Families and Their Elderly Dependents. Philadelphia, JB Lippincott Co, 1 988, video tape.
This video has two basic foci. The first devotes itself to explanations of family feelings and family dynamics encountered when one of the members must be placed in a nursing home, and the second focuses on how staff can help families overcome the problems that occur within family relationships at this ti me.
In speaking about family dynamics, Virginia Brooke, RN, who narrates this film, illustrates her points by having the players act out some of the usual situations that can arise, including the feelings of guilt and the reworking of old, unresolved problems. Brooke emphasizes that although it is the individual patient who has come to the nursing home, it is the family that is the real client. One of the more interesting points is that there is no such thing as role reversal. The parent remains the parent and the child remains the child, even in the face of growing parental disabilities. Because this view is at odds with the beliefs in popular culture and among many health-care providers, more information and discussion would have been cogent to the presentation.
When focusing on staff interventions, Brooke discusses what can be done to help families with a dependent elder overcome family problems and strengthen bonds. The main role of staff, she states, is to remain neutral and to help families accept themselves as they are. Promoting effective communication within families can avert or interrupt destructive communication cycles. The use of therapeutic questions as interventions can help keep clients open to solutions and to effective problem-solving.
Although this film was informative and wefl-played, the family relationships portrayed seem rather unusual. The elderly husband/father being delivered to a nursing home by his wife and daughter seemed to focus almost exclusively on hrs daughter's behavior rather than on his wife's. Even though the wife seemed to be healthy, she was strangely passive, and did not seem to be in the family "decision loop." The authence might have benefited from some explanation of such family dynamics. An additional question concerns the "cast of characters" acting in this video. Why did the makers of this video use actresses instead of actual nurses to demonstrate techniques of care? It would be preferable to have actual nurses, instead of actresses, demonstrating assessments and interventions for the benefit of professional colleagues.