It is agonizing to lose someone or something
It is agonizing to lose someone or something. Grief is a natural response to loss and though it is a universal experience, the grieving process is unique to everyone. Merriam Webster dictionary defines grief as a deep and poignant distress caused by or as if by bereavement. It is the emotional, social, spiritual and physical discomfort suffered when one loses someone or something. Several emotions are experienced when one is grieving including, sorrow, anger, and peace to mention a few. There are numerous may causes of grief such us passing of a friend, relative or companion. It can involve loss of job, pet, marriage, money or independence, the list is endless. This paper will discuss complicated grief related to caregiver strain in addition to interventions and practices that are used to manage this burden.
Caregivers play a significant role in assisting people in their care with activities of daily living. Caregiving roles are usually assumed by close family members like parents, children, or partners. One of the prevalent issues associated with caregiving is loss of independence of the individual providing care. Many people many think that assuming the care of a loved one when they become incapable of doing so themselves is a natural responsibility. Nonetheless, caregivers develop role strain in the process of caring for their chronically ill loved ones.
Several caregivers mourn role strain in through a complicated grief process which is prolonged and often unresolved. Because grief doesn’t always progress as expected, in some cases, the weight and duration of grief significantly impedes a person’s ability to function. Complicated grief may present as depression and anxiety. The thoughts, feelings, behaviors, and reactions may continue over long periods of time with little upturn. Complicated grief doesn’t subside on its own and requires professional intervention. Let’s explore the relationship the relationship between role strain and complicated grief.
In a bi-national study conducted by Diaz, de Almeida Lopes Monteiro da Cruz and de Cassia Gengo e Silva, it was stated that “stress of caregiver’s role is a nursing diagnosis that was accepted by NANDA-International in 1992. Since then, it has been revised twice, in 1998 and 200. It currently belongs to the 7 domain, Roles and relationships (“connections or positive and negative associations between people or groups of people and means by which these connections are demonstrated”) and class 1, Caregiver’s roles (“behavioral patterns, socially expected for people who provide care who are not healthcare professional”). It is defined as the difficult to play role of the family caregiver or significant other” (Diaz et el, 281). This article provides a brief definition and history of caregiver role strain in nursing diagnosis. In other words, role strain is the difficulty associated with performing caregiving task.
The purpose of the study was to conduct a clinical validation of the nursing diagnosis “caregiver role strain.” The authors identified that removal from social life, changes in leisure activities, increased emotional lability and lack of time to meet personal needs were characteristics indicative of stress which is the defining factor of diagnosing “Caregiver role strain” (Diaz et el, 286). In other words, caregivers who experience role strain go through stress while caring for their loved ones. When unresolved, it can build up into hopelessness and anger which are all characteristic of complicated grief.
To further solidify the relationship between role strain and complicated grief, an article states “Complicated grief is associated with numerous psychological problems including loneliness, social isolation, anxiety, clinical depression, cognitive impairment and PTSD. Certain risk factors elevate the likelihood of complicated grief. Manifestations of complicated grief include intense longing, loneliness, emptiness or lack of meaning to life and intrusive thoughts that interfere with functioning” (Tofthagen, 331). When caregivers experience role strain, it takes a toll on their ability to function independently. Most of them feel alone and drained by the responsibilities of caring for their loved ones. Relational factors with the person being cared for can influence the degree of grief experienced. The closer the relationship, the more likely complicated grief will be experienced.
Furthermore, another study conducted found that nine clinical indicators presented significant statistical legitimacy with the nursing diagnosis caregiver role strain which included withdrawal from social life; changes in leisure activities; increased emotional lability; difficulty performing required tasks; increased nervousness; lack of time to meet personal needs; disturbed sleep; concerns about family members; and stress (Oliveira et el, 220). As seen in the data presented, caregivers increasingly continue to experience role strain in performing their tasks which causes them to lose their independence.
Healthcare providers play important role in identifying caregiver role strain and aid. First, role strain must be diagnosed by providers. Through interview and measurement tools, providers and detected signs of role strain. Some tools currently used in practice include:
• Appraisal of Caregiving Scale: measures burden related to harm/loss, threat, challenges, benefit, and benign.
• Caregiver Demands Index: measures burden related to meals, intimate care, movement and comfort, medications and treatments, supervision, rest, and acquisition of new skills.
• Caregiver Reaction Assessment: measures burden related to self-esteem; lack of family support; and impact on finances, schedule, and health.
• Caregiver Strain Index: measures burden related to financial, physical, and social well-being and time.
• Memorial Symptom Assessment Scale: measures burden related to frequency, severity, and distress of patient symptoms.
• Zarit Burden Inventory: measures burden related to health, psychological well-being, finances, social life, and relationship with patient (Honea et el, 509).
To lessen the burden of caregiver strain and managing grief, caegivers must understand the process of grief.