Jane Hron, RN
Home Health and Hospice Department Head
Marcus Daly Home Health and Hospice
November is National Family Caregiver Month and National Home Care and
The perfect time to honor and thank all the family caregivers in our community
who do so much for the people they serve; who give so much, often with
very little recognition for their contributions. Through their selfless
action, these caregivers provide their loved ones support, security, and
comfort as they age, combat illness, suffer from disability, or face the
end of their life. Family caregiving is hard - very hard - and very stressful;
it is tremendously difficult emotionally. Over 50 million family caregivers
provide eighty percent of our nations long-term care services; 29% of
the U.S. adult population is providing care to someone who is ill, disabled,
or aged. (Statistics are from the Family Caregiver Alliance November 2012
data.) This comes out to close to $450 billion annually in "free
caregiving services", nearly double the combined costs of home health
care ($58 billion) and nursing home care ($134 billion). 60 % of caregivers
are women, 1/3 of those caring for 2 or more people; 40% are male and
research suggests that the number of male caregivers may be increasing
and will continue to do so as our population of 65+ will more than double
between the years of 2000 and 2030. Among spousal caregivers 75+, both
sexes provide equal amounts of care. In Montana there are over 130,000
family caregivers providing more than 125 million hours of care per year
for their loved ones. A third of family caregivers say they do it alone
- they get no help from anyone. Through home care and hospice services,
we strive to support these caregivers and their loved ones by providing
clear information and education regarding disease process and progression,
symptoms, comfort, medications, functional abilities and goals, and what
to do in the event of a change in condition.
The emotional impact of caregiving can be profound, for both the caregiver
and the patient. Confrontation with serious or prolonged illness lays
bare the spiritual dimensions of our lives. It raises all kinds of feelings,
emotional struggles, questions of purpose, and hope versus hopelessness.
When the caregiver feels confident and prepared the experience can be
meaningful and valuable for all. Conversely when the caregiver feels alone
and uncertain, exhausted and anxious, the caregiving experience can leave
everyone involved with a sense of abandonment, inadequacy, resentment,
hopelessness, and/or anger. Our home health and hospice teams work closely
with the patient and family to provide individualized, holistic care and
support when it is critically needed. We offer practical solutions to
some of life's most difficult challenges, while also providing dignity
and humanity. We truly make a difference in people's lives.
Rosalyn Carter said it best: "There are only four kinds of people
in the world - those who have been caregivers, those who are currently
caregivers, those who will be caregivers and those who will need caregivers".
It is important that all of us, no matter what our current situation,
talk with those we love about a future that will include changing health
conditions and caregiving; explore the choices, be aware of the decisions
to be made, and understand the desires and wishes of those we love. Open
communication and discussion regarding these issues will help all of us
as we find ourselves in one of those four categories.
Our country's ability to maintain an effective health care delivery
system will be decided on how we care for our fragile and vulnerable populations
of Americans such as the aged, the chronically ill, the disabled and children.
However, the increased health care demands from 77 million more retirees
from the baby boom generation will soon come to fruition. How will we
as a society provide high quality long-term care to our parents and eventually
for ourselves? 10 million caregivers over 50 who care for their parents
lose an estimated $3 trillion in lost wages, pensions, retirement funds
and benefits due to their caregiving responsibilities. These losses hold
serious consequences for the caregiver in their own future. To manage
cost and improve quality in an overstressed health delivery system we
must initiate greater support for family caregivers in our community.
They are the bedrock of the nation's long term care system. The vast
majority of people with functional limitations live at home, and nearly
all of them rely on family members and friends for support. How can we
best support them? Policy makers need to be looking at ways to provide
support; family caregiver's mental and physical health and well-being
are legitimate causes for concern for bioethicists, public health officials,
and medical professionals. Currently supportive services tend to focus
on the one who needs care, the patient; we need to encourage policy makers
to provide supportive services for the caregiver.
Locally, in our community, we need to provide support for family caregivers.
The Family Caregiver Alliance (
) suggests the following:
Help the caregiver learn about the disease their loved one has. Encourage
them to learn about communication skills and behavior management, especially
if they are caring for someone with dementia, by taking a class, reading,
or over the internet. The more they know, the better prepared they will
be, the more capable and confident they will feel, and the more they will
be able to plan for the future.
Encourage them to use community resources, such as the Ravalli County
Council on Aging, Meals on Wheels, local transportation assistance and
Encourage them to take a break from caregiving. Find them or offer assistance
so they can leave their loved one and do something not related to caregiving.
Encourage them to attend a support group. Ask them how they are doing.
Listen without judgment, and let them talk about their frustrations. Help
them find answers to their caregiving dilemmas, and find the support they need.
Encourage them to relax, meditate, read a book, pray, garden, get a massage,
or take a long bath.
They need to take care of their own health. Go to the doctor for exams,
get a flu shot, get enough sleep, and eat their fruits and vegetables.
No one can be a perfect caregiver, all day, every day. Encourage them
to forgive themselves - often. Find ways to help them laugh and keep their
sense of humor on a daily basis.
Above all encourage them to ask and accept help.
No one can do this alone.
As we prepare for Thanksgiving and recall our many gifts, please remember
the family caregivers who make a difference every day for our nation's
seniors, disabled, and infirm. Make some time to take care of the family
caregiver. Never let yourself forget that they have responsibilities,
as well as hopes and dreams, outside their caregiving duties. With appropriate
information and support, family caregivers can continue to help their
loved ones across the lifespan.
Questions and or comments regarding this week's health column please
contact, Marcus Daly Hospice Center and Services, a service of Marcus
Daly Memorial Hospital, 1200 Westwood Drive, Hamilton, MT 59840. Working
together to build a healthier community!