Nurses Can Help Caregivers Too
As the population ages, increasingly people are caregivers for aging parents. An extra wrench in the spokes is that often now patients themselves are caregivers for someone else. The caregiver role is expensive, stressful, and often guilt-inducing:
That list can go on and on depending on the relationships involved and their history. People also feel guilty if they choose not to be primary caregivers and instead opt for long-term care or other institutionalization.
Most of the time, regardless of the option chosen, a sick relative who needs care is going to cost money and time, cause relentless worry, and result in sleepless nights and multiple trips to medical appointments and hospitals. Being a caretaker is in itself a full-time job, and its financial stresses can cause the caretaker to assume an increased workload rather than decreasing hours worked to stay home and care-take.
Just taking care of the patient feels like all nurses can do most of the time. We are busy and so on. However, I believe that caretakers, like family members in general, should be seen as our “patients” too. For one thing, they often have vital information that the patient has not supplied. By involving them in patient care, we both show our appreciation of their role and obtain helpful knowledge we can use for treating the patient. They may know of recent medication changes, supply baseline mentation information, and even give tricks and tips for transfers. Perhaps their most vital role can be “interpreting” for patients who have lost language skills. For example, I recently cared for a stroke patient whose caregiver told me “he’s in pain. He points at his nose when he’s in pain.” This gesture is not to be found on any pain scale, and the caregiver was my only avenue to this information. I was then able to treat my patient’s symptoms appropriately.
Caregiver fatigue is an issue that can affect the patient whether the patient IS the caregiver or simply has one. If the patient is the caretaker for someone else, that stress may be contributing to the illness or may cause logistical problems with a hospitalization (who will take care of my parent while I’m in the hospital?). If the patient’s caretaker is at the end of his or her rope, this may have contributed to the illness: fatigue can result in missed medication, decreased exercising and transfers, and inappropriate nutrition. Transferring and feeding someone take a lot of time.
Therefore, I suggest nurses consider assessing caregiver status and simply asking whether help is needed. Sometimes, just recognizing the difficulty of the job is satisfaction enough for a dedicated but exhausted caregiver. Other times, a social work referral can change lives. Perhaps a home health nurse or respite volunteer can be a live-saver. Or perhaps the patient really has reached a point where he or she cannot be adequately or safely cared for at home. Caregivers may feel better having someone else bring up this possibility rather than doing it themselves.
Whatever the decision, it is always appropriate to acknowledge and thank caregivers, and it is never appropriate to summarily refuse their input or help. Taking the time to listen to them may give nurses the opportunity to increase the quality of life for the both caretaker and patient, and that is a superb use of time.
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