The Experiences Of A Care Giver

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Families Caring for an Aging America

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 0309448093
Total Pages : 367 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Families Caring for an Aging America by : National Academies of Sciences, Engineering, and Medicine

Download or read book Families Caring for an Aging America written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-11-08 with total page 367 pages. Available in PDF, EPUB and Kindle. Book excerpt: Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

Patient Safety and Quality

Author : Ronda Hughes
Publisher : Department of Health and Human Services
ISBN 13 :
Total Pages : 592 pages
Book Rating : 4.:/5 (318 download)

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Book Synopsis Patient Safety and Quality by : Ronda Hughes

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

A Cast of Caregivers

Author : Sherri Snelling
Publisher : BalboaPress
ISBN 13 : 1452559147
Total Pages : 550 pages
Book Rating : 4.4/5 (525 download)

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Book Synopsis A Cast of Caregivers by : Sherri Snelling

Download or read book A Cast of Caregivers written by Sherri Snelling and published by BalboaPress. This book was released on 2013-01-01 with total page 550 pages. Available in PDF, EPUB and Kindle. Book excerpt: What caregiving role will you play? How will you avoid the caregiving cost drain? Are you prepared for the end? How will you overcome stress, burn-out, depression, guilt? How will you find happiness and support? How do you start the caregiving conversation with a loved one? Are you caring for yourself while caregiving? More than 65 million Americans are caring for a loved one yet most dont know what they are facing or where to get help. Caregiving expert Sherri Snelling shines a spotlight on the world of caregiving and interviews celebrities who have taken the caregiving journey and shared their lessons learned. This how-to guide also covers caregiving topics A to Z, self-care advice and more. Inside you will find numerous expert interviews and tips on how to have the C-A-R-E Conversation and how to find your Me Time Monday. Written to inspire and empower you, this is your screenplay for health and happiness while caregiving. As Dorothy said in The Wizard of Oz, Toto, I have a feeling were not in Kansas anymore. Welcome to the Cast of Caregivers.

The Caregiving Trap

Author : Pamela D. Wilson
Publisher :
ISBN 13 : 9781630475352
Total Pages : 0 pages
Book Rating : 4.4/5 (753 download)

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Book Synopsis The Caregiving Trap by : Pamela D. Wilson

Download or read book The Caregiving Trap written by Pamela D. Wilson and published by . This book was released on 2015-10-06 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The Caregiving Trap" combines the authentic life and professional experience of Pamela D. Wilson, who provides recommendations for overwhelmed and frustrated caregivers who themselves may one day need care. "The Caregiving Trap" includes stories about Pamela's actual personal and professional experience along with end of chapter exercises to support caregivers. Common caregiving issues include: A sense of duty and obligation to provide care that damages family relationships Emotional and financial challenges resulting in denial of care needs Ignorance of predictive events that result in situations of crises or harm Delayed decision making and lack of planning resulting in limited choices Minimum standards of care supporting the need for advocacy

The Unexpected Journey of Caring

Author : Donna Thomson
Publisher : Rowman & Littlefield
ISBN 13 : 1538122243
Total Pages : 257 pages
Book Rating : 4.5/5 (381 download)

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Book Synopsis The Unexpected Journey of Caring by : Donna Thomson

Download or read book The Unexpected Journey of Caring written by Donna Thomson and published by Rowman & Littlefield. This book was released on 2019-06-05 with total page 257 pages. Available in PDF, EPUB and Kindle. Book excerpt: With a foreword by Judy Woodruff, The Unexpected Journey of Caring is a practical guide to finding personal meaning in the 21st century care experience. Personal transformation is usually an experience we actively seek out—not one that hunts us down. Becoming a caregiver is one transformation that comes at us, requiring us to rethink everything we once knew. Everything changes—responsibilities, beliefs, hopes, expectations, and relationships. Caregiving is not just a role reserved for “saints”—eventually, everyone is drafted into the caregiver role. It’s not a role people medically train for; it’s a new type of relationship initiated by a loved one’s need for care. And it’s a role that cannot be quarantined to home because it infuses all aspects of our lives. Caregivers today find themselves in need of a crash course in new and unfamiliar skills. They must not only care for a loved one, but also access hidden community resources, collaborate with medical professionals, craft new narratives consistent with the changing nature of their care role, coordinate care with family, seek information and peer support using a variety of digital platforms, and negotiate social support—all while attempting to manage conflicts between work, life, and relationship roles. The moments that mark us in the transition from loved one to caregiver matter because if we don’t make sense of how we are being transformed, we risk undervaluing our care experiences, denying our evolving beliefs, becoming trapped by other’s misunderstandings, and feeling underappreciated, burned out, and overwhelmed. Informed by original caregiver research and proven advocacy strategies, this book speaks to caregiving as it unfolds, in all of its confusion, chaos, and messiness. Readers won’t find well-intentioned clichés or care stereotypes in this book. There are no promises to help caregivers return to a life they knew before caregiving. No, this book greets caregivers where they are in their journey—new or chronic—not where others expect (or want) them to be.

