FOUR STAGES OF CAREGIVING - The Practical Caregiver Guides

There are four stages of caregiving, but not all caregivers go through each stage. Where are you as a caregiver?

Stage 1 — Basic Care

— easy, casual assistance for common tasks, activities and issues

Stage 2 — Intermediate Care

— more involved assistance for common tasks, activities and issues; greater dependence on the family caregiver

Stage 3 — Advanced Care

— very “hands on” caregiving, with much time spent providing physical care and dealing with related issues

Stage 4 — End-of-Life Care

— intense caregiving that involves providing “comfort care” to loved one

Basic Care

— You usually spends 4-8 hours a week providing care

— The care is uncomplicated and straightforward

— You act as a helpful companion

— Your loved one is still active and independent, but has some limitations

— The need for care may be temporary

–There are simple solutions to common problems

— This is a mutually cooperative relationship because care needs are manageable by both loved one and caregiver

Common Tasks

— Your loved one may need help with big physical tasks

— You may occasionally drive for your loved one

— You may accompany a loved one to important medical appointments

— Your loved one may need assistance with grocery shopping and other errands

— You may provide assistance and physical support after surgery or during illness

— You may organize activities and home duties to make things easier for your loved one

Common Issues

— Your loved one has an awareness of dependence, even on a temporary basis

— He or she may experience frustration with current limitations

— Your loved one is looking for a balance between needing help and providing for self

Caregiver Goal

— Encourage your loved one to remain independent and focused on the positive things he or she can still do

Intermediate Care

— You provide more than 8, but less than 15 hours of care a week

— Physical limitations interfere with your loved one’s normal activities

— You arrange care around your loved one’s needs

— Your loved one has a greater need for monitoring, communication, reassurance

— The balance of the relationship begins to shift from cooperative to dependent

Common Tasks

— The family caregiver is the care coordinator

— You and/or other family members do routine driving around town for your loved one

— Your loved one needs help with meals and other household activities

— You accompany your loved one to medical appointments, tracking medical issues and records, prescriptions, treatments

— You coordinate and/or monitor care in the home

— You spend more time organizing, overseeing, or completing household tasks and responsibilities for your loved one

Common Issues

— Your loved one has a growing awareness of increasing dependence

— He or she may express fear of the future

— Your loved one may be concerned about becoming a burden

— Decreasing physical abilities interfere with everyday life

— Your loved one may experience increasing frustration when trying to overcome obstacles

Caregiver Goals

— Keep your loved one as independent as possible

— Find ways to address the physical limitations

–Address the emotional aspects

— Create your resources list

Advanced Care

— You provide more than 15 hours a week – it’s labor intensive

— Your loved one has a greater need for hands-on physical care

— He or she has a higher level of dependence on the family caregiver

— Palliative care and pain management can help reduce symptom discomfort

— Safety often becomes an issue for your loved one

— You benefit from utilizing resources to help you provide better care

Common Tasks

— Family caregiver is the care manager

— Your loved one needs help with most activities

— There is a greater need to assist with mobility, especially if your loved one is unsteady

— You often have to take over the physical management of the household

— Medication management is important — you may have to take over dispensing prescriptions and supplements to ensure patient safety

— You may be in charge of coordinating in-home care services

— You are likely to provide greater assistance in making decisions

Common Issues

— Your loved one may experience increased depression

— He or she may have less tolerance for frustration

— Fatigue (physical, mental, and emotional) may limit your loved one’s activities

— You can observe progressive physical deterioration

— There is greater risk of injury in the home from falls, burns, accidents

— Your loved one may experience an increase in serious health problems that require routine and emergency medical treatment

Caregiver Goals

— Address the changing physical, mental, and emotional needs of your loved one

— Use your resource list to get the kind of assistance you need to be a good caregiver

— Take care of your own health — don’t ignore symptoms

— Take respite time to recharge your batteries

End-of-Life Care

— You are likely to provide and/or coordinate around-the-clock caregiving

— Hospice team comes to the home to provide treatment and to instruct you in care

— You, as the family caregiver, work with the hospice team

— This is a very emotional time for family and friends

— Directed comfort care and pain management can ease suffering for your loved one

— There are often rapid physical changes, and medical treatment is likely to change with each

— Rest is important for your loved one and you may see a significant increase in sleeping

Common Tasks

— You are the hospice coordinator, working under the direction of the hospice team

— Your goal is to provide your loved one with the best comfort care possible

— Medication and nutrition management for the dying patient are critical

— You are likely to provide physical assistance for most or all activities

— You can help loved one finish unfinished business

— You are likely to keep family and friends directly informed of loved one’s condition, or work with a family member to do so

Common Issues

— Many families experience depression, anger, sadness during hospice care

— Your loved one may feel frustration with or denial of impending death

— He or she may have fears of how death will come and what will happen to the family afterwards

— The family may feel uncertainty and dread as your loved one’s health begins to spiral downward

— Your loved one may have extreme fatigue due to the physicality of death

— Physical pain, discomfort and muscle atrophy may result from the body’s deterioration

— In preparing for death, your love one may physically and socially withdraw

Caregiver Goals

— Provide physical, mental and emotional comfort

— Coordinate with the hospice team and family

— Take respite time, especially because you need to accept the reality of hospice care
— Accept that the death of your loved one is not a failure of your care

When the End Comes….

— Gather your family and friends together

— Understand that your emotions will be strong

— Reach out to each other and share your grief and your memories

— Honor your loved one