the health process stops and she remains in her suffering. The study is a qualitative literature review with latent content analysis of seven scientific articles. The results revealed three categories that describe the meaning of the caregivers fear and how it affects the caring relationship. The first category is about that caregivers is forced by their duty where it is found that caregivers, despite their fear, acts out of her duty as a constraint, or inside as a virtue. The second category includes the other's frightening world where caregivers is fear ofwhat is experienced as and incomprehensible. The third and final category is about mutual powerlessness where caregiver experience fear for the unpredictable and uncontrollable that can´t be foreseen. The powerlessness make the caregiver to question her professionalism andcompetence. The result showed that carers experienced fear of people with mental illness. Carers had difficulty understanding the patients life-world when it experienced incomprehensible and frightening. There was also fear in carers losing control and not to be sufficiently skilled in their profession. When the caregiver felt that she could not maintaincontrol, she was compelling in its approach to the patient and took the control to respond to her, witch affected the relationship negatively. It was found that caregivers were feared of being injured by patients. The results also showed that fear was making the caregiver rejective. This fear blocks the caring relationship. When the caregiver instead affirms her fearand accept it the conditions increase for the establishment of a caring relationship with the patient.</p>

<p>Syftet med studien var att öka kunskaperna om och förståelsen för de äldre anhörigvårdarnas situation genom att låta dem berätta om sin situation ur egen synvinkel för de äldre anhörigvårdarna, 75 år eller äldre, som vårdar sin maka / make.</p><p>Metoden som användes för att samla information var semistrukturerad intervju. Intervjutexterna analyserades med manifest innehållsanalys och med separat analys av de underliggande känslouttryck som framkom i intervjun.</p><p>Resultatet visar att dessa äldre anhörigvårdares situation innefattar många dagliga stressorer. Deras sömn blir störd av vårdtagaren, de har aldrig en lugn stund utan de har beredskap dygnet runt, deras avlastningstid i samband med inköp är otillräcklig och skapar stress, möjligheterna till dagavlastning för egen tid är obefintlig, de blir isolerade, de är oroade därför att back-up saknas som kan ta över om deras egen hälsa sviker, färdtjänstlagen ger inget stöd för besvär som uppkommer vid normalt åldrande, de önskar en universalkontakt, så kallad hjälpkontakt för äldre vid kommunen samt saknar känslan av förståelse från kommunen om de konsekvenser det innebär att bli äldre oavsett hälsotillstånd.</p><p>Slutsatsen är att det behövs mer forskning inom området för att vi skall kunna hjälpa dessa äldre anhörigvårdare till en värdigare tillvaro.</p> / <p>The purpose of this study  was to enriche the knowledge about the life conditions of elderly caregivers by letting them tell about their own ´point of view, in order to create a basis for deeper understanding of the eldrely caregivers, 75 years old or older, who care for their spouse.</p><p>The method used for collecting data was a semistructured intervju. The  interviews were analysed using qualitative manifest content analysis of the interwiews and counting of the underlying feelings of the participants.</p><p>The results  shows that the elderly caregiver´s situation includes many daily stressors.</p><p>Their sleep gets disturbed by the care recipient, they have never a moment of rest, instead they are on constant alert day and night, moments of free time in connection with purchase are insufficient and create stress, the possibilties to get daycare is inifinitimal, they become isolated, they are worried due lack of back-up,  if thier own helth fails, the legislation of journeyservice does not give any aid for inconveniences that are caused by getting old, they wish that there would be an overall contact help at the municipality that could help the elderly caregivers, and they lack understanding  from the municipality about the fact of getting older irrespective of healthcondition.</p><p>Conclusion: If we will be able to give these elderly caregiver´s a life that is more worthy there will be a need for more reaserch in this area.</p>

<p>Abstrakt</p><p>När någon i familjen drabbas av sjukdom, står oftast de närmast anhöriga för den vårdande omsorgen, vilket kan vara påfrestande för hälsan. Det senaste decenniet har det offentliga stödet till anhöriga uppmärksammats i Sverige, vilket har inneburit en satsning på 300 miljoner kronor, Anhörig 300. Vars avsikt var att stödja och underlätta de anhörigas livssituation. Då kan en stödjande verksamhet som anhöriggrupp, vara ett viktigt komplement för reflektion och utveckling med andra. Tillvaron är full av påfrestningar, vad är det som gör att vissa klarar av dessa, medan andra inte gör det? Antonovsky (1991) svar på detta är känslan av sammanhang (KASAM). Syftet med studie var att studera om och i så fall hur interventionen i en anhöriggrupp kan påverka de anhörigas KASAM. Arbetet inleddes med en genomgång av både litteratur och forskning, för att öka kunskap inom problemområdet. Datainsamlingsmetoden som användes var ett ”Livsfrågeformulär”. Urvalet bestod av anhöriga till person över 20 år som drabbats av sjukdom och/eller funktionshinder. Studien genomfördes som en för- och eftermätning av interventionen i en anhöriggrupp. Resultatet visade att KASAM förändrades, men inte endast i positiv riktning, vilket var författarnas hypotes. Detta behöver inte ses som något negativt enligt Antonovsky (1991), utan det är mycket vanligt att en utveckling föregås av ett tillstånd av obalans, vilket kan påverka KASAM tillfälligt. Vad som orsakade detta kan vara svårt att fastställa. De slutsatser som gjordes var att trots fördelar med stöd i grupp, så kan det vara svårt att påvisa att det var just det stödet som påverkade KASAM, däremot kan det ses som en resurs, enligt forskning, i omsorgsarbetet för de anhöriga.</p>

Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2009.

