The following blog post is from Cathy Cress, author of Handbook of Geriatric Care Management:
November is National Caregiver’s Month. This is an opportunity for Geriatric Care Managers (GCMs) to celebrate and call attention to the plight of family caregivers. In the third edition of Handbook of Geriatric Care Management, I have added a chapter, “Assessing and supporting the Family Caregiver” (Ch.9). This new chapter highlights GCM’s important role in building this desperately needed platform for drowning family caregivers. Why are they drowning?
Family care-giving is fraught with dilemmas. New roles and responsibilities are acquired, often unexpectedly, with no job descriptions, little preparation, and few, if any, role models. The care-giving duties are heaped on already full plates of work and family demands, piled on top of personal responsibilities and needs. For many individuals, care-giving is a long-term commitment, often lasting years—so long, in fact, that gerontologists speak of the care-giving career.
The average woman today will spend more years providing parent care than she did childcare. This care-giving burden comes with substantial costs: adverse physical, emotional, and social effects. In fact, research has revealed that caregivers experience excess morbidity and mortality. They actually die giving care.
Family caregivers develop stress-related illnesses and injuries. Depression is prevalent among them. They suffer shrinking social networks, and there are consequences in the workplace—time lost, opportunities missed for advancement, and economic losses in terms of earnings, benefits, and pensions. These economic impacts will also have repercussions for the caregiver’s own later years. Care-giving kin may face a mired swamp of legal problems through wills, trust, and inheritance issues involving the family members they care for. Caregivers can also risk serious injury. The “sicker and quicker” DRG discharges in the America hospital system create a care-giving nightmare. Family caregivers then face older relatives discharged with pumps, IV lines, or wounds that require care needs that involve nursing skills. Most family caregivers are untrained and unprepared to render this level of medical care. They risk personal injury through turning, lifting, and repositioning the client. In the chapter “Assessing the Caregiver,” found in Care Manager’s Working With The Aging Family, Nancy Guberman, MSW points out that if family caregivers were paid and employed by a home health agency, they would be a worker’s compensation nightmare.
Untrained, under-supported, and emotionally stressed family caregivers may at times, paradoxically, have a negative effect on their frail elder’s well-being. Whether intentionally or inadvertently, the care they provide may be inadequate. Overburdened or burned out caregivers may become neglectful or even abusive to their care recipient. The strain of family caregivers can be overwhelming, a fact that the GCM needs to understand in order to deliver good care to their GCM client.
Other nations have seen this more clearly than the United States where we are, it seems, slow to learn this lesson. In 1995, the United Kingdom legislated the Recognition and Services Act, which afforded British caregivers a statutory right to ask for a caregiver assessment at the same time that a frail elder or adult with disability is assessed
What can GCM’s do to help family caregivers? My new chapter gives an excellent caregiver assessment, designed especially for GCM’s to assess caregiver strain and come up with a care plan to help family caregiver better care for GCM clients while at the same time taking care of themselves. This chapter, especially designed for the GCM, brings us to the point of other nations like Britain, who have recognized the critical need for caregiver assessment.
Celebrate National Caregiver’s month. Start using a caregiver assessment tool in your work available in the new 3rd edition of Handbook of Geriatric Care Management.