Caregivers provide care in a wide variety of situations. Caregiving can be a very difficult task to accomplish, especially when it involves caring for an elderly parent. This is definitely a role reversal, which many individuals are not prepared for, or equipped to handle. A Bureau of Labor Statistics reported that, there were nearly 40 million caregivers in the nation. As a Registered Nurse, I have been rendering care to the sick for thirty plus years.
Int J Geriatr Psychiatry. J Gerontol: Psychol Sci. And technological advances are allowing nurses to monitor vital signs and symptoms remotely. How Volunteering Stimulates Mental Growth. Ta,ing caregiver issues and nursing interventions after a stroke. The constant concern for managing disruptive behaviors such as turning on stoves, walking into the street, taking too many pills, yelling, screaming, or cursing also affects the caregivers negatively.
Small butts big boobs. Who Takes Care of the Caregiver?
How Nurse taking care of caregivers perceive and respond to an event is a significant factor in how we careggivers and cope with it. People varegivers experience caregiver stress can be vulnerable Nurse taking care of caregivers changes in their own health. You are responsible for your own self-care. In the next 24 Black blow job shemale, you will receive an email to confirm your subscription to receive emails related to AARP volunteering. Any nurse feeling the effects of job stress will find useful advice that yields positive results. Keep in mind, though, that unless the nursing home has private rooms, and you can afford one, dealing with a period of adjustment is normal. Possible action steps:. Seek and accept the support of others. Tool 8: Learning from Our Emotions It is a strength to recognize when your emotions are controlling you instead of you controlling your ta,ing. Some caregiving situations are more stressful than others. Our Nuurse are messages to which we need to listen. Added: July 3rd, Category: In the spotlight. Here are some of the most commonly expressed:. Leaving AARP. Centers for Disease Control and Prevention.
It is easy for family and friends, as well as professionals, to suggest finding someone to help with housekeeping tasks and care responsibilities.
- You have been on your feet for 12 hours or more delivering the best care you can to your patients.
- Caring for a loved one strains even the most resilient people.
- Nurses excel at caring for others but often forget to care for themselves.
- On an airplane, an oxygen mask descends in front of you.
- Staying Sharp empowers you to take control of your brain health as you age.
NCBI Bookshelf. Hughes RG, editor. Susan C. Authors Susan C. Most patients have families that are providing some level of care and support. Family caregiving raises safety issues in two ways that should concern nurses in all settings. Second, family caregivers are unpaid providers who often need help to learn how to become competent, safe volunteer workers who can better protect their family members i.
This chapter summarizes patient safetyand quality evidence from both of these perspectives. The focus is on the adult caregiver who provides care and support primarily for adults with chronic illnesses and chronic health problems. The focus is not on those with developmental disabilities. In the first section, we discuss the evidence for protecting the caregiver from harm. The second section addresses research aimed at protecting the care recipient from an ill-prepared family caregiver.
For centuries, family members have provided care and support to each other during times of illness. Who are these family caregivers, what do they do, and what harm do they face? What does the research tell us about ways to assess the needs of these hidden patients and evidence-based interventions to prevent or reduce potential injury and harm?
This section answers these questions and highlights the need for nurses to proactively approach family caregivers as clients who need their support in their own right. The terms family caregiver and informal caregiver refer to an unpaid family member, friend, or neighbor who provides care to an individual who has an acute or chronic condition and needs assistance to manage a variety of tasks, from bathing, dressing, and taking medications to tube feeding and ventilator care.
Recent surveys estimate there are 44 million caregivers over the age of 18 years approximately one in every five adults.
Those caring for someone 50 years or older are 47 years old—on average—and working at least part-time. About two out of three older care recipients get help from only one unpaid caregiver. Caregivers spend a substantial amount of time interacting with their care recipients, while providing care in a wide range of activities. Nurses have a limited view of this interaction. Caregiving can last for a short period of postacute care, especially after a hospitalization, to more than 40 years of ongoing care for a person with chronic care needs.
On average, informal caregivers devote 4. More than half of family caregivers provide 8 hours of care or more every week, and one in five provides more than 40 hours per week.
Most researchers in the caregiving field conceptualize the care that family members give as assistance with activities of daily living ADLs and instrumental activities of daily living IADLs. But those concepts do not adequately capture the complexity and stressfulness of caregiving.
Supervising people with dementia and observing for early signs of problems, such as medication side effects, are serious responsibilities as family members are often unable to interpret the meaning or the urgency.
Family caregivers often feel unprepared to provide care, have inadequate knowledge to deliver proper care, and receive little guidance from the formal health care providers.
