2008 - Communication Across the Curriculum (CAC)

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N u r s i n g one back to a healthy state. When this is the case it is helpful to refocus the caregiver’s attention on small attainable goals that they can achieve that will bring about positive effects for both the patient and the caregiver. Physical intimacy is an issue that is commonly underestimated and many times dismissed in patients who are facing long-term illness. Research has revealed that couples facing long-term illness are rarely given advice or information regarding their future sexual relationship. Adaptive devices and equipment and revised expectations should be discussed with any and all couples facing this life-altering change. It is very important that the couple have a support system that they can depend on when the strain becomes too great. Support groups have also proven to be invaluable for the caregiver, in that they represent a safe place for the spouse to be open and honest about his/her feelings about their situation as caregiver, to hear other people’s stories, recognize that others face the same issues as well, and learn what others are doing in their relationships to promote healing and health. Research has proven that a grateful attitude makes a remarkable difference in the caregiver’s perspective on their situation. The caregiver can be encouraged to keep a gratitude journal and to plan positive events into their day. Caregiving is a difficult task and the healthcare team has the weighty responsibility of ensuring that patients whose lives are affected in this way have sufficient knowledge about appropriate coping mechanisms, and resources that can lessen the burden. The healthcare team can also subtly help the patient accentuate the positive and the benefits of providing home care for their loved one. If this is achieved successfully the caregiver will develop a sense of pride/competence, and a feeling that they are needed. Couples may be brought closer together through the experience if they have the appropriate tools and resources made available to them. The Caregiver Burden Scale and the Assessment questions listed below can be used to accurately determine the level of burden a person has, and to develop a plan to assist the patient and caregiver with developing new coping mechanisms, etc. Viktor Frankl, a psychiatrist/holocaust survivor, spoke of the victims that he observed in the Nazi death camps by saying “The way they bore their suffering was a genuine inner achievement. It is this spiritual freedom 7 3 W r i t i n g A c r o s s t h e C u r r i c u l u m
C l i n i c a l A n a l y s i s that cannot be taken away – that makes life meaningful and purposeful.” (Frankl, 1959) With the proper guidance, help, and information regarding resources, the same may be said about patients and their caregivers. An active life serves the purpose of giving man the opportunity to realize values in creative work, while a passive life of enjoyment affords him the opportunity to obtain the fulfillment in experiencing beauty, art, or nature. But there is also purpose in that life which is almost barren of both creation and enjoyment and which admits of but one possibility of high moral behavior: namely, in man’s attitude to his existence, an existence restricted by external forces. A creative life and a life of enjoyment are banned to him. But not only creativeness and joyfulness are meaningful. If there is meaning in life at all then there must be a meaning in suffering. Suffering is an ineradicable part of life, even as fate and death. Without suffering and death human life cannot be complete. –Victor E. Frankl (Frankl, 1959) Assessment of the caregiver’s adjustment to their new role is vital. Some questions that the nurse can keep in mind while interacting with the caregiver are as follows: - Does the caregiver recognize the need for personal time - How much rest does the caregiver get - How does the caregiver find time for privacy and time to get personal errands done - How much time does the caregiver have away from the client - What alternatives for client care has the caregiver made in order to provide private time - How does the caregiver cope with demands - What value does the caregiver see to home care - What kind of lifestyle changes has the caregiver made - Are these changes realistic and feasible - How does the caregiver allow for flexibility in routine (Stolte, 1994) Caregiver Burden Scale (Rate each statement on a scale of 0 [not true] – 4 [very true] ) 1. I feel that my (relative) makes requests of me that are over and above what he/she needs. 2. Because of my involvement with my V o l u m e I V : F a l l 2 0 0 8 7 4
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2008 - Communication Across the Curriculum (CAC)

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