November is National Family Caregivers Month, and while caregivers work year-round to provide care for their loved ones, it is important to reflect on and honor the value of caregivers in supporting loved ones in remaining at home and autonomous. Caregivers help older adults and family members with disabilities and complex medical conditions navigate day-to-day activities, as well as support access to complex medical treatments, such as administering in-home dialysis, respiratory therapies, and injections. Caregivers will often take on the role of physical and occupational coach, behavioral health therapist, personal chef, and housekeeper. This is in addition to managing their own tasks of daily living, careers, and caring for other family members. According to the Centers for Disease Control and Prevention (CDC), one quarter of caregivers for family members with dementia are “sandwich caregivers,” meaning they care for both an aging parent and a child under the age of eighteen.
ConcertoCare’s clinical model recognizes the important role of caregivers in delivering exceptional in-home medical care, and supports their efforts with a robust interdisciplinary team, comprised of several disciplines: advanced practice providers delivering in home medical care; nurse case managers that support with coordination of care, transitions of care and disease-specific education to the patient and their caregivers; community health workers who are knowledgeable about community resources to supplement or enhance the supports available to patients and their caregivers; pharmacists to help with medication access and management of chronic conditions; and behavioral health practitioners that recognize the real and present concern of caregiver burn-out and the challenges of navigating disease progression.
Mrs. J’s story highlights the important role of caregivers in delivering exceptional care. Mrs. J is 88 years old. She is widowed and lives with her son and daughter-in-law. Mrs. J has chronic kidney disease, hypertension, peripheral vascular disease and dementia. Mrs. J’s family wants to provide her with compassionate care in the comfort of their own home. Mrs. J’s daughter-in-law is her primary caregiver; a typical day for her includes waking up at 5 AM to begin caregiving for her mother-in-law, including preparing Mrs. J’s breakfast and administering her morning medications. She then assists with toileting, showering and dressing Mrs. J. Throughout the day she prepares meals, takes care of household chores, and picks up medication refills from the local pharmacy. Come evening, after preparing and serving a diet-specific dinner, she readies Mrs. J for bed. Mrs. J’s daughter-in-law then gets up the next morning at 5 AM to do it all over again. Amidst these intense caregiving needs, the ConcertoCare team has been able support Mrs. J and her family as they navigate disease progression. Her provider meets with Mrs. J and her daughter-in-law in the home and coordinates care across her specialists. After a recent fall, the nurse case manager supported a successful return home, ensuring the right supports were in place, including physical therapy. The community health worker stepped in to introduce home modifications to prevent future falls, and the pharmacist reviewed Mrs. J’s medications to identify possible changes to reduce her future risk of falls. The licensed clinical social worker continues to ensure that Mrs. J’s family is better prepared for what’s ahead as Mrs. J’s disease progresses.
As highlighted in Mrs. J’s story, caregivers are unsung heroes that allow those with complex medical needs to remain in the comfort of their own home, remain autonomous for as long as possible, and be surrounded by loved ones invested in their well-being. Mrs. J’s family members are not alone in their desire to provide compassionate care for a loved one. According to the CDC, millions of adults rely on unpaid caregivers to stay independent. These caregivers are at high risk of burnout, self-neglect, and memory loss. As we recognize caregivers in November, consider the following tips to promote self-care:
- Ask for and accept help: Make a detailed list of how others could help, including providing transportation details for medical appointments, the address of the local pharmacy for medication pickups, and a list of favorite meals that could be pre-made and dropped off
- Consider respite care: Think about options such as home health care aides, adult care centers and programs, or short-term nursing homes, to provide support when needed
- Set realistic goals: Break down larger tasks into smaller steps, follow a daily routine, and say ‘no’ to requests from others that are draining or too much to handle
- Learn about local resources: Most local county and government websites have a list of adult aging resources, such as free rides to medical appointments and free meal delivery options
- Get connected: Join a support group for family caregivers, many of which take place virtually
- Practice self-care: Try not to miss medical appointments and regular health screenings, eat a nourishing diet, and get restorative sleep.
Additional caregiver resources can be found at Today’s Caregiver (www.caregiver.com), The National Council on Aging (www.ncoa.org), Family Caregiver Alliance (www.caregiver.org), CDC (www.cdc.gov) and Mayo Clinic (www.mayoclinic.org).
