Stressed and exhausted caregivers need better support

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Up to 80 per cent of community care for older adults is provided by unpaid informal caregivers. In the absence of government supports, many of them struggle with exhaustion, stress and depression.
(Shutterstock)

Jenny Ploeg, McMaster University and Maureen Markle-Reid, McMaster University

When Brenda retired from paid work, it was like a care-giving tsunami.

Her dad and stepmom moved in with her, her husband had a heart attack and she became a grandma — all within six months.

Brenda is one of 8.1 million Canadians who have taken on challenging unpaid roles — as informal caregivers for people living with physical or cognitive conditions or chronic life-limiting illnesses.

Her stress increased as her parents started to deteriorate physically and mentally. She tried to stay ahead of the ever-changing situation, but became exhausted after her dad started waking in the middle of the night and getting dressed to go out.

She looked on the internet for support in her care-giving role.

As co-scientific directors of the Aging, Community and Health Research Unit at McMaster University, we are working together with older adults with multiple conditions and caregivers like Brenda to promote optimal aging at home.

Our research shows that current health and social services do not address the complex needs of older adults or their family caregivers.

It also suggests that web-based interventions may help reduce depressive symptoms, anxiety and stress or distress for these caregivers.

Who cares for the caregivers?

Older adults with chronic conditions rely heavily on their family caregivers to coordinate their care, monitor medication and accompany them to appointments.

In fact, 70 to 80 per cent of community care for older adults is provided by informal caregivers as opposed to formal care providers.

Increasingly, these older adults have multiple chronic conditions (MCC), such as dementia and stroke, not just one. And as this prevalence of multiple conditions increases worldwide, it’s associated with poor health and higher health-care use and costs.

Women represent a slight majority of Canadian caregivers at 54 per cent and spend more time per week on caregiving than males.

Caregivers report that they do not receive adequate home care or respite services to support them in their roles. There are, for instance, long wait lists for long-term care beds.

Research shows that caregivers spent $12.6 million in one year on expenses related to their roles.
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While caregiving is rewarding, many informal caregivers experience stress and anxiety leading to their own poor mental and physical health.

Informal caregivers feel overwhelmed with multiple requests for their time and frustrated when they can’t plan too far in advance.

“I felt like I was spending a lot of time waiting. Waiting for people to get ready. Waiting for people to get back to me. Waiting at appointments,” said Brenda.

Some reach a crisis point and leave their loved ones in the hospital emergency room because they are unable to continue in their caregiving role. This contributes to an already overburdened acute-care system.

Web-based supports can help

We conducted a systematic review and meta-analysis that examined the impact of different types of internet-based interventions on caregiver mental health outcomes.

One example of such a web-based support is My Tools 4 Care, developed by our colleague Dr. Wendy Duggleby at the University of Alberta and her team.

We found evidence that internet-based interventions had a positive effect on reducing depressive symptoms, stress, distress and anxiety in caregivers of adults with a chronic condition.

Internet-based interventions reduce caregiver depression and anxiety.
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The most effective category of online support was information and/or education with or without professional psychological support. Information provided together with combined peer and professional psychological support was also effective, to a lesser extent.

However, although many websites for caregivers provide valuable information, we found that they need to be easier to navigate and use.

Caregivers in our study made recommendations to improve the content and format of online resources. Suggestions included: Providing personalized information about local resources; sharing practical caregiving tips and strategies; creating opportunities to connect online with other caregivers; and having user-friendly features that are easy to navigate.

Nova Scotia leads the way

Caregiving comes with costs to the caregivers — to their health and to their finances.

Half of caregivers are between 45-65 years of age, in the peak of their earning years. They often take time off work to take their loved ones to appointments, and some must leave work early when the health of their loved one worsens. Out-of-pocket expenses for equipment, medications and parking can also be expensive.

Research shows that caregivers spent $12.6 million in one year on expenses related to their roles.