Due to inadequate knowledge and skill, family caregivers may be unfamiliar with the type of care they must provide or the amount of care needed. Family caregivers may not know when they need community resources, and then may not know how to access and best utilize available resources. Caregivers get very little help from health careprofessionals in managi ng their tasks and the emotional demands of caregiving.
Health professionals in emergency departments and inpatient hospital settings do not adequately determine the after-care needs of older patients when they are being discharged. Effective discharge planning is impeded by gaps in communication between the hospital and community interface, such as illegible discharge summaries and delays in sending information to the physician.
Many caregivers felt abandoned at a critical time, and none of the focus group participants had been referred by any health care professional in the hospital to community-based organizations for emotional support—or any other kind of support.
Caregivers are hidden patients themselves, with serious adverse physical and mental health consequences from their physically and emotionally demanding work as caregivers and reduced attention to their own health and health care. Declines in physical health and premature death among caregivers in general have been reported.
Elderly spouses who experience stressful caregiving demands have a 63 percent higher mortality rate than their noncaregiver age-peers. Declines in caregiver health have been particularly associated with caregivers who perceive themselves as burdened. Burton and colleagues 38 examined the relationships between provision of care by family members and their health behaviors and health maintenance. These researchers found that, with a high level of caregiving activities, the odds of the caregiver not getting rest, not having time to exercise, and actually not recuperating from illness were also high.
In addition, caregivers were more likely to forget to take their prescriptions for their own chronic illnesses. Providing care poses a threat to the overall health of caregivers, which can compromise their ability to continue to be caregivers.
If caregivers are to continue to be able to provide care, relief from the distress and demands of maintaining the required care must be considered. Both highly negative and highly positive consequences of providing care may exist simultaneously. Picot and colleagues 41 , 42 worked primarily with African American caregivers and found that the rewards perceived by caregivers were more important than coping. A specific Picot Caregiver Reward Scale of 25 items exists and has been widely used to show that both rewards and costs can exist in the same care situation.
Caregivers who attempt to balance caregiving with their other activities, such as work, family, and leisure, may find it difficult to focus on the positive aspects of caregiving and often experience more negative reactions, such as an increased sense of burden. They have difficulty maintaining work roles while assisting family members. Low personal and household incomes and limited financial resources can result in increased caregiver risk for negative outcomes, particularly if there are substantial out-of-pocket costs for care recipient needs.
Overall, financial concerns cause particular distress for caregivers during long treatment periods, 52 , 53 as resources become depleted. Higher-income families, with greater financial resources to purchase needed care, might not become as distressed or burdened as those with limited resources.
Caregiver burden and depressive symptoms are the most common negative outcomes of providing care for the elderly and chronically ill. The constant concern for managing disruptive behaviors such as turning on stoves, walking into the street, taking too many pills, yelling, screaming, or cursing also affects the caregivers negatively.
Caregivers may suffer severe fluctuations in sleep patterns over time, which may affect depression 65 and exacerbate symptoms of chronic illnesses. Pain management is an intractable problem for caregivers that results in substantial caregiver distress, as caregivers assist with both nonpharmacologic and pharmacologic pain-management strategies.
The literature provides substantial evidence that caregivers are hidden patients in need of protection from physical and emotional harm. Interventions directed to the family caregiver should serve two purposes see Evidence Table. First, interventions can support the caregiver as client, directly reducing caregiver distress and the overall impact on their health and well-being. In this intervention approach, the caregiver is the recipient of the direct benefit and the patient benefits only secondarily.
Second, interventions can be aimed to help make the caregiver become more competent and confident, providing safe and effective care to the patient, which can indirectly reduce caregiver distress by reducing their load or increasing their sense of certainty and control.
In this section, we focus on the research evidence supporting caregivers as clients. Despite the importance of information and support to help family caregivers, studies on interventions to increase support for family caregivers have lagged far behind those provided for patients. Few randomized clinical trials of educational interventions directed toward family caregivers have been conducted or published, and there is limited research to inform us about skills training for caregivers to prevent back injuries, infection, and other potential risks inherent in the caregiver situation.
Recent meta-analyses of caregiver interventions found mixed results, which are important to note. Multicomponent interventions, rather than single interventions like support groups or education, significantly reduced burden. Reasons for this are unclear. The effectiveness of caregiver interventions lasts approximately 7 months. Few studies are funded for long-term followup. Comprehensive counseling sessions for spouses caring for a person with dementia help reduce depression.
