Chapter 6. Issues in Caregiving

SUMMARY

Some 10 to 29% of persons over 65 in the United States are sufficently physically, cognitively, or emotionally impaired to need some level of caregiving from their informal and formal support systems. Unfortunately, there are still some older persons who need care, but care is either not provided, inadequate, or involves some form of mistreatment. This chapter discusses the difficulties of maltreatment and substance abuse.     

Predictors of Burden of Family Caregivers of Women with Substance Use Disorders or Co-Occurring Substance and Mental Disorders

ABSTRACT

This study examined the impact of having a female family member with a substance use or co-occurring disorders on family caregivers. Predictors of subjective burden (worry, stigma, and displeasure) and objective burden (family disruption) on caregivers and on types of burden were explored. Subjects were 82 women receiving substance abuse treatment and their family member providing most social support. Behavioral problems of the recipient and lack of social support for caregivers predicted higher levels of family member burden, with different types of social support predicting different types of burden. Having a dual disorder did not predict family member burden. Implications of findings for treatment are discussed.     

Religiosity as a Predictor of Successful Post-Treatment Abstinence for African-American Clients

ABSTRACT

The purpose of this study was to examine the role of religiosity as a predictor of post-treatment abstinence. A sample of 96 African-American clients receiving community-based outpatient alcoholism treatment were interviewed at treatment entry and three months later. Achieving complete abstinence was predicted from client gender and 17 other predictors, including 6 substance-related factors, 7 psychosocial and health variables, and 4 religiosity/spirituality measures. Bivariate analyses showed that abstainers drank less prior to treatment, had more prior formal treatment and AA involvement, practiced their religion more regularly, and scored higher on measures of both spirituality and extrinsic religiosity. In addition, women were more likely to achieve abstinence. Forward entry binary logistic regression revealed that, controlling for client gender and pre-treatment consumption, only regular practice of one's religion/faith significantly predicted abstinence. Recommendations include (1) the need for research to evaluate if the current findings can be generalized across race/ethnicity and religious affiliation and (2) directing more attention to clients' religiosity in alcoholism treatment.     

Physical Activity as a Helpful Adjunct to Substance Abuse Treatment

ABSTRACT

While limited research exists on the topic of physical activity as an adjunct to substance abuse treatment, a review of relevant multidisciplinary literature indicates a logical rationale for its potential benefits to recovery from addiction. This article provides an overview of common variables that contribute to addictive disease and summarizes the relationship of regular physical activity to improvements on many of these variables. The stages of change from the Transtheoretical Model (TTM, Prochaska & DiClemente, 1982; Prochaska & Velicer, 1997) are described in the context of effectively matching clients in substance abuse therapy to interventions that may include physical activity. Finally, important practical suggestions for implementing physical activity as a useful adjunct to substance abuse treatment are provided.     

Legal and Other Determinants of Effective Court Intervention in Child Protection Proceedings

An outcome standard and measure are proposed for use in assessing the effectiveness of official interventions in child protection proceedings. It is argued that the standard, as operationalized in the variable Rapid Services/Reunion, is responsive to the needs of public policy analysts concerned with child abuse and neglect. Using an inductive multivariate model, the determinants of Rapid Services/Reunion are identified and estimated. These determinants are discussed in the context of the needs of child protection policy. The analysis is based on a random sample of 210 North Carolina child protection cases.     

Counseling for the Family: The Neglected Aspect of Addiction Treatment in Canada

ABSTRACT

There has been a historic neglect of both research and practice in the area of counselling for the family members of alcohol or other drug abusers by the addiction field in Canada. As a result, treatment for individual family members affected by alcoholism and other drug addiction remains a neglected component of the majority of Canadian addiction programs. When family involvement is incorporated, the tendency has been to concentrate on orientation and education rather than on the provision of counseling for the family members. This dearth of programming exists despite the knowledge that an active alcohol or drug abuser's behaviour disrupts the entire family system, including the functioning and development of children. Each family member is uniquely affected with negative outcomes ranging from economic hardship to violence being perpetrated against them to an increased risk among children of becoming alcohol or drug abusers themselves. Thus, treating only the active alcohol or other drug abuser is limiting and an overly narrow orientation for the enhancement of both family and community health.     

柏拉图的“理式”与生物遗传基因－－为柏拉图的“理式论”两千多年来的冤案昭雪

柏拉图哲学中的"理式"与生物遗传方面的"基因"是同一个概念,从而它既是实体也是普遍,是先于任何具体、个别、感性的生命物质而存在的一种形式和质.因此,自亚里士多德开始,两千多年以来人们对于柏拉图的理式论的误解和批判是错误的.     

心性本不二--从《郭店竹简·性自命出》篇论儒家"性"论之特征

在儒家正统哲学中,"性"作为人得以成立之依据,乃是天赋的.这也可以表述为"性善论".<郭店楚简·性自命出>篇的贡献在于,它论证了人性(天性)之实践环节在"心"上,由此形成"心性不二"的天-人关系框架.突出"心"之本体地位,"人道"内在同一于"天道",对"天道"的追求也实践地落实为人道追求;但另一方面,人道实践乃是天道实现的环节,又深刻地区别于"人类中心"的泥淖,从而有助于建立天-人,人-物的合宜关系.     

对目前我国大学“文学概论”课几个问题的思考

从建国至今半个世纪以来,我国大学“文学概论”教科书在有关“社会主义现实主义”和“两结合”创作方法问题、典型理论问题、“文学反映生活”问题和“生活是文学的唯一源泉”问题上,一直显现出理论上的矛盾和学术态度上的雷同或模棱两可,并由此带来一系列的问题,这些问题值得人们去探讨和反思。