When Dan (80) And Jane (65) Began Dating More ✓ Solved

When Dan (now 80) and Jane (now 65) began dating more

When Dan (now 80) and Jane (now 65) began dating more than 15 years ago, both were emotionally charged to begin their lives anew. Well-educated and financially secure, they had a lot in common. Dan was a Protestant minister, and Jane’s deceased husband had been a Protestant minister. Both had lost their spouses. Jane’s first husband had suffered a catastrophic cerebral aneurysm 2 years earlier.

Dan had conducted the funeral service for Jane’s husband. Dan’s wife had died of terminal cancer a little over a year earlier. Dan’s first wife had been a school counselor; Jane was a school teacher. Both had children in college. They shared a love for travel.

Dan was retired but continued part-time employment, and Jane planned to continue teaching to qualify for retirement. Both were in great health and had more than adequate health benefits. Within the year they were married, summer vacations were spent snorkeling in Hawaii, mountain climbing in national parks, and boating with family. After 7 years, Dan experienced major health problems: a quadruple cardiac bypass surgery, followed by surgery for pancreatic cancer.

Jane’s plans to continue working were dropped so she could assist Dan to recover and then continue to travel with him and enjoy their remaining time together. Dan did recover—only to begin to exhibit the early signs and symptoms of Alzheimer’s disease. One of the early signs appeared the previous Christmas as they were hanging outdoor lights. To Jane’s dismay, she noted that Dan could not follow the sequential directions she gave him.

As time passed, other signs appeared, such as some memory loss and confusion, frequent repeating of favorite phrases, sudden outbursts of anger, and decreased social involvement. Assessments resulted in the diagnosis of early Alzheimer’s disease. Dan was prescribed Aricept, and Jane began to prepare herself to face this new stage of their married life. She read literature about Alzheimer’s disease avidly and organized their home for physical and psychological safety. A kitchen blackboard displayed phone numbers and the daily schedule. Car keys were appropriately stowed.

It was noted that she began to savor her time with Dan. Just sitting together with him on the sofa brought gentle expressions to her face. They continued to attend church services and functions but stopped their regular swims at their exercise facility when Dan left the dressing room naked one day. Within the year, Jane’s retired sister and brother-in-law relocated to a home a short walk from Jane’s. Their intent was to be on call to assist Jane in caring for Dan.

Dan and Jane’s children did not live nearby so could only assist occasionally. As Dan’s symptoms intensified, a neighbor friend, Helen, began to relieve Jane for a few hours each week. At this time, Jane is still the primary dependent-care agent. She prides herself in mastering a dual shower; she showers Dan in his shower chair first, and then, while she showers, he sits on the nearby toilet seat drying himself. Her girlfriends suggested that this was material for an entertaining home video!

Although Jane is cautious in her care for Dan, she often drives a short distance to her neighborhood tennis court for brief games with friends or spends time tending the lovely gardens she and Dan planted. During these times, she locks the house doors and leaves Dan seated in front of the television with a glass of juice. She watches the time and returns home midway through the hour to check on Dan. On one occasion when she forgot to lock the door while she was gardening, Dan made his way to the street, lost his balance, reclined face-first in the flower bed, and was discovered by a neighbor. Jane has given up evenings out and increased her favorite pastime of reading.

Her days are filled with assisting Dan in all of his activities of daily living. And, often, her sleep is interrupted by Dan’s wandering throughout their home. At times, when the phone rings, Dan answers and tells callers Jane is not there. Jane, only in the next room, informs him, “Dan, I am Jane.” Friends are saddened by Dan’s decline and concerned with the burdens and limitations Jane has assumed as a result of Dan’s dependency.

Paper For Above Instructions

The case of Dan and Jane presents a poignant exploration of dependency in later life, deeply intertwined with the psychological and emotional dynamics of caregiving and care-receiving relationships. To understand their experience through the dependency cycle model, one needs to examine the varying degrees of dependency in their relationship over time. The dependency cycle emphasizes that dependency is not static but rather a process of evolving needs that can change based on health conditions, emotional states, and external support.