An automated, interactive voice-response telephone support system for caregivers reduced burden for those caregivers with a lower sense of control over their situation. Home visits and enhanced social support also can help reduce caregiver depression. Zarit and colleagues 79 used a quasi-experimental design to demonstrate that caregivers who used adult day care services for their relatives with dementia had significantly lower levels of caregiver stress, anger, and depression after 3 months of this respite care than a control group of similar caregivers who did not obtain this intervention.
Smeenk and colleagues 80 investigated the quality of life of family caregivers who received a home care intervention that consisted of a specialist nurse coordinator, a hour nurse telephone service with access to a home care team, a collaborative home care dossier and case file, and care protocols. The care dossier was used to assist with communication and coordination between caregivers and health professionals. From these reports, specific patient intervention approaches were developed.
The intervention significantly improved caregiver quality of life at 1 week and 4 weeks after discharge from the hospital. Houts and colleagues 81 describe a prescriptive program that is based on research on problem-solving training and therapy. COPE teaches caregivers how to design and carry out plans that focus on medical and psychosocial problems that are coordinated with care plans of health professionals. Although proponents of this program assert it has positive outcomes for caregivers, a formal evaluation of COPE was not found.
Twenty-five years of research have documented that the work of family caregiving can be stressful. That stress can adversely harm both the caregiver and the care recipient. This section addresses research aimed at protecting the care recipient from an ill-prepared or emotionally stressed family caregiver.
It describes the link between the work of caregiving and patient harm, and examines interventions that aim to make the caregiver a better worker and less likely to harm the patient. Caregivers can place their family members at risk in two ways, and both situations are preventable. First, despite their good intentions and hard work, if caregivers do not have the knowledge and skills to perform their work, they may unintentionally harm their loved one.
This risk for injury is directly related to lack of knowledge and competence, which can be improved through caregiver education and support.
For example, a recent study confirmed that patients had many negative outcomes when untrained informal caregivers managed their home enteral nutrition or tube feeding. A second concern is that the demanding work of caregiving can put caregivers at risk of engaging in harmful behaviors toward their care recipients, particularly among caregivers of persons with cognitive impairments. Caregivers who are at risk of depression while caring for spouses with significant cognitive or physical impairments are more likely to engage in neglect or abusive behaviors, such as screaming and yelling, threatening to abandon or use physical force, withholding food, hitting, or handling roughly.
In general, family members may be challenged to find the capacity or ability to provide care, but Fulmer 86 found that caregivers who were in poor health or from low-income or dysfunctional situations might have the most limited capacity to provide needed care.
They also might not understand the standard for quality and might not provide the level of care that is needed. The presence of dementia and cognitive behavioral problems put the care recipient at risk for abusive behaviors by the caregiver.
Caregiver neglect may occur because the dementia patient is unable to communicate and the caregiver is unable to understand or know how to deal with nutritional intake and pain management. Mittelman and colleagues 88 , 89 found that counseling and support for caregivers who face disruptive behaviors from their ill family members will decrease their stress over their multiyear caregiving responsibility.
A substantial number of community-dwelling elders do not recall receiving any instructions on taking their medications. Travis and colleagues 12 found that caregivers manage between one and 14 medications on a daily basis, have difficulty keeping so many prescriptions filled, and often miss doses due to their work schedules.
Their responsibility to monitor for adverse or toxic effects in family members who are not capable of reporting problems themselves is important in preventing dehydration brought on by vomiting and diarrhea, and even more serious emergency situations.
Neglect is more common when the caregiver is depressed or distressed.
Taking Responsibility for Your Own Care You cannot stop the impact of a chronic or progressive illness or a debilitating injury on someone for whom you care. Nurses excel at caring for others but often forget to care for themselves. What is something you really love to do? A single copy of these materials may be reprinted for noncommercial personal use only. Walk three times a week for 10 minutes. A caregiver is anyone who provides help to another person in need, such as an ill spouse or partner, a disabled child, or an aging relative. The responsibility of this partnership ideally is shared between you, the caregiver, the physician, and other healthcare staff.
Nurse taking care of caregivers. Caregiver stress: Tips for taking care of yourself
Nursing professor Cynthia A. The most common reason for neglecting self-care is that it feels selfish. With so much going on in your professional and personal life, it feels selfish to take time just for yourself. However, it is not a selfish act, especially if you work in one of the most stressful careers in the United States. The benefits of self-care reach into all areas of your life, including your home and career.
