Here’s the person you’re forgetting…

You have someone in your office today that is at risk for adverse health outcomes.
They are not your patient but they play an important role in your patient’s outcomes.

Over 41 million people care for a family member and that number will continue to rise along with life expectancies. They are the people who bring their care to you, who take notes, who track medications, who, often are spending hours each week handling appointments, insurance issues, meeting the physical and emotional needs of their loved ones, preparing special diets, tracking symptoms that warrant follow-up, and encouraging engagement in your care plans.

Consider how your patients would be faring without someone at home to meet their needs? Without the dedication and the hours invested by unpaid family carers, early discharges are more dangerous, recoveries more complicated. You’re likely making decisions everyday based on your insights into the level of care that your patient has at home but at any moment, this person might be rendered unable to do what’s needed.

These family caregivers are our invisible health care heroes.   We build our health care system assuming their contributions, without seeing or tending to their needs.

The family carer is our focus this month as we organize fundraising for NAMI (the National Alliance for Mental Illness) with our January Mindfulness Retreat in Madison, Wisconsin.

We would like to help you to acknowledge and engage these often invisible, but key, members of the Circle of Care for your patients. One definition of stress is a condition in which demand outweighs the resources. Even as we discuss the needs and the stress factors for unpaid family caregivers, the reality is that if you’re working in healthcare, you’re overextended and facing challenges and changing pressures everyday yourself! We see what YOU do. And it’s tremendous. So we’re aiming to have your back.

In my years of helping to fill gaps in maternal child health care systems, it was clear that everyone was putting incredible personal resource into caring for one another. I recognize that not all doula models are holding space for the health care team but in ours, we trained to tune in to the system itself. To helping everyone in the room, within our scope. Where can we create ease? If we could get something for our clients that would otherwise mean a call to the nurse, we did it. If the nurse needed an anticipating helper to get a better position for Fetal Heart Tones or a kind word on a busy day, we were on it. If we could answer a non-medical question or help our clients to understand how to refine their questions and concerns for their next appointment, we had the provider in mind who likely didn’t have time to discuss the minutia of detailed birth plans. If, in an urgent situation, we could sit with an agitated partner while their wife was prepped for surgery, the operating room was going to receive a much calmer, more informed, more trusting person. In the recovery room, when staffing shortages limit the ability to have a new baby reunited with the parent, we see where we can be helpful to fill the gap. When a late preterm baby isn’t feeding well, and the next appointment is 3 days from now, we’re helping families get connected to timely resources.
I still support lactation consultants and doulas to train in mindful care of families, and skillful collaborations with health care teams. I still help partners when their spouse is suffering with postpartum anxiety access resources for their family. But maternity care isn’t the only place where there is more demand than resources.

While you’ve been taking care of really critical needs, we’ve seen you too.

Particularly in areas where the need is high, the resources lean, we can not only envision ways to better utilize collaboration, to see more clearly how the matrix of care sources can be better mobilized, but we can bring our attention to sustainability, to creating health and wellbeing out of the ground of health and wellbeing.

There are many parts to a healing system, and in our small way, at WisdomWay Institute, we’re determined to make it more sustainable for everyone. We’re paying attention to where those hidden resources are, to tip that balance towards caring connection and away from stress and pressure.

We’ll exploring how we can impact health care quality measures not by doing more, but by using overlooked resources. We’re practicing the skills that are needed to create a culture of compassion not just for those family caregivers, not just for the patients or clients, but for everyone in the room, including yourself. You see, we’re just not paying attention to those overlooked family carers. We’re seeing you. We’re seeing all the people who make up a complex system.

We’re solving the obstacles of time, pressure, and ‘one more thing’ because much of what we explore is not doing more, it’s doing differently.

Want to get easy to implement, effortless initiatives to bring big change, in small ways?  We’ve got some great resources to share this month to support the family carer, and to support you!  Sign up and we’ll be sending some kindness, appreciation, and inspiration your way.

