Carolyn L. Lindgren

Fatigue among Elders in Caregiving and Noncaregiving Roles

Fatigue is a complex symptom prevalent in informal caregiving. When role demands exceed caregiver resources, fatigue ensues and caregiving can be compromised. The purpose of this study was to compare perceptions of fatigue among older adults (N = 92) caring for spouses with Alzheimer’s disease, Parkinson’s disease, or cancer with a control group of older adults (N = 33) whose spouses required no extra care. Caregiving elders reported more fatigue, less energy, and more sleep difficulty than did control participants. All caregiving groups reported similar levels of fatigue, energy, sleep, and self-reported health even though there were marked differences regarding spousal status. Health care providers can support older caregivers in monitoring their own health and in recognizing the need for services that support the caregiving role.

Current knowledge and research on chronic sorrow: A foundation for inquiry

Abstract Research on the phenomenon of chronic sorrow has been limited to samples of parents of children with disabilities. The Nursing Consortium for Research on Chronic Sorrow was formed to study this concept in individuals with chronic illness and their family caregivers across the life span. Although no research on this concept has focused on a life-span approach, the level and quantity of related research indicate that a qualitative method is most appropriate. A study of parents of children with spina bifida provided a usable instrument, the Chronic Sorrow Questionnaire. The purpose of additional study is to determine when chronic sorrow occurs and what characteristics it displays in a variety of populations across the life span, how groups suffering from chronic sorrow compare with parents of children with disabilities, whether chronic sorrow is an inherent phenomenon in chronic illness situations, and how the major subconcepts of chronic sorrow theory are linked.

Perceived Control and Well-Being in Parkinson's Disease:

Sense of control in the context of an uncontrollable chronic illness is explored by analyzing the impact of the patients perceived control over symptoms (PCS) and perceived control over disease progression (PCDP) on patient and caregiver outcomes. PCS was significantly associated with patient well-being, caregiver well-being, and less caregiver burden. No relationship was found between PCDP and patient well-being, caregiver well-being, or caregiver burden. Findings support the importance of symptom management, viewing the patient-caregiver dyad as a unit, and the needforfuture research on control and transition points in chronic illness.

Grief in Spouse and Children Caregivers of Dementia Patients

Caring for a family member with dementia involves loss and inevitable grief during the illness duration. The purpose of this study was to determine the patterns of grief of caregivers of family members with dementia and the relationship of those patterns to the losses and experiences of the caregivers. Participants were 22 spouse caregivers and 11 adult children caregivers of family members with dementia. Caregivers’experiences were measured using visual analog scales and grief using The Grief Experience Inventory. Caregivers’ perceptions of the level of affection before the illness and the satisfaction of the marriage before the illness were inversely related to grief symptoms. Grief symptoms were also related to participants’ perceptions of loss of the future. Caregivers’emotional distress includes reaction to the losses they are encountering long before their care recipients die.

Effects of an educational intervention on students' attitudes toward the disabled.

The purposes of this study were to determine if the attitudes of nursing students toward the disabled would improve following participation in a one-day educational conference on care of the physically disabled and to identify variables influencing these attitudes. Nursing students completed Yuker and Blocks Attitudes Toward Disabled Persons scale (ATDP) (1986) prior to and one month following the conference. T test indicated that subjects had significantly higher ATDP scores following the rehabilitation conference (p = < .0001). Subjects with prior work experience with the disabled had significantly higher scores on the ATDP, indicating more positive attitudes toward the disabled.

Chronic sorrow in multiple sclerosis. A case study.

Multiple sclerosis, one of the most common chronic disabilities among young adults, may potentiate the occurrence of chronic sorrow. Chronic sorrow differs from acute grief because it is permanent, periodic, and progressive in nature; it may be a normal component of chronic illness and disability. This study describes one womans experience with multiple sclerosis, her chronic sorrow about the trajectory of her disability, her progressive loss of bodily function, and the stigma of chronic illness. It also reports some of the feelings experienced by her husband, the primary caregiver.

A typology of residential fire survivors' multidimensional needs.

This article presents an analysis of the tangible, psychological, and general needs of adults and their children reported by residential fire survivors approximately 14 weeks postfire. Three hundred and seven survivors, who identified that they needed help for themselves or their children, differed from 133 survivors who did not request help. Those needing help were more likely to be women with children younger than age 18 living in their household, have low-income status, less education, and to have already received services from church groups. The classification of self-identified needs of fire survivors included the need for specific tangible and social service assistance, psychological and spiritual support, and nonspecific assistance. This classification contributes to our understanding of the relationship between needs and loss, grief, and changes in family and life situations postfire.

Commentary by Lindgren

The researcher(s) are commended for taking on a detailed clinical study to find answers to the complex and important needs of hydration levels and confusion in nursing home residents. Their attention to detail in measuring each of these variables was exemplary. The problem with the study was the weak link between the acute confusion (AC) and the hydration variables. The assumption was made in this study that the reduced levels of hydration that typically occur in residents of LTC facilities trigger AC. The study was lacking in background knowledge that supported the relationship between fluid deficit of the nursing home residents and the acquisition of AC in those residents. In the background section, the authors state that AC is difficult to detect in LTCs because of the high prevalence of dementia. Later on, they state that in previous work they established a link between AC and hydration status. That work is not described in any detail. This study was, essentially, seemingly based on that thread of evidence from that previous work. The background did not provide evidence of what the occurrence of AC is in the typical population of LTC residents nor what hydration levels in nursing home residents are associated with a higher incidence of AC. Fluid and electrolyte imbalance is considered one of the significant risk factors of AC (Wakefield et al., 2001) and change in mental state is a characteristic of fluid volume deficit (Reese, 2001). The authors acknowledge in their discussion that the assumption that hydration alone would impact the incidence of AC was perhaps erroneous and cite recent studies that support the multifactorial nature of AC. Having this knowledge as background for the study would have provided a different direction for the research questions that ensued and the study design. A strong contribution of the study was the methods developed for measuring the hydration status and the meticulous intervention protocols to increase the fluid intake of the experimental group. Even though it was difficult for the researchers to obtain absolute compliance with the hydration protocols by the nursing caregiving staff, the increased hydration levels of the experimental group of participants contributed to their improved physiological state. Regardless of AC, addressing the hydration needs for nursing residents and learning what is required to meet this basic physiological need is a meaningful addition to the knowledge of care for these persons.