Alzheimer's/Dementia from the Experiences of a Caregiver

Author : Rev. Frederick Trunk
Publisher : Xulon Press
ISBN 13 : 1619965844
Total Pages : 64 pages
Book Rating : 4.6/5 (199 download)

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Book Synopsis Alzheimer's/Dementia from the Experiences of a Caregiver by : Rev. Frederick Trunk

Download or read book Alzheimer's/Dementia from the Experiences of a Caregiver written by Rev. Frederick Trunk and published by Xulon Press. This book was released on 2012-02 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: If you are a caregiver, or know someone who is, you owe it to yourself to read this book. It is very important to know the phases of Alzheimer's as well as the effects it has, not only on the patient, but on those who care for, or live with the patient. If you know someone who is struggling with the challenge you need to know how to help them. This book will give you insight into the challenges of dementia and Alzheimer's from the prospective of a caregiver who started attending caregivers meetings shortly after he realized that his wife was having unusual challenges and behaviors. Frederick and Marjorie were caregivers for about three years for a couple from their church. They were not able to get satisfactory help from family members or friends so they stepped in and got the appropriate legal Power of Attorney and helped them get into assisted living. We took care of their needs until they passed away. During this period we learned a lot about care giving. Frederick has been caregiver for his wife Marjorie for eleven years. His wish is that the book he has written will get into the hands of those who are just beginning to recognize there is a problem as well as those who may be experiencing many years as a caregiver. He also wants people to know that getting help early on is very important and makes the challenge of care giving much easier. For over forty years Frederick has served as Minister of Music/Organist in eleven churches in New Jersey, Massachusetts and Georgia. He attended Northeastern Bible College and Seminary in Essex Fells, New Jersey, and International Christian College and Seminary in Plymouth, Florida where he earned a Bachelor of Music and a Masters in Ministry.

Long Term Care Services in the United States: 2013 Overview

Author : National Center for Health Statistics
Publisher : Government Printing Office
ISBN 13 : 9780160922619
Total Pages : 108 pages
Book Rating : 4.9/5 (226 download)

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Book Synopsis Long Term Care Services in the United States: 2013 Overview by : National Center for Health Statistics

Download or read book Long Term Care Services in the United States: 2013 Overview written by National Center for Health Statistics and published by Government Printing Office. This book was released on 2014-03 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: Long-term care services include a broad range of services that meet the needs of frail older people and other adults with functional limitations. Long-Term care services provided by paid, regulated providers are a significant component of personal health care spending in the United States. This report presents descriptive results from the first wave of the National Study of Long-Term Care Providers (NSLTCP), which was conducted by the Centers for Disease Control and Preventions National Center for Health Statistics (NCHS). This report provides information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional composition of users of these services. Service users include residents of nursing homes and residential care communities, patients of home health agencies and hospices, and participants of adult day services centers.

The Caregivers

Author : Nell Lake
Publisher : Simon and Schuster
ISBN 13 : 1451674163
Total Pages : 336 pages
Book Rating : 4.4/5 (516 download)

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Book Synopsis The Caregivers by : Nell Lake

Download or read book The Caregivers written by Nell Lake and published by Simon and Schuster. This book was released on 2014-02-11 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: A moving, intimate, and compassionate book that chronicles the experiences of a group of long-term caregivers—spouses, parents, and friends of the elderly and ill—illuminating critical issues of old age, end-of-life care, medical reform, and social policy—and “providing comfort in the time-honored form of shared experience” (The Minneapolis Star-Tribune). In 2010, journalist Nell Lake began sitting in on the weekly meetings of a local hospital’s caregivers support group. Soon members invited her into their lives. For two years, she brought empathy, insight, and an eye for detail to understanding Penny, a fifty-year-old botanist caring for her aging mother; Daniel, a survivor of Nazi Germany who tends his ailing wife; William, whose wife suffers from Alzheimer’s; and others with whom all caregivers will identify. Witnessing acts of devotion and frustration, lessons in patience and in letting go, Lake illuminates the intimate exchanges of caregiving and care-receiving and considers important and timely social issues: How can we care for the aging, ill, and dying with skill and compassion, even as the costs and labors of care increase? How might the medical profession take into account the needs of caregivers as well as patients? In The Caregivers Nell Lake shares a thoughtful and tenderly reported depiction of the real-life predicaments that evoke these crucial questions. With more and more people spending their late years ill and frail, and 43 million Americans already caring for family members over age fifty, this is an important chronicle of a widely shared experience and a public concern. “The Caregivers is as elegantly constructed as a novel, but more than that, Lake writes about these people with such warmth and vividness that they feel as memorable as our favorite fictional characters. It is a beautifully written account” (The Boston Globe).

