Mitzi Perdue

Caregiving: There Are Two Patients Involved

FULL-TIME CAREGIVING IS ALMOST A MEDICAL DIAGNOSIS IN ITSELF

The effects of caregiving on the caregiver’s health are so profound that they actually impact life expectancy. This particularly impacts women, since women are most often the caregivers. She is likely to ignore her health as she devotes her attention to the more seriously ill patient. Over time,  she is likely to be increasingly exhausted and emotionally wiped out. She may not feel she has the time or the energy to see her doctor. The problem here is that her physical conditions are likely to worsen, becoming less easily treated and more debilitating. As for her mental health issues, roughly 40% of caregivers are either depressed or anxious. Many of them will either gain or lose significant amounts of weight.

WHEN ONE FAMILY MEMBER GETS A SERIOUS CHRONIC OR TERMINAL ILLNESS, THERE ARE TWO PATIENTS

We health care providers pay attention to the sick person. However, there are two people who need medical attention. The caregiver may be reluctant to discuss her health issues since she doesn’t want to infringe on the time that her patient has with the doctor. Believing that the entire focus should be on the patient, she may feel selfish about even mentioning her health issues and so says nothing. If the caregiver becomes disabled, the quality of care for the patient is going to go down dramatically. Concomitantly, the cost for both will go up dramatically.

EVERY CAREGIVER SHOULD BE ASSESSED

There are unfortunate consequences for all concerned. Make it a point to look into whether the caregiver is having medical problems. In particular, assess her for anxiety and/or depression since both of these are very likely to occur. If she’s not your patient, it’s important to encourage her to see her own healthcare provider.

HAVE A CARE PLAN FOR THE CAREGIVER

We all make care plans for the chronically ill or terminal patient, but it’s also important to have a care plan for the caregiver. In addition to making sure the caregiver’s medical issues are addressed, it’s also essential for the caregiver to have a respite plan.

Ideally, another family member or perhaps a friend can come for a few hours while the caregiver does something that’s a respite for her. It could mean having a massage or seeing a movie or having lunch with a friend. If family members or friends aren’t available, another possibility is having a social worker or a chaplain intervene. The caregiver may also benefit from joining an internet support group. What’s crucial is to have people in her life who will validate what she’s feeling. The doctor who tells her, “This must really be hard on you,” is validating her, and those simple words can mean the world to her.

CONSIDER HOSPICE CARE EARLY ON

When a patient has a diagnosis of a terminal illness, that’s the time to call Hospice. Early referrals don’t do any harm. On the other hand, we know that patients and their caregivers often suffer needlessly by waiting too long to call Hospice. Hospice is available for patients who have six months to live, yet the median time with hospice is only 20 days and almost a third of patients enroll when they have only a week or less to live.Those patients who were only with Hospice a short time never got to benefit from the comfort and care Hospice provides not only for the patient, but for the caregiver as well.