taking care of the caregiver

TAKING CARE OF THE CARE GIVER:

Art as therapy in support groups for women who function as the primary caregivers in the

rehabilitation process of their partners recovering from a stroke/ brain injury.

1

Natalie Nachmani Shohat1,2, Bracha Azoulay1, Einat Shraga-Sharir2, Jean-Jacques Vatine2,3

1Graduate Program in Visual Art Therapy, Lesley University Extension Program, Netanya, Israel. 2Outpatient Rehabilitation Center, Reuth Medical Center, Tel Aviv, Israel. 3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Reuth Medical CenterOur Vision, Our Future

2


Vision: Professional leadership in rehabilitation and post - acute health care with the spirit of ‘Reuth’.

Purpose: Developing and providing medical service in post - acute health care.

The guiding principles: To put the patient and his/her family in the center. Professional leadership and constantly striving for

excellence. Providing professional, personal and humane care.

3

The Spirit of Reuth“All have a right to respect and dignity.”

4

Reuth

•Founded 1936•One of Israel’s oldest and largest non-profit organizations•Specializing in healthcare and social welfare

Reuth Medical Center •Founded 1961•400-bed, state-of-the-art rehabilitation and chronic care public facility•Providing treatment to patients:

From throughout the country and overseas

Of all ages

From all religions and walks of life

A Model for Successful Rehabilitation

Patients• Adults, seniors, soldiers, veterans,terror victims, babies, children, and more are referred to Reuth after treatment in acute care facilities.

Customized Care• Individualized treatment programs• Family involvement encouraged

Treatment• Israel’s leading rehabilitation center• Public hospital treating patients from all health care services.• Affiliated to Sackler School of Medicine, Tel Aviv University.

Staff• 450 professionals• 200 volunteers

5

Purposes of study:

• To understand how ‘art as therapy’ contributes in coping strategies for the caregivers, distinguishing between spouse and a hired caregiver.

• To understand the acclimatization to change in the quality of life for the primary caregiver.

6

TAKING CARE OF THE CARE GIVER

Art as therapy: • Enables the participants to express their

experiences and emotions concerning the changes in the marital relationship after the injury.

• The study addressed the changes in family structure pertaining to roles and responsibilities and how they are expressed through the arts.

7

Subjects: 6 women with a partner recovering from stroke/brain injury and receiving rehabilitation treatment in the outpatient department at Reuth Medical Center.

Inclusion criteria: •Women who function as the primary caregivers during the treatment in the outpatient rehabilitation department.•Age 18 and up•Speaking fluent Hebrew. •No less than 3 months after the injury and at least one month of living at home after the hospitalization.

Exclusion criteria: •Blindness•No less than one well functioning hand•Severe speech disturbances

8


Methodology:

Participants met once a week for 1.5 hours for a period of 6 weeks.

Every session began as a group circle.

After presenting the session topic the participants engaged in a 30-40 minutes of creative time using various art materials. Afterwards, participants had the opportunity to share their experiences.

Questionnaires related to demography, satisfaction and cognitive process were recorded along with the contents raised during the sessions. 9


Topics discussed:

• Group acquaintance• Sharing personal stories• Dependency• Expressing emotions

through images• Finding inner Strength -

Positive Thinking

10


The Setting:

11


A3 paper, gouache paints and feathersParticipant’s thoughts:

“My life has become moments of highs and lows, but time does not reflect their intensity"

12


A3 paper, gouache paints

Participant’s thoughts on dependency:

“Looking at the work I’ve created, I realize how I have become dependent on my children and my grandchildren

since the event”13


Clay and colored toothpicks

Expressing emotions through images,

participant’s thoughts:

“Sometimes I feel like I’m on a journey of obstacles” 14


clay

By working with the materials, the participant was able to express the “crappy” difficult issues

that are part of being the primary caregiver. 15


Cardboard cutout puzzle, decorated with a variety of materials

The final session where each participant received a part of the puzzle, symbolizing their part in the

group.16


Results:

•The art group therapy formulated for the purpose of this study meets a primary need. •Addressing the spouses as caregivers during the rehabilitation process provided visibility, recognition and emotional support. •The setting provided a non-judgmental environment which enabled the participants to share their personal issues and difficulties regarding the rehabilitation process.

17


Results: • By the use of art, participants were able to express and unload their burdens and issues which were difficult to express verbally, enabling spontaneous expressions.

• As a result of sharing a common experience, participants were exposed to different coping strategies and were able to learn from one another’s experience and gain a sense of togetherness.

18


Conclusions: • There is clear advantage in adding

expressive therapies as a standard in the medical tool box.

• Addressing not only the patient but also his familial environment is an important step for the reintegration of the disabled in the community.

• A Rehabilitation Department working fundamentally with a holistic interdisciplinary approach is a privileged place to develop the use of art as therapy.

19


In the Future

Looking forward to opening new support groups and to make this program permanent in the rehabilitation process supporting the primary caregivers.

20


21

taking care of the caregiver

Health & Medicine

humane care

care givermethodology

care giverart

rehabilitation treatment

acute care facilities

health care services

post acute health care

reuth medical centerour