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Caregiver Assessment: A Practical Approach

Caregiver Assessment: A Practical Approach. Carole A. Cohen March 10, 2008. Learning Objectives. At the end of this session the participants will be able to: Describe opportunities & challenges the caregiving role affords Outline a caregiver assessment framework

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Caregiver Assessment: A Practical Approach

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  1. Caregiver Assessment: A Practical Approach Carole A. Cohen March 10, 2008

  2. Learning Objectives At the end of this session the participants will be able to: Describe opportunities & challenges the caregiving role affords Outline a caregiver assessment framework List 2 caregiver assessment tools

  3. Needs Assessment • Who are you? • Successes & challenges in working with caregivers

  4. Introduction • Primary caregivers (family/friends) • Partners in care (supplements “formal care”) • “Hidden patient”

  5. Caregiver Opportunities • Multiple tasks • Changes over time • Decision-making role • Maintain respect, dignity, identity • Positive aspects of caregiving

  6. Caregiver Challenges • Effects of caregiving • Physical consequences • Psychological consequences • Schulz et al.

  7. Why Caregivers? • Many outcomes determined by caregiver factors • CG health, social network, knowledge, coping skills, relationship with CR • CG religious beliefs & practices, positive aspects of caregiving

  8. Caregiver Inventory Mittelman et al. Schulz et al. Others

  9. 1. Caregiver Personal History • Interpersonal relationships • Caregiving experiences • Relationship with care recipient

  10. 2. Caregiver Medical & Psychiatric History • Current physical health problems • ADL limitations • Current & past psychiatric illnesses

  11. 3. Care Recipient’s History • Previous personality • Diagnosis & prognosis • Onset of symptoms • ADL limitations • Behavioural problems • Response to deficits & provision of care

  12. 4. Caregiver Identity

  13. 5. Current Situation:Typical Day • Other responsibilities • What needs to be done • Caregiver involvement

  14. 6. Caregiver Knowledge • Dementia • Problem-solving • Behavioural interventions • Available services

  15. 7. Caregiver Psychological Resources & Challenges • Depressive symptoms • Caregiver reactions & strategies • Positive aspects of caregiving • Desire for counseling • Role of spirituality

  16. 8. Caregiver Support • Informal & formal support • Availability & acceptability • Willingness and ability to ask for help • Expectations of family/friends

  17. 9. Ethical & Legal Issues • POA • Wills • Tolerance of risk • Potential for exploitation

  18. 10. Future Planning • Formal support services • Institutional placement • Palliative care

  19. Caregiver Risk Assessment(Schulz & Martire) • Safety • Self-care & preventative health behaviours • Caregiver support; information, instrumental, emotional • Depression & distress • Problem behaviours of CR

  20. AMA Caregiver Self-Assessment • Physical symptoms • Psychological symptoms • Satisfaction with support • Overall “stress” • Overall “health”

  21. Zarit Burden Interview • Effects of caregiving on many aspects of life ($$, social life, privacy etc.) • Overall “burden”/”stress” • Psychological affects

  22. Successful Caregiver Interventions • Multiple strategies • Continuing relationship over time • Involving CG & CR together if possible

  23. Caregivers: What Do They Need • One size does not fit all • Brodaty: 1)Information & Education 2) Psychological support 3) Mobilizing social support

  24. Using the assessment findings • Caregiver identity

  25. Using the Assessment Findings

  26. Conclusions

  27. References • www.alzheimer.ca • http://www.ama-assn.org/ama/pub/category/5099.html (access documents on health risks of caregiving, caregiver self-assessment questionnaire, etc.) • Schulz et al. REACH study

  28. References cont’d • M. S. Mittelman, C. Epstein, A. Pierzchala, Counseling the Alzheimer’s Caregiver. AMA Press, 2003 • S.M. Parks & K.D. Novielli, (2000) A Practical Guide to Caring for Caregivers American Family Physician Vol 62 No 12. available at http://www.aafp.org/afp/20001215/2613.html (includes the Zarit Burden scale)

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