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Nurse's assessment of caregiver burden.

Article Excerpt
After her father was diagnosed with Alzheimers disease 2 years ago at age 70, Carrie assumed sole responsibility for his care. Carrie has been married for 15 years and has two young sons. She quit her part-time job at a local bank to assume care for her father. After her mother died from cancer 4 years ago, Carrie's father was her sole remaining family member. He lives with her and her family after the decline of his condition 6 months ago. Caring for her father has been difficult for Carrie and her family financially and emotionally. Recently, her father developed urinary and bowel incontinence; Carrie now cleans and bathes him several times a day. She also supervises him closely during the day to ensure he does not wander or hurt himself. Carrie has given a great deal of the time she used to spend with her husband and sons to care for her father, and this intensive care has taken a toll on both her emotional and physical health. Today, Carrie has an appointment at a primary care clinic with her nurse practitioner to evaluate her back pain due to turning and lifting her father. How can the nursing staff help Carrie adjust to her family situation? What resources can be offered to help them cope with the new role of care giving?

Family Caregivers: Backbone of Long-Term Care

As the population ages, the need for both formal and informal care for older adults rises. According to the National Alliance for Caregiving (2007), those age 65 and older are among the fastest growing segment of the U.S. population. This trend means more caregivers are needed by older adult family members to provide medical care as well as assistance with activities of daily living. Contrary to some beliefs, the family provides about 80%-90% of informal care and medical care to its older member (Hanson, Gedaly-Duff, & Kaakinen, 2005). Unfortunately, due to shortened hospital stays, and lack of rehabilitation services and home health aides, caregivers are more challenged to care for their family members (Burns & Rabins, 2000). As an elder's health deteriorates, the caregiver takes on more responsibility and provides more assistance with tasks that may be uncomfortable or unpleasant. Caregivers to older adults with dementia consistently report higher levels of burden and depression than those caring for elders without dementia. This increased burden and depression are seen more frequently in persons who report spending more time caring, helping with more basic and personal activities, and caring for those with behavioral problems (Bertrand, Fredman, & Saczynski, 2006).

Although they play an informal role in the care of older adults, caregivers are vital to elders' health. When caregivers set aside their own needs and sacrifice other relationships in their lives to assume caregiver's responsibilities, they are at high risk for caregiver burden, physical and mental illness, financial burden, social isolation, and depressive symptoms (Sherwood, Given, Given, & Von Eye, 2005). If not addressed appropriately and timely (Bertrand et al., 2006), caregiver burden can progress to caregiver burnout and may increase potential for elder abuse and neglect.

As the baby boomer generation ages and faces longer life expectancies, the need for family caregivers increases significantly. Care giving provided by family members saves an average of $257 billion yearly in governmental and institutional health care spending (National Alliance...

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