Recent Caregiver Blogs

Posted: 2/13/2019 8:47:08 AM

The Whys and How-tos of Promoting Independence in the Patient

By nature, we value our independence as human beings, whether as an individual or as a country. We fight to be able to decide and do things on our own and live our lives free from the control of other people.

Remember taking that first bike ride around your neighborhood without your parents tailing you? How about the mixed feelings of pride, excitement, and uncertainty when moving out of your parent's house to live on your own?

Wanting independence is a sign of a healthy mental state. A person who wants to do things without the help of others feels motivated and can have a positive outlook on life. This is true even in patients who are struggling with their health.

But there are times, such as in the midst of debilitating disease or disability, wherein patients lose their confidence to tend to their own needs, thinking that others can do it better. So, they begin to (unnecessarily) completely rely on others for their wellbeing. There are also situations wherein a patient feels depressed and expresses no interest in getting better.

In some cases, it is the caregivers who lack trust for their patient’s ability to care for themselves without sustaining some kind of injury in the process. So, instead of assisting them and doing things WITH a patient, they do everything FOR their patient, which ultimately results in poorer health outcomes.

Caregivers can be instrumental in promoting independence in patients. Self-care is an important part of the patient’s physical, emotional, and mental well-being.

So, why promote independence in patients?

• It strengthens a person's sense of purpose in society as an individual capable of making a contribution.

• It promotes a sense of control.

• It makes them feel good about themselves, so it curbs frustration.

• It gives them a sense of achievement, thereby enhancing mood.

• It improves their physical condition because they can exercise their muscles.

• It makes them want to do more for their health.

When your patients lose their drive for self-care, consider the following tips:

1. Start a procedure and let the patient finish it. For example, if you are giving your patient a full bath, wash the areas they cannot reach, then let them clean and rinse the rest of their body.

2. Do the most difficult procedures, then let them perform the simple ones. Have a patient brush their teeth and comb their hair after giving them a bed bath. Over time, slowly involve them in more complex activities.

3. If they are confused and having trouble making sound decisions, provide at least two safe options for them to choose from so that, either way, they benefit from their decision.

4. Recognize achievements and improvements, however small. Focus on what they can do and not on what they can’t. If they fail to make any progress on a given day, try again the next day.

5. Encourage physical activity like taking a walk. Exercise can improve the flexibility and strength needed to do things on their own.

6. Provide tools that help them manage self-care, such as reachers, buttonhooks, sock aids, raised toilet seats, shower or bath seat, etc. Keep commonly used items within easy reach. If moving around is a problem, provide wheelchairs, a cane, and crutches, whichever they are allowed and trained to use.

7. If you are using technology, such as mobile devices, to help patients, enable voice recognition, screen readers, and font adjustment.

8. If the patient is stubborn or reluctant to act more independently, encourage them and provide opportunities to perform a simple activity by themselves. You may observe them the first few times, until they are fully capable.

Promoting and maintaining independence in a patient is indeed a challenge, not only because there are disease or disability to overcome, but also because safety can be compromised if done incorrectly. Caregivers can work with the rest of the healthcare team in providing holistic care and while safely involving a patient in their own care.

Posted: 2/4/2019 9:10:11 AM

The Unwritten and Unlikely Roles of Caregivers

A caregiver is a lot of things to a patient and the patient’s family. A big part of their duties is providing personal care to the patient and assisting them with activities of daily living. These responsibilities are written and described in employee manuals and are expected to be carried out by caregivers according to the best practices of their institutions.

What’s interesting is there are certain skills that are hidden or disguised within their primary roles. Funny, since we all know caregiving is already a challenge in the real world! So, what are these hidden skills?

Here are some roles that are not technically in the job description, but caregivers accomplish anyway:

1. Hairstylist

Patients sometimes request a certain hairdo that they’re comfortable with or they feel good about and caregivers just do their best to deliver. Going the extra mile, caregivers can even apply hairstyling products. If you are a newbie and have no idea how to gather hair in a nice, neat bun, you could be in for a challenge!

