By: Mary Cato
On a typical Sunday morning I have my coffee with Jane Pauley while watching CBS Sunday Morning. One Sunday in August a news bite caught my attention. It mentioned a CDC study indicating that 11 percent of Americans seriously considered suicide in June 2020, and that rates were highest among two groups: those 18 to 24 years old and unpaid caregivers for adults. I naturally went to the source: “Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic” by Czeisler and colleagues published in the Morbidity and Mortality Weekly Report (MMWR).
Sure enough, unpaid caregivers for adults were at risk for a number of mental-health-related symptoms. Caregiving can be stressful in the best of times, but the current pandemic is amplifying the strain. For example, writing in July, Suzanne Smeltzer, Bette Mariani, and Colleen Meakin discussed a number of stressors related to the impact of Covid-19 on individuals with disabilities. These stressors also impact older adults and their caregivers in similar ways.
With National Family Caregivers Month in November, we have an excellent opportunity to shine a light on those who devote their time and efforts to help family members manage their often complex lives. In keeping with Interprofessional Family Caregiving Competencies, from the Betty Moore School of Nursing, let’s stretch the definition of “family” and include in this discussion the friends, neighbors, and others who take responsibility as caregivers. The competencies define a family caregiver as a person who provides assistance with instrumental and other activities of daily living, or complex care tasks, to a care recipient who is related by blood, marriage, or affinity, in other words, families of choice.
The NLN recognized caregivers as a vulnerable population with the addition of ACE.C to its Advancing Care Excellence for Vulnerable Populations series. Funding from The John A. Hartford Foundation and the AARP Foundation facilitated the creation of unfolding cases, teaching strategies, and other resources available to educators at no charge.
The ACE.C materials refer to a national family caregiving crisis and cite the need to prepare health care professionals to integrate family caregivers into the team. Suggestions for how to do this can be found in a free one-hour course for faculty that offers suggestions for teaching students how to work with caregivers who are managing a loved one’s care.
The ACE.C unfolding cases differ from others in the ACE series because they focus on the caregiver, not the patient. This may be strange at first for faculty and students, as they may be prepared to perform patient assessments and treatments, look at charts, and study test results and medications. But the cases demonstrate the need to broaden our view and see the caregiver as an integral part of the case. Four domains of family caregiving are defined in the competencies as areas where clinicians can support caregivers in managing the changing needs of care recipients.
Another document from the Betty Moore School of Nursing discusses the family caregiving domains of preparedness and identifies nine specific needs that care recipients may have, including personal care, mobility, and care coordination. Clinicians can help evaluate these areas and assist caregivers in making plans to meet those needs.
A discussion of these domains can help learners understand their role in helping caregivers. Using unfolding ACE.C cases as simulations can impact student learning in another way as well. While investigating resources and offering websites, support groups, and other materials can be helpful, the simulated personal contact between clinician and family caregiver can be invaluable. No list of websites is as impactful as addressing the individual with questions such as these: “How are you feeling about all of this? What do you need so that you can make it through this difficult time? Tell me what you are most concerned about.” Providing encouragement with such statements as, “I know this must seem hard right now. You are doing exactly what is needed,” can be equally impactful.
During National Family Caregivers Month 2020, let’s recognize and honor the partners, children, siblings, and others who devote time and energy to improve the quality of life for their family members. As we do so, let’s also help teach health professionals ways to support caregivers in their practice. For tips for family caregivers amidst Covid-19, visit the Caregiver Action Network at https://caregiveraction.org/.
Czeisler, M.É., Lane, R. I., Petrosky. E, et al. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic — United States, June 24-30, 2020. MMWR Morbity and Mortality Weekly Report, 69:1049-1057. http://dx.doi.org/10.15585/mmwr.mm6932a1.
UC Davis Health Betty Irene Moore School of Nursing. (n.d.). Interprofessional family caregiving competencies. https://health.ucdavis.edu/nursing/familycaregiving/pdfs/Interprofessional_Family_Caregiving_Competencies.pdf
UC Davis Health Betty Irene Moore School of Nursing. (n.d.). Family caregiving institute education: Interprofessional family caregiving competencies and domains of preparedness. https://health.ucdavis.edu/nursing/familycaregiving/Family_Caregiving_Institute_Education.html