Question

Based on the core ethical principals we've examined, what would be the major concerns surrounding the below study? Are there particular modifications or clarifications that might alleviate concerns?

Individuals who are responsible for the care-giving of another individual with Alzheimer's Disease (AD) experience high levels of mental stress. A group wishes to study the most effective form of respite or short-term day-care services for caregivers of persons with AD. The study involves use of three groups - two treatment and one control.

One treatment group will be provided 4 hours of "day care" for the AD person, five days per week, giving the caregiver 4 non-care-giving hours on these days. The second treatment group will be provided three 8-hour "day care" sessions per week for the AD person, plus a support group for the caregiver. Caregivers in the control group will not have access to either respite service, but will simply be interviewed every month for the 3-month period of the study to measure stress and coping. Part of the data collection also involves some baseline assessment of each caregiver's AD ward, using mental status tests and obtaining information from medical records.

Answer 1

A patient with Alzheimer's Disease needs proper care and attention especially when it comes to old patients. A caregiver usually have a very hectic schedule and should be very attentive while on work which sometimes leads to fatigue and other chronical issues too.In this case, the first group is supposed to take care of the Alzheimer's Diesease person five days a week for four hours a day and having four non-care hours too ,which seems the first treatment group gets an ample amount of time to have a personal time and have break to get back to their service more enthusiastically. In the case of the second group , the caregivers are alloted eight hours for three days a week and a support group too. Here, the continuous work of eight hours could lead to fatigue for some of the care givers. As the Alzheimer patients needs more attention , it is impossible for a caregiver to take things lightly. So generally , caregivers become so tired that it starts reflecting in their behaviour in a very negative way . Though,in this case care givers are given a support group too but continous work could lead to more  exhaution.

Just think how one feels after attempting an test paper for an hour? Usually, one feels tired. Now think about the caregivers who are addressed to work for eight hours long without any break that too taking care of Alzheimer  patients who need proper attention for each and every second. Now, to find out the major concern one should first know who are care givers? Caregivers work at home, are housewives or retired, and are personally involved in caring for the patients. The greater the level of a patient's cognitive impairment and the less independent they are, the greater amount of care and supervision they require, leaving less free time for the caregiver; this leads to higher levels of anxiety related to caregiving. Toward the final stages of the disease, patient care tasks take up nearly all of the caregiver's free time, leaving them only about two hours per week for themselves or their friends. Therefore , the management of Alzheimer patients  places a particular burden on the caregiver and involves several economic and social costs. The burden becomes heavier as the disease progresses, since the increase of cognitive disorders and the resulting reduction of independence in daily life, together with the onset of behavioral symptoms, heighten the caregiver's distress, anxiety, and depression.For the last group which is the control group it is less effective . They being called after every month for the interview. This group will be less stressed and exhausted from other two groups.

Level of cognitive function and hours of caregiving were directly related to caregiver's burden. Social support, family function and caregiving experience could mediate the relationship between patient factors and caregiver burden. Focusing on patient factors and promoting caregiver care will be helpful in lowering the perceived burden of caregiving. Caregivers must be asked to provide sociodemographic information including age, gender, relationship with the patient,if made or any, level of education, and number of contact which can be a great tool for this experiment . Caregiver burden should also be assesed. The Positive Aspects of Caregiving should also be noted down like the Family Adaptation, Partnership, Growth, Affection, and Resolve, and the Social Support rating scale.The care receivers’ level of cognitive function, physical function, and behavioral problems should be treated  as original stress, the primary appraisal variable must be measured as the number of hours of caregiving in the previous week as decided. Mediator variables must includ perceived social support, family function, and caregiving experience. Path analysis must be used to build the interrelationship among caregiver burden and patient or caregiver factors.