If you’re out of practice, browse YouTube for simple hairstyle tutorials to sharpen your skills, or even ask your patient for tips on styling their hair in a way that suits them.

2. Chef

Cooking is one thing. Being tasked with preparing food that is low-fat, zero-salt, unprocessed, and mostly fruits and vegetables is another. Your patient happened to be a meat-lover, which they now avoid (and which likely exacerbated their health problems). You still need to come up with something appetizing and healthy.

So, use your creativity to provide a healthy, appetizing meal and cross your fingers that the patient is hungry! Ask your patient for some of their favorite recipes to see if they can be modified or search the internet for healthy options with easy-to-follow steps.

3. Event Organizer

Three of your patients seem down lately. One is becoming more confused, another doesn’t want to leave their room, and another is twice as difficult to work with. As their caregiver, you suggest to your supervisor that they need a new and fresh activity to perk them up and stimulate their minds.

As soon as your supervisor gives the green light, you get into action. Is it music, art, or dance? When’s the best time for all three of them? Who sits with who? How do you encourage them to gather in one place? All of a sudden, you’re not just hosting an activity, you’re an event organizer!

To avoid feeling overwhelmed, start small and create a meaningful, enjoyable activity for a few patients. Once you get the hang of it (and understand everyone’s preferences), move on to activities a little more complicated to plan.

4. Negotiator

You are a home health aide, and one day your patient decides not to take their medications. Naturally, their family is concerned and attempts to force their loved one to take their meds on time. The struggle and tension are real and growing, and you stand in the middle. What do you do?

You know that the patient needs to continue their meds. You also know that both sides should calm down. You know you're the odd one out, but the only person who can help. You are an instant negotiator.

Communication skills are absolutely key in these situations, as well as a concrete knowledge of patients’ rights. Be sure to advocate for your patient at all times.

5. Fashion Stylist

True, the patient makes the final decision on what to wear, but it was you who came up with the choice of clothes. The important thing is taking into consideration a patient’s tastes as well as their comfort and safety. Make sure their clothing is not too light (or heavy) for the elements and provide choices that are appropriate to their lifestyle and needs.

Congratulations! Now they’re dressed warmly for the cold weather!

Caregivers are truly amazing workers. They are asked to wear a thousand different hats while advocating for the patient’s best interests in every task.

Do you relate to these situations? Can you add any to the list?

Posted: 1/30/2019 11:47:16 AM

What to Do When Cancer and Infection Team Up

Cancer, also called malignancy or malignant tumor, is an abnormal growth of cells. Cancerous tumors crowd out healthy cells and prevent affected organs from functioning well. They also grow and spread easily because they receive nutrients intended for healthy cells. Think of them as pirates and conquerors who pillage and take over, establishing their presence wherever they go.

Of the many effects of malignancy, one of the most debilitating is the weakening of the immune system, which primarily works to protect the body against diseases. Once cancer spreads to the bone marrow, the bone marrow cannot produce enough healthy white blood cells to fight infections.

Some cancer treatments, such as chemotherapy and steroid medications, are given to kill or prevent the spread of malignant tumors but, ironically, they have an unusual side effect. They temporarily weaken the immune system by also affecting the function of bone marrow. Another common procedure, radiation, can cause breaks in the skin, disrupting the body's first line of defense against invading microorganisms.

The combined effect of cancer and the side effects of some of the treatments mentioned above destroy the body's natural protection against harmful organisms. As a result, the patient gets sick.

The bottom line is, cancer patients are very much prone to infections, and this should not be taken lightly.

If you are a caregiver working with cancer patients, be extra vigilant and meticulous in making sure that the patient is not exposed to disease-causing microorganisms.

Here are some tips to remember and follow when cancer and infection decide to team up:

1. Prevention is key.

The best way to tackle infection is to prevent the patient from getting infected in the first place. It all boils down to avoiding their exposure to infectious materials and sick individuals.

This is where thorough handwashing is of utmost importance. Both the caregiver and patient, as well as every other person in contact with the patient, should strictly follow proper handwashing techniques to prevent the spread of viruses and bacteria.

