Caregiver
A caregiver, carer or support worker is a paid or unpaid person who helps an individual with activities of daily living. Caregivers who are members of a care recipient's family or social network, who may have specific professional training, are often described as informal caregivers. Caregivers most commonly assist with impairments related to old age, disability, a disease, or a mental disorder.
Typical duties of a caregiver might include taking care of someone who has a chronic illness or disease; managing medications or talking to doctors and nurses on someone's behalf; helping to bathe or dress someone who is frail or disabled; or taking care of household chores, meals, or processes both formal and informal documentations related to health for someone who cannot do these things alone.
With an aging population in all developed societies, the role of caregivers has been increasingly recognized as an important one, both functionally and economically. Many organizations that provide support for persons with disabilities have developed various forms of support for caregivers as well.
Uses
A primary caregiver is the person who takes primary responsibility for someone who cannot care fully for himself or herself. The primary caregiver may be a family member, a trained professional or another individual. Depending on culture there may be various members of the family engaged in care. The concept can be important in attachment theory as well as in family law, for example in guardianship and child custody.A person may need care due to loss of health, loss of memory, the onset of illness, an incident of falling, anxiety or depression, grief, or a disabling condition.
Technique
Basic principles
A fundamental part of giving care is being a good communicator with the person receiving care, not just giving instructions but also listening actively, showing empathy, and making sure they understand there health needs. Care is given with respect for the dignity of the person receiving care while acknowledging the patients feelings, and values. The carer remains in contact with the primary health care provider, often a doctor or nurse. They also helps the person receiving care make decisions about their treatment, daily life and healthcare plans while also supporting them throughout there treatments.In addition to communication, the caregiver is responsible for managing hygiene of themselves, the person receiving care, and the living environment. Hand washing for both caregivers and the patients happen frequently. If the person receiving care is producing sharps waste from regular injections, then the caregiver should manage that. Surfaces of the living area should be regularly cleaned and wiped as well as the laundry managed to ensure a healthy living environment.
The caregiver also helps organize of the person's daily agenda including medical appointments, medication schedules, and daily living task. Of special importance is helping the person meet medical appointments. Also routine daily living functions are scheduled, like managing hygiene tasks and keeping health care products available.
Monitoring
The caregiver is in close contact with the person receiving care and should monitor their health in a reasonable way.Some people receiving care require that someone take notice of their breathing. It is expected that a caregiver would notice changes in breathing, and that if a doctor advised a caregiver to watch for something, then the caregiver should be able to follow the doctor's instructions in monitoring the person.
Some people receiving care require that the caregiver monitor their body temperature. If this needs to be done, a doctor will advise the caregiver on how to use a thermometer. For people who need blood pressure monitoring, blood glucose monitoring, or other specific health monitoring, then a doctor will advise the care giver on how to do this. The caregiver should watch for changes in a person's mental condition, including becoming unhappy, withdrawn, less interested, confused, or otherwise not as healthy as they have been. In all monitoring, the caregiver's duty is to take notes of anything unusual and share it with the doctor.
Keeping the person mentally alert
There is a link between mental health and physical health and mind–body interventions may increase physical health by improving mental health. These practices seek to improve a person's quality of life by helping them socialize with others, keep friendships, do hobbies, and enjoy whatever physical exercise is appropriate.Caregivers encourage people to leave their homes for the health benefits of the resulting physical and mental activity. Depending on a person's situation, a walk through their own neighborhood or a visit to a park may require planning or have risks, but it is good to do so when possible.
Depending on a person's situation, it may be useful for them to meet others also getting similar care services. Many places offer exercise groups to join. Social clubs may host hobby groups for art classes, social outings, or to play games. For elderly people there may be senior clubs which organize day trips.
Eating assistance
Caregivers help people have a healthy diet. This help might include giving nutrition suggestions based on the recommendations of dietitians, monitoring body weight, addressing difficulty swallowing or eating, complying with dietary restrictions, assisting with the use of any dietary supplements, and arranging for pleasant mealtimes.A healthy diet includes everything to meet a person's food energy and nutritional needs. People become at risk for not having a healthy diet when they are inactive or bedbound; living alone; sick; having difficulty eating; affected by medication; depressed; having difficulty hearing, seeing, or tasting; unable to get food they enjoy; or are having communication problems. A poor diet contributes to many health problems, including increased risk of infection, poor recovery time from surgery or wound healing, skin problems, difficulty in activities of daily living, fatigue, and irritability. Older people are less likely to recognize thirst and may benefit from being offered water.
