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Alzheimers Disease an Analysis of Primary Caregiving

It affects the nerve cells responsible for storing memories which affects a person’s ability to think, understand, remember, and communicate( Sims & Odle ,2006). It is also considered progressive and irreversible ( Sims & Odle ,2006). This movie is about the stages portrayed through the wonderful love story between Fiona and Grant. In the beginning of the movie, as the disease began to show signs in Fiona, Grant lovingly took on the role of primary caregiver.

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He met all her needs, but he seemed quite and observant on his wife’s changing behaviour. At first they were small things like putting the frying pan in freezer or forgetting her train of thought. It became more disturbing as her memory loss caused her to become lost and disoriented during cross country skiing until Grant could find her. It was at this point that Fiona had pretty much declared it as being in this stage now. By providing in-home care for Fiona, Grant may have been able to have some respite needed in the daily grind of caring for Fiona.

That’s right…prior to her admission, Fiona was independent with her ADLs and was just starting to need help and supervision with her IADLs – she did not need help with her personal care. She could well have stayed at home with minimal formal support until her condition deteriorated As the movie progressed into the next stage, Grant struggled on making the decision on whether or not to move Fiona into a long term care facility. When the patient becomes a danger to oneself is the determining factoring for Grant and Fiona in regards to the skiing incident. Grant did not want to make the ecision and Fiona on her own judgment made the decision for him. v prior to that incident, Grant was not aware that Fiona required supervision – once the limitation in her memory were realized, they could have made concessions to keep her safe at home…perfect example of how the community health care system can fail -2- As Grant moves Fiona into Meadowlake, Grant only wanted to make it a temporary solution for them and they both struggled with the facilities policy on separation for thirty days.

I have to admit I was extremely upset by this. Not only did the Manager of the facility not listen to any of his needs but also minimized his concerns by not acknowledging them. She also demanded a thirty day absence from his wife. Having been married for over forty years, this was to be there first separation. Instead of a gradual transition it was like they threw her to the lions. of note, this 30 day no visitation policy was probably included for cinematic reason – so the film would progress; I am not aware of any facility that would adhere to such a restriction – families would not tolerate that)There was no respect in the amount of change and loss associated with such a big move in their lives. Feelings of abandonment of the loved one and a failure of the family is common ( Sims & Odle ,2006).

Grant would have been an extreme asset to have on hand especially in Fiona’s first days because he simply knows how to care for her, comfort and ensure her specific needs are met (Sorrentino, 2004). He was the primary caregiver and would be an asset to work with the facility as a team member and become part of her care plan, instead of eliminating him as an important part of her care completely for thirty days (Sorrentino, 2004).

I was also upset with the time that Fiona and Grant were saying their goodbyes and when he walked out of Fiona’s room, the passing nurse shot him a look of disgust on zipping his pants up. Every client has the right to privacy and confidentiality and that should be something that every health professional should be respectful of (Sorrentino, 2004). Encouraging affection and to respectively allow privacy in continuing with their normal practices as husband and wife should automatically be given by health professionals in any facility (Sorrentino, 2004). Exactly 3- In the scene where family members were having a holiday supper with their loved ones living in the facility it was well defined the emotions and silence that prevailed after the families went home. Where were the social workers when all was said and done and the clients were left alone? Although these feelings would be normal, a scheduled activity at the time when families were leaving could of helped the clients by simply distracting them. v Fiona has needs like any other human being and when she was left alone for thirty days she looked to fill these needs up with an obsession with another male patient.

Grant showed signs of anger towards Fiona showing affection towards someone else, and for a time throughout the movie, had thought she was doing it on purpose to make him jealous of past wrongs he had done to her. As Grant began to realize that Fiona did not choose to have this illness and therefore does not choose her symptoms or behaviour (Sorrentino, 2004). Grant began to come to terms with his guilt, and in doing so, pursued his own physical and emotional needs through Marianne.

To love and care for someone with AD requires an incredible amount of understanding and self sacrifice…as in this case…the love is not reciprocated…much to the contrary…Grant must watch as his wife bestows her love on another…jealousy, anger, resentment are all sentiments that would be a normal reaction to what appears to be a betrayal…it is only with education and a true understanding of the nature of the disease can a loved one actually cope; and even then, it can be very, very difficult.

When the Manager of the facility abruptly told Grant that Fiona should be up on the second floor due to facility policy, he told her off and became devastated. As a health care professional, discussing the -4- next step should have been done in privacy and not in the facility hallway, and in a more caring and concerned manner (Sorrentino, 2004). It showed a lack of respect for the situation and his feelings for what was to come. A social worker should have been present, or at the very least been offered to him to help cope with his apparent distress at the moment.

Fiona and Grant show only one of the many situations couples and families live on a daily basis with respect to AD. Each client with AD has unique care needs, depending on the stage and the care setting they are in. In Facilities, health care workers are overworked (Sorrentino, 2004). As there is not enough staff to ensure proper individual care, families are responsible in picking up this slack (Sorrentino, 2004). There are so many of Fiona and Grants needs not being met in this movie, which is also true about our own health care system.

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