Another step is to help the patient improve their health by making sure they eat the right types and amount of food. As a rule of thumb, their plates should be filled with mostly fruits and vegetables and no cancer-causing processed foods whatsoever.

Also, remember to keep the patient hydrated and ensure that they are in a well-ventilated room with lots of fresh air. Help them get restful sleep at night and encourage them to go outside for some early morning sunshine.

Another aspect of cancer care is maintaining cleanliness everywhere. Give the patient a proper bath, clean their immediate surroundings, and disinfect surfaces and equipment.

Lastly, discourage people with infectious diseases from being in close contact with the patient. If the interaction cannot be avoided, ask the patient to wear an appropriate mask as protection.

2. When you suspect an infection of any kind, act fast.

However careful we might be as caregivers in protecting our patients, they can sometimes still get an infection. And, for people with cancer, there is no such thing as a simple cough and cold. Infections that healthy individuals recover from naturally can be disastrous for those with weakened defenses.

The first thing to do is learn how to identify possible infections by knowing the common signs and symptoms. If a patient catches a disease, they will likely say they don’t feel well or are feeling a bit run down. They’ll start to run a fever, too. Then, there’ll be new and worsening discomforts, such as cough and cold, a bad-looking wound, or a headache.

What should the caregiver do if they suspect that a patient caught an infection? Do not waste a second. Contact your supervisor or the patient's physician immediately.

3. Assist the patient with follow-up visits to the doctor, too.

Be observant of improving or worsening signs and symptoms, and promptly report and document your observations to the supervisor, nurse, or physician.

Once the patient has received medical help, follow every detail of the care plan, especially in making sure that the patient is taking their medications at the right time, without missing a dose. Caregivers should also see to the patient's comfort and encourage them to be vocal about what they feel.

The danger of infections in cancer patients is all too real and can even lead to a patient's death. Always work with the healthcare team and ask for the patient's cooperation for the most positive health outcomes.

Posted: 1/21/2019 9:52:43 AM

Late-Stage Caregiving: Caring for Patients with Pain

When patients are in the late stage or terminal phase of a disease, they experience many difficulties. The signs and symptoms signify that their body is succumbing to the disease.

A very common symptom present in hospice patients is pain. Although the goal of end-of-life care is to provide comfort and preserve quality of life, many patients still experience extreme discomfort.

The challenge for caregivers lies not just in providing measures to ease pain, but also recognizing signs and symptoms. Not all patients who are distressed will tell staff that they are uncomfortable. Some patients stay silent about their pain because they believe that illness is a part of life and should be endured. Some patients take pain upon themselves as a way of penance or punishment for their perceived wrongdoings. These patients keep their distress to themselves.

And then there are patients such as those in late-stage Alzheimer’s disease, who are not able to communicate at all. It takes extra alertness and skill to spot whether they are in pain. Caring for these patients is tricky because they lack the ability to express their discomfort directly, but keep in mind that this doesn't mean they are pain-free.

If you are assisting and caregiving for a patient in the terminal phase of their illness, consider the following steps to help them manage their pain:

1. Ask away.

For patients who can still communicate, ask them if they are in any state of discomfort. If they answer yes, ask them if their pain is getting worse or the type of pain which seems to get better. Then, inform the nurse or physician of their response, so they do a more thorough examination of the patient.

2. Look for physical signs.

Check for swollen body parts. Swelling is almost always accompanied by pain. Check for broken skin and sores, because open wounds hurt. A patient in pain may also have flushed skin.

3. Observe for nonverbal signs.

Grimacing, wincing, unwillingness to move, tearfulness, tensed muscles, and gestures that protect the painful part (e.g., curling up and wrapping arms around their aching belly) are observable signs of extreme discomfort.

4. Pay attention to changes in behavior.

Patients who are in pain appear anxious, agitated, and irritable. They toss and turn in bed attempting to find a comfortable position, and stay still once they feel some relief.

