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Caregiving is a little like having a fuel tank: In order to keep pumping gas out, you have to have a steady supply coming in. There is a large number of Americans who need home care; consequently, there is also a large number of family caregivers. But, what about the aid, sustenance, and fuel needed to keep these family tanks filled?


Family caregivers are the ones who must tap an ever changing healthcare system's resources to meet the needs of their ill family member, even when it is not clear what resources are currently available or if any are available at all. These are the people who ultimately bear the exhaustion and isolation that result from caring for a spouse, mother, father, or other relative. If family caregivers do not have some relief in their daily lives, they are at risk of overload and breakdown from stress.


Unfortunately, there is no concerted national effort to make services available to family caregivers. But home care nurses have long known the necessity for and value of mobilizing, nurturing, and sustaining families to help care for their ill members. In fact, many of our nursing interventions could be the seeds for a grass roots movement toward local, regional, and national programs for fueling family tanks. Here are some suggestions for supporting the family caregiver:


1. Ask how the family caregiver is doing and what he/she is feeling. Questions such as, "This has been hard on you, hasn't it?" or "How have you been holding up?" are good openers to encourage talking about feelings. Just having someone listen and understand one's feelings of anger, depression, guilt, frustration, fear (or whatever!) can be a relief. And you may need to do nothing more than listen.


2. Give family members as much information as they are ready for, want, and can understand about their relative's illness. Ignorance is not bliss and families have a right to information about health, disease, treatment, medications, and care.Encourage caregivers to compile a list of community services that could assist them in a file box with phone numbers and basic information. Everyone in the family can contribute to this effort.


3. Encourage and, if need be, facilitate family caregiver meetings to share thoughts, feelings, determine roles, share problems, and discuss services and finances. Sometime include the ill family member and sometimes caregivers meet alone.


4. Encourage privacy and independence of family members so that they may pursue their own interests outside the family.


5. Help family members set healthy ground rules for themselves such as:


* It's okay to have time for yourself.


* It's okay to have others share in the care.


* Take good care of yourself; make sure your tank is filled so that you can care for yourself and another.


6. Explore respite and adult day-care programs.


7. Be generous with your praise when family caregivers are doing a good job. It's amazing how much a simple statement such as, "Mrs. Randall, you're doing such a nice job caring for your husband," can help to fill a family's fuel tank.



All of these suggestions can go a long way toward helping families replenish and maintain their supply of fuel so that they'll be able to be successful at the job of caring for another.