Family Caregiving Managing Stress and Accessing Resources

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Family Caregiving Managing Stress and Accessing
Resources

• Organizational Lesson 2004
• Sean E. Brotherson, PhD
• Extension Family Science Specialist
• North Dakota State University
• EM sbrother_at_ndsuext.nodak.edu
• PH 701.231.6143

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Lesson Objectives

• Understand key issues related to family
  caregiving for aging persons.
• Learn about specific strategies and resources to
  help manage caregiver stress and provide quality
  care to family members.
• Access specific resources to further understand
  issues related to caregiving and stress.

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True or False?

• The most common care decision that families need
  to make about care for aging adults is about what
  type of care facility to have them live in.

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Answer - False

• Myth The majority of older adults who need
  care will spend time in a nursing home at some
  point in their lives.
• Reality Most care provided to older adults is
  done by family caregivers in a home setting. 70
  to 80 percent of all community-based care needed
  by older persons is done by family caregivers.
  The most common care decision is thus who will
  provide family-based care when it is needed.

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True or False?

• Adults who are still caring for children at home
  and also assume care of an aging parent have been
  referred to as being part of the sandwich
  generation.

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Answer - True

• Myth Nearly every adult American will pass
  through the experience of being part of the
  sandwich generation.
• Reality Although it is not uncommon for adult
  Americans to have this experience, the majority
  of adults do not have dependent children when
  they assume care for a parent in need.

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True or False?

• Adult daughters are the most common primary
  caregivers when family care is given to an aging
  or needy adult.

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Answer False

• Myth Daughters are usually the primary
  caregiver for an adult who needs family care.
• Reality It is first spouses, either husbands
  or wives, who are the most common primary
  caregivers, followed by daughters and
  daughters-in-law. So, adult daughters provide a
  great deal of care, but it is even more common
  for aging spouses to be in this circumstance.

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True or False?

• Family-friendly business policies are paying
  increased attention to the need for family leave
  to care for dependent adults.

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Answer - True

• Myth Care for dependent adults is mostly
  ignored in the policies of companies relating to
  care for dependent family members.
• Reality With more and more adults caring for
  aging family members, companies are being
  required to give increased attention to the need
  for flexible work and leave policies that allow
  for care for dependent adults. These trends are
  more likely to increase in the near future as the
  aging population increases significantly.

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True or False?

• Women provide most of the direct care that is
  given in family caregiving situations to aging
  parents or family members.

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Answer - True

• Myth The amount of direct care provided in
  family caregiving varies by cultural context so
  that men are most responsible in some cultures.
• Reality While it is true that there is an ethic
  of care by adult sons for parents in some
  cultural settings, even in those situations most
  direct care is still provided by women such as
  daughters-in-law or other women in the family.
  However, involvement by men in direct care is
  slowly increasing.

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True or False?

• The feelings of obligation that an adult child
  feels toward a parent are the strongest predictor
  of how often an adult child has contact with a
  parent.

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Answer - False

• Myth A sense of filial obligation or duty
  toward a parent is the strongest motivation and
  predictor of how often an adult child has contact
  with a parent.
• Reality Although an adult childs feelings of
  obligation are important, the biggest factor in
  regular contact between adult children and
  parents is proximityhow close they live to the
  parent. The next most important factor is the
  feelings of parent-adult child closeness that
  exist, and then feelings of obligation.

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Suggested Benefits of Caregiving

• It can be helpful to discuss how the caregiving
  experience has provided positive benefits to both
  the caregiver and the care recipient. This focus
  on the positive aspects of the experience can
  help give perspective and needed hope when stress
  increases. According to research, there are
  specific positive things associated with
  caregiving by many who pass through this
  experience.

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Positive Benefits for the Caregiver

• Developing closer relationships with the person
  they care for and having sufficient time to be
  together.
• Increased understanding of a parent or family
  member and the ability to forgive or heal past
  difficulties.
• Greater patience with individuals and life
  challenges.
• Personal growth as an individual due to being
  challenged and stretched in emotional and other
  ways.

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Positive Benefits for the Care Recipient

• Opportunity to receive assistance in a setting
  that is caring and personal.
• Greater individualized care and attention than in
  other circumstances.
• Sharing of life experiences and close
  relationships with persons who are close to them
  and who they appreciate.

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What is Family Caregiving?

• Caregiving involves providing direct physical
  and emotional support to a family member or other
  adult who has become dependent and needs some
  care and assistance. The level of caregiving can
  vary from occasional monitoring of how a person
  is doing to full-time, round-the-clock care for
  a bed-bound individual.