When you take time for yourself, you will be able to give more to others. Taking even a small amount of time to refresh and refocus reaps great rewards. This just shows how prevalent a problem stress and burnout is for nurses. A survey published on Nurses. Nurses strive to give their patients care that is top-notch. One significant way to ensure that this happens is for nurses to remember themselves.
When nurses take time to focus on self-care, they are helping relieve stress and potential burnout, which allows them to continue to serve their patients to the best of their ability. Less stress equals better health and mood, which will benefit all areas of your life. Ideally, you need to set aside time daily for self-care. Sometimes it may only be 10 minutes. Some days you may have an hour to yourself.
Find what works for you. What calms you? What healthy habits help you relieve stress? A few minutes of quiet could be all you need to help you revive and tackle the rest of your day. There are many different ways to focus on self-care. The following areas are important to focus on when addressing self-care:. Nurses spend their lives gaining and applying their knowledge in their profession. Use that knowledge on yourself.
Most people want to stay in their homes as they age, and more family caregivers will be needed to provide more, and more complex, care. Nurses have long played a key role in supporting family caregivers and are doing so even more as the health care system evolves. Nurses are providing more care for the sick and elderly in their homes and communities, which alleviates burdens on family caregivers.
They are training caregivers to provide skilled care so their loved ones can live longer in their homes—and avoid expensive long-term care facilities. And they are teaching caregivers how to stay healthy and well.
Nurses are also taking on bigger roles in care coordination, care transitions, and health and wellness education and promotion, all of which support caregivers.
Thankfully, health reform is making it possible for more nurses to provide more care in homes and communities, Cotton said. The Affordable Care Act ACA loosened federal limits on insurance coverage for in-home nursing care so that people with chronic conditions can qualify. The ACA is also supporting patient-centered medical homes and other innovations that allow nurses to do more to support caregivers, she added. The rise of accountable care organizations, which provide coordinated care to Medicare recipients, has also enabled more nurses to provide care in homes and communities, Cotton said.
And technological advances are allowing nurses to monitor vital signs and symptoms remotely. Brody, associate director of the Hartford Institute for Geriatric Nursing at the NYU College of Nursing and an RWJF Nurse Faculty Scholar , is exploring ways that home-health nurses and physical and occupational therapists can train caregivers to provide complex care for elderly patients with dementia.
Brody recalls one home-care nurse who sought his advice about an elderly woman with dementia who had become agitated. The nurse wanted him to prescribe an anti-psychotic drug, which can be dangerous, but Brody determined that the patient was in pain from bedsores and treated her accordingly. Once treated, the woman returned to her normal state. Many other nurse scientists are studying ways they and other health professionals can improve elder care and support caregivers—research that is critically needed as the nation changes.
Read a story on new nurse residencies at long-term care facilities.
Hiring In-Home Help | Family Caregiver Alliance
On an airplane, an oxygen mask descends in front of you. What do you do? As we all know, the first rule is to put on your own oxygen mask before you assist anyone else. Only when we first help ourselves can we effectively help others. Caring for yourself is one of the most important—and one of the most often forgotten—things you can do as a caregiver. When your needs are taken care of, the person you care for will benefit, too. Researchers know a lot about the effects of caregiving on health and well-being.
For example, if you are a caregiving spouse between the ages of 66 and 96 and are experiencing mental or emotional strain, you have a risk of dying that is 63 percent higher than that of people your age who are not caregivers. Older caregivers are not the only ones who put their health and well-being at risk. If you are a baby boomer who has assumed a caregiver role for your parents while simultaneously juggling work and raising adolescent children, you face an increased risk for depression, chronic illness, and a possible decline in quality of life.
But despite these risks, family caregivers of any age are less likely than non-caregivers to practice preventive healthcare and self-care behavior. Regardless of age, sex, and race and ethnicity, caregivers report problems attending to their own health and well-being while managing caregiving responsibilities.
They report:. Family caregivers are also at increased risk for depression and excessive use of alcohol, tobacco, and other drugs. Caregiving can be an emotional roller coaster.
On the one hand, caring for your family member demonstrates love and commitment and can be a very rewarding personal experience. On the other hand, exhaustion, worry, inadequate resources, and continuous care demands are enormously stressful.
Caregivers are more likely to have a chronic illness than are non-caregivers, namely high cholesterol, high blood pressure, and a tendency to be overweight.
Studies show that an estimated 46 percent to 59 percent of caregivers are clinically depressed. You cannot stop the impact of a chronic or progressive illness or a debilitating injury on someone for whom you care. But there is a great deal that you can do to take responsibility for your personal well-being and to get your own needs met. Many times, attitudes and beliefs form personal barriers that stand in the way of caring for yourself.
