CAREGIVER. Definition An individual, such as a physician, nurse, or social worker, who assists in...

CAREGIVER

Definition

• An individual, such as a physician, nurse, or social worker, who assists in the identification, prevention, or treatment of an illness or disability

Definition

• Someone who has the job of looking after people, usually people that are unable to completely care for themselves

4 Stages of Caregiving

• The Four Stages of Caregiving covers caregiving from beginning to heavy home care to nursing homes and end-of-life care.

• Stage One: Getting StartedRecognize the impact of caregiving on your life and family, learn how to be a caregiver, and find out more about the older person who needs care.

• Section 1: Impact of caregiving. • Section 2: Dignity and Decisions. • Section 3: Educating Yourself. • Section 4: Using a Care Manager. • Section 5: Information List and Notebook. • Section 6: Disater Plan Update. • Section 7: Driving Assessment.

• Stage Two: Finding HelpAccept help from family, friends, place of worship, support groups, and formal services. Learn about help for working caregivers.

• Section 1: Help from Family and Friends. • Section 2: Help from Faith Communities. • Section 3: Support Groups. • Section 4: Help for Employed Caregivers. • Section 5: Formal Support Services. • Section 6: Relief Through Self Expression. • Section 7: Relief From Telemarketers.

• Stage Three: Heavy CarePrevent caregiver burnout and injury while providing heavy-duty care, protect your care receiver's health and safety, and consider facility care.

• Section 1: Preventing Caregiver Burnout. • Section 2: Protecting Your Care Receiver. • Section 3: Facility Care.

• Stage Four: Letting GoResolve relationships, complete end-of-life decisions, use Hospice care, let yourself grieve, care for yourself, and have a plan for your life after caregiving has ended.

• Section 1: Resolving Relationships. • Section 2 End-of-Life Decisions. • Section 3: Hospice Care. • Section 4: Common Concerns of the Dying. • Section 5: Grieving. • Section 6: Caring for the Stage Four Caregiver. • Section 7: Memorials to the Deceased. • Section 8: Reconnecting.

Responsibilities of a Caregiver

• Respect patient’s privacy and individuality• Cultivate patient’s trust• Objective in dealing with the patient• Communicate thoughts clearly• Approach the patient with an open mind• Be organized• Have good hygiene• Perform the different caregiver skills adequately

CAREGIVING FOR:

Caregiving for Cancer Patients

Cancer and caregiving While it is important to address the hardships and obstacles to providing

care, it is also helpful to focus on some of the fulfilling aspects of caregiving:

* Caregiving shows the person who is ill that you are committed to providing as much needed help and support as you can.

* Caregiving makes a difference to the quality of life and well-being of the person who is ill.

* Caregiving gives you a unique opportunity to develop or renew a relationship with the person who is ill.

* Caregiving helps set the tone of respect and caring for other family members, regardless of their situations.

Potential challenges of caregiving include:

* Physical and emotional stress

* Less time for personal and family life

* The need to balance job and caregiving responsibilities

* Financial stress

* Lack of privacy

* Feelings of isolation and loneliness

Point to Remember

• Caregiving is a team effort

• Be proactive • Be a problem solver • Try to stay positive • Know yourself

Emotional well-being

• Communicate • Accept the limitations of

a person who is seriously ill

• Include the person with cancer in activities that provide meaning or pleasure

Medical and physical care

• Gather information about the patient’s diagnosis, treatment, and prognosis (the chance of recovery)

• Be an advocate • Learn how to provide

proper physical care

Legal and financial issues

• Determine financial status

• Have legal documents in place

End-of-Life Care

Purpose of palliative care The goals of palliative care include:• Treating pain and all other physical symptoms caused by

cancer and its treatment• Addressing a person's spiritual needs or concerns• Addressing a person's practical needs, such as transportation

and financial concerns. Learn more about managing the cost of cancer care.

• Treating a person's psychosocial (emotional and social) needs, such as coping with changes in body image and depression

• Providing support for the patient's family, friends, and caregivers

http://www.cancer.net/vgn-ext-templating/v/index.jsp?vgnextoid=2c7947a77924f110VgnVCM100000ed730ad1RCRD

The palliative care team

•Comparing palliative care and hospice care

Although the terms palliative care and hospice care are sometimes used interchangeably, they have slightly different meanings. Palliative care applies to every step of the cancer process, whereas hospice care in the United States is used when the life expectancy is six months or less.

DoctorNurseSocial workerHospital chaplain or

other spiritual advisor

DietitianPhysical therapistGrief and

bereavement coordinator

Review and share legal documents

• Power of Attorney – a person who can legally make

health care decisions for him or her.

• Living Will– a person’s wishes about types of

medical care he or she may or may not want in order to sustain life

• Do Not Resuscitate Order– instructs medical personnel not

to give cardiopulmonary resuscitation (known as CPR)

Preparation at the End of Life

• Grieving your losses• Getting your affairs in

order • Completing unfinished

business • Reviewing your life • Religion and spirituality

Caring for a Terminally Ill Child: A Guide for Parents

• Treatment should focus on controlling the underlying cancer and symptoms, so the child can enjoy a high quality of life for as long as possible. Parents play a crucial role in helping their child continue to live a fulfilling and comfortable life, as well as helping their child prepare for a peaceful and dignified death.

