Recent Caregiver Blogs

Posted: 12/10/2018 2:33:27 PM

The Emotional Roller Coaster of Caregiving and the Eight R’s You Need to Overcome

Caregiving is not for the faint of heart, because of the extraordinary challenges that come with the job. The work brings out the best as well as the worst in a person. Physical exhaustion as part of caregiving is one thing, but the emotional drain that comes with it is entirely another. If caregivers don’t keep their emotions in check, they'll likely feel burned out and may carry mental health issues in the future.

If we were to use emojis to describe a caregiver's feelings in a day, we'd probably come up with expressions describing them as they interact with patients, their family, and colleagues at work. There are days the ‘angry’ or ‘sad’ face dominates, and the emotional roller coaster of caring for patients will take its toll, especially if its a loved one who needs care.

Here are some emotions that caregivers should keep in check:

1. CONFLICTING WANTS

There will be times you'll want to care for others, but the work is overwhelming. You feel like quitting, but know you need to stay.

Maybe you feel like giving up on the one patient who makes your day miserable, but this same patient has no one visiting them.

Or, you unfortunately have to say “no” to a patient whose joy is taking a walk, when the doctor's order is for them to be confined to bed.

We are often stuck between doing two things that both seem right, and that can be exhausting.

2. ANGER

As a caregiver, perhaps all you really wanted was to finish your tasks, but something or someone made sure you don't, and that's when anger issues came up.

There are times you have patients who seem to annoy you on purpose, like spilling food and giving you something to clean up in addition to the dozen tasks still to be done with only an hour before the shift ends. You get frustrated and lose it, letting anger get the better of you.

3. WORRY

Often, you’ll feel anxious about a patient's wellbeing or worry you’re neglecting your family's needs because of caregiving. Worrying is stressful and robs you of peace of mind.

4. IRRITABILITY

When you don’t remember the last time you had a good night’s rest or you missed lunch because your patient was especially uncooperative that day, it’s also the day you snap at every little thing. You find it hard to be patient and cheerful.

5. SADNESS

Caregivers can feel down and out for a hundred different reasons. You wonder if good news will ever come. Now, every day looks grey, and you feel empty inside.

6. DISGUST

Many aspects of caregiving are a matter of expectation vs. reality. Sure, you were taught how to change incontinence pads while in training, but on the job, the sight and smell of stool, urine, and vomit can really be repulsive.

7. GRIEF

The gentlest and most affectionate of your patients just died, and no amount of “getting used to it” will save you the pain you feel when you hear news of their passing.

8. GUILT

A patient fell and broke their hip because they attempted to go to the toilet unassisted. You think that maybe you should’ve taken your lunch a little later and you feel responsible. You feel miserable because you lost it, yelled at your patient, and stormed out of the room, and you know that you shouldn't have acted like that.

If you experience the above often, here’s what you can do to manage your emotions:

RECOGNIZE

Acknowledge your feelings. It's not good to deny that you are affected. Emotions are indications that you are not stone-cold and indifferent—that you care.

RESTRAIN

Yes, you got angry, but you did not have to scream in frustration. While you acknowledge and sort out your feelings, contain behaviors that can potentially hurt others’ feelings or endanger their safety.

REFLECT

Go back and reflect on situations where you let your emotions get the better of you, and think of ways you could have acted or responded better. Use the lessons and build yourself a strategy to overcome.

REWARD

Do something nice for yourself during breaks or after work. Enjoy your favorite muffin with your coffee, or get a massage after your shift. Being kind to yourself is the start of healing.

REACH OUT

When your emotions are on overdrive, you need to talk to people you trust. If you feel yourself losing hope, talk to a therapist. You'll find that unloading your burdens by verbalizing them is very effective in clearing up your negative emotions.

RECREATION

Find some healthy entertainment for yourself and enjoy the company of others who take you to your happy place. Savor the moments and promise yourself that you'll do better moving forward.

REST AND FORGIVE

Adequate and proper rest and sleep are a must to keep your emotions in check. But, before you can do that, you also must be at peace with yourself and others. Forgive your patients and take it one day at a time. Do not harbor hurtful feelings. Nurture your spiritual health. And most of all, learn the lessons from your mistakes and forgive yourself.

RESPITE

You must take a moment to reset and renew your energy and composure. This is where respite can be a big help. Take a break from caregiving and use your time away to do all of the above.

Easier said than done! Managing your emotions is difficult, but it’s the only way to cope and grow as a person while caregiving. If you are already actively keeping your feelings in check, kudos to you and keep up the good work!


