The Primary Care Companion for CNS Disorders

CME Institute

Home | About Us | Mission Statement | All CME Activities | MyCME | CME Facebook | CME Twitter

JCP

Home | About JCP | Subscribe | Archive | Information for Authors | Information for Reviewers | Information for Advertisers | CNS Job Market | Customer Service | JCP Facebook | JCP Twitter

PCC

Home | About PCC | Register | Archive | Information for Authors | Information for Reviewers | PCC Facebook | PCC Twitter

Help

FAQ | About Psychiatrist.com | Terms of use | Privacy policy

magnifying glass for search

  • magnifying glass for search
  • Advanced Search

Login

Login  
Login | Login Help | Register | Subscribe
Register | Elerts

Quick Links

Font: A | A | A

Top

Purchase PDF

Vol 19, No 5
Table of Contents

Facebook ShareShare

twitter shareTweet This

envelope iconEmail a link

Related ►

Related Articles

[X]

<p class="frontmatter-fieldnotes disclaimernew" style="margin-bottom:15px;">This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s <a href="/pages/termsofuse.aspx" target="_blank">Terms & Conditions</a>.</p> <div id="_idContainer000">
<img src="/PublishingImages/2011_psychotherapy_casebook.gif">
  <p class="title-left"><span class="bold"><a id="_idTextAnchor000"></a>Aftermath</span></p>
  <p class="byline-regular">Dean Schuyler, MD</p>
  <div id="abstract"><img src="/publishingimages/new_articles/grey_side_rule.jpg" alt="Vertical divider" />
    <p class="subheads-abstract-head"><span class="bold">EDITOR’S NOTE</span></p>
    <p class="abstract-text">Through this column, we hope that practitioners in general medical settings will gain a more complete knowledge of the many patients who are likely to benefit from brief psychotherapeutic interventions. A close working relationship between primary care and psychiatry can serve to enhance patient outcome.</p>
    <p class="abstract-text"><span class="bold">Dr Schuyler</span> is a psychiatrist and a member of the palliative care team at the Ralph H. Johnson Veterans Administration Medical Center, Charleston, South Carolina</p>
    <p class="abstract-citation"><span class="italic">Prim Care Companion CNS Disord 2017;19(5):17f02204</span></p>
    <p class="doi-line"><span class="italic">https://doi.org/</span><span class="doi">10.4088/PCC.17f02204</span></p>
    <p class="abstract-copyright"><span class="italic">© Copyright 2017 Physicians Postgraduate Press, Inc.</span></p>
    <p class="front-matter first"><span class="bold-italic">Published online:</span> September 21, 2017.</p>
    <p class="front-matter"><span class="bold-italic">Corresponding author:</span> Dean Schuyler, MD, Geriatrics/Extended Care, Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401 <span class="hyperlink">(<a href="mailto:deans915@comcast.net">deans915@comcast.net</a>)</span>.</p>
    <p class="front-matter"><span class="bold-italic">Funding/support:</span> None.</p>
    <p class="front-matter"><span class="bold-italic">Potential conflicts of interest:</span> None.</p>
  </div>
  <p class="drop-cap-with-body-text"><span class="bold-14pt-for-cap"><span class="bold">T</span></span>here are caretakers who devote a significant part of their lives to taking care of a spouse at the end of life. Some are young and will live for a great many years after losing a spouse. Some are older and will also live for quite a few years on their own. The track record of a spouse who loses a lifelong partner is not a good one—many die in the year that follows a spouse’s death.</p>
  <p class="body-text">It becomes incumbent on the survivor to establish a new identity once relieved of the responsibility of taking care of a dying spouse. This is easier said than done. It is tempting to return to ways of spending time that have worked in the past, but for many, this is no longer possible.</p>
  <p class="body-text">Helping a formerly married partner adjust to the changes that life brings is a worthwhile endeavor. Assigning a therapist to a former caretaker makes abundant sense. I spoke with a woman who made caring for her dying husband her number one priority. Once he had passed on, there was a new agenda for me and for her: figuring out how to spend the rest of her life.</p>
  <p class="subheads_subhead-1-left"><span class="bold">PSYCHOTHERAPY</span></p>
  <p class="body-text">Mrs A is a 50-year-old woman married for 30 years to her husband who recently died of a medical illness. They had 2 children who were now  grown and married. Mrs A lived to “please others.” The only person she had provided care for was her husband. However, this task had taken up most of her free time.</p>
  <p class="body-text">Born in the Midwest of the United States, she was the oldest child of 2 in her family. Her father was a lawyer, and her mother taught school. Mrs A graduated from high school and met and married her husband soon thereafter. They had many happy years together. She had played and watched sports as a young girl and had developed a talent for knitting and sewing.</p>
  <p class="body-text">Since her husband’s death, she has received requests for help from a wide circle of friends. She has tried to be available to anyone who has a need for help. One concern in treating Mrs A is the need for her to develop some alternatives to life as a caretaker. Her husband was ill for a period of 5 years, and she took care of him while continuing her office job. She rarely missed a day of work despite having a rather structured existence at home.</p>
