Drawing the Line: A Case Study of Ambivalence in Sibling Support for Adults with Complex Needs

University of Calgary , Calgary, Alberta , Canada.
Issues in Mental Health Nursing 11/2012; 33(11):727-34. DOI: 10.3109/01612840.2012.699163
Source: PubMed


The purpose of this article is to illuminate the dynamics of sibling group support when one sibling has complex needs accompanied by difficult behaviors. A case study of sibling support for a twenty-year-old woman with a disability, a mental health issue, and addictions, drawn from the perspectives of her full brother, her half-brother, and their mother, is presented. The brothers express ambivalence between devotion to supporting their sister and limits to the support they feel able to provide. The limits the brothers place on their support allow them to adhere to their values, preserve their energy and, ultimately, sustain their ability to provide support.

Download full-text


Available from: Bonnie Mylinda Lashewicz, May 29, 2014
  • Source
    • "Difficulty achieving collaborations with family caregivers arises as paid caregivers report that some families are absent and/or difficult to involve in the lives of adults with disabilities and/or mental health issues. Family caregivers' own lives may be complicated by financial stress, mental health issues and/or addictions (Lakeman 2008, Lashewicz et al. 2012, Lashewicz in press). Alternatively, paid caregivers working with individuals who have sudden onset disabilities resulting from brain injury indicate that some family caregivers have a pronounced presence in planning and decision-making to the point of being unrealistic and demanding in their expectations . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Our purpose in this paper is to report on the frustrations and unmet needs of paid, formal caregivers and unpaid, family caregivers who together provide care to adults with disabilities and/or mental health issues. We conducted eight focus group interviews between November 2010 and June 2011 in two large, urban centres and one smaller centre in Western Canada. Four of our focus groups were with family members including adults with disabilities and/or mental health issues, their parents and their siblings, and four were with representatives from agencies providing support and services to adults with disabilities and/or mental health issues and their families. Data were collected from 23 family members and 24 agency representatives who responded to questions about successes and struggles in meeting, and collaborating to meet, care needs of adults with disabilities and/or mental health issues. Each focus group session was digitally recorded and transcribed; field notes were also taken and we thematically analysed data according to family versus agency perspectives of their successes and barriers in care provision and care collaboration. We found that family members desire greater and more effective support in enriching the lives of adults with disabilities and/or mental health issues and in preparing for age-related changes. Agency representatives are keenly aware of the needs and challenges faced by families, yet grapple with being effective collaborators with families of widely varying priorities and styles of care and collaboration.
    Full-text · Article · Oct 2013 · Health & Social Care in the Community
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The purpose of this paper is to explore a literature gap--sibling involvement in the care and support of people with schizophrenia, and to make recommendations for filling the gap. Method: The method used was observation and documentation of clinical notes over a ten-year period in an outpatient clinic for women with schizophrenia. Illustrative examples were selected from approximately 200 entries dealing with sibling relationships. Findings: Siblings constitute an important segment of the social network of persons with schizophrenia, although they do not usually take an active part in their brother or sister's care until parents are no longer able to cope alone. The role of primary caregiver appears to be a stressful one for siblings. The closest sibling bonds were those between sisters, and in most cases, the eldest girl in the family assumed the caregiver role. This depended, however, on the family's means, values, and cultural traditions, as well as on the personal attributes and life circumstances of the siblings. Financial, human, and social capital were critical determinants of sibling involvement. Sharing responsibilities and negotiating the distribution of required caretaking tasks was often the most effective way of dealing with the burden of care giving. Conclusion: Although some clinical recommendations can be made, specificities that distinguish this population and the effectiveness of sibling caregiving need to be further researched.
    No preview · Article · Dec 2013 · Psychiatry Interpersonal & Biological Processes
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper provides an account of prevailing conceptualizations of resilience (namely, social–psychological/ecological definitions of resilience) and critiques them using a disability studies approach. We argue that, to date, the concept of resilience is overly prescriptive and constrained by hegemony, positivism, and ability-centrism. When unbounded, resilience may more robustly reflect the complexities of relationships and life processes of those deemed ‘impaired’, and may allow scholars to further interrogate related concepts of ‘risk’, ‘vulnerability’, and ‘disability’. We conclude that individuals deemed ‘impaired’ are marginalized by current definitions of resilience. We point to the value of conceptualizations that incorporate a constructionist orientation and a critical account of risk and vulnerability, and which avoid competency-centrism or ability-centrism.
    No preview · Article · Oct 2014 · Disability & Society
Show more