Points to Remember

• The need to talk with your child

How to talk with your child about death.o Ask open-ended questions that give your child

the chance to answer in his or her own way. o Look for hidden meanings in your child's

questions or comments. o Look for "teachable moments"—everyday

moments that are opportunities talk about what your child is thinking and feeling.

o Younger children may find it easier to communicate through play or art.

o Look for signals from your child that he or she is ready to talk, such as asking you questions or bringing up the subject of death, even if it is the death of an animal or an imaginary person.

o Look for signals that your child is done talking for the moment, such as changing the subject, looking away, fidgeting, or playing with toys rather than listening to you.

Points to RememberMeeting your child's needs • Give your child time to play and engage in

other age-appropriate activities• Encourage your child to continue attending

school, even if he or she cannot attend full time.

• Encourage your child to maintain friendships and other meaningful relationships.

• Encourage your child to continue setting goals. To help children gain a sense of achievement and give meaning to their lives.

• Continue to set limits on your child's behavior and practice normal parenting.

• Advocate for your child to help ensure that pain and other symptoms are quickly and effectively treated.

Points to RememberHelp for parents• Talk with your spouse, family members, or

friends about your feelings and fears.• Seek support from a professional grief counselor

or attend a support group with other parents. • The dual role of parent and caregiver can be

physically and emotionally exhausting. Allow yourself a break from caregiving.

• Ask the medical staff to go over symptoms that occur close to death, such as skin and respiratory changes. So you can be more prepared and enable you to be with your child when death occurs.

• Make funeral arrangements in advance, as well as other plans such as whether to have an advance directive or an autopsy.

• Take time to just be with your child and tell him or her how much you love him or her.

http://www.cancer.net/vgn-ext-templating/v/index.jsp?vgnextoid=f83903e8448d9010VgnVCM100000f2730ad1RCRD

The Caregiver and the Patient’s Family

• Triad relationship: patient, caregiver, family• Family

– May be mobilized as a therapeutic ally– Can also act as caregivers– Moral support

Involving the Family in Caregiving

• Parent involvement– Talk to parents about the importance of working

together in meeting the needs of the patient.– Talk openly about issues and agree on ground

rules.


• Sibling involvement– Limit participation to siblings or others directly

involved in care.– Avoid arguing. – Do not try to resolve old family wounds.– Focus on the task of taking care of the patient.


• Spouse involvement– Encourage the spouse to talk about his/her

feelings.

• Children involvement– Be honest with the children about the situation.– Listen to their concerns.

Primary Care Family Conference

• Education- discussion of health beliefs, apprehensions, etc.

• Prevention of family dysfunction if the impact of illness is discussed

• Support• Challenge- for family members to share their

individual capabilities to help the member who is ill

Steps in the Conduct of a Family Meeting

• Socialize with the family.• Set the goals.• Discuss the problems and issues.• Identify resources.• Give tasks.

Joint Commission on Accreditation of Healthcare Organizations

Journal on Quality and Patient SafetyMay 2006 Volume 32 Number 5

What Makes for a Compassionate Patient-Caregiver Relationship?

ForumDarshak M. Sanghavi, M.D.

Communication

• Suggestions to improve compassionate care often focused on style and content.

• Rounds attendees felt that compassionate care also depends on:– Imparting medical facts in a clear and useful

manner to patients: often difficult for complex medical issues

Common Ground

• Compassionate care depends on showing empathy for a patient’s illness experience no matter what his or her background. – Rounds participants felt that caregivers could

make a conscious choice to care deeply for patients.

• Sharing personal information with patients and admitting mistakes were key methods for identifying common ground.

Treating the Patient as an Individual

• Compassionate care requires striking an individualized balance between– Providing guidance – Allowing autonomy to achieve shared consensus,

especially with complex information

A Prescription for Change• Target the students

– Yet do not continually reinforce compassion.• Advocates for compassionate care should instead treat lack of

compassion not as an acute trauma but as a chronic condition requiring – Lifetime of continuous support– Regular guidance– Repeated reinforcement– Specific targeted outcomes, and more innovative care

programs

CAREGIVER TRAINING PROGRAM: Louise nd Cin

Caregivers interested in obtaining additional training in caring for seniors can obtain certification as a nursing aide or home health aide and attend customized training programs in hospice care and memory loss care.

Caregiver Training

• Essential for in-home, privately hired caregivers

• Certificate level of training is easily available and affordable through a variety of classes or fully online through web-based training professionals

• High quality training and thorough skills building builds stronger skills for coping with caregiving tasks and with caregiver stress

Nursing Aide training involves: 1. Positioning and Helping in Mobilization 2. Assisting with Personal Care 3. General Caregiving Skills 4. Caring for the Caregiver 5. Legal and Financial Issues 6. Home Safety 7. Healthy Eating

Relationship of the caregiver and the patient’s family

The Caregiver and the Patient’s Family

• Triad relationship: patient, caregiver, family• Family

– May be mobilized as a therapeutic ally– Can also act as caregivers– Moral support


• Parent involvement– Talk to parents about the importance of working

together in meeting the needs of the patient.– Talk openly about issues and agree on ground

rules.