Posted: 12/2/2018 3:22:23 PM

It’s Never “Just Lighting” in the Care of Alzheimer’s Patients

Most people usually take a room's lighting for granted. They switch lights on and off for comfort, like wanting total darkness when they sleep. For some, the concern is purely for design, like dim lights to make the room cozy or yellowish light to give a hotel-like feel to the place.

For patients with Alzheimer's disease, however, caregivers adjust the lighting, not because of the above reasons, but for a more worthwhile purpose—to foster a patient’s wellbeing.

Experts agree that typical dementia-related behavior, such those stated below, worsen when a room is poorly or improperly lit.

ABNORMAL SLEEP PATTERNS

People need adequate lighting, not only to see, but also to establish wake and sleep patterns. When the sun rises, it signals the body to wake and be active during the day. When the sun goes down in the late afternoon, it signals the body to stop working and start relaxing until finally drifting off to sleep at night. Brain changes in Alzheimer's, however, make the patient unable to do this repetitive pattern.

As dementia worsens, a patient's sleep and wakefulness cycles become abnormal. They tend to sleep more during the day but are up and about for most of the night. Caregivers who care for these patients can be burned out from disrupted and inadequate rest, themselves.

DIFFICULT AND AGGRESSIVE BEHAVIOR

Patients with Alzheimer’s also tend to be more upset, forgetful, restless, and worried in the late afternoon and early evening, which coincides with the setting of the sun. This behavior is called “sundowning” and is frequently observed in those with unrestful sleep during the night.

DEPRESSION

Depression is common in dementia patients, especially those in nursing homes. Brain changes as well as being away from family and friends make a patient lose interest in formerly enjoyable activities, which makes them sicker and weaker in the long run.
Here are helpful ways to adjust lighting in an area to improve the wellbeing of a patient with Alzheimer's disease:

1. Use lots of natural light.

Let the sunshine in! In the morning, open curtains and windows. If possible, put them in a room with views of the outside world, something that stimulates memory and thinking. This is a good way to help establish their sleep and waking cycles. They'll be more alert and active during the day and sleep better at night. They are also less likely to get anxious at nightfall.

Also, natural light is the best for older people to see things around them. Here’s a fact: Older people aged 75 years and above need their environment twice as bright as the standard to be able to see their surroundings properly, and lots of natural light will do the trick.

2. When the weather is gloomy, or if access to natural light is limited, caregivers need to be creative.

In the morning, turn on the brightest light that will give an equal amount of brightness across the room. Here's an interesting thing to consider: People with Alzheimer's tend to misinterpret things around them, so unequal lighting that produces shadows is a big no-no! Keep the lights on until just before bedtime to prevent or lessen sundowning behaviors.

At night, turn on yellow lights or LED strips that lead to the restroom. These lights will guide the patient if they need to use the toilet. Strong lights in the hallway can make them think it is daytime and add to their confusion.

3. Remove glare.

Glare is light bouncing off smooth and shiny surfaces, such as metal, floors, and mirrors. It can also result when a light source shines directly in one's eyes, such as a bare bulb, spotlight, or direct sunlight passing through a window. Glare is uncomfortable and distracting, and must be avoided.

So, you see, when caring for an Alzheimer's patient, lighting is a big deal. When someone wonders about all the fuss over keeping a room brightly and uniformly lit, tell them it's about promoting a patient's wellbeing.


Posted: 11/28/2018 1:46:49 PM

Seven Effective Ways to Deal with Your Patient’s Pain

Pain is a hallmark symptom of many diseases and is the most common reason why patients seek medical help. It is a signal the body sends to mean that something is wrong and needs attention. For some, the discomfort they feel is short-lived or mild. In others, however, pain is unrelenting and affects many aspects of their lives.

According to the Centers for Disease Control and Prevention, about 50 million adults had chronic pain in 2016, and 19.6 million had pain so severe that it significantly affected their daily lives, mental health, and the way they act.

Caregivers spend the most time with patients and play a vital role in managing their discomfort so that, even amidst their diseases, they can have the best quality of life possible.

If you think that your patient is in pain and are unsure of what to do, here are some beneficial tips:

1. Be alert for signs of pain.

Some patients cannot communicate well or feel that their discomfort must be endured, so they won’t tell you directly. Caregivers should watch out for signs of pain including grimacing, frowning, writhing, restlessness and agitation, moaning, groaning, and whimpering. Patients’ muscles may also appear tense. If you see these signs, tell your supervisor or nurse immediately and document your observations.

2. Ask if the patient is in pain.

Not all patients will report their distress, but most answer truthfully if they are asked. So, ask directly, "Are you in pain?" and if the answer is “yes” even after taking their pain medication, tell your supervisor or nurse. The patient may not be getting adequate relief, so the physician needs to prescribe a higher dose or a new drug for effective control.