Taking Care of Our Own

Author : Sherry N. Mong
Publisher : Cornell University Press
ISBN 13 : 1501751468
Total Pages : 217 pages
Book Rating : 4.5/5 (17 download)

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Book Synopsis Taking Care of Our Own by : Sherry N. Mong

Download or read book Taking Care of Our Own written by Sherry N. Mong and published by Cornell University Press. This book was released on 2020-10-15 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mixing personal history, interviewee voices, and academic theory from the fields of care work, the sociology of work, medical sociology, and nursing, Taking Care of Our Own introduces us to the hidden world of family caregivers. Using a multidimensional approach, Sherry N. Mong seeks to understand and analyze the types of skilled work that family caregivers do, the processes through which they learn and negotiate new skills, and the meanings that both caregivers and nurses attach to their care work. Taking Care of Our Own is based on sixty-two in-depth interviews with family caregivers, home and community health care nurses, and other expert observers to provide a lens through which in-home care processes are analyzed, while also exploring how caregivers learn necessary procedures. Further, Mong examines the emotional labor of caregiving, as well as the identities of caregivers and nurses who are key players in the labor process, and gives attention to the ways in which the labor is transferred from medical professionals to family caregivers.

Already Toast

Author : Kate Washington
Publisher : Beacon Press
ISBN 13 : 0807011754
Total Pages : 224 pages
Book Rating : 4.8/5 (7 download)

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Book Synopsis Already Toast by : Kate Washington

Download or read book Already Toast written by Kate Washington and published by Beacon Press. This book was released on 2021-03-16 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: The story of one woman’s struggle to care for her seriously ill husband—and a revealing look at the role unpaid family caregivers play in a society that fails to provide them with structural support. Already Toast shows how all-consuming caregiving can be, how difficult it is to find support, and how the social and literary narratives that have long locked women into providing emotional labor also keep them in unpaid caregiving roles. When Kate Washington and her husband, Brad, learned that he had cancer, they were a young couple: professionals with ascending careers, parents to two small children. Brad’s diagnosis stripped those identities away: he became a patient and she his caregiver. Brad’s cancer quickly turned aggressive, necessitating a stem-cell transplant that triggered a massive infection, robbing him of his eyesight and nearly of his life. Kate acted as his full-time aide to keep him alive, coordinating his treatments, making doctors’ appointments, calling insurance companies, filling dozens of prescriptions, cleaning commodes, administering IV drugs. She became so burned out that, when she took an online quiz on caregiver self-care, her result cheerily declared: “You’re already toast!” Through it all, she felt profoundly alone, but, as she later learned, she was in fact one of millions: an invisible army of family caregivers working every day in America, their unpaid labor keeping our troubled healthcare system afloat. Because our culture both romanticizes and erases the realities of care work, few caregivers have shared their stories publicly. As the baby-boom generation ages, the number of family caregivers will continue to grow. Readable, relatable, timely, and often raw, Already Toast—with its clear call for paying and supporting family caregivers—is a crucial intervention in that conversation, bringing together personal experience with deep research to give voice to those tasked with the overlooked, vital work of caring for the seriously ill.

Profiles in Caregiving

Author : Carol S. Aneshensel
Publisher : Elsevier
ISBN 13 : 0080539831
Total Pages : 406 pages
Book Rating : 4.0/5 (85 download)

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Book Synopsis Profiles in Caregiving by : Carol S. Aneshensel

