Recognizing The Family Caregiver: Integral And Formal Members Of The Rehabilitation Process

Timothy R. Elliott Richard M. Shewchuk

In the article, "Recognizing the Family Caregiver: Integral and Formal Members of the Rehabilitation Process" by Timothy R. Elliot and Richard M. Shewchuk, the authors discuss how more responsibility has shifted to the family of people with disabilities and the problems that these caregivers encounter.

The article is geared toward people with spinal cord injuries however, families of TBI patients will benefit from reading this article. The problems are similar in both types of injuries.

The article touches on five different aspects of caregiving.

1) The personal costs of caregiving. 
2) Caregiving and adjustment to physical disability. 
3) Ethnic and minority issues in caregiving. 
4) Integrating the caregiver in the rehabilitation process.

The first part of the article discusses how, with the onset of a disability, the family is forced to take on new roles and greater responsibility. This causes high levels of stress in an already stressful situation.

Caregivers are sometimes forced to give up their own needs in order to care for a loved one. The caring for someone and constantly giving up ones own personal interests can affect the caregiver both physically and emotionally which, in turn affects the patient. The article also notes that there are not only personal costs to the caregiver, but financial costs also (no longer being able to work).

The second part of the article notes how caregivers need to be aware of their own feelings, judgments, and different ways of reacting to the patients' behavior.

The article states that caregivers must take care of their own physical and emotional health in order to provide care to their loved one.

The article suggests that ethnicity and cultural issues play a role in caregiving as well. In society today, we have many different types of families. Some cultures tend to have extended and blended families, which can offer more support to the caregiver. Some cultures also view caregiving as an expected family function that can put added pressure and stress on the family.

The last part of the article stresses the importance of having the family involved in the rehabilitation process. Not just having the family involved at the time of discharge but integrating the family and the treatment team throughout the rehabilitation process. The authors also note that it is important for the treatment team to understand the patients' needs, but it is also important that they understand the families' (caregivers) needs.

In summary, the article suggests that in our society more and more responsibility is placed on the family to provide care. Due to lack of government resources and appropriate assistance upon discharge, it is important that during the rehabilitation process we provide the family with as much information and training as possible.

For further information, please refer to:
Elliot, Timothy R and Shewchuk, Richard M.  "Recognizing the Family Caregiver: Integral and Formal Members of the Rehabilitation Process". Journal of Vocational Rehabilitation. 123-132 (1997, December)

Submitted by: Noreen Bock, CSW
Social Worker, Jamaica Hospital Medical Center
 The Brady Institute: Traumatic Brain Injury / Coma Recovery