I was delighted to learn that November is National Caregiver month. Caregivers deserve recognition. They often are unsung heroes who go about caring for their loved ones by putting their needs in second place.
Caregivers may be parents of children, spouses, siblings, adult children with parents, or not biologically related to the person receiving care. Those for whom they care may have a chronic condition, a terminal illness, or a disability. Regardless of circumstance, caregivers often experience similar feelings and spiritual needs.
Sr. Mary Elizabeth O'Brien (2006) wrote that caring for ill children poses an incredible challenge for their caregivers. I agree and feel that it applies to all caregivers. Not only do caregivers face incredible challenges and work very hard, but they also share feelings that accompany their role. Caregivers often have the following feelings:
1) A sense of isolation and loneliness. People may no longer visit, plus the caregiver isn't free to get out as before. The caregiver may not have anyone to talk to or have people with whom she can share concerns.
2) A sense of sadness, as he sees his loved one suffer or when the loved one is so changed that recognition is lost. Caregiving also brings a change in the relationship.
3) Emotional upheaval is experienced by not knowing what each day will bring. Some of the accompanying emotions are fear, frustration, and anxiety, as well as the feeling of being trapped.
4) Fragmentation in caregiving occurs in coordinating appointments and services, as well as trying to maintain a personal life and keeping a household intact. Uncertainty in daily events is stressful and makes it difficult to plan. Interruptions also contribute to fragmentation, in that the caregiver may be unable to finish what he or she was doing.
5) Fatigue is another reality because of demands and the tendency to neglect personal needs. Caregivers often don't realize the burden of caregiving and simply may be worn out and not be benefiting from quality sleep.
6) Often caregivers do not have a nursing or medical background. They need assurance that they are doing a good job. Caregivers benefit from interactions with social workers, home healthcare specialists or, as death approaches, hospice nurses.
How can nurses implement interventions to help caregivers process their feelings, as well as address their spiritual needs?
Offer encouragement. Encourage the caregiver that he can meet the challenges. Sometimes caregivers need to be encouraged to accept help. Prayer and Scripture can be helpful. Philippians 4:13 reminds the believer that he or she can do all things through Christ, who gives strength. One caregiver told me that she prayed not only for strength, but also for enough strength to give away.
Keep them connected. Help caregivers stay connected with resources, friends, and family. Guide them in finding a support group that meets their specific caregiving needs. A caregiver support group brings together people who are experiencing similar feelings and situations. They'll find support in shared stories and feel safe in pouring out their hearts and can talk freely about feelings and frustrations (Shelly, 2000).
Help them take care of their emotional and physical needs. I've heard it expressed that caregivers should be taking at least as good care of themselves as they are for the person in their care. Remind caregivers of the importance of nutrition and sleep so they have energy to provide care. Giving or arranging for respite care can be a huge help. One caregiver expressed that after having time away, she was given a chance to reset her emotions. She returned feeling more patient. The hope of another respite kept her going, and she no longer felt trapped (Shelly, 2000).
As nurses, we need to assess the spiritual needs of caregivers. Awareness assists us in meeting the spiritual needs of a caregiver through the interventions noted. However, we can also do so by offering friendship and care or by simply arranging for them to get away for a cup of coffee or a good meal.