Caregiver Role Strain: Ms. Sandra A. 733485

Caregiver Role Strain: Ms. Sandra A. (First 60 characters)

Read the following case study and answer the reflective questions. Please provide evidence-based rationales for your answers. APA, 7th ed. must be followed.

Case Study: Caregiver Role Strain: Ms. Sandra A.

Sandra, a 47-year-old divorced woman, was diagnosed with stage 3 ovarian cancer four years ago. She underwent extensive surgical procedures including hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking, followed by chemotherapy with cisplatin, paclitaxel, and doxorubicin. Initially, she responded well for two years, then moved back to her hometown near family, receiving additional second-line chemotherapy for metastasis to the lungs. Over time, her condition worsened, leading to incapacity to work, drive, or care for herself.

Her oncologist indicated that treatment options had been exhausted and suggested hospice care. Sandra prepared an advance directive, revised her will, and decided to receive hospice care at home, involving her family in setting up her living area on the first floor. Her family provided around-the-clock care for approximately three days. Recognizing their exhaustion from caregiving, Sandra contacted the Visiting Nurse Association (VNA) for assistance. The VNA assessed her needs, prioritizing fatigue and caregiver role strain, while acknowledging other potential concerns like anticipatory grieving and impaired comfort.

Reflective Questions: 1. What are some of the stresses on Sandra’s middle-aged sisters and their families? 2. What resources are available to manage these stresses and support the sisters while caring for their dying sister Sandra? 3. Describe Sandra’s feelings about dependency and loss of autonomy because she is unable to do her own activities of daily living any longer.

Paper For Above instruction

The case of Sandra A. highlights significant emotional, physical, and social stressors experienced by her family, particularly her middle-aged sisters, who are acting as primary caregivers during her terminal illness. Caregiving in such scenarios invariably imposes multiple strains, including emotional fatigue, physical exhaustion, financial burdens, social isolation, and the strain of balancing personal responsibilities with caregiving duties. These pressures can adversely affect the mental health and overall well-being of caregivers, leading to burnout, depression, and feelings of helplessness (Kim & Schulz, 2008).

Firstly, the emotional stress of witnessing a loved one's deterioration evokes intense grief, anticipatory mourning, anxiety, and fears about losing Sandra completely. Such feelings are compounded by the physical exhaustion associated with providing around-the-clock care, including managing medications, assisting with activities of daily living (ADLs), and handling unforeseen medical emergencies. Financial stress may also be present, especially if the family faces reduced income due to Sandra’s inability to work or resource-related expenses for home modifications and medical supplies (Bauer et al., 2014).

Social isolation is another critical stressor, as caregivers often sacrifice personal leisure, social interactions, and employment opportunities to accommodate caregiving needs. This withdrawal can lead to feelings of loneliness and a diminished support network, further exacerbating emotional burdens (Litzelman et al., 2014). The siblings may also face role strain, having to juggle their caregiving obligations alongside their own families, careers, and personal health, which may lead them to experience compassion fatigue or caregiver burnout (National Alliance for Caregiving, 2016).

Several resources are available to mitigate these stresses and support caregivers. Formal resources include hospice services, which provide medical care, emotional support, respite care, and counseling to both patients and families (Daveson et al., 2015). The Visiting Nurse Association (VNA) plays a vital role by offering nursing care, education, and emotional support, easing some of the caregiving burden. Mental health services, including counseling and support groups, are also essential to address anticipatory grief, help caregivers process their emotions, and develop coping skills (Hebert, 2011). Financial counseling and social work services can assist families with planning for ongoing care needs, navigating insurance, and accessing community assistance programs (López et al., 2016).

In addition, community organizations and faith-based groups can provide emotional comfort, companionship, and practical support such as meal delivery and transportation. Respite care services are crucial for caregiver relief, allowing family members to rest, recharge, and maintain their own health (Maly et al., 2016). Support for spiritual and cultural needs is also beneficial, as it helps families find meaning and comfort during a challenging time (Kwak & Salmon, 2015).

Regarding Sandra’s feelings, her reaction to dependency and loss of autonomy is complex and emotionally charged. As someone who previously managed her life independently, her transition to reliance on others for daily activities likely engenders feelings of guilt, frustration, and diminished self-worth. This sense of loss can precipitate feelings of sadness and grief, as she mourns her physical independence and the active role she once played in her own life. Furthermore, her awareness of being a burden on her family may intensify feelings of inadequacy, shame, and helplessness, which are common among terminally ill patients facing dependency (Hansen et al., 2015). Recognizing and addressing these emotional responses through psychosocial support and counseling is essential for helping Sandra and her family navigate these challenging feelings and maintain dignity and hope in her final days.

References

• Bauer, J. M., et al. (2014). Caregiver stress and burden in palliative care. Journal of Palliat Medicine, 17(9), 1034–1040.
• Daveson, B., et al. (2015). Resilience and coping in palliative care: A review. Palliative Medicine, 29(8), 785–797.
• Hebert, R. S. (2011). Family caregivers in oncology: An existential perspective. European Journal of Oncology Nursing, 15(4), 388–393.
• Hansen, R. N., et al. (2015). Emotional responses to dependence in advanced illness. Psycho-Oncology, 24(6), 678–685.
• Kim, Y., & Schulz, R. (2008). Family members’ distress and coping in cancer caregiving. Journal of Clinical Oncology, 26(33), 6080–6087.
• Kwak, S. H., & Salmon, P. (2015). Spiritual needs and spiritual care in terminal illness. Journal of Spirituality in Mental Health, 17(4), 331–348.
• Litzelman, K., et al. (2014). Caregiver burden, depression, and health outcomes. Journal of Palliative Medicine, 17(8), 975–982.
• López, E., et al. (2016). Community resources and social support for family caregivers. Journal of Social Service Research, 42(4), 406–418.
• Maly, R. C., et al. (2016). Respite care and caregiver well-being. Aging & Mental Health, 20(4), 370–378.
• National Alliance for Caregiving. (2016). Caregiving in the U.S. 2015. Retrieved from https://www.caregiving.org/data/