Perhaps the most important aspect of this step is to believe what the patient says about how they feel, because some people still manage to smile even in pain.

3. Help the patient take their medications on time.

The best way to help patients relieve their discomfort is to remind them when it is time to take their pain meds and assist when they take them. Those who strictly follow their schedule can receive continuous relief.

4. Make the patient comfortable.

Be gentle when moving them, especially if movement worsens the pain. Help your patient wear clothes that are easy to put on and take off. Smooth the creases on the bed. Adjust the room temperature if needed.

5. Provide a distraction.

Keeping the mind and body busy will help take focus off the negative sensations. The simplest way to distract patients is to talk to them about their interests.

Let them do most of the talking by using open-ended questions and statements, such as, "How did you feel back then?" and "Tell me more about your favorite TV show." Encourage them to elaborate by asking, “And then, what happened?” and “What did you do?”

Let them use gadgets and devices for games and social media. Play your patient’s favorite movies and songs. If they have pets, help them interact with their animals. If your patient has no travel restrictions, take them places (per agency policies). Take short walks. Also, encourage them to attend social events and activities.

6. Let them rest comfortably.

Do not push beyond what the patient can tolerate or overdo it on days they feel fine. If pain worsens, stop whatever activity you are doing together and let them rest. Help them get a good night’s sleep, too.

7. Use relaxation techniques.

Caregivers can help patients relax by guiding them through deep breathing and mindfulness exercises, a combination of deep breathing and being consciously aware of body movements, such as relaxing muscles. If you are unsure of how to proceed with these techniques, always consult your supervisor or nurse before going ahead.

Helping patients live pain-free is perhaps one of the greatest accomplishments you can have (and the most caring way to show compassion) as a caregiver. With your efforts to relieve patients of their discomfort, they will experience a better quality of life and be in a better place to interact with you, and others!


Posted: 11/19/2018 12:39:37 PM

A Scientifically Proven Relaxation Technique to Promote Sleep in Patients

All too often, especially for older patients, insomnia is a formidable enemy that leaves them feeling agitated but still tired upon waking in the morning. It is a common patient complaint. For many patients, a good night’s sleep becomes just wishful thinking—too difficult to achieve.

There are four ways patients usually experience insomnia:

• Difficulty falling asleep
• Waking up many times in the night
• Waking up too early and finding it hard to get back to sleep
• Waking up still feeling unrefreshed

When insomnia happens frequently or for a long period of time, a patient cannot recharge their immune system, so their defenses against diseases weaken.

If you are a caregiver caring for a patient with difficulty getting restful sleep at night, you must be creative in finding ways to facilitate sleep.

First, set the stage to promote relaxation in the patient. They must not be hungry, or feeling too full, either. Help them take a warm shower or just freshen up, whichever helps them relax. Give them a backrub.

Perform mouth care and comb their hair. Help your patient take their pain medications if they have one scheduled before bedtime. Give warm milk if they have no dairy restrictions.

Finally, dim the lights, keep the room temperature comfortable, and reduce background noise. Some white noise, such as dripping water from the faucet or the static noise of the television may be helpful, though.

Now, take a look at the relaxation technique below. This strategy is recommended by the National Sleep Foundation and is proven to help promote sleep.

1. Instruct the patient to position themselves comfortably in bed. Tell them to relax and become aware of the sensations they feel.
For example, describe how their head rests on the soft pillow, how their hands touch the smooth blanket, and how their feet are slightly touching the foot of the bed. Be specific in asking them what muscles are tense and tell them to consciously relax them.

2. At this point, an active mind usually wanders, and the patient may lose focus thinking of many other things, so call their attention back.
Tell the patient if they find their thoughts drifting, they have to refocus on the sensations that they are currently feeling.

3. Next, instruct your patient to pay attention to their breathing—that, as they inhale deeply, air enters their nose, fills their lungs and expands their chest and abdomen.

Let them put a hand over their belly and feel it get bigger as they breathe in. Tell your patient to hold their breath a few seconds and then release. Ask them to be aware of the air leaving their body, and their chest and abdomen deflating. As your patient breathes in and out, tell them to feel how the hand resting on their abdomen moves up and down with their breathing. Remind the patient to go always back to this process if they start thinking of something else other than their breathing.

4. If the patient feels pain or tension anywhere in their body, have them consciously relax that part as they continue to do deep breathing.
Help them through this process for a few minutes. If the patient drifts to sleep, you can leave the room quietly. If not, tell the patient to free their minds until they fall asleep.