In the initial stages of their relationship, both Dan and Jane were relatively independent. They had shared life experiences, personal achievements, and social networks that provided them with support and companionship. However, as Dan's health deteriorated, requiring multiple surgeries and eventually the onset of Alzheimer's disease, the balance of their relationship shifted. In the dependency cycle, they can be placed within the engaged and dependent phase, where Jane assumes the role of the primary caregiver, responding to Dan’s increasing needs and vulnerabilities.

According to the basic dependent-care system model, the functioning dynamics within the caregiving relationship can be analyzed through personal conditioning factors that affect both Dan and Jane’s abilities to maintain their self-care agency. These basic conditioning factors (BCFs) include health status, economic stability, social support systems, and individual psychological resilience.

For Dan, his BCFs have shifted dramatically, particularly after his major health crises. The initial health issues led to a loss of physical health, which compounded with the cognitive decline from Alzheimer’s. His self-care agency has been significantly hindered, as indicated by his inability to carry out daily tasks and his increasingly fragile state. Dan’s diagnosis of early Alzheimer’s limits not only his cognitive functioning but also his ability to recognize his own needs and the needs of his caretaker, which leads to a self-care deficit. As described, he struggles with memory loss, confusion, and behavioral symptoms, demonstrating a clear inability to meet his therapeutic self-care demands without assistance.

The self-care deficit diagnosis for Dan is evident: he requires comprehensive support for daily living activities such as bathing, dressing, and management of medication—as well as emotional support to cope with his declining condition. With increasing demands on him, Dan also suffers from an emotional burden, which can manifest as frustration or anger during caregiving interactions, further complicating the dependency dynamic.

In terms of assessing Jane’s self-care system, it is clear that she has transitioned into a role of caregiver with significant responsibilities. Her BCFs include her emotional resilience, social support from her family and friends, and her professional background as a school teacher, which may provide her with some organizational skills. However, the burden of caregiving is intensive and encompasses several challenges such as physical exhaustion, emotional stress, and, increasingly, social isolation. The cumulative effects of these challenges often lead to caregiver burnout, which can affect her physical and mental health.

To address Jane's evolving self-care as she takes on this increased role as a caregiver, a tailored nursing system should be developed that focuses on her needs while enabling her to support Dan effectively. This nursing system should include multiple components:

Education and Support

Provide Jane with resources and workshops about Alzheimer’s care strategies. Support groups can also foster a sense of community among caregivers, alleviating some feelings of isolation.

Respite Care Services

Identifying and utilizing respite care services will help Jane take breaks, reducing burnout. This may involve part-time professional care or volunteer help from community services for short periods.

Health Monitoring

Encouraging regular self-care practices and health monitoring for Jane is essential. This includes physical activity, routine medical check-ups, and emotional health assessments to manage stress levels.

Cognitive Stimulation Activities

Designing activities both Jane and Dan can engage in, such as memory games, reminiscence therapy, and simple outdoor strolls to reconnect them and stimulate Dan’s cognitive function.

Safety Measures

Implementing safety measures in their environment, such as fall prevention protocols and assistive devices, ensures both Dan's safety and provides Jane peace of mind while caring for him.

The nursing system must ultimately support Jane in maintaining her self-care while also addressing Dan’s needs, fostering a holistic approach to their circumstances, and adapting to the progression of dependency inherent in Alzheimer’s care.

References

• Alzheimer's Association. (2023). Alzheimer’s Caregiving: A Guide for Caregivers.
• Schulz, R., & Sherwood, P. (2020). Physical and Mental Health Effects of Family Caregiving.
• Billings, J., & Kauffman, A. (2022). Psychological Resilience and Effect of Caregiving.
• Zarit, S. H., & Higginson, I. J. (2023). Assessment of Caregiver Burden: A Review of the Literature.
• Family Caregiver Alliance. (2023). Understanding Caregiver Health.
• Whitlatch, C. J., & Schmitt, M. (2021). Caregiver Support and Alzheimer’s Disease: A Systematic Review.
• Hepburn, K., et al. (2022). The Role of Family Caregivers in Alzheimer’s Disease Management.
• National Institute on Aging. (2023). Caregiving for a Person with Alzheimer’s Disease or Other Dementias.
• Cohen, L., & Bosworth, H. (2023). Managing Caregiver Stress in Alzheimer's Care.
• Rosenberg, M. (2021). The Impact of Respite Care on Family Caregivers of Individuals with Dementia.