Lecture 7 - Chronic Illness and Caring for the Caregiver Flashcards
Care of families in medical surgical settings
Critical Features
- What kind of wait times are changed
- what does it do to capacity
- What policies has it changed
- How has it changed the layout of hospitals
- How has it changed nursing interventions
ER wait times (No more formal visit times)/depends who work there
Over capacity
Visiting policies
Waiting rooms/family rooms (Space limitations, depends)
Family interventions
Family Care Givers
- How many people are unpaid caregivers, and what % are 15 and under
- They are often what and their contributions are often what
- THey are described as what to the health care system
- What % of them felt as if they had no other choice
- What % are resentful
- What % are negatively affected
- How much of them experience financial costs
- What is the largest care group
- Second?
Millions are unpaid caregivers (28% >= 15 yrs old)
-Often invisible, contributions are often unrecognized
- The glue holding the health care system
- 61% felt had no other choice
- 36%, 33% resentful
- Almost 50% negatively affected (personal time, travel, social life)
- 1/3 experienced financial costs (out of pocket expenses, time off work, turning down career opportunities)
- Largest care group = Alzheimer’s and r/t dementias
- Second largest is frailty
Nursing strategies to support caregivers
- Identify what and what need to increase what for caregiving
- Form a what with the caregiver before what
- Identify the caregiving what and what
- Assist the caregiver in identifying what
- Assist the caregiver in finding what
- Help caregiver identify and manage what
- Use a what approach
Family care givers do the same thing but they don’t have the knowledge, its uncomfortable
That’s where we come in to teach them on how to do it
- Identify content and skills needed to increase preparation for caregiving
- Form a partnership with the caregiver before generating strategies to address issues and concerns
- Identify the caregiving issues and concerns on which the caregiver want to work and generate strategies
- Assist the caregiver in identifying strengths in the caregiving situation (McGill model)
- Assist the caregiver in finding and using resources
- Help caregivers identify and manage their emotional responses to caregiving
- Use an interdisciplinary approach
Family Caregiver Strain and Burden
- Defined as what
- What are the consequences SGDLD
- Who are the caregivers
Defined as: “When the emotional or physical health of caregivers is compromised or when the demands of care outweigh available resources”
Stress Guilt Depression Lack of sleep Disruption of family dynamics
Often women (2/3), usually family, close proximity
Who are most at risk
9
CFELASPCL
Caregivers in General Female (could injure themselves of physical demand) Ethnic Minority Less Education Aging and Pre-existing Conditions Spouses Poor-quality Relationships Competing Demands(sandwich gen.) Lack of Preparedness
Assessment of Caregiver Burden
- What 2 measuring tools OS and describe them
- Assess what distress and look for what symptoms
- Whats a good optional question
Objective (dealing with hours of burden)
- Not affected by bias
- Cant assess the emotional impact
Subjective
- Looks at specific impact of the care
- Lengthy
- Open Ended
- For everyone it might be different
Emotional distress
Depressive symptoms
Option: Ask about a specific issue or task they perform and the amount of distress or difficulty associated with it
Assessing Caregiver Strain and Burden
- Use of the Honea et al (2008) table 1 (instrument) called what
- 13 questions that look at what 5 domains EFPST
- What kind of tool and how is it administered
- 7 or higher means what
Caregiver Strain Index
Employment Financial Physical Social Time
Objective tool
Can be self administered
7 or higher = risk of caregiver strain
Interventions
PSPMRMI
Psycho-educational (tools to provide care)
Supportive (growth and rapport)
Psychotherapy and cognitive behavioural (Therapy, to develop skills)
Massage or healing touch(self care)
Respite or adult day care
Multicomponent (combo)
Interventions aimed at improving care recipient’s competence (education)
Videos
Video 1:
Older adult taking care of her mother
If you’re employed and a caregiver, but take time to look after yourself
Video 2 from website 1
Family caregivers are different
Over 1 million in bc taking care of people
Elder Project: Joanna Video 1: Lives by herself Doesn’t hire anybody Loses her memory Doesn’t understand the extent The start is awful Only gets medicine in presence of the nurse
She defines herself as independent, able to take care of her self, without the need for help, doesn’t hire anyone, she doesn’t know shes very sick, problem with eyes, doesn’t know she doesn’t read, tired after an hour, thinks she gets guests but she doesn’t, kind of knows her memory isn’t as good as it used to be, gets worse by the year, she might be declared incompetent
Being a woman, she has diabetes, struggles with depression, loves her mother deeply
Over 7 possibly
Depends on her husband, sees gertiician, is hoping for cousin for Poland to take care of her, has a lady that comes and keeps an eye on her
