Managing a depressed and suicidal loved one at home: impact on the family

This qualitative study examined the process families use to care for a depressed and suicidal family member at home. The grounded theory method was used for data collection and analysis. Seventeen family members were interviewed. The data revealed the basic social process of Maintaining Vigilance Through Managing, which depicts an ongoing, cyclical process that begins at a point of not knowing. Family members then move on to identifying, then gaining awareness, followed by knowing or understanding. This allows them to take action, then to proceed to watching and waiting. They then return to gaining awareness armed with new knowledge or understanding. It is at this point that the process becomes cyclical. It varies in intensity over time, depending on the level of depression and the risk for suicide. To preserve the integrity of these families, nurses must help develop strategies to guide them through this process as they care for their depressed and suicidal loved one.     

Parents as caregivers: when a son has AIDS

1. Factors to consider in parental reactions to children with AIDS are the unique relationship of each family member to the affected individual; the difference of the parent's reaction compared with other family members; and the roles that the person with AIDS plays in each individual's life. 2. The debilitation caused by AIDS often leads to regression to earlier developmental stages; parents are confronted with a need to once again provide basic support as they work to attain completion of their own psychosocial tasks. 3. Caring for patients with AIDS presents profound challenges to nursing; nurses must carefully schedule breaks and vacations so that this does not become the focus of all their attention.     

When a family member has an intellectual handicap

Oral histories of ten close relatives of people over the age of 50 defined as intellectually handicapped have been collected as part of the New Zealand Ageing and Intellectual Handicap study. Many of the individuals with intellectual handicap were institutionalized from an early age; some had little or no contact with family members for a very long time; others lived continuously at home. The qualitative data record over 50 years' experience of having a family member with intellectual handicap, from early childhood through to middle or old age, and outline concerns about deinstitutionalisation and the future. It is concluded that families cannot go it alone and that the full participation of people with disabilities in community life and culture depends on well-resourced public policies and programmes of inclusion.     

Non-attendance for health care: When rational beliefs collide

Some patients choose not to attend for health care despite health concerns or an opportunity for improved health. Social norms that privilege professional expertise, and good health, deem this choice irrational. However, this paper explores how a particular version of rational choice theory suggests ‘positive choices’ for such non‐attendance. These are cognitive and subjectively rational decisions, which are made freely with potentially positive consequences and are not social problems if respect for personal autonomy trumps obligations to others. Specifically, Boudon's ‘cognitivist theory of action’ is used to conceptualise non‐attendance as both a rational and irrational choice, from different perspectives. Because the perspective of non‐attendees has been marginalised, the paper also suggests a typology of instrumental and non‐instrumental ‘strong reasons’ for rational non‐attendance. This may help groups such as professionals to understand and accept that non‐attendance can be subjectively rational, without relinquishing their own perspective that it is irrational. Acceptance of the defensibility, if not the rightness, of the perspective of non‐attendees is needed to show respect for non‐attendees' moral agency and to begin to repair relationships with these individuals, who may seek help from health professionals in the future.     

AIDS: developing a primary health care task force

As the number of people with AIDS increases, the number of people impacted by the AIDS crisis will also increase. Larger metropolitan areas have already responded to the crisis with various services (Deuchar, 1984); but the disease has yet to fully impact on smaller cities and towns. The formation of community service groups to cope with the AIDS crisis is a virtual necessity in health care preparation for persons with AIDS. The experience of the Fort Wayne AIDS Task Force reflects the potential of any community to utilize the existing resources in the gay and lesbian community, health and social service professions, and among family and friends of persons with AIDS. Consultation and resources are available through local and state boards of health, as well as local social service and health personnel currently dealing with the AIDS crisis.     

When caregivers are in need of care: African-American caregivers' preferences for their own later life care

To “care for one's own” is a cultural expectation within a larger ethic of care in the African-American community. Applied to caregiving of aging elders, this ethic of care emphasizes the importance of providing in-home family care rather than opting for out-of-home placement. This study explores why a subset of African-American caregivers prefer or are open to out-of-home placement over in-home family care if they are no longer able to care for themselves. In-depth interviews with 24 family caregivers are analyzed. Three themes emerged including the desire to “spare our children” the burden associated with caregiving, viewing the next generation of potential caregivers as unequipped for the task, and having no one left to provide care for them.     

When the cost has sunk: Measuring and comparing the sunk-cost bias in autistic and neurotypical persons

This paper measures and compares the sunk-cost bias among autistic adults, and neurotypical controls. Frequent influencing personality traits and task factors affecting the sunk-cost bias such as age, gender, and education level, time spent in the decision task, and the level of sunk cost (e.g., very low, low, moderate, and high), are controlled for in the analysis. Results show that both autistic and neurotypical individuals are subject to the sunk-cost bias, however, with autistic individuals being less affected by this bias. Results also show significant differences among subgroups of autistic and neurotypical individuals, with autistic individuals with more autism traits being less subject to the sunk-cost bias. For individuals with autism, time spent in the decision task is found to be negatively associated to the sunk-cost bias.     

Couple dynamics and attributions when one partner has an acquired hearing loss: implications for couple therapy

We discuss the communication difficulties that many couples face when one partner has a hearing loss. We also discuss the role of attribution theory in understanding the marital distress of these couples. Finally, we offer interventions to support better communication between couples facing the challenges of hearing loss.     

When a scratch becomes 'a scary story': the social construction of micro panics in center-based child care

This study analyzes the everyday world of center‐based child care and the climate of suspicion that permeates that world. Based on four and a half years of participant observation field research and thirty focused interviews with men and women child care workers, the author examines the existence of ‘micro panics’ which occur in child care centers when deviant labels are attached to caregiving acts or activities. Drawing from traditional Moral Panic Theory, this paper demonstrates how the context of suspicion surrounding center based child care and the ‘micro panics’ that sustain it are generated historically, structurally, and interactionally. These phenomena, in other words, are in part, a historical artifact from the 1980s moral panics concerning day care abuse, an interactional product of the gendering of child care as ‘women's work’, and a phenomenological byproduct of the positioning of paid child care in the everyday lives of workers, children, and parents.     

The impact of AIDS on foster care: a family-centered approach to services in the United States

This article highlights current changes in our understanding of HIV infection in children; examines two central concepts--family-centered care and prevention--for the development of child welfare services; and explores certain implications for foster care for HIV-infected children while reviewing the training needed by foster care personnel and foster parents if they are to provide competent services.     

Dementia & depression in persons with AIDS: causes and care

1. Nurses who care for AIDS patients are challenged to effectively manage two common problems: AIDS dementia complex (ADC) and depression. 2. Nurses can briefly assess certain neuropsychological functions related to ADC and differentiate dementia from depression. 3. Nursing interventions to manage the behaviors associated with ADC and depression can ensure patients' safety and promote the quality of their lives.     

When being overpaid makes me feel good about myself: It depends on how the other feels

The present research examined whether the emotions of others (i.e., disappointment versus happiness with respect to a received outcome) influence own self-esteem when being overpaid. Results from two experiments demonstrated that participants reported higher performance self-esteem when the other expressed happiness rather than disappointment. This effect was only found in the condition where one was overpaid relative to the condition where one did not yet know one’s own outcome. In the second experimental study we further found that this interaction between the emotion of the other and the distribution situation only emerged among participants low (relative to high) in personal need for structure. Implications with respect to the relationship between overpayment and self-esteem and the interpersonal effects of emotions in this process are discussed.