Nova Scotia is the only province in Canada that has a monthly income or allowance for caregivers, known as the Caregiver Benefit Program. Financial assistance from the government for caregivers in other parts of Canada mainly take the form of federal tax credits and insurance benefits.

And yet caregivers make vitally important but often unrecognized contributions to our society. It is estimated that they contribute $25 billion in unpaid labour.

Change is urgently needed to better support our caregivers.The Conversation

Jenny Ploeg, Professor, School of Nursing, McMaster University and Maureen Markle-Reid, Associate Professor and Canada Research Chair in Person Centred Interventions for Older Adults with Multimorbidity and their Caregivers, School of Nursing, McMaster University

This article was originally published on The Conversation. Read the original article.

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The Art of Spoken Word & Dementia

Poetry sometimes for many of us who are not English Literature majors or come from a non-English speaking background, may sound like something that is really difficult and requires a high level of linguistic skill and perfection. However, poetry is found to be cathartic for many people with dementia and high therapeutic. So how do we get over that wall of stigma? For those who may wish to try an alternative, here is the Spoken Word.

This video above is an example of spoken word or some may call it spoken word poetry. The video above is performed by IN-Q, a professional spoken word artist. Spoken word unlike traditional poetry that is meant for paper is a contemporary high-energy performance of the heart, mind and soul. It embraces poetry, storytelling, theatre, and folk, jazz, hip hop and even R&B. It can be a performance by anyone of any age. Topics are mostly issues close to the heart and the home.

Bring spoken word to your home today and bring out the inner a spoken word artist in you. Here’s a video on how to write and perform Spoken Word by Khalil Smith.

Step 1: Brain Storming

Pick a topic that is personal and familiar. Think of words associated with the topic.

Step 2: Construction

Connect the words and carry out a process of association to enable word form and structure.

Step 3: Finalisation Phase

Writing and thinking of the tone and the beat.

Step 4: Performance

Memorise if possible, and add physical movements and ways to engage the audience.


 

For more spoken word performances please visit: http://blog.ted.com/10-spoken-word-performances-folded-like-lyrical-origami/. I’ll leave you with a spoken word performance by Raymond Antrobus Ode to his father’s dementia.

 

 

 

Animal-assisted therapy helps reduce BPSD

A successful pilot study that helped to reduced behavioural and psychological symptoms of dementia (BPSD) was conducted on 15 nursing homes residents living with dementia who were exhibiting agitation and aggression. The study was carried out over a period of nine weeks on weekdays (2.30pm – 3.30pm) in two nursing homes that offering recreation programs. The team providing the intervention consisted of therapeutic recreation staff, therapy dogs, and their handlers. Residents in the program could play, pet, feed. chat or just talk about pets that they had in the past or just chat with the handlers. At three weeks, changes in the reduction in behaviour were apparent and after nine weeks, it was found that agitated behaviours were reduced and the residents in the program have become more engaged.

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This study was published in the American journal of Alzheimer’s Disease and other Dementias by Nancy Richeson from the College of Nursing and Health Professions in the University of Southern Maine, Portland.

Reference:

Richeson, N. (2003). Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia.American Journal Of Alzheimer’s Disease & Other Dementias, 18(6), 353-358 6p.

Source: Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia

Quick, easy and healthy asian meals: Part 1

Quickandeasymeals

For most of us caring for our parents or a loved one at home, putting together a home cooked meal can feel like a tough feat. After a busy day at work, it’s so much easier for us to just pick up a takeaway meal at the food centre or just grab some fast food for the whole family.

For care staff that may have residents or clients who are caring for older Asian living in residential or community aged care facilities, fellow nurses have shared that sometimes, trying to figure out a healthy, delicious and easy Asian meal may be challenging. Most of the time, it is easier to just dish up what’s available, or get meals on wheels, and for clients, it may be a lamb roast, fish and chips, casserole, not something that residents or clients may be familiar with. It’s not difficult to understand why residents/clients may start losing weight or their appetite.

