Creating Support Systems for the Ill and Elderly: The Crucial Role of Family
During my clinical rotation at a senior citizen home in a local community in Karachi, I got a chance to meet and interview an 80 year old female patient. She had been admitted in the nursing home for total nursing care after suffering a fall in which she had broken a leg and was consequently immobilized. Since she was widowed, she had been living with her married daughter, who was now unable to care for her mother and so, had brought her to the nursing home.
During my interview with her, she admitted to feeling lonely; she missed her family a lot and wished to be with them. She received no visitors during the entirety of my rotation there. Though suffering from amnesia as well, her sentiments about her near-estranged family were clear. Going through family detachment and missing her family members made her vulnerable to depression and mental illness. On assessment, I found that she was less interested in participating in activities, most of her time passed being alone in her room with little company, and no one to lend an ear.
Globally, elderly people make up the fastest growing population to develop mental illness. Research indicates that older adults who are isolated or ill are more likely to be depressed. For this reason, family support is very fundamental for psychological well being. This issue merits discussion, as very often the younger and busier members of the family fail to recognize the need to rally around the elderly, and extend their support in the face mental health issues.
The lack of social support from family members leads the elderly client into psychological deprivation, which may manifest as aggression, loneliness, social isolation or depression. Taqui et al (2007) have stated that depression is the most common psychiatric disorder among the elderly which can manifest as major depression or as minor depression characterized by a collection of depressive symptoms.
My client was similarly experiencing social isolation; her closest family ties having somewhat abruptly been cut off. Initial adjustment to a nursing home was a problem, as she had to break away from her familiar routine and adhere to a new one. Transplanted into a new setting, without familial support to ease the transition, the client lost her psychological and social connectedness.
According to Gallegher and Londrigan (2004), those elderly people who are connected to society and have good social system, tend to show better physical and mental health than others. Moreover when they are with their family, they feel more motivated towards all tasks, which ultimately helps them remain socially competent.
Taqui et al. (2007) found that 1 in 5 elderly nursing home clients suffers from depression and depression rate is higher among those who live nuclear family rather than joint family.
Family is an important, yet often neglected area of care. Nurses can play a fundamental role in enhancing family interaction, guiding family for collaboration, supporting clients in social interaction and promoting their psychological well being. A holistic approach to nursing care for these patients is one where the nurse can evaluate family support system, and intervene to actively involve family members in the mental and physical well being of the elderly.
Taqui,A., Itrat,A., Qidwai,W ., &Qadri,Z. (2007). Depression in the elderly: Does family system play a role? A cross-sectional study.BMC Psychiatry, 7, 1-12.doi:10.1186/1471-244X-7-57
Ragan,M., & Kane, C.F. (2010). Meaningful Lives: Elders in Treatment for Depression. Archives of Psychiatric Nursing, 24, 408–417. doi:10.1016/j.apnu.2010.04.002
Gallagher, L.P., &Londrigan, M.T. (2007).Community Support: Older Adults’ Perceptions. Clinical nursing research, 13, 3-23. doi: 10.1177/1054773803259466
Husain, N., Chaudhry, I. B., Afridi, M. A., Tomenson, B., & Creed, F. (2007).Life stress and depression in a tribal area of Pakistan. The British Journal of Psychiatry, 190(1), 36-41.
Robinson, E., Rodgers, B., & Butterworth, P. (2008). Family relationships and mental illness: Impacts and service responses. Australian Institute of Family Studies
Stuart, G. W (2013).Principles and practice of psychiatric nursing. (10thed.). St. Louis: Mosby.
Townsend, M. C. (2012). Psychiatric mental health nursing: Concepts of care. (7th Ed.). Philadelphia: F. A. Davis Company.
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