  <p class="body-text">Her children are concerned with her reaction to the changes in her life. They have warned her not to continue caretaking activity now that her primary responsibility has ended.</p>
  <p class="body-text">We spoke about some of the reactions she has received from friends who have asked her for help. She spoke about “being seen as selfish” when she felt she had to turn them down. She spent some time initially alone in the house. It went rather well. I made clear to her that she would now be responsible for her own life. I spoke in some detail about the new life stage she was about to begin.</p>
  <p class="body-text">I stressed the importance of her finding something meaningful to occupy her time. I committed myself to working with her to determine an identity separate from that of her husband. She is very likely to have many years to live and lots of space to occupy. We made a next appointment to continue exploring her options.</p>
</div>
Manage Subscriptions
/_layouts/images/ReportServer/Manage_Subscription.gif
/PCC/article/_layouts/ReportServer/ManageSubscriptions.aspx?list={ListId}&ID={ItemId}
0x80
0x0
FileType
rdl
350
Manage Data Sources
/PCC/article/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
rdl
351
Manage Shared Datasets
/PCC/article/_layouts/ReportServer/DatasetList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
rdl
352
Manage Parameters
/PCC/article/_layouts/ReportServer/ParameterList.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
353
Manage Processing Options
/PCC/article/_layouts/ReportServer/ReportExecution.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
354
Manage Cache Refresh Plans
/PCC/article/_layouts/ReportServer/CacheRefreshPlanList.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
355
View Report History
/PCC/article/_layouts/ReportServer/ReportHistory.aspx?list={ListId}&ID={ItemId}
0x0
0x40
FileType
rdl
356
View Dependent Items
/PCC/article/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsds
350
Edit Data Source Definition
/PCC/article/_layouts/ReportServer/SharedDataSource.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsds
351
View Dependent Items
/PCC/article/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
smdl
350
Manage Clickthrough Reports
/PCC/article/_layouts/ReportServer/ModelClickThrough.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
smdl
352
Manage Model Item Security
/PCC/article/_layouts/ReportServer/ModelItemSecurity.aspx?list={ListId}&ID={ItemId}
0x0
0x2000000
FileType
smdl
353
Regenerate Model
/PCC/article/_layouts/ReportServer/GenerateModel.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
smdl
354
Manage Data Sources
/PCC/article/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
smdl
351
Load in Report Builder
/PCC/article/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderModelContext&list={ListId}&ID={ItemId}
0x0
0x2
FileType
smdl
250
Edit in Report Builder
/_layouts/images/ReportServer/EditReport.gif
/PCC/article/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderReportContext&list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
250
Edit in Report Builder
/PCC/article/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderDatasetContext&list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsd
250
Manage Caching Options
/PCC/article/_layouts/ReportServer/DatasetCachingOptions.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsd
350
Manage Cache Refresh Plans
/PCC/article/_layouts/ReportServer/CacheRefreshPlanList.aspx?list={ListId}&ID={ItemId}&IsDataset=true
0x0
0x4
FileType
rsd
351
Manage Data Sources
/PCC/article/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
rsd
352
View Dependent Items
/PCC/article/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsd
353
Compliance Details
javascript:commonShowModalDialog('{SiteUrl}/_layouts/itemexpiration.aspx?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/hold.aspx?ID={ItemId}&List={ListId}'); return false;} if(pageid == 'audit') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/Reporting.aspx?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/expirationconfig.aspx?ID={ItemId}&List={ListId}'); return false;}}, null); return false;
0x0
0x1
ContentType
0x01
898
Document Set Version History
javascript:SP.UI.ModalDialog.ShowPopupDialog('{SiteUrl}/_layouts/DocSetVersions.aspx?List={ListId}&ID={ItemId}')
0x0
0x0
ContentType
0x0120D520
330
Send To other location
javascript:GoToPage('{SiteUrl}/_layouts/docsetsend.aspx?List={ListId}&ID={ItemId}')
0x0
0x0
ContentType
0x0120D520
350

Information Links

Terms of Use | Privacy Policy | Information for Authors (JCP) | Information for Authors (PCC) | Reprints and Permissions | CNS Job Market | Information for Advertisers | Media Relations | PPP COVID-19 Statement

Help

Contact us | Unsubscribe from Elerts | Customer Service | FAQ | About JCP | About PCC | About Psychiatrist.com

Our Family of Sites

Psychiatrist.com | The Journal of Clinical Psychiatry | The Primary Care Companion | The CME Institute | Strong Veterans
Anonymous