Difficulty eating is most often caused by difficulty swallowing. This symptom is common in people after a stroke, people with Parkinson's disease or who have multiple sclerosis, and people with dementia. The most common way to help people with trouble swallowing is to change the texture of their food to be softer. Another way is to use special eating equipment to make it easier for the person to eat. In some situations, caregivers can be supportive by providing assisted feeding in which the person's independence is respected while the caregiver helps them take food in their mouth by placing it there and being patient with them.
Support with managing medications
Caregivers have a vital role in supporting people with managing their medications at home. A person living with chronic illness may have a complex medication regimen with multiple medications and doses at different times of the day. Caregivers may assist in managing medications in many ways. This may range from going to the pharmacy to collect medications, helping with devices such as a Webster-pak or a dosette box, or actually administering the medications at home. These medications might include tablets, but also creams, injections or liquid medications. It is important that the healthcare providers in the clinic help educate caregivers since those caregivers will often be the ones that manage medications over the long term for an individual living with a chronic condition at home.Changes to the home
Living arrangements
To have a caregiver, a person may have to decide on changes on where they live and with whom they live. When someone needs a caregiver, the two must meet, and this typically happens either in the person's own home or the caregiver's home. Consequently, this could mean that a person moves to live with the caregiver, or the caregiver moves to live with the person. It is also possible that the caregiver only visits occasionally or is able to provide support remotely, or that the person who needs care is able to travel to the caregiver to get it.A common example of this is when a parent gets older and has previously lived alone. If the parent's children are to be caregivers, then they may move in with the parent or have the parent move in with them.
Safety in the home
Persons who need care are also frequently people who need homes that are accessible in a way that matches their needs. If the caregiving plan calls for a check on the home, then typically this includes checking that the floor is free from hazards which could cause a falling, has temperature control which suits the person getting care, and has faucets and knobs which suit the users. To reduce risk of any major problem, smoke detectors should be put in place and appropriate physical security measures taken for home safety.Complications
Discontinuing unnecessary treatment
For some diseases, such as advanced cancer, there may be no treatment of the disease which can prolong the life of the patient or improve the patient's quality of life. In such cases, standard medical advice would be for the caregiver and patient to have conversations with the doctor about the risks and benefits of treatment and to seek options for palliative care or hospice.During end-of-life care the caregiver can assist in discussions about screening which is no longer necessary. Screenings which would be indicated at other times of life, like colonoscopy, breast cancer screening, prostate cancer screening, bone density screening, and other tests may not be reasonable to have for a person at the end of life who would not take treatment for these conditions and who would only be disturbed to learn they had them. It can be the caregivers place to have conversations about the potential benefits for screenings and to participate in discussions about their usefulness. An example of a need for caregiver intervention is to talk with people on dialysis who cannot have cancer treatment and can have no benefit from cancer screening, but who consider getting the screening.
People with diabetes who use caregiving services, like those in a nursing home, frequently have problems using sliding-scale insulin therapy, which is the use of varying amounts of insulin depending on the person's blood sugar. For people receiving caregiving services, long-acting insulin doses are indicated with varying doses of insulin being the less preferred treatment. If exceptions must be made, then use the long-acting insulin and correct with small doses of sliding scale insulin before the biggest meal of the day.
Advance care planning should note if a patient is using an implantable cardioverter-defibrillator and give instructions about the circumstances in which leaving it activated would be contrary to the patient's goals. An ICD is a device designed to prevent cardiac arrhythmia in heart patients. This is a life saving device for people who have a goal to live for a long time, but at the end of life it is recommended that the caregiver discuss deactivating this device with the patient and health care provider. For patients at the end of life, the device rarely prevents death as intended. Using the device at the end of life can cause pain to the patient and distress to anyone who sees the patient experience this. Likewise, ICDs should not be implanted in anyone who is unlikely to live for more than a year.