Not taking care of yourself may be a lifelong pattern, with taking care of others an easier option. If I die? The first task in removing personal barriers to self-care is to identify what is in your way. For example:. Sometimes caregivers have misconceptions that increase their stress and get in the way of good self-care. Here are some of the most commonly expressed:. Because we base our behavior on our thoughts and beliefs, attitudes and misconceptions like those noted above can cause caregivers to continually attempt to do what cannot be done, to control what cannot be controlled.
The result is feelings of continued failure and frustration and, often, an inclination to ignore your own needs. Ask yourself what might be getting in your way and keeping you from taking care of yourself.
Following are some effective tools for self-care that can start you on your way. How we perceive and respond to an event is a significant factor in how we adjust and cope with it. The stress you feel is not only the result of your caregiving situation but also the result of your perception of it—whether you see the glass as half-full or half-empty. It is important to remember that you are not alone in your experiences.
Setting goals or deciding what you would like to accomplish in the next three to six months is an important tool for taking care of yourself. Here are some sample goals you might set:. Possible action steps:. Seeking solutions to difficult situations is, of course, one of the most important tools in caregiving.
Note: All too often, we jump from Step 1 to Step 7 and then feel defeated and stuck. Concentrate on keeping an open mind while listing and experimenting with possible solutions. When you communicate in ways that are clear, assertive, and constructive, you will be heard and get the help and support you need. The box below shows basic guidelines for good communication. Be prepared with a mental list of ways that others could help you. For example, someone could take the person you care for on a minute walk a couple of times a week.
Your neighbor could pick up a few things for you at the grocery store. A relative could fill out some insurance papers. When you break down the jobs into very simple tasks, it is easier for people to help. And they do want to help.
It is up to you to tell them how. Help can come from community resources, family, friends, and professionals.
Ask them. Reaching out for help when you need it is a sign of personal strength. In addition to taking on the household chores, shopping, transportation, and personal care, 37 percent of caregivers also administer medications, injections, and medical treatment to the person for whom they care.
Some 77 percent of those caregivers report the need to ask for advice about the medications and medical treatments.
The person they usually turn to is their physician. Building a partnership with a physician that addresses the health needs of the care recipient and the caregiver is crucial. The responsibility of this partnership ideally is shared between you, the caregiver, the physician, and other healthcare staff. Perhaps you think that physical exercise might harm you, or that it is only for people who are young and able to do things like jogging.
Fortunately, research suggests that you can maintain or at least partly restore endurance, balance, strength, and flexibility through everyday physical activities like walking and gardening. Even household chores can improve your health.
The key is to increase your physical activity by exercising and using your own muscle power. Exercise promotes better sleep, reduces tension and depression, and increases energy and alertness.
If finding time for exercise is a problem, incorporate it into your daily activity. Perhaps the care recipient can walk or do stretching exercise with you. If necessary, do frequent short exercises instead of those that require large blocks of time. Find activities you enjoy. Walking, one of the best and easiest exercises, is a great way to get started. Besides its physical benefits, walking helps to reduce psychological tension. Walking 20 minutes a day, three times a week, is very beneficial.
Work walking into your life. Walk around the mall, to the store, or a nearby park. Walk around the block with a friend. It is a strength to recognize when your emotions are controlling you instead of you controlling your emotions. Our emotions are messages to which we need to listen. They exist for a reason. However negative or painful, our feelings are useful tools for understanding what is happening to us.
Even feelings such as guilt, anger, and resentment contain important messages. Learn from them, then take appropriate action. For example, when you cannot enjoy activities you previously enjoyed, and your emotional pain overshadows all pleasure, it is time to seek treatment for depression—especially if you are having thoughts of suicide.
Speaking with your physician is the first step. Caregiving often involves a range of emotions. Some feelings are more comfortable than others. When you find that your emotions are intense, they might mean the following:.
You are responsible for your own self-care. Focus on the following self-care practices:. Family Caregiver Alliance FCA seeks to improve the quality of life for caregivers through education, services, research and advocacy. Through its National Center on Caregiving, FCA offers information on current social, public policy and caregiving issues and provides assistance in the development of public and private programs for caregivers. Administration for Community Living For caregiver support groups, respite providers, and other caregiving services.
Eldercare Locator eldercare. How To Be a Resilient Caregiver lifework. This fact sheet was prepared by Family Caregiver Alliance. All rights reserved. Learn more. Skip to main content. Search form Search. You are here Home. Order this publication. Printer-friendly version By Family Caregiver Alliance.