Download or read book Profiles in Caregiving written by Carol S. Aneshensel and published by Elsevier. This book was released on 1995-09-15 with total page 406 pages. Available in PDF, EPUB and Kindle. Book excerpt: Given medical advances and greater understanding of healthful living habits, people are living longer lives. Proportionally speaking, a greater percentage of the population is elderly. Despite medical advances, there is still no cure for dementia, and as elderly individuals succumb to Alzheimer's Disease or related dementia, more and more people are having to care their elderly parents and /or siblings. Profiles in Caregiving is practical source of information for anyone who teaches caregiving, acts as a caregiver, or studies caregiving. This book discusses recent research on stress factors associated with caregiving, and what factors impact on successful versus non-successful adaptation to the care-giving role. This is an expanding field in gerontology, and is also of interest to personality and social psychologists studying stress and interpersonal relations. Although there are many books on the cause and treatment of dementia, there has been a book that provides a research investigation into the factors associated with effective caregiving to dementia patients. - Conceptualizes caregiving as a multistage career whose impact on the caregiver continues to be felt after in-home care has ceased - Based upon a longitudinal survey of a demographically diverse sample of principal caregivers over a three-year period - Identifies caregivers who are most at-risk for adverse adaptation to the role - Describes preventative and clinical intervention strategies - Identifies post-care risk and issues - Identifies antecedents to successful adaptation - State of the art analytic techniques - Graphic presentation of empirical findings - Renowned multidisciplinary research team

The Emotional Survival Guide for Caregivers

Author : Barry J. Jacobs
Publisher : Guilford Press
ISBN 13 : 1606237934
Total Pages : 273 pages
Book Rating : 4.6/5 (62 download)

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Book Synopsis The Emotional Survival Guide for Caregivers by : Barry J. Jacobs

Download or read book The Emotional Survival Guide for Caregivers written by Barry J. Jacobs and published by Guilford Press. This book was released on 2006-03-17 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: Caring for a parent whose health is in decline turns the world upside down. The emotional fallout can be devastating, but it doesn't have to be that way. Empathic guidance from an expert who's been there can help. Through an account of two sisters and their ailing mother--interwoven with no-nonsense advice--The Emotional Survival Guide for Caregivers helps family members navigate tough decisions and make the most of their time together as they care for an aging parent. The author urges readers to be honest about the level of commitment they're able to make and emphasizes the need for clear communication within the family. While acknowledging their guilt, stress, and fatigue, he helps caregivers reaffirm emotional connections worn thin by the routine of daily care. This compassionate book will help families everywhere avoid burnout and preserve bonds during one of life's most difficult passages.

The Soul of Caregiving (Revised Edition): A Caregiver's Guide to Healing and Transformation

Author : Edward M. Smink
Publisher : Wise Media Group
ISBN 13 : 9781629672243
Total Pages : 228 pages
Book Rating : 4.6/5 (722 download)

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Book Synopsis The Soul of Caregiving (Revised Edition): A Caregiver's Guide to Healing and Transformation by : Edward M. Smink

Download or read book The Soul of Caregiving (Revised Edition): A Caregiver's Guide to Healing and Transformation written by Edward M. Smink and published by Wise Media Group. This book was released on 2021-10-28 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: 2022 Revised Edition Who are the caregivers? We all are, for at the heart of being human is the capacity to care, to reach out to others and explore the relationships we build. The Soul of Caregiving is about us, and how we, as caregivers, serve, even sacrifice, for those in need. I invite you to explore with me how we can partake in a kind of sacred journey exploring our experiences as caregivers. Who will be your guide on this journey? Unlike other pilgrims who have a guide assigned to them, you will soon discover it is your own Soul guiding you. We may be professionally skilled to meet the needs of others, but we must also learn to stop and rest. It is not a waste of time, but rather, a necessity. We need time to ponder, reflect, and grow from our experiences. Not an easy endeavor amid a whirlwind of activity. We, as caregivers, experience vulnerability, helplessness, fears, and pain over the traumatic events we experience because we care. We care about those whom we are called to serve. Compassion fatigue arises because we care. Overview of the Chapters Chapter 1 begins by outlying the tension most caregivers experience: the tension their own needs and the needs of those they care for. I call this tension the Dance of Caregiving. Chapter 2 discusses the importance of discovering interior strengths and values where one discovers Soul. Chapter 3 emphasizes caregivers do not care in a vacuum, as there are broad cultural boundaries and expectations which affect them and shape their behaviors. Chapter 4 describes The Archetype of Caregiving, both its strengths and shadow sides. This archetype also relates to several other leadership archetypes, which are also discussed. Chapter 5 discusses hospitality. This chapter positions the caregiver as the host who experiences three different dimensions of hospitality: to host the stranger, to listen to the stories of the guest, and to reflect on their reactions and experiences. Chapter 6 address the frailty of humankind and the notion that we are wounded healers. Chapter 7 addresses the art of reflection as a fundamental skill for caregivers. Chapter 8 argues that the essential actions of a caregiver are spiritual. Chapter 9 explores how the ordinary becomes spiritual as inner strengths and values give birth to meaning, insight, and transformation. Chapter 10 explores compassion fatigue and its two sisters, secondary traumatic stress disorder and burnout. In this chapter, we learn how to recover from compassion fatigue and burnout by building compassion resilience. At the end of each chapter, the reader is invited to ponder and reflect. Your insights are the gold hidden beneath the sands of confusion. Mining these insights will lead to a greater understanding of your strengths and values. The questions at the end of each chapter help facilitate this process.

