Assessing Caregiver Needs
Key Points for This Section
Caregiver assessment helps the health care team understand the caregiver’s everyday life, recognize the many jobs done by the caregiver, and look for signs of caregiver strain. Caregiver strain occurs when caregivers are not comfortable in their roles or feel they cannot handle everything they need to do. Caregiver strain may lead to depression and general psychological distress. If the caregiver feels too much strain, caregiving is no longer healthy for either the caregiver or the patient.
A caregiver assessment should look at not only what the patient needs the caregiver to do, but also what the caregiver is willing and able to do. Caregiver strain may occur when the family caregiver does not have the knowledge needed to care for the patient. The health care team can support the caregiver in this area.
Family caregivers report many problems with their caregiving experiences. Assessment is done to find out what the problems are, in order to give the caregiver the right kind of support. Support services can help the caregiver stay healthy, learn caregiving skills, and remain in the caregiving role, all of which help the patient as well.
Some of the factors that affect caregiver strain:
- The number of hours spent caregiving.
- How prepared the caregiver is for caregiving.
- The types of care being given.
- How much the patient is able to do without help (such as bathing and dressing).
There is no standard tool for caregiver assessment. It may be different for each caregiver and family. Some of the factors assessed are culture, age, health, finances, and roles and relationships. Support services can then be chosen to help where the caregiver needs it.
Studies have shown that a family's culture affects how they handle the caregiver role. In some cultures, the family chooses not to get any outside help. Caregivers who have no outside help or help from other family members are usually more depressed than those who receive help from other sources.
Some of the reasons caregivers do not get outside help is that they:
- Don't want to share family matters with others.
- Can't find outside help.
- Don't trust social service providers.
- Don't know how hospice care can help them.
Caregivers may have issues related to age and health that increase their risk for caregiver strain:
- For an older adult caregiver, issues that are a part of aging may make caregiving harder to handle. Older caregivers may have health problems, live on fixed incomes, and have little social support. As they try to meet the demands of caregiving, older caregivers may not take care of their own health. This can make their health worse or cause new health problems. Caregiver strain in older caregivers may lead to an earlier death than noncaregivers the same age.
- Middle-aged and younger caregivers who have jobs and children or other family members to care for are often strained by the caregiving role. These caregivers try to meet the needs of work and family and give up much of their social life while caring for the patient.
Families with low household incomes may not be able to afford the costs of caregiving. When the family cannot pay for costs related to treatment, the patient's recovery may be affected. Caregiver distress increases.
As the number of roles the caregiver must fill increases, the risk of caregiver strain also increases. Given too many roles to fill, the caregiver will not have the time and energy to do them all. For example, caregivers who have a job and also care for children report high levels of stress. However, working while caregiving can also be helpful. Time away from the caregiving role and the social support from co-workers can give the caregiver some relief.
Roles and relationships among family members can be affected by caregiving. A caregiver assessment looks at family relationships to see if there is risk of caregiver strain.