Kit Ivan J. Salming

 The Effects of Alzheimer’s Disease on Adult Child Caregivers Name of Student Institution Affiliation Abstract Adult child caregivers play an essential role in taking good care of their parents with Alzheimer’s disease. Most often than expected, they might feel the negative effects of doing so, especially because they are the primary care givers. While others reported to feel the effects as rewarding and that is beneficial to overall personal growth. Due to this difference, this paper aims to determine the negative and positive sides of adult child caregivers as a primary role in caring for their parents with Alzheimer’s disease. This would add to existing information in assessing these different effects in order to create interventions and programs in helping adult child caregivers acknowledge the positive side of the condition and to counteract the negative aspects of it. This would then be a reliable source for mental health practitioners in developing coping strategies and sharing it to adult child caregivers. The Effects of Alzheimer’s disease on Adult Child Caregivers Caregivers play an essential role in taking good care of their patients. Most often than expected, they might feel the negative effects of doing so, especially because they are the primary care givers. Modern researches aim to determine the negative effects in order to provide awareness and possible intervention for such individuals. However, this paper examines such effects as it could either be positive or negative, not solely on the negative, and to incorporate such findings into existing researches in-line with this area. It is the purpose to assess these effects and to be able to contribute reliable information as to how Alzheimer’s disease impacts Adult Child caregivers. Literature Review Various researches have taken into account the adverse effects of caring a person with Alzheimer’s disease, Dementia, or other Neurodegenerative Diseases (Heller, Gibbons, & Fisher, 2015; Gaugler, Reese, & Mittelman, 2015). The National Institute of Aging or NHI website (n.d) mentioned that caring for individuals with a neurodegenerative disease impacts the caregiver’s mental, physical and social health, as well as career life and relationship. In addition, high levels of emotional stress were reported together with high levels of physical strain and financial strain (AARP, 2015). Though most of the studies focused on the stressful role of a caregiver, only a few number of studies started to explore its positive aspect. Some of these positive effects were mentioned to be really rewarding for the adult child caregiver. These examples are improved interpersonal skills, greater patience, more compassionate, as well as finding meaning and happiness while taking care of their parent with (AD) Alzheimer’s disease (Butcher, Holkup, & Buckwalter, 2001; Sanders, & McFarland, 2002). Due to these different findings it is important then to really determine these effects and to weigh it in order to provide considerable information useful for implementing interventions for adult child caregivers. In a study that aims to examine factors that influence the burden that adult child caregivers experience, it was founded that caregiver burden increased with AD severity (Reed, Belger, Dell'Agnello, Wimo, Argimo, Bruno, & Vellas, 2014). Reed and colleagues even mentioned that the time spent with the patient does not really influence the burden that adult child caregivers carry. In the same study, adult child caregivers are reported to have experienced a higher burden than spousal caregivers despite the lower time spent with AD parents. Aside from that factor, patient behavior is also related to the emotional stress that adult child caregivers feel. As a result, the way that parents behave and their functioning impacts their adult child caregivers. The parent’s characteristics, the way they treat their adult children, all influence the degree of their emotional burden. The high advantage of this study is that it compares different patients with different levels of severity to adult child caregiver’s burden. In turn, this provides evidence that an increase in severity also increases the burden of such caregivers. Furthermore, a study conducted by Goren and colleagues (2016) discovered that caregivers role in caring with their parents also influence their overall lifestyle and decision making (Goren, Montgomery, Kahle-Wrobleski, Nakamura, & Ueda, 2016). For instance, it was concluded by the same study that compared to non-caregivers, adult child caregivers reported to have lower health utilities such as increase in engagement of cigarette smoking and heavy drinking. Additionally, they reported to have a significant decrease in physical and mental health status, experienced greater occurrence of comorbidities such as anxiety and depression, insomnia, and pain. Although this study was limited to Japanese samples, the study made it clear that these results were aligned to previous studies throughout the global setting, supplying empirical proof of caregiver burden in spite of individual healthcare systems or cultural disparities. More importantly, it provides clear evidence of the adverse effects towards adult child caregiver that should be given the highest degree of emphasis in providing support to this vulnerable group. Even so, it is important to make it clear that the effects were more apparent to adult child caregivers than spousal caregivers. Another negative effect that needs to be discussed specifically is when adult child caregivers experience grief while caring for their parents with AD. Grief is defined as an attachment-emotional distress of caregivers towards their parents with AD. And as the disease gets worsen, so does the grief of such caregivers, especially if the parent dies (Ott, Sanders, & Kelber, 2007). This is quite interesting for the reason that grief includes the overall feeling of sadness, anger, guilt, regret, anxiety and loneliness of an adult child caregiver. Although it may seem obvious to feel sad as gradually caring for AD parents get worse, it is interesting to identify how this feeling is expressed by adult child caregivers. A similar study suggests that as the disease gets worse or as it follows different stages and leads to the terminal stage, gradual changes of grief also occurs (Sanders & Adams, 2005). Each grief stage is expressed differently by adult child caregivers and is often seen in the ways they behave and conduct themselves socially. Grief is characterized in a similar sense to compassion fatigue – a combination of helplessness and hopelessness as well as inability to be empathetic which results to isolation (Day, Anderson, & Davis, 2014). Similarly, this impacts their overall functioning. Some adult child caregivers have been related to be anxious in