The Caregiving Journey: Information. Guidance. Inspiration.

Author : Debbie Howard
Publisher :
ISBN 13 : 9780692429310
Total Pages : 248 pages
Book Rating : 4.4/5 (293 download)

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Book Synopsis The Caregiving Journey: Information. Guidance. Inspiration. by : Debbie Howard

Download or read book The Caregiving Journey: Information. Guidance. Inspiration. written by Debbie Howard and published by . This book was released on 2018-11-22 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: Our world is currently experiencing a global Caregiving Crisis. If you, like so many others, are increasingly concerned about your loved one's needs as they age, then ask yourself the following questions: How does your loved one see their life playing out? Where do they want to live as they age (in their own home vs. assisted living)? What kind of health do they aspire to be in? What kinds of activities do they want to engage in? If and when your loved one can no longer live independently, what is their preference (i.e., paid in-home help, assisted living or nursing facility)? Is their preference realistic considering their financial situation, and if not, what are the feasible alternatives? The Caregiving Journey goes far beyond the basics of wills and logistical funeral plans-basics many people have in place (especially where children are involved). Rather, you'll be guided and supported to create a well-thought-out plan for those three, five or even 10 or more years when your loved one needs your help because they can no longer live on their own. With the inspiration, practical steps, support, and tools provided inside these pages, you'll be well-equipped to guide your family members and loved ones to the end of their lives with love, ease and grace.Bringing together her 30+ years as a professional market analyst and her personal experience as a live-in caregiver for her mom, author Debbie Howard has integrated her experiences-along with the journeys of over 200 other caregivers-into this book to help you choose your best way forward. Learn more at www.theCaregivingJourney.com.

Chicken Soup for the Caregiver's Soul

Author : Jack Canfield
Publisher : Simon and Schuster
ISBN 13 : 1453279121
Total Pages : 274 pages
Book Rating : 4.4/5 (532 download)

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Book Synopsis Chicken Soup for the Caregiver's Soul by : Jack Canfield

Download or read book Chicken Soup for the Caregiver's Soul written by Jack Canfield and published by Simon and Schuster. This book was released on 2012-08-07 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: A dose of inspiration for caregiving professionals and the millions of souls who help care for family and friends.

Collaborative capacity development to complement stroke rehabilitation in Africa

Author : Quinette Louw
Publisher : AOSIS
ISBN 13 : 1928523862
Total Pages : 536 pages
Book Rating : 4.9/5 (285 download)

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Book Synopsis Collaborative capacity development to complement stroke rehabilitation in Africa by : Quinette Louw

Download or read book Collaborative capacity development to complement stroke rehabilitation in Africa written by Quinette Louw and published by AOSIS. This book was released on 2020-12-31 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: This scholarly book focuses on stroke in Africa. Stroke is a leading cause of disability among adults of all ages, contributing significantly to health care costs related to long term implications, particularly if rehabilitation is sub-optimal. Given the burden of stroke in Africa, there is a need for a book that focuses on functioning African stroke survivors and the implications for rehabilitation within the African context. In addition, there is a need to progress with contextualised, person-centred, evidence-based guidance for the rehabilitation of people with stroke in Africa, thereby enabling them to lead socially and economically meaningful lives. The research incorporated in the book used a range of primary and secondary methodological approaches (scoping reviews, systematic reviews, meta-analyses, descriptive studies, surveys, health economics, and clinical practice guideline methodology) to shed new insights into African-centred issues and strategies to optimise function post-stroke.

Helping Yourself Help Others

Author : Rosalynn Carter
Publisher : University of Arkansas Press
ISBN 13 : 1682262340
Total Pages : 259 pages
Book Rating : 4.6/5 (822 download)

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Book Synopsis Helping Yourself Help Others by : Rosalynn Carter

Download or read book Helping Yourself Help Others written by Rosalynn Carter and published by University of Arkansas Press. This book was released on 2023-07-17 with total page 259 pages. Available in PDF, EPUB and Kindle. Book excerpt: "In Helping Yourself Help Others, former first lady Rosalynn Carter draws upon her own experiences and those of hundreds of others to offer reassuring, practical advice to caregivers. Long before the COVID-19 pandemic inspired national conversations about the vast undervaluing of unpaid caregiving, the dangers of burnout, and the merits of self-care for relief, Rosalynn Carter was shining a light on these matters and everything else that caregivers confront"--