Achieving a restorative mental break for family caregivers of persons with Alzheimer's disease
Janet H. Watts,
Jodi Teitelman,
Janet H. Watts
Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
Search for more papers by this authorJodi Teitelman
Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
Search for more papers by this authorJanet H. Watts,
Jodi Teitelman,
Janet H. Watts
Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
Search for more papers by this authorJodi Teitelman
Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
Search for more papers by this authorJodi Teitelman, Virginia Commonwealth University, Box 980008, Richmond, VA 23298-0008, USA. Email: [email protected]
Janet Watts PhD, OTR/L; Quality Assurance and Training Leader (Chamberlin Edmonds and Assoc.) and Emeritus Associate Professor. Jodi Teitelman PhD; Associate Professor (Department of Occupational Therapy).
Abstract
Background/Aim: This phenomenological exploration of how caregivers of persons with Alzheimer's disease achieve a mental break defined them as distinct periods of freedom from caregiving concerns and conceptualised them as the essence of respite and as a restorative occupation.
Methods: Four in-depth interviews each with 15 family caregivers revealed two categories.
Results: Factors associated with achieving a mental break included: social support, traditional respite, relief-enhancing conditions, techniques for momentary stress reduction, and respite impediments. Achieving a mental break included mental break techniques and experiencing a mental break.
Conclusions: Restorative mental breaks are often within caregiver control, are achievable independent of formal respite services, and involve both rest and engagement in absorbing activities. Restorative breaks are often pleasurable, support productivity, may be entwined with caregiving activities, and importantly, do not compromise care recipient well-being.
References
- Alzheimer's Association and National Alliance for Caregiving. Who cares? Families caring for persons with Alzheimer's disease. (n.d.). Retrieved 31 July, 2002, from http://www.caregiving.org/content/repsprods.asp
- American Occupational Therapy Association, Inc./Commission on Practice (2002). Occupational therapy practice framework: Domain and process. Bethesda, MD: AOTA.
- Bateson, M. C. (1990). Composing a life. New York: Plume/Penguin.
- Bateson, M. C. (1996). Enfolded activity and the concept of occupation. In: R. Zemke & F. Clark (Eds.), Occupational science: The evolving discipline (pp. 5–12). Philadelphia: FA Davis.
- Benson, H. & Proctor, W. (2003). The breakout principle. New York: Scribner.
- Con Lin, M. M., Caranasos, G. J. & Davidson, R. A. (1992). Reduction of caregiver stress by respite care: A pilot study. Southern Medical Journal, 85, 1096–1100.
- Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper & Row.
- Czaja, S., Eisdorfer, J. C. & Schulz, R. (2000). Future directions in caregiving: Implications for intervention research. In: R. Schulz (Ed.), Handbook on dementia caregiving: Evidence-based Interventions for family caregivers (pp. 283–319). New York: Springer Publishing.
- Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). Mini-mental state. Journal of Psychiatry Research, 12, 189–198.
- Frank, G. (1997). Is there life after categories? Reflexivity in qualitative research. The Occupational Therapy Journal of Research, 17, 84–98.
- Gill, C. E., Hinrichsen, G. A. & DiGiuseppe, R. (1998). Factors associated with formal service use by family members of patients with dementia. The Journal of Applied Gerontology, 17, 38–52.
- Gottlieb, B. H. & Johnson, J. (2000). Respite programs for caregivers of persons with dementia: A review with practice implications. Aging and Mental Health, 4, 119–129.
- Guralnik, D. B. (Ed.). (1970). Webster's new world dictionary of the American language (2nd college ed.). New York: World Publishing.
- Hasselkus, B. R. (1989). The meaning of daily activity in family caregiving for the elderly. American Journal of Occupational Therapy, 43, 649–656.
- Hasselkus, B. R. (1991). Ethical dilemmas in family caregiving for the elderly: Implications for occupational therapy. American Journal of Occupational Therapy, 45, 206–212.
- Hasselkus, B. R. (1997). Everyday ethics in dementia day care: Narratives of crossing the line. The Gerontologist, 37, 640–649.
-
Howell, D. &
Pierce, D. (2000). Exploring the forgotten restorative dimension of occupation: Quilting and quilt use.
Journal of Occupational Science, 7, 68–72.
10.1080/14427591.2000.9686467 Google Scholar
- Kennet, J., Burgio, L. & Schulz, R. (2000). Interventions for in-home caregivers: A review of research 1990 to present. In: R. Schulz (Ed.), Handbook on dementia caregiving: Evidence-based Interventions for family caregivers (pp. 61–125). New York, NY: Springer Publishing.
- Lawton, M., Brody, E. & Saperstein, A. (1989). A controlled study of respite service for caregivers of Alzheimer's disease patients. The Gerontologist, 29, 8–16.
-
Lincoln, Y. S. (1995). Emerging criteria for quality in qualitative and interpretive research.
Qualitative Inquiry, 1, 275–289.
