Silverberg Eleanor
Alzheimer Society of York Region, Thornhill, Ontario, Canada.
Omega (Westport). 2006;54(3):215-35. doi: 10.2190/d1r5-0473-1922-4n70.
With our aging population, it is estimated that in the near future there will be an overwhelming increase in the number of individuals dealing with Alzheimer's disease or a related dementia (ADRD). From the time that symptoms begin to insidiously emerge, it can take well over ten years for the disease to run its course. In addition to the crippling effect for those inflicted, this lengthy duration can have an ongoing debilitating effect on the family members who are grieving while providing care. Researchers have claimed that the manner in which family members experience and manage their grief reactions to the pre-death losses can influence both caregiving outcomes and adjustment to bereavement once those with the disease have died. Given the relevance of grief management, this article provides answers to such questions as: How do family caregivers of individuals with ADRD manifest their grief? How can healthcare professionals intervene in assisting with grief management? The answers are provided introducing the 3-A grief intervention model for family caregivers of individuals with ADRD. The 3-A model enfranchises the caregiver grief experience through Acknowledging, Assessing, and Assisting in grief management. In doing so, different grieving styles are identified and the role that denial and respite plays in adapting to the family caregiver's grief experience is recognized. Clinical strategies to assist in grief management are also provided.
随着人口老龄化,据估计在不久的将来,患阿尔茨海默病或相关痴呆症(ADRD)的人数将大幅增加。从症状开始悄然出现之时起,这种疾病可能需要十多年才能发展到最后阶段。除了给患者带来严重影响外,如此漫长的病程还会持续对那些在提供护理的同时悲痛万分的家庭成员造成身心疲惫。研究人员称,家庭成员经历和应对其对患者生前丧失情况的悲痛反应的方式,既会影响护理结果,也会影响在患者去世后对丧亲之痛的调适。鉴于悲痛管理的重要性,本文回答了以下问题:ADRD患者的家庭护理人员如何表达他们的悲痛?医疗保健专业人员如何介入以协助进行悲痛管理?文中通过为ADRD患者的家庭护理人员介绍3-A悲痛干预模型给出了答案。3-A模型通过在悲痛管理中进行确认、评估和协助来赋予护理人员悲痛体验权利。在此过程中,识别出不同的悲痛风格,并认识到否认和缓解在适应家庭护理人员悲痛体验中所起的作用。还提供了协助悲痛管理的临床策略。