a slight degree while others lead to major depression and eventually needs professional help. But one thing is clear, experiencing grief or compassion fatigue is a strong predictor in the genesis of depressive symptoms and in effect, depressive disorders as it gets worsen. It is evident how adult child caregivers really had the hardest time to cope with such conditions. It influences their lifestyle and overall functioning. Also, the impact is greater on adult child caregivers who lived with the patient and has other family responsibilities rather than spousal caregivers who think of it as just a marital obligation. Most critically, the burden that is felt by an adult child caregiver is significantly correlated to mental health and thus enormously affects their normal functioning. Although the focus is more on the negative aspects of being an adult child caregiver, there are also several researches that had conclusions on its positive impact. For example, in a study conducted by Rashchick & Ingersoll-Dayton (2004) in which experiences of adult child caregivers were compared to spousal caregivers in whom adult child caregivers reported to label their experiences as rewarding and satisfying. It was argued that it is highly connected to their subjective experience in taking care of their parent. As an adult child, it was mentioned that it is their primary role in taking care of their parents as an exchange of the way they treated them before. In other words, they viewed their parental care giving as a privilege and express a higher level of appreciation and therefore rewarding. Adult children tend to be more helpful to their parent’s needs and positively affect their emotions. In contrast, spousal caregivers tend to view their caregiving as a social expectation – a role as a caregiver on the basis of society’s norm as to how spouses should care for each other especially in the course of an illness – or in other words a social responsibility or obligation. However, adult children views their caregiving not as an obligation but a privilege that exceeds far above what the society expects, making it as mentioned – rewarding. A similar study with regards to the optimistic view of adult child caregiving is on how it increases personal growth. Ott et al (2007) stated that aside from experiencing grief, adult child’s caregiving can result to optimal personal growth and that it contributes to the positive emotional aspect of adult children caregivers. Some of these aspects that were mentioned include endurance, preserving integrity, moving with continuous change, and finding meaning and joy. These aspects were in fact components toward personal growth. Adult child caregivers also reported to have acquired the following realizations; an enduring quality toward life’s challenges and suffering, viewing it as part of living and should be acknowledged, accepting reality as the bases of accumulating happiness while suffering, and moving on with change therefore finding meaning and joy during this process. Butcher and colleagues (2002) also accumulated comparable information with regards to this matter. It was proven that adult children caregivers describe such care as the chance to establish a closer relationship to their parent that would not be existent without the disease, create additional joyful memories, and develop a much stronger sense of commitment. Although the experience might be tragic for both the parent and their adult children, the experience itself will be a strong source of endurance and in viewing life differently, thus more purposeful during and after the experience. Coping mechanisms tend to increase as the parent and adult children deal with the situation and once collaboration is established between parties, positive emotions and stress sustaining efforts counteracts with the negative consequences of stress, grief, and other factors that harm social and psychological functioning. Other positive effects of adult child caregiving experiences were elaborated by the study of Sanders (2005) on strain and gain in caregivers of individuals with AD. The study clarifies that adult children caregivers experience subjective feelings of satisfaction through the increase of their spirituality and relationship with God, and similar experiences of personal growth such as becoming more caring, loving, compassionate, and less self-centered. It was also reported that they also felt a considerable sense of accomplishment on their satisfying way of caring their parents and to their capacity to provide care. As a result, adult children tend to be happier and felt more gratified in their dealings to their parent with AD. More importantly, adult children reported to feel more responsible on their new roles in taking care with their parents. And as they accumulate such a privilege with other new responsibilities, they admitted to feel more mature and with a strong sense of purpose. Conclusion In the course of this exploration, it is evident that the effects of Alzheimer’s disease in adult child caregivers depend on the individual’s experiences and how they respond to it. Different people have different views on how they interpret experiences and are greatly influenced with their culture, beliefs, upbringing as well as other experiences in life. It is important though to take note that more findings are made on the negative effects of adult child caregiving simply because minimal number of research focuses on the rewarding aspects of it. Therefore it is recommended that substantial number of researchers should also aim to comprehend the positive side of adult child caregivers in caring for parents with AD. This would add to existing information in assessing these effects and in order to create interventions and programs to help adult child caregivers acknowledge the positive side of the situation and to counteract the negative aspects of it. More supporting strategies in collaboration with mental health practices would arise in assisting adult children caregivers in making the best out of their situation, accepting reality, and achieving higher sense of joy and contentment while caring for their parents with Alzheimer’s disease. If implemented, this would then be a reliable source for mental health practitioners in developing coping strategies and mechanisms and in sharing it to adult child caregivers. References Butcher, H. K., Holkup, P. A., & Buckwalter, K. C. (2001). The experience of caring for a family member with Alzheimer’s disease. Western Journal of Nursing Research, 23(1), 33-55. Day, J. R., Anderson, R. A., & Davis, L. L. (2014). Compassion fatigue in adult daughter caregivers of a parent with dementia. Issues in mental health nursing, 35(10), 796-804. Gaugler, J. E., Reese, M., & Mittelman, M. S. (2015). 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