10.1177/107780049500100301 Google Scholar
- Lincoln, Y. S. & Guba, E. G. (2000). Paradigmatic controversies, contradictions, and emerging confluences. In: N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 163–188). Thousand Oaks, CA: Sage Publications.
- Logan, R. (1985). The ‘flow’ experience in solitary ordeals. Journal of Humanistic Psychology, 25 ( 4 ), 79–89.
-
McGrath, W. L.,
Mueller, M. M.,
Brown, C. M.,
Teitelman, J. &
Watts, J. (2000). Caregivers of persons with Alzheimer's disease: An exploratory study of occupational performance and respite.
Physical and Occupational Therapy in Geriatrics, 18 (2), 51–69.
10.1300/J148v18n02_04 Google Scholar
- McNally, S., Ben-Shlomo, Y. & Newman, S. (1999). The effects of respite care on informal carers’ well-being: A systematic review. Disability and Rehabilitation, 21, 1–14.
- Meyer, A. (1922). The philosophy of occupation therapy. Archives of Occupational Therapy, 1, 1–10.
- Meyerhoff, B. & Ruby, J. (1992). [Orig 1982]. A crack in the mirror: Reflexive perspectives in anthropology. In: B. Myerhoff (Ed.), Remembered lives: The work of ritual, storytelling, and growing older (pp. 307–340). Ann Arbor, MI: University of Michigan Press.
- Moody, H. R. (1992). Ethics in an aging society. Baltimore, MD: Johns Hopkins University.
- Mueller, M. M., Brown, C. M. & McGrath, W. L. (1999). Caregivers of persons with Alzheimer's disease: An exploratory study of occupational performance and respite. Richmond, VA: Virginia Commonwealth University.
- QSR International Pty Ltd. (2000). NVivo [Computer software]. Victoria, Australia: QSR International Pty Ltd (http://www.qsrinternational.com/)
- O'Rourke, N. & Tuokko, H. (2000). The psychological and physical costs of caregiving: The Canadian study of health and aging. The Journal of Applied Gerontology, 19, 389–404.
- Onions, C. T. (Ed.). (1966). The Oxford dictionary of English etymology. London: Oxford University.
- Ory, M. G., Yee, J. L., Tennstedt, S. L. & Schulz, R. (2000). The extent and impact of dementia care: Unique challenges experienced by family caregivers. In: R. Schulz (Ed.), Handbook on dementia caregiving: Evidence-based interventions for family caregivers (pp. 1–32). New York, NY: Springer Publishing.
- Parker, S. R. (1983). Leisure and work. London: George Allen & Unwin.
- Patton, M. Q. (2002). Qualitative evaluation and research methods, 3rd ed. Thousand Oaks, CA: Sage.
- Pierce, D. (2001). Occupation by design: Dimensions, therapeutic power, and creative process. American Journal of Occupational Therapy, 55, 249–259.
- Pierce, D. E. (2003). Occupation by design: Building therapeutic power. Philadelphia, PA: F. A. Davis.
- Primeau, L. A. (2003). Reflections on self in qualitative research: Stories of family. American Journal of Occupational Therapy, 57, 9–16.
- Reisberg, B. (1984). Stages of cognitive decline. American Journal of Nursing, 84, 225–228.
- Schulz, R., Burgio, L., Burns, R., Eisdorfer, C., Gallagher-Thompson, D., Gitlin, L. N. & Mahoney, D. F. (2003). Resources for enhancing Alzheimer's caregiver health (REACH): Overview, site-specific outcomes, and future directions. The Gerontologist, 43, 514–520.
-
Strang, V. R. &
Haughey, M. (1998). Factors influencing the caregiver's ability to experience respite.
Journal of Family Nursing, 4, 231–254.
10.1177/107484079800400302 Google Scholar
- Strang, V. R. & Haughey, M. (1999). Respite — A coping strategy for family caregivers. Western Journal of Nursing Research, 21, 450–471.
- Teitelman, J. & Watts, J. H. (2004). Family members’ recommendations for achieving a mental break from caring for a loved one with Alzheimer's disease. Alzehimer's Care Quarterly, 5, 252–260.
-
Teitelman, J. &
Watts, J. H. (2005). How family caregivers of persons with Alzheimer disease achieve mental breaks: Preliminary analysis from a qualitative study.
Physical and Occupational Therapy in Geriatrics, 23 (
1
), 9–24.
10.1300/J148v23n01_02 Google Scholar
- Yerxa, E. J. (1998). Health and the human spirit for occupation. American Journal of Occupational Therapy, 52, 412–418.
-
Zarit, S. H.,
Stephens, M. A. P.,
Townsend, A. &
Greene, R. (1998). Stress reduction for family caregivers: Effects of adult day care use.
Journal of Gerontology: Social Sciences, 53B (
Suppl.), S267–S277.
10.1093/geronb/53B.5.S267 Google Scholar
