Caregiver Intervention

As the elderly population continues to grow, more and more caregivers will be needed to provide care to this particular population.  Caregivers often suffer from extreme stressors and burdens which can lead to decreased overall physical and mental health. An intervention needs to be implemented in order to minimize such harmful stressors.

Goals of Intervention:

• Increase physical and mental health.

• Improve the relationship with the person that care is being provided to.
• Use effective coping strategies and energy conservation techniques to help mitigate stressors.
• Caregivers using what they have learned to educate other friends and family.
• Decrease insomnia.
• Provide a support structure for caregivers.

Intervention Activities

• Group discussion
•  Education on caregiver burden
• Education on effective coping mechanisms for stress
• Education on building and maintaining a relationship with the person being cared for

Video Overview of Caregiver Burden

Click here for a brief video summarizing caregiver burden and how to determine if you or someone you know is experiencing the taxing effects of providing consistent care. Also included are tips on how to maintain ones health and wellness while providing direct care to elderly clients, friends, or family members.

The Top Ten

Top Ten Tips for Family Caregivers:

Remember to reward, educate, and believe in yourself.

Caregiving doesn't always have to be stressful!

Click here to view the full list of helpful tips for caregivers.

Hospice Caregivers

Providing care for a Hospice patient is one of the most stressful types of care giving a family member can provide.  In addition to the physical and emotional stressors of providing care many hours a week to a loved one, Hospice caregivers are aware of the limited time their loved one has left.  For a person to qualify for the Hospice program, they have to have received a prognosis from their provider that they have less than six months to live (180 days). 

Interventions for Hospice Caregivers have been completed over the years to help reduce the burden of their role.  An intervention published in the Journal of Palliative Medicine focused on this type of care giving.  “A Problem Solving Intervention for Hospice Caregivers: A Pilot Study” took new hospice caregivers and met with them three times within the first three weeks of the caregiver providing care (Demiris, Oliver, Washington, Fruehling, Haggarty-Robbins, Doorenbos, Wechkin, Berry , 2010).  The Hospice caregiver intervention identified new caregivers to Hospice, by newly admitted patients.  The intervention lasted the first few weeks of Hospice care and allowed Caregivers to learn about their new role.  It also provided resouces to help cope with stress.

Outcomes of the hospice caregiver intervention were very positive.  Even with all of the stressors of being a hospice caregiver and the time constraints, caregivers felt that they had a better quality of life and a lower anxiety level after the intervention (Demiris, et al, 2010).  One positive trait of the intervention was that there was a structure to the meetings and specific tools were provided instead of ambiguous discussion and questions (Demiris, et al, 2010).  One participant explained, “a lot of time the social workers will come out and they will say, what can I do for you? You’re in this position, well, I don’t know what you have to offer, I don’t know what your agency encompasses” (Demiris, et al, 2010). This is very common in the care giving world, people offer to help; but if they don't offer a tangible service that the caregiver can easily understand and use, the good deed goes unused.

Click here to read the full journal article discussed above.

Below are some resources for Hospice Caregivers - Please take a look:

• Watch a short video on suggestions around the holidays to minimize caregiver burden.
• Respite Care Information: http://www.medicare.com/assisted-living/respite-care.html
• Hospice Foundation's Blog: http://blog.hospicefoundation.org

Medical Insurance and Caregivers

Many people may not be aware, but health insurance typically covers respite care, as well as bereavement counseling for caregivers. For example a member who is in a Hospice program would actually have benefits for their primary caregiver and close family members.  Typically, we see six to forteen days of respite care and a few hours of bereavement counseling in health insurance plans. If you or a loved one is in a caregiving role and needs assistance, I highly recommend calling the person being cared for's health insurance company and inquiring about their caregiver help.  In addition to traditional benefits (bereavement and respite care), many insurance companies offer discount programs to assist in other elder care areas, such as adult day care, long-term care, and support groups for caregivers.  Click here to see an example of one such discount program.

Occupational Therapists and Caregiving

Occupational therapy is a profession that has become more and more renowned in recent years. Occupational therapists have the ability to work directly with caregivers to help minimize the intense stressors and burdens that can occur as a result of caring for a client, friend, or family member. Taking on the role of a caregiver can often lead to changes in individuals’ habits, routines and roles; can lead to occupational deprivation, imbalance, and disruption; and requires increased distribution of time, energy, and finances. It is up to the occupational therapist to propose several interventions in order to help the caregiver develop some form of occupational balance and provide the individual with suitable support systems and resources.

During caregiver training, occupational therapists play the role of educator by providing the caregiver with important information regarding coping strategies and support groups or resources to help minimize stress.  The therapist will also teach caregivers what level of supervision should be provided for the person they are caring for. The amount of supervision each caregiver provides to the person they are caring for depends on the individual’s needs. The appropriate amount of supervision will allow the person with needs to become as functional as possible and reduce the caregiver’s stress.

After the occupational therapist has performed an initial evaluation with the caregiver, interventions will be proposed in order to meet both caregiver and client needs. The therapist can make specific recommendations regarding home safety, home modification training, energy conservation techniques, support systems, time management, stress management, coping skills, and relaxation techniques. These applied interventions can be used collaboratively to help further minimize the debilitating effects of caregiver stress. As occupational therapists, it is our responsibility to advocate for the caregivers and clients to make sure they receive necessary and appropriate services and care.

Occupational therapists play a big role and can recommend that caregivers make specific modifications to their home. Additionally, the therapist can suggest adaptive equipment that is appropriate for the individual receiving care in order to increase his or her independence. Examples of adaptive equipment or home modifications include: rearranging furniture in the home, adding a grab bar and shower chair in the bathtub, utilizing a bedside commode, and adding railings inside the home.

To get more information and find caregiver assistance training near you, contact the American Occupational Therapy Association (AOTA) via website at http://www.aota.org/Practitioners/Resources/Collections/Resources.aspx or by telephone (301-652-2682). Also, you can contact your local hospital, ask to speak directly to an occupational therapist, and find out the closest places where you can receive such services.

Occupational Therapy Advocacy

          Caregivers should advocate for occupational therapists to become certified in caregiver training. Many occupational therapists who work specifically with geriatrics are unfamiliar with caregiver training due to it being a recent emerging occupational therapy practice area. It would be good for occupational therapists who work with older adults and for them to also become familiar with caregiver training so that they will be able to educate individuals who may need to eventually care for their elderly friends or family. This link is a continuing education course that occupational therapists can take to become certified to train caregivers on how to help manage dementia-related symptoms on a daily basis. There are also additional courses that can be taken if you are interested in further study.
          Providing occupational therapy services to caregivers allows these individuals to manage their role as caregiver and to maintain a good occupational balance. Educating caregivers about appropriate techniques such as stress management, coping skills, and time management allows the caregivers to cope with their role and decrease their overall stress.