The changing nature of caregiving
Posted on November 30, 2016 by bob in In Every Life
At some point in life, most people find themselves needing to provide care or support to a family member. A child, spouse, sibling, parent or grandchild is likely to experience an illness, accident or injury, or to develop a chronic condition. Recent data revealed than more than half of Americans have at least one chronic disease, mental illness or problem with drugs or alcohol, and increasing numbers are experiencing two or more chronic conditions simultaneously (Walker & Druss, 2016).
Individual situations affect a person’s ability to function independently to manage care needs. Fluctuations in health status can require assistance from either paid or volunteer family or community caregivers. Personal characteristics, life situation, location and family dynamics influence who may provide support for various specific need(s). For example, one person may help with self-care while another is more skilled at financial management. Individualized needs can be met by a blend of resources. Collaboration may be needed to determine financial needs and resources. However, challenges arise as more care is required. Difficult decisions may be necessary to plan ways to balance meeting the needs and respecting autonomy and dignity of the person who needs help with the needs of the person(s) providing care. What at one time was a temporary solution can become a more permanent need as one or more chronic conditions persist. Preparation of two or three meals a week and transportation develops into a need for daily personal assistance and monitoring.
Conversations before the situation escalates can be of tremendous benefit for anticipatory planning, even if the person’s health improves. Conversations should include the affected persons as much as possible to determine their desires and priorities. Although the future cannot be accurately predicted, knowing a person’s wishes can guide decisions, without making specific promises. Consideration for the person’s desires must be balanced with reality of other life demands and maintaining health of those who assume caregiving roles.
Knowing relevant and available resources is key:
— Begin by offering to accompany the family member to healthcare visits, maintaining a written personal health record that lists providers, conditions, medications and other treatments.
— Engage in discussions with healthcare providers or case managers to gain awareness of various potential trajectories and needs associate with different possibilities. Communicate with other family, supportive people or agencies.
— Determine what resources will be helpful as situations change.
— Gather information through referrals, word of mouth, websites, or from agencies such as the Alabama Department of Senior Services (www.alabamaageline.gov/) or National Institute of Aging (https://www.nia.nih.gov/).
Caregivers, realize that you must take care of yourself as well as the person for whom you care, or both of you will become in need of additional care. Caregiving can be highly rewarding, but is often more like a marathon than a sprint. Adaptation is needed each day to achieve an ever-evolving new normal to balance needs of the caregiver and care-recipient.
During the holiday season, you may have opportunity to identify a changed situation in need of support or planning for caregiving resources. Be willing to participate in conversations regarding options. Additionally, you may become aware of simple ways you can offer support to a caregiver and care-recipient. Share some time, meal, gift or service to bring joy to their “new normal”.
Arlene Morris
Arlene H. Morris, EdD, RN, CNE is Professor of Nursing, Auburn Montgomery School of Nursing. Reach her at amorris@aum.edu.
