Week 5 Flashcards
(59 cards)
1
Q
what is caregiving
A
- providing unpaid support to family members or friends who have physical, emotional, or practical needs d/t an illness, disability, or aging
2
Q
a pt’s ability to be cared for and die at home is heavily dependent upon…
A
- the efforts of family caregivers
3
Q
describe caregiving in canada (5)
A
- 8.1 mil family caregivers
- provide 66.5 bil worth of care/year –> “invisible providers”
- 80% of all care at home is provided by fam caregivers
- principle source of support for pts who are dying at home
- need for family caregivers will increase dramatically in the coming years
4
Q
why will the need for family caregivers will increase dramatically in the coming years because… (4)
A
- population is aging
- longevity is increased
- those w chronic illnesses are living longer and have increasingly complex health care needs
- formal health care system is overwhelmed
5
Q
what is the caregiver recognition act (2)
A
- MB legislation passed in June 2011
- purpose is to acknowledge vital role of caregivers & set up general principles for gvmt agencies to better support caregivers
6
Q
how effective has the caregiver recognition act been (2)
A
- other than designating 1st Tues of every April as caregiver recognition day in MB
- no tangible actions taken to increase caregiver experiences
7
Q
palliative care is…
A
- an approach that improves the QOL of pts and their families (!!!) facing the problems associated w life-threatening illness, thru the prevention and relief of suffering by means of early id and impeccable assessment, and treatment of pain and other problems - phys, psychosocial, and spiritual
8
Q
what is caregiver-centered care
A
- care that values caregiver as central
- outlines 6 competencies
9
Q
what are the 6 competencies of caregiver centered care
A
- recognize the caregiver role
- communicate with family caregivers
- partnering w family caregivers
- fostering resilience w family caregivers
- navigate health and social systems and accessing resources
- enhancing the culture and context of care
10
Q
describe the competency of “recognizing the caregiver role”
A
- be aware of & identify their role and responsibilities
11
Q
describe the competency of “communicating w family members” (4)
A
- communicate in a matter than demonstrates respect, empathy, and compassion
- listen actively
- provide timely info in ways they can understand
- consistent documentation & info
12
Q
describe the “partnering w family caregivers” competency (5)
A
- directed by our attitude towards them (some HCP annoyed or ignore them)
- understand benefits of including them on care team
- do WITH caregivers as essential partners in care
- value their knowledge of pt
- include them in assessments and care planning
13
Q
describe the “fostering resilience in family caregivers” competency
A
- identify & assess their needs r/t their ability to provide care and maintain their own health & wellbeing
14
Q
describe the “navigating health & social systems and accessing resources” competency (3)
A
- work together to collab to access applicable supports in timely manner
- communicate w and make referals to other providers in accordance w family caregiver’s needs & preferences
- work together to overcome barriers to access services & supports
15
Q
describe the “enhancing the culture & context of care” competency
A
- recognize that care & caregiving are effected by societal views
ex. consider how ageism may effect our caregiver’s experiences
16
Q
who are caregivers? (7)
A
- 54% women, 46% men
- ~25% are >65 yo
- ~70% are >45
- sandwich generation
- most commonly family relationship
- may be friend or neighbor
- most likely to be retired (but often not)
17
Q
what is the “sandwich generation”
A
- generation who provides care for their parents and children at same time
18
Q
what stresses can be associated w caregiving (3)``
A
- physical
- psychosocial
- financial
(but dont make assumptions)
19
Q
describe how the time commitment and intensity of caregiving changes in a chronic progressive illness (2)
A
- caregiving experience is fundamentally uncertain
- time commitment and intensity increases at end of life
20
Q
why does time commitment and intensity of caregiving increase at the end of life (2)
A
- distressing symptoms
- pt becomes more functionally, and sometimes cognitively, impaired
21
Q
what caregiver feelings are common in caregiving for someone w a chronic progressive illness (6)
A
- helplessness
- vulnerability
- uncertainty (r/t unpredictable trajectory)
- feel ill-prepared
- pressured to provide care
- uncertain abt their abilities
22
Q
what are 3 aspects of caregiving
A
- family effect
- caregiving responsibilities
- self-care
23
Q
what is family effect and what does it describe (3)
A
- states that merely having a family member living w a chronic progressive illness will have impact those around them
- family also experiences loss, grief, uncertainty abt future, what things will look like as disease unfolds and after they pass
- family has to also deal w own emotions and responses to having a family member who is ill
24
Q
what are some of the responsibilities of caregivers (9)
A
- managing symptoms (ex. constipation)
- domestic chores & household tasks
- personal care
- assisting w ADLs
- emotional and social support
- be a spokesperson, advocate, proxy decision maker for them
- coordinate all aspects of their care v
- develop new skills
- acquire lrg amts of new info in short amt of time
25
describe caregiver self-care (7)
- caregiving = disruption in own routines & restrictions on time and energy to engage in activities they usully do
- social isolation common
- cease activites outside of home
- may stop attending community activities they normally are part of for companionship & social support
- signif fatigue , sleep deprivation
- postpone own health & wellbeing, medical appts
- may find it difficult to find time to engage in activities that increase their health (exercise, eating well, etc.)