5. Provide comfort.

a. Help them take their pain medications and make sure they don’t miss a dose.

b. For mouth sores, avoid giving spicy foods or those with strong flavors, as they may make the pain worse. Use nonalcohol-based mouthwashes when providing mouth care.

c. Help them find a position comfortable for them. For those who cannot communicate how they prefer to be positioned, keep the head of the bed slightly elevated and prop them up with pillows, especially under bony areas.

d. For immobile bedridden patients, turn them every two hours or as per physician’s recommendations.

e. Provide adequate nutrition and keep the patient hydrated. Although patients with terminal illnesses usually have a poor appetite, caregivers can still be creative while providing healthy comfort foods and offering something to drink every so often.

Late-stage caregiving is both challenging and gut-wrenching, especially when caring for patients in pain. Keep in mind that there many ways to treat pain, but only if caregivers recognize and report their observations in a timely manner. Above all (and perhaps most importantly), caregivers must make their presence known to the suffering patient. Just being there to sit with them or hold their hand can provide much needed emotional support and relief.

Posted: 1/14/2019 4:09:02 AM

How to Speak with a Patient’s Family: Tips for the Home Health Aide

As a home health aide (HHA), your primary workplace is the patient’s home, where you’ll likely be in constant interaction with their family. Patient care is one thing, but communicating with the family is entirely another, which can be a huge challenge.

By challenging, we mean that, other than building a trusting relationship with the patient, the home health aide also needs to consider the family. Here's where the job of caregiving gets more interesting.

Every family is different, with their own set of rules and unique ways of doing things. As a home health aide, you need to acknowledge this while still providing proper care for your patient. To do so, you'll need to know how to speak up regarding your concerns.

A lot of communication challenges experienced by home health aides relate to patient and family expectations, and their knowledge of the HHA's skillset and job description. Some families feel it is not a home health aide's place to speak up and that the family has the final say on a patient's health concerns.

There are some trust issues, too, like whether or not a caregiver's observations are valuable. They'd rather ask the nurse or physician, leaving the home health aide without a voice. HHAs are just expected to do as they're told. The communication gap between the HHA and the family results in compromised patient care.

Here are some common scenarios where communication with the patient's family can be a cause of anxiety for the home health aide as well as some ways they can work around such situations:

1. Family conflicts

It is not easy to feel trapped between family members who oppose each other regarding patient care. If you find yourself in this situation, what should you do? Should you side with one and risk angering the other?

The answer is no. As long as the patient is an adult capable of deciding for themselves, and the request does not risk their safety, the final say rests with the patient.

If the matter exposes the patient to some risk, respectfully say “no” and explain why you cannot follow their requests. If they are persistent, ask them to contact your supervisor or agency and get formal permission before going along with their wishes.

2. Unreasonable patient demands

There are times that a patient makes unreasonable demands, like insisting on taking a walk in the middle of the night in very cold weather. You decide to ask the family for help explaining to the patient why such demands are not safe to allow.

First, consider talking to the patient's spouse or other immediate family members such as adult children or parents. Ask for a few minutes of their time, or ask for the best time to talk to them about your concerns.

3. Chores beyond your scope

Sure, you do light housekeeping for the patient and family, and the patient’s daughter asks you to water the plants. But, considering her instructions, it seems more like gardening and landscaping to you. How do you handle it?

If ever you're in a similar situation, where the family asks you to do a task beyond the care plan, politely say “no.” You may tell them that you'd like to help, but your contract, as per agency instructions, does not allow you to do tasks beyond your scope of duty.

Be assertive but respectful. Have the confidence to tell them your concerns and observations or ask for their help if needed. Your focus should be on helping the patient, not making your tasks easier.

For example, you want to move your patient and need a family member to assist you. Instead of saying, “I need help transferring your dad to the wheelchair,” try “Your dad needs transferred to the wheelchair. Could you give me a hand to make sure he doesn’t fall?”

See how a patient-focused request makes a world of difference?

Being a home health aide is rewarding because you’re able to appreciate how a family shares common values and traditions. Building a trusting working relationship requires you to always communicate respectfully, while following agency policies and the care plan as you go about your daily duties.