Class provides insight into caregiving pros, cons
Teach family-by-family to address individual needs
A class for caregivers was established at the University of Minnesota, Fairview in Minneapolis because caring for an ill family member is becoming common practice as more people are treated as outpatients.
The class is taught at the Patient Learning Center one family at a time.
The need for the class became evident as more and more people requested information on how to take care of very ill family members at home, explains Alexa Umbreit, MS, RN, C, a Patient Learning Center nurse. Family members who enroll in the class are usually caring for loved ones with end-stage illnesses such as cancer, pulmonary disease, and amyotrophic lateral sclerosis (ALS). "The class is really appropriate for most end-stage illnesses, because the content is flexible depending on the priority issues of the patient and the needs that the family expresses," says Umbreit.
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Body mechanics classes, equipment ease job Mature workers expect safe workplace Addressing the ergonomic needs of a nursing staff is important for all health care providers, but it's especially important for hospice agencies because their nurses are working independently and might not have anyone else in the home to help lift or reposition a patient. Education and appropriate equipment are important to make the work environment, which is the patient's home, a safe place for hospice nurses as well as patients, says Roy Hoxworth, SPHR, director of human resources for Hospice of Marion County in Ocala, FL. The extra help is also an important factor in keeping older nurses on the job, he says. "We do have hoyer lifts and other types of patient lifting devices in homes of patients that require lifting and repositioning, but we also focus on education for all employees of all ages," he says. Extensive inservice classes cover all aspects of proper body mechanics when employees are lifting or repositioning patients or when they are moving equipment or lifting boxes of supplies, Hoxworth explains. To increase the appeal of the classes, the hospice offers continuing education units at no charge to employees and allows them to take the classes during the workday, he says. In addition to attending educational classes on body mechanics, the staff at MidMichigan Medical Center's hospice in Midland, MI attends an annual skills day at which they demonstrate competencies, including proper body mechanics, says Jill Roby-Snyder, RN, operations director of the hospice and home medical equipment departments. In hospital settings, lift teams or even additional employees to help move patients are close by for assistance, but hospice nurses are on their own, points out Roby-Snyder. For that reason, the hospice will send an aide to the home along with the nurse if the patient needs to be moved and if the nurse needs help, she says. Some patients have family members who can help, but not all do, she explains. "It is our responsibility to make sure that our nurses have the help they need to care for the patient, and we can easily schedule an aide at the same time of the nurse's visit." |
The class begins by using a flip chart format to convey the program objectives, which are to help caregivers acquire the support, knowledge, and skills they need to provide care to a loved one at home. They are told they might need to learn about symptom management, how to find support services and help for their loved one and themselves, time management, as well as how to develop better communication skills. They also are told that caregivers can live in the home with the patient, outside the home, or even be long distance caregivers.
Class content includes an overview of the common symptoms that end-stage illness can present, the causes, and the signs and how to manage them. These symptoms can include fatigue, pain, depression, changes in eating, bowel changes, fever, bleeding problems, shortness of breath, skin problems, hair loss if related to chemotherapy, anxiety, sleep disturbances, changes in mental state, and mobility problems. "We really focus on the expressed needs of the family. We don't always cover every single topic," says Umbreit.
Every participant has a unique story, and their concerns vary, she explains. For example, an older man wanted to know how to respectfully care for a female loved one who was dependent upon him for her physical care. Another family, who was determined to care for a very ill loved one at home, realized they were not able to do so. During the class they decided to talk to the medical team about care options, because they couldn't manage the patient's intense health care needs at home. Some families need to learn how to move immobile patients safely. The Patient Learning Center has a video on the topic that caregivers watch, and then they practice the techniques with the bedside nurse before their loved one is discharged.
At the Patient Learning Center, away from the bedside, family members are able to share their concerns and have their questions answered. Caregivers often are exhausted from the patient's illness and hospital experience. Often, they are experiencing emotions of grief, helplessness, and uncertainty, but they want to do their best to support their loved one, says Umbreit. "We find that our family member's worries are eased during the class, and they can become more realistic about all that caregiving involves. They can make a decision on whether or not they can do the job or if they need to ask for extra help," she explains.
During the class families learn about the various options they have for help such as hospice, the palliative care program at the medical center, and home care. Organizations for certain diseases such as amyotrophic lateral sclerosis (ALS) and multiple sclerosis often offer help as well.
The families can take the class if their loved one is an inpatient or outpatient at the University of Minnesota Medical Center, Fairview. Often the health care team or a bedside nurse suggests the class. Families can ask to take the class as well.
Umbreit says the curriculum was developed from conversations with patients and family members, along with input from the palliative care expert and oncology social worker. In addition, they looked at available course content. "In the class, we are very candid about the rewards and stressors of caregiving," says Umbreit.
Source
For more information about the caregiving class at the Patient Learning Center, contact:
- Alexa Umbreit, MS, RN,C, Patient Learning Center, University of Minnesota Medical Center, Fairview. E-mail: [email protected].
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