Finding good quality Asian food can be tough and studies have indicated that eating out may not be the best for our health. Food prepared commercially usually contains a high amount of saturated fat, carbohydrates and sodium. For many older adults, this may not be ideal, taking into consideration the multiple co-morbidities that they already have. For caregivers, after a long day at work, a high fat, high carbohydrate and high sodium meal, though tasty, may not be ideal for the body in the long term. This may also make us feel sluggish and tired, instead of rejuvenated after a good nutritious meal. Below are some quick and easy Asian recipes that are clean and healthy.

recipes

1. Bak Chor Mee Soup Recipe 肉脞面 (Chinese Mince Meat Noodle Soup)

Serves:

Click here: http://www.noobcook.com/bak-chor-mee-soup/2/

2. Congee 粥(Rice porridge)

Serves: 1 

Click here: http://www.mijorecipes.com/chinese-congee-jook-chicken/

3. Chicken Noodle 鸡丝面

Serves: 2

Click here: http://rasamalaysia.com/chicken-noodles-recipe/2

Potstickers 鍋貼

Serves: 6

Click here: http://damndelicious.net/2014/03/01/potstickers/

4. Baked Honey Garlic Chicken 甜甜鸡

Serves: 4

Click here: http://damndelicious.net/2014/03/01/potstickers/

5. Hot and Sour Soup 酸辣汤

Serves: 4

Click here: http://www.closetcooking.com/2015/02/quick-and-easy-chinese-hot-and-sour-soup.html

6. Chinese Chives with Tofu 炒韭菜豆腐

Serves: 4

Click here: http://www.bubblews.com/posts/sauteed-chinese-chive-with-tofu

7. Bok Choy and Shiitake Mushroom Noodles 面条加香菇白菜

Serves: 2

Click here: http://divinehealthyfood.com/bok-choy-shiitake-mushroom-noodles/#comment-145

8. Stir-Fried Pea Shoots 炒豆苗

Serves: 4

Click here: http://www.bonappetit.com/recipes/article/how-to-cook-pea-shoots

9. Shrimp with Snow Peas 豌豆虾仁

Serves: 4

Click here: http://rasamalaysia.com/shrimp-with-snow-peas-recipe/?pid=616#image-337

10. Salt and Pepper Tofu 椒盐豆腐

Serves: 4

Click here: http://www.veggiebelly.com/2010/07/restaurant-style-chinese-salt-pepper-tofu.html

References:

Altman M, Cahill Holland J, Lundeen D, Kolko RP, Stein RI, Saelens BE, Welch
RR, Perri MG, Schechtman KB, Epstein LH, Wilfley DE. Reduction in Food Away from
Home Is Associated with Improved Child Relative Weight and Body Composition
Outcomes and This Relation Is Mediated by Changes in Diet Quality. J Acad Nutr
Diet. 2015 May 8.

Bezerra IN, Curioni C, Sichieri R. Association between eating out of home and body weight. Nutr Rev. 2012 Feb;70(2):65-79.

Djoussé L, Petrone AB, Gaziano JM. Consumption of fried foods and risk of
heart failure in the physicians’ health study. J Am Heart Assoc. 2015 Apr
23;4(4).

Guthrie JF, Lin BH, Frazao E. Role of food prepared away from home in the
American diet, 1977-78 versus 1994-96: changes and consequences. J Nutr Educ
Behav. 2002 May-Jun;34(3):140-50.

won YS, Ju SY. Trends in nutrient intakes and consumption while eating-out
among Korean adults based on Korea National Health and Nutrition Examination
Survey (1998-2012) data. Nutr Res Pract. 2014 Dec;8(6):670-8.

Yeh MC, Heo M, Suchday S, Wong A, Poon E, Liu G, Wylie-Rosett J. Translation
of the Diabetes Prevention Program for diabetes risk reduction in Chinese
immigrants in New York City. Diabet Med. 2015 Jul 14.