Promoting restful sleep in a patient is a wonderful accomplishment as a caregiver, so go ahead and pat yourself on the back. You have given your patient an amazing gift that will absolutely contribute to their wellbeing. Kudos to you!


Posted: 11/12/2018 11:09:08 AM

Proper Hygiene Goes a Long Way to Promote Health and Prevent Diseases

Proper hygiene and cleanliness are basic requirements for good health. Even as kids, we were taught that. Now, working as a caregiver, we level up this approach to health in three areas: personal, patient, and environmental hygiene.

Why do we need to step up our game on cleanliness? The concept is pretty simple. Where there is dirt, moisture, warmth, and foul smell, microorganisms such as bacteria, viruses, fungi, and parasites thrive and multiply. These microorganisms cause disease. Patients have weakened immune systems and become perfect victims for infections because they are physically vulnerable. They can become even sicker or ill with another disease.

According to the Centers for Disease Control and Prevention (CDC), healthcare-associated infections (HAIs), or infections a patient gets in the hospital or other healthcare settings, is a huge problem. On any given day, about 1 in 31 patients acquire HAIs. Looking at the bigger picture, the CDC also reports that in 2015, there were around 687,000 cases of HAIs in acute care hospitals and that 72,000 of these patients died during hospitalization.

What do these figures tell us? Infections are real and scary, but caregivers can do a lot to lower these depressing numbers by being champions of hygiene. Keeping everything clean and sanitized can go a long, long way to promote health and prevent infections for both you and your patient.

How can a caregiver help in this regard?

Personal Hygiene

1. Bathe before going to work.

It is the most basic hygiene practice that can decrease microorganisms we carry around and transfer to patients. Keep your hair neatly tied back, if possible. Trim your nails regularly and clean under them when you bathe or wash your hands.

2. Wear fresh and clean uniforms.

Always have a spare set in your locker or car, in case your uniform gets soiled while on duty. Also, work shoes should ideally be used only within the workplace and not worn outside. Sanitize your shoes regularly.

3. Practice proper handwashing techniques.

Your hands touch a lot of things every day, and while they may look and feel clean, they really aren’t—unless you wash them thoroughly. Hands are the perfect vehicle to carry germs around, so wash your hands before and after every procedure and when going from patient to patient.

4. Clean equipment that you typically bring with you.

Do you use a fanny pack to carry around your stuff? That would need regular washing and cleaning, too. Same goes for the things inside, such as thermometers, pens, scissors, and safety pins.

Patient Hygiene

1. Bathe patients regularly and help them put on a fresh set of clothes.

As discussed, this is basic procedure to decrease the number of microorganisms on the patient’s body.

2. Encourage your patients to wash their hands after every use of the toilet, bedpan or urinal, and every time they touch dirty things and soiled clothes.

Remind them that anything that falls on the floor is considered dirty and should be sanitized or thrown away.

3. Keep hand sanitizer handy.

For some patients, going to the sink to wash their hands is too tiring, so have hand sanitizer within easy reach. Teach them to drop a dime-sized amount of the sanitizer in a palm and rub the sanitizer, covering all surfaces of their hands and fingers until the hands feel dry.

4. Perform grooming measures.

Comb your patient’s hair, trim nails, and help them perform mouth care.

5. If your patient is an wearing incontinence pad and undergarment, change them immediately after they are soiled.

Be sure to wash and dry the genital area and the buttocks before replacing the pads. If they accidentally soiled their clothes, they need a fresh change as well.

Environmental Hygiene

1. Practice “cleaning as you go.”

When preparing your patient's food, immediately throw away vegetable peels and food packaging that will not be used anymore. Wash their trays, plates, and utensils immediately after use.

2. Leftover foods should not stay on the table for longer than two hours.

If a patient cannot finish a portion, store it in a sealed container in the fridge. Any leftovers in the refrigerator should be thrown away after three days of storage.

3. Change bed sheets regularly and every time they are soiled.

Do not pile the sheets on the floor to be picked up at a later time. Put them in a hamper and take them away immediately.

4. Sanitize surfaces according to agency procedures.

These surfaces include floors, toilets, sinks, countertops, urinals, bedpans, equipment, doorknobs, and even the computer keyboards and telephone units.

5. Do not let trash or leftover food collect on the bedside table.

Throw trash in the right garbage bin and dispose of garbage properly.

Being hygienic in all aspects of providing care is a must for caregivers. Other than preventing infections, it is also a reflection of your overall attitude to your work environment and your patients. It’s ok to be a neat freak sometimes, especially when it ensures patient health and proper care!