- notorious for prioritizing needs of the pt at the expense of their own needs
26
describe the psychosocial burden associated w caregiving (5)
- sense of disruption in "normal life"
- social isolation common
- obtaining support hampered by the fact that many family members do not identify themselves as legitimate recipients of help; focus instead on dying person
- high psychological stress
- cease activities outside of the home
27
what emotional stressors are associated w caregiving (5)
- vivid awareness of impending death
- face uncertain future
- grieve successive losses
- high anxiety lvls
- experience depression
28
describe the physical burden associated w caregiving (4)
- long hours of provision of care = signif fatigue
- sleep deprivation
- improper nutrition
- postpone their own medical appts
29
describe the financial burden associated w caregiving (3)
- many caregivers quit working or reduce their hours
- where benefits are available, difficulty in negotiating the system
- limited paid leave or job security if take time off work
30
what some issues associated w Canada's Compassionate Care Benefit (3)
- limitations of benefit
- strict eligibility
- short duration of assistance
31
despite feeling overwhelmed, many family caregivers report... (6)
- caregiving as life-enriching
- derive signif benefits
- sense of accomplishments
- belief that they are able to give something back to the indiv
- allows them to spend intimate times together
- share final moments together that are meaningful
32
what are some motivators for pt's desire for care at home (2)
- more familiar enviro
| - poor experiences w acute care
33
`what factors impact caregiving experience? (6)
- age
- culture
- family dynamics
- reasons for taking on role
- view of role within large system
- preferences for location of care
*can impact (+) or (-)*
34
describe how age can impact caregiving experience (5)
- if older adult, may not be able to support as much physically & own chronic condition
- retired vs still working or in school
- consider developmental stage
- impacts coping mechanisms
- have different life demands
35
describe how culture can impact caregiving experiences (4)
different expectations:
- who should take care of them
- is it their "duty"
- attitude towards older adults
- voluntary vs obligated
36
describe how family dynamics can impact caregiving experience (3)
- pre-existing tension = more challenging
- disagreements between children r/t who should be caregiver
- good vs poor communication
37
describe how the reasons for taking on a caregiving role can impact caregiving experience (2)
- voluntary vs obligated
| - some make promises to providing care at home out of a sense of duty, love, and obligation
38
describe the view of role within larger system can impact caregiving experience (2)
- if they feel like they are an essential part of the healthcare team
- vs if feel like a burden
39
describe how preferences for location of care can impact caregiving experience
- pt may want to be at home, but the caregiver may have individual needs that make it difficult
40
what factor plays a main role in health outcomes of the caregiver
- caregiving does not = poor health outcomes
- main factor is how caregivers cope w their role and how they appraise and perceive the situation
*review chart from previous week*
41
describe assessment of family caregivers (2)
- whole person approach
| - recognize that they may be impacted & have needs in any 4 domains
42
what is used to assess caregiver needs
- carer support needs assessment tool (CSNAT(
43
what is the CSNAT (4)
- tool used in the caregiver centered approach
- not a checklist, way to guide convo
- represents 14 domains of support needs
- 7 focus on need that will enable to carer to provide care
- 7 focus on direct support for carers
44
what are the benefits of using the CSNAT
- provides visiibility abt area of support the caregiver need
- often dont know what they dont know
45
list the 7 domains of the CSNAT under the "enabling carers to care" category
- knowing who to contact when concerned
- understanding the pt illness
- knowing what to expect in the future
- managing symptoms & giving meds
- talking to pt about their illness
- equipment to help care for pt
- providing personal care to pt
46
list the 7 domains of the CSNAT under the "direct support for carers" category
- own physical health concerns
- dealing w their own feelings and worries
- beliefs or spiritual concerns
- practical help in the home
- financial, legal, work issues
- having time for themselves in the day
- overnight break from caring
47
what are the 5 stages of the CSNAT approach
1. intro to CSNAT
2. carer consideration of needs
3. assessment convo
4. shared action plan
5. shared review
48
when should the CSNAT be initiated and used? why is this imp?
- initiate early
- re-visit regularly & as situation changes
- imp to check in voluntarly & regularly to demonstrate care & understand there needs and if theyve changes
49
what are the take home messages r/t caregiver assessment (6)
- do not make assumptions
- engage in conversation w family caregivers
- acknowledge family caregivers
- genuinely listen
- do with family caregivers
- check in w family caregivers regularly and voluntarly
50
describe the importance of not making assumptions abt caregivers (3)
- do not assume they are under only (-) stresss
- do not assume their needs
- do not make assumptions abt their experiences
51
describe the importance of engaging in convo w family caregivers (5)
- get to know them
- use whole person approach
- learn how illness is impacting them & their needs
- listen to their story
- ask open ended questions
52
what is meant by "do with caregivers"(3)
- partner with them , not "do to" or "for them"
- find out what they need
- value what you know abt them
53
what should you not say to caregivers? why?
- "you need to take care of yourself"
| - they know they need to, may be offensive, not helpful
54
what are some questions to guide care/assessment for the caregiver (6)
- what does the caregiver view as benefits to self-care?
- what does the caregiver identify as barrier to self-care?
- how confident is the caregiver that they can overcome these barriers?
- what kind of self-care activities does the caregiver enjoy?
- who will support the caregiver to engage in these activities?
- where is an attractive, safe place to engage in these activities?
55
what are some appropriate supportive resources for caregivers (6)
- referals to approp colleagues (homecare, social work, spiritual care)
- disease specific resources (alzheimer society, CCMB pt & family support services)
- caregiving w confidence
- canadian virtual hospice
- carers canada
- employment insurance caregiving benefits
56
what EI caregiving benefits are available for caregivers (3)
- family caregiver benefit for children (max 35 weeks)
- family caregiver benefit for adults (max 15 weeks)
- compassionate care benefits (max 26 weeks)
57
what is imp to consider regarding approp supportive resources
- need to be matched and individualized to their needs
58
what should caregivers know abt stress (4)
- there are warning signs
- various sources of stress
- things you can and cannot change --> focus on the things you can
- there are things we can do to reduce stress
59
what are some warning signs of stress (4)
- irritability
- sleep problems
- weeping
- changes to appetite
