JABSOM Department of Geriatrics Objectives Understand factors of caregiver stress and burnout Recognize warning signs Identify ways you can help caregivers Case Ms KS is a 94yearold ID: 643903
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Slide1
PROJECT ECHO:Caregiver Support
JABSOM Department of GeriatricsSlide2
Objectives
Understand factors of caregiver stress and burnoutRecognize warning signs
Identify ways you can help caregiversSlide3
CaseMs. K.S is
a 94-year-old female who lives in a home with her daughter. She suffered a Cerebral Vascular Accident (stroke) 3 years ago, and had Left side weakness. Since her stroke, she has had cognitive decline and was diagnosed with Vascular dementia about 2 years ago.
She
has difficulty feeding
herself and all of her ADLs are dependent. The
stroke has left her extremely weak, and she is confined to a
wheelchair
during daytime.
She
continues to recognize her family, but has become increasingly confused to place and time
. Her
68-year-old daughter,
Kim,
devotes the majority of her time to attending to her mother’s care at
home. Kim is her primary care giver and her sister who lives one hour away comes to help her over the weekend.
During your check up on Ms. K.S,
Kim
looked tired.
When
Kim
was asked “How are you doing? How is you stress level?”, her eyes started tearing. Slide4
CaseKim stated she has been in poor health herself, and has been diagnosed with Type II Diabetes, hypertension, and kidney problems. She has lost almost fifteen pounds in the last five months.
Although her sister is helping her over the weekend, she feels she is too busy to take care of herself. Her sister thinks they need to place Ms. K.S in the NH, however she does not want to because she believes MS. K.S does not want to go to the NH. She wants to visit her daughter in mainland to attend her collage graduation, but she does not think her sister can take care of their mother that long. Slide5
Caregiver BurnoutA
state of physical, emotional, and mental exhaustion May be accompanied by a change in attitudeOccur when caregivers don't get the help they need, or if they try to do more than they are able
(physically
or
financially)Slide6
Caregiver BurnoutM
ay experience:FatigueStressAnxietyDepressionHave guilty feeling if they spend time on themselves rather than on their ill or elderly loved onesMay think they are “weak” because they feel overwhelmed while other people
seem
to be fineSlide7
Causes of Caregiver BurnoutLack of training for caregiver duties
Nursing tasks, medication management, managing finances, knowledge of dementiaRole confusionBoth caregiver and care receiver may struggle with role changesUnrealistic expectations: of self and care receiverLack of control
Unreasonable demandsSlide8
Plan for the future
Legal Matters
Care options
Cost of care
Safety ex. DrivingSlide9
Legal Matters
Capacity and Competence
Health care decisions and Financial care decisions
Powers of Attorney
Court-Appointed Guardians
Trustees
Representative PayeesSlide10
Care Options
DaycareRespite Care
Hired Care (Home Health Care)
Care home or Foster home
Assisted living
Intermediate care Nursing HomeSlide11
Cost of care
Insurance: Medicare, Medicaid
COBRA
Life Insurance
Long Term Care Insurance
Disability Insurance
Retirement benefits
Personal assets
Government assistance
Community support servicesSlide12
Safety
Talk about driving
Assess home for safety
Bedroom upstairs?
Handrails?
Trip hazards?
Risks of Wandering or getting lost of loved ones (
MedicAlert
, Alzheimer’s Association Safe Return Program)Slide13
Signs of Caregiver BurnoutWithdrawal from friends and family
Loss of interest in activities previously enjoyedFeeling blue, irritable, hopeless, and helplessChanges in appetite, weight, or bothChanges in sleep patternsGetting sick more oftenFeeling of wanting to hurt themselves or the person for whom they are caring
Emotional and physical exhaustion
Excessive use of alcohol and /or sleep medications
IrritabilitySlide14
How Can You Help?
Start the conversation about caregiver stressMake asking about caregiver duties a standard part of intake/follow up information gathering for all patientsLook for signs of burnoutScreen for diagnosable mental health issues: depression/anxietyRefer to treatment
Normalize/validate their experience
“most caregivers find it very tough at times, but no one talks about it”
”most caregivers have a hard time seeking help, but most that do are glad they did”
“It makes so much sense to feel ___________. This is not a role you were trained for. Would you like to talk about some people/programs you can call to get information and support?”
Offer recommendations:Slide15
Encourage caregivers to:
Speak upSpread the responsibilitySet up a regular check-inSay “Yes” when someone offers assistanceBe willing to relinquish some control Slide16
What you can recommendReassure them: Self care is not selfish!
Maintain their personal relationshipsPrioritize activities that bring them enjoymentFind ways to pamper themselvesMake themselves laughGet out out the houseTake care of their healthJoin a support group and connect with other resourcesSlide17
CaseReassure: Self care is not selfish
!Family therapyEncourage to take time off : Utilize available resources -Daycare -Hired help (Home Care)
-Respite care
Join a support group and connect with other
resources
-Alzheimer’s association
Slide18
COMMENTS?
QUESTIONS?
OTHER CASES?