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Areas of Stress Impact Related to Family
Caregiving

• Physical Demands direct care, lifting, bathing,
  feeding, etc.
• Financial Demands medical costs, equipment,
  hired help, lost income
• Emotional Burdens feeling isolated, alone,
  without time for oneself
• Relationship Challenges sibling conflict,
  conflict with dependent adult, etc.

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Stress Sources of Physical Demands in Caregiving

• Creating a safe physical environment, preventing
  falls
• Providing first aid and medical assistance as
  possible
• Bathing a care recipient
• Assisting with oral hygiene
• Dressing a care recipient
• Assisting with toileting needs
• Feeding or assistance with eating, nutrition
  needs
• Meal planning and preparation
• Lifting, turning, or transferring a care
  recipient
• Routine housework
• Management of behavior with care recipients who
  have cognitive impairment
• Other physical challenges

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Suggested Coping Tips Physical Demands

• Learn how to properly care for your family
  member. Get training so you know to perform
  needed skills, which will make your work easier
  and safer.
• Practice healthy habits, including a balanced
  diet, regular exercise, sufficient sleep, and
  visits to the doctor.
• Get help when needed with physical tasks from
  other care providers, neighbors, or sources of
  help.
• Work to keep your care recipient as independent
  as possible. This reduces your stress and
  maintains dignity.
• Utilize adaptive or assistive equipment with
  specific needs.

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Stress Sources of Financial Demands in Caregiving

• Costs of medical care and treatment
• Costs of adaptive or assistive equipment that is
  needed
• Costs of hired help
• Lost income
• Reduced work hours
• Loss of employee benefits
• Management of financial concerns for care
  recipients
• Planning for long-term care financial needs

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Suggested Coping Tips Financial Demands

• Evaluate and utilize programs that assist with
  medical and treatment costs related to family
  caregiving
• Identify programs that provide assistive
  technology at reduced fees or on loan
• Discuss financial needs and impacts with other
  family members
• Plan ahead for projected medical costs or
  treatment needs
• Work with financial planning specialists as needed

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Stress Sources of Emotional Demands in Caregiving

• Feeling alone and unaided
• A sense of isolation and frustration
• Insufficient time for oneself and personal
  activities
• Fatigue and emotional irritability
• Anger or frustration at perceived unfairness of a
  situation
• Discouragement or personal depression
• Loss of opportunities
• Feeling overburdened with demands from care
  recipient or others
• Lack of control over circumstances

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Suggested Coping Tips Emotional Demands

• Find someone you trust and talk about your
  feelings or frustrations.
• Be realistic about the demands of caregiving and
  turn to others for help.
• Set aside time for self-care and personal
  renewal.
• Take advantage of respite care services and get a
  break for a few hours or a couple of days.
• Join a caregiver support group so you can share
  feelings, learn about resources, and reduce
  stress.
• Get assistance from others.

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Stress Sources of Relationship Challenges in
Caregiving

• Feeling overburdened by care responsibilities so
  you become resentful of the care recipient
• Conflict with care recipient about care demands
  or plans
• Disagreement with family members about care
  responsibilities or plans
• Insufficient time and energy for other family
  relationships
• Difficulties with spouse due to care demands
• Criticism or lack of help from other family
  members related to caregiving
• Limited communication about needs

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Suggested Coping Tips Relationship Challenges

• Focus on positive experiences with the care
  recipient such as sharing memories or doing a
  life story.
• Involve the care recipient as much as possible in
  discussion of guidelines for care.
• Express needs and issues clearly to other family
  members related to caregiving responsibilities.
• Take time for other family relationships.
• Participate in a support network for caregivers
  and get respite care.
• Have each family member participate in caregiving
  and express appreciation for each other.

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The North Dakota Family Caregiver Project

• The North Dakota Family Caregiver Project has
  in-depth training and educational materials to
  assist caregivers and community professionals
  with issues of family caregiving. These materials
  can be accessed on the Internet at
  http//www.ndsu.nodak.edu/ndsu/caregiver/educatio
  n/index.htm

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Training Materials on Caregiving

• How We Age
• Personal Care Tasks
• Family Relations and Caregiving
• End of Life Issues
• Caregiver Abuse, Neglect and Exploitation
• Assistive Technology and Older Adults
• Behavior Management
• Personal Care Challenges
• Nutrition Counseling
• Caregiver Stress and Coping
• Financial Counseling and Planning

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North Dakota Senior Information

• The North Dakota Senior Facilities Locator is an
  ambitious project intended to assist individuals
  and caregivers in locating facilities that
  provide services to seniors in North Dakota. It
  is part of a larger initiative sponsored by the
  North Dakota Department of Human Services that
  focuses on informal caregiving in the state.
• Visit the North Dakota Senior Information's Web
  site to learn morehttp//www.ndsu.nodak.edu/sdc/
  ndseniorinfo/