Caregivers Home Alone-And Needing Our Support

Family caregivers performing complex care.

When my mother needed care at home in her final days, she was fortunate in that two of her daughters were nurses who were familiar and comfortable in providing her care. We were fortunate in that she did not require complex care like tube feedings or IVs or ostomy care or wound care or dialysis. But many people do, and must rely on family members to do these complex tasks.

I remember how I felt as a nursing student when I had to administer one of these complicated interventions. I remember being anxious, my hands sweating as I desperately tried to recall the list of instructions I had looked up the night before.

And yet I had an instructor with me to walk me through it. Family caregivers have no such support and often don’t even get adequate instruction beforehand.

Family caregivers need more than recognition.

November is National Family Caregivers month and I can’t think of a group more in need of recognition. But while naming a month in their honor is nice to increase awareness of the more than 40 million family caregivers in this country, they need much more than that. Specifically, they need more in […]

2019-11-18T11:16:45-05:00November 18th, 2019|family caregiving, family caregiving, Nursing, Patients|1 Comment
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Nursing Homes: A ‘Place No One Wants to Be’

I’m on my way home from Atlanta, site of the 2018 NICHE (Nurses Improving Care for Healthsystem Elders) conference. This organization, housed at New York University-Rory Meyers College of Nursing for the last 26 years, provides education and consultation to organizations to improve the delivery of health care to older adults. It now counts over 700 member organizations in five countries and has been successful in helping facilities implement best practices for providing care to older adults.

Redesigning long-term care.

One of the speakers, Migette Kaup, PhD, from Kansas State University and an expert in designing care facilities, spoke about current efforts to redesign long-term care. She noted that traditional nursing homes, which were designed to mimic hospitals, are “a product no one wants” and a place many people would rather die than go to.

Kaup spoke about the success of the newer “household” model of long-term care, which mimics a home setting rather than a hospital. Key aspects of this model are that it centers around an open kitchen space and is made up of a dedicated staff and small group of residents who live together and implement best practices. Kaup cited successes in decreasing depression and pressure ulcers in low-risk patients, among other parameters. Of course the real goal, as we […]

2018-04-13T11:43:57-04:00April 13th, 2018|family caregiving, Nursing, nursing perspective|3 Comments
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Wound Care: A Common, Often Stressful Family Caregiving Task

“Teaching Wound Care to Family Caregivers” is currently one of AJN‘s most-viewed articles. As the article points out, more than one-third of family caregivers have to perform wound care, and doing so at home “can be a stressful experience.”

In a recent study of the challenges faced by family caregivers, 35% of those sampled reported performing wound care. Importantly, 66% of these caregivers indicated that wound care was difficult for them. For almost half, fear of making mistakes or causing harm was even more of a concern than the time and inconvenience of providing wound care….

The CARE Act mandates family caregiver teaching.

A nurse teaches a family caregiver how to assess a diabetic foot ulcer and safely change the dressing. Photo courtesy of the AARP Public Policy Institute.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Some other topics covered in the series include managing mobility and fall risk in the home, managing complex medication regimens, administering injections, and others.

As AJN editor-in-chief Shawn Kennedy wrote in a

2018-03-16T08:45:20-04:00March 16th, 2018|family caregiving, Nursing, Patients|0 Comments
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Helping Family Caregivers with Fall Prevention in the Home

“Because mobility in later life results in positive health benefits but increases exposure to falls, many researchers and health care providers in geriatric nursing and medicine have called for ensuring safe mobility while protecting older adults from harm. It’s especially important to identify strategies that can potentially reduce the risk of fall-related injuries in older adults.This increasing focus on fall-injury prevention—in addition to fall prevention—represents a major shift in safety practice.”

(Click image to enlarge)

How can nurses best help family caregivers?

How can nurses help family caregivers identify fall risk in their family members, prevent falls, and respond to them if they occur?

According to the authors of “Preventing Falls and Fall-Related Injuries at Home“—the latest in our ongoing series of articles and videos, Supporting Family Caregivers: No Longer Home Alone—the need for better education and resources on such topics is widespread among family caregivers:

“In a national survey of caregivers who provide unpaid care to a relative or friend, 46% reported they assisted with medical and nursing tasks. Of these, 43% said such help involved the use of assistive mobility devices, such as walkers or canes. Almost half of family caregivers are also known […]

2018-01-25T10:24:11-05:00January 25th, 2018|family caregiving, family caregiving, Nursing, patient safety|0 Comments
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Family Caregivers: Nurses by Default

Caregiver guides family member using safe stair-climbing technique. Photo courtesy of AARP Public Policy Institute.

We all know how compressed hospital stays are. Patients are frequently admitted and discharged within a few days, even for what used to be “big” surgeries. We dutifully send them home with discharge instructions—sometimes, pages of them—and often have only a few minutes to go over them with whoever is taking the patient home. And in many cases, that person is not even the one who will be caring for the patient, so instructions for medications and treatments are given second-hand. And we wonder why there are so many readmissions within 30 days!

Forty million plus unpaid caregivers in the United States.

As I note in this month’s editorial, there are over 40 million unpaid caregivers in this country who are administering complex medical and nursing interventions such as ostomy and wound care,  tube feedings, injections, and tracheostomy care, in addition to taking on bathing, toileting, and other necessary care. Many of these caregivers do so without any real training. Aside from the real danger that […]

2017-12-04T12:34:59-05:00December 4th, 2017|family caregiving, Nursing|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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