November is National Family Caregiver Month and National Home Care and Hospice Month

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 Hospice Month
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 ( www.caregiver.org) 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 support groups.

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!
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