 

Mindfulness as a Stress Buffer for Carers

  • Mindful Based Stress Reduction (MBSR) reduces stress and improves the mental health of those providing care for people with dementia.13
  • Mindfulness based practices decreases depressive symptoms of family caregivers providing care to the chronically ill.4
  • Mindful Based Stress Reduction interventions decreases mood disturbances and stress symptoms of parents caring for children with special needs.4
  • The stress of family caregiving can be reduced by medication mindfulness-based practices.8
  • Mindful Based Stress Reduction practices can help both the caregiver and the “patient” to face the process of illness with presence and calmness.6

Family Caregiving statistics

  • 36% of U.S. adults provided unpaid care to an adult relative or friend in the past year.
  • 8% of caregivers provided unpaid care to a child living with health challenges or disabilities.3
  • 39% of U.S. adults are caregivers.3
  • 4 million Americans care for someone with mental illness1
  • 63% of parents caregiving for adult children with mental illness report not having enough time to meet their own needs.1
  • Caregivers experience higher levels of depression and anxiety with lover levels of self-efficacy and general wellbeing.9
  • Female caregivers are at increased risk for cardio vascular incidents.11
  • Caregivers of cancer patients experience higher levels of depression.10
  • Caregivers of Alzheimer’s patients experience higher levels of anxiety and depression.5
  • Spousal caregivers of patients with Alzheimer’s experienced higher levels of cognitive decline than spousal noncaregivers after 2 years of caregiving.12

 

(1). American Psychological Association (2015). Stress in American:  Paying with our Health National Alliance for Caregiving, National Alliance on Mental Illness, Diehl, S., Niles-Yokum, K.

(2.) Caldwell, J. (2018).  Circle of Care:  A Guidebook for Mental Health Caregivers Caregiving.com (2017).  Retrieved from https://www.caregiverstress.com/stress-management/daughters-in-the workplace/caregiver-friendly-business-practices/

(3). Desilver, D.  (2013).  Pew Research Center.  As population ages, more American become caregivers.

(4.) Hou, R. J., Wong, S.Y., Yip, B.H., Huung, A.T.F., Lo, H.H., Chan, P.H.S., Kwok, T.C., Tang, W.K., Mercer, S.W., & Ma, S. H.  (2014).  The effects of Mindfulness-Based Stress Reduction Program of the Mental Health of Family Caregivers:  A Randomized Controlled Trial.  Psychotherapy and Psychosomatics, 83(.  45-53.

(5). Mahoney, R., Regan, C., Katona, C., & Livingston, G. (2005). Anxiety and depression in family caregivers of people with Alzheimer’s disease: the LASER-AD study. American Journal of Geriatric Psychiatry, 13(9), 795–801.

(6). McBee, L.  (2003).  Mindfulness Practice with the Frail Elderly and Their Caregivers:  Changing the Practitioner-Patient Relationship.  Topics in Geriatric Rehabilitation, 19(4).  257-264.

(7). Minor, H. G., Carlson, L.e., Mackenzie, M.J., Zernicke, K. & Jones, L.  (2006).  Evaluation of Mindfulness-Based Stress Reduction (MBSR)Program for Caregivers of Children with Chronic Conditions.  Social Work in Health Care, 43(1).  91-109.

(8.) Oken, B.S., Fonareva, I., Haas, M., Wahbeh, H., Lane, J.B., Zajdel, D., & Amen, A.  (2010).  Pilot Controlled Trian of Mindfulness Meditation and Education for Dementia Caregivers.  The Journal of Alternative and Complementary Medicine.

 (9). Pinquart, M. & Sorensen, S.  (2003).  Differences between caregivers and noncaregivers in psychological health and physical health:  A meta-analysis.  Journal of Psychology and Aging, 18(2).  250-267.

(10). Rivera, H.R.  (2009).  Depression Symptoms in Cancer Caregivers.  Clinical Journals of Oncology Nursing, 13(2) 195-202.

(11.) Sunmin, L., Colditz, G., Berkman, L.F., & Kawachi, I.  (2003).  Caregiving and risk of coronary heart disease in U.S. women:  A prospective study.  American Journal of Preventive Medicine, (24)2.  113-119.

(12.) Vitaliano, P. P., Echeverria, D., Yi, J., Phillips, P. E. M., Young, H., & Siegler, I. C. (2005). Psychophysiological Mediators of Caregiver Stress and Differential Cognitive Decline. Psychology and Aging, 20(3), 402-411.

(13.) Whitebird, R. R., Kreitzer, M.J., Crain, A. L., Lewis, B.A., Hanson, L.R., Enstad, C. J.  (2013).  Mindfulness-Based Stress Reduction for Family Caregivers:  A Randomized Controlled Tiral.  The Gerontologist, 53(4).  676-686.