Caregiver training

Training is Essential

Howard Glickman, senior contributor at Forbes Magazine, regularly writes about caregivers. His most recent article, Compassion isn’t enough for family caregivers. They need training too, resonated with me as I consistently ask, even demand, that healthcare providers equip me with insight and instructions beyond the basics. The benefits of caregiver training extend beyond caring for elders.

The article explores the necessity and dearth of training for family members (and friends) who provide increasingly complex care for elders. This care extends lifespans and keeps seniors out of hospitals and care facilities, “Yet, a new study published in JAMA Internal Medicine (paywall) finds that 93 percent  of family members caring for an older adult say they never have been taught how to do this difficult work.”

Would you hire this person?

Glickman rightly notes that a nurse or aide with insufficient skills would be fired immediately, but family members are expected to provide difficult technical care with no training at all. I’ve found that few healthcare providers (which includes doctors, nurses, physical and occupational therapists, etc) are equipped with the skills to teach a family caregiver the proper techniques to care for a wound, give a shower, transfer from a wheelchair to car and more. They resort to handing you a printed page of instructions — a wholly inadequate approach.

The article discusses programs available in some states that require training upon discharge from a facility or before caregivers can be paid with public insurance dollars. As the programs don’t specify a training curricula, it’s difficult to assess their comprehensiveness or success. A promising example of caregiver training is AARP’s “Home Alone Alliance℠” video series. The “How-To” videos and resource guides for family caregivers are on specific medical/nursing tasks – including preparing special diets, managing incontinence, wound care, mobility, and managing medications. The videos and resource guides, many of which are available in both English and Spanish, are free of charge. I’ve watched several of the guides which are educational though mostly at an introductory level.

No one solution fits all problems

Each caregiver encounters a unique set of problems and the most difficult and potentially dangerous problems can’t be solved by reading instructions or watching a generic video. For example, J can easily sit up from a prone position when she’s lying on a therapy platform or other relatively firm foundation. Put her in her bed and she’s struggles to overcome the soft mattress. To help with this problem and others, I’ve had physical and occupational therapists come to the house to both develop a reliable and safe procedure and teach J and me how to do it.

One alternative is to make my own videos when at therapy sessions or doctor appointments. This way I can both review the techniques at home and show them to any aides. Here is a recent example of J learning a new exercise at a physical therapy session:

It’s not just about protecting your family member

One last important item to remember is that proper training is critical to protecting yourself as the caregiver from physical and emotional injury. It’s easy to injure yourself when transferring someone or giving a shower, and it can be devastating when you discover that your actions contributed to a new problem. For example, I learned the hard way how to deal with incontinence-related hygiene problems after a urinary tract infection landed J back in the hospital.

The bottom line is be assertive about asking for specific, hands-on help and keep an eye out for alternative and improved solutions.

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