An individual with advanced cancer moves through his or her illness trajectory engaged in an ongoing process of negotiation with the health care system, caregivers, and family members. The ability to maintain control is a key principle upheld in western society, but it may be difficult to do so if cognitive or physical decline occurs during the palliative phase of advanced cancer. Cognitive decline in progressive dementias such as Alzheimers disease or AIDS Dementia Complex is often gradual, allowing such individuals and their family members time to reassign responsibilities for illness management that protect the sense of control of the ill family member. When the onset of cognitive decline occurs more quickly, as is often the case in advanced cancer, ill individuals and their family members may not have the luxury of time to incorporate a transition in responsibilities for illness management into their collective decision-making process, leading to a sense on the part of the person with advanced cancer that he or she has lost control. Current understanding of this transition is limited, and thus the qualitative, grounded theory study, Decision-Making in Family Dyads in the Context of Advanced Cancer was conducted. Advanced cancer patients (n = 5), family caregivers (n = 3), and bereaved caregivers (n = 9) from palliative home care settings in Ontario were recruited for the study. Purposive and theoretical sampling of participants occurred until saturation was reached. Data collection, coding, and analysis occurred simultaneously. Results indicated that family caregivers who tried to fulfill their dying family members wishes often did so at the expense of their own health or finances. The core category Covering captured the strategies caregivers used to enable their family members to die in the manner of his or her choosing. The basic social process Dancing on the Stairs chronicled the stages of the patient-caregiver relationship as they navigated through the grey areas of decision-making in their final months together. The findings may assist health care personnel striving to help individuals with advanced cancer and their family caregivers maintain a sense of control during the palliative phase of an illness.

The positive link between children's joint attention skills and subsequent language outcomes is well established. There is also abundant evidence that responsive caregiver behaviors lead to optimal language outcomes. Though directive behaviors are generally considered detrimental to children's growth, specific types of directive behaviors which extend or build upon a child's behavior are thought to promote children's learning. No study has examined how caregiver behaviors interact with children's joint attention skills to affect subsequent language. Therefore, the objective of the present study was to examine how three different caregiver behaviors (Responsiveness, Supportiveness, and Intrusiveness) measured at 18 months moderated the relation between joint attention (also measured at 18 months) and language in two separate samples (a 24-month and a 36-month outcome sample). Intrusiveness was a significant moderator of the relation between RJA and 24-month language. RJA was a significant predictor of 24-month receptive and expressive language only in children whose caregivers had a low to moderate level of intrusiveness. Understanding the child and caregiver factors that promote or hinder children's language outcomes in children at risk for delay may help inform and target interventions that will help improve children's school readiness outcomes.

Caring for an individual with Alzheimer’s disease is especially challenging and impacts every aspect of the lives of the informal caregivers. Informal caregiving is defined as unpaid care provided by family or friends to people with a chronic illness or disability (Young & Newman, 2002). Caregiver burden involves the physical, psychological, social and emotional problems experienced by a caregiver of an impaired loved one (Gwyther & George, 2006). Alzheimer’s disease caregivers report more depression than their caregiving and non-caregiving peers, experience increased physical decline, and often experience financial challenges. Evidence suggests Alzheimer’s disease caregiver burden is a result of both care recipient and caregiver factors. Pearlin et al’s Stress Process model (1990) is widely used to examine triggers in caregiver burden. The model consists of antecedents, stressors, and outcomes. Few studies have examined moderators in the burden process in Alzheimer’s disease caregiving. Whether resilience accounts for variance in outcomes associated with caregiver burden is not addressed in the literature. Data from a convenience sample of Alzheimer’s disease caregivers (N=111) were examined for the purpose of exploring the moderating effect of resilience on the relationship between stressors and caregiver burden predictors. RESULTS: Resilience did not moderate the relationship between the caregiver stressors and caregiver burden. However, results indicated a relationship between resilience and caregiver burden. Specifically, as resilience increases, caregiver burden decreased. This finding highlights the importance of Alzheimer’s caregivers and implementing support and interventions that will increase their resilience.

Fear among caregivers in mental health care has always existed. Fear is a basic feeling that will protect us from dangerous situations and it makes itself constantly reminded in the care of mentally ill patients. The feeling makes the carer distanced in the relationship. A distancemean consequences for the patient. When the caregiver don´t relieve the patients suffering, the health process stops and she remains in her suffering. The study is a qualitative literature review with latent content analysis of seven scientific articles. The results revealed three categories that describe the meaning of the caregivers fear and how it affects the caring relationship. The first category is about that caregivers is forced by their duty where it is found that caregivers, despite their fear, acts out of her duty as a constraint, or inside as a virtue. The second category includes the other's frightening world where caregivers is fear ofwhat is experienced as and incomprehensible. The third and final category is about mutual powerlessness where caregiver experience fear for the unpredictable and uncontrollable that can´t be foreseen. The powerlessness make the caregiver to question her professionalism andcompetence. The result showed that carers experienced fear of people with mental illness. Carers had difficulty understanding the patients life-world when it experienced incomprehensible and frightening. There was also fear in carers losing control and not to be sufficiently skilled in their profession. When the caregiver felt that she could not maintaincontrol, she was compelling in its approach to the patient and took the control to respond to her, witch affected the relationship negatively. It was found that caregivers were feared of being injured by patients. The results also showed that fear was making the caregiver rejective. This fear blocks the caring relationship. When the caregiver instead affirms her fearand accept it the conditions increase for the establishment of a caring relationship with the patient.