Caring for Caregivers

Tools and Resources to Assist Caregivers

Physicians providing care for individuals with dementia are also providing care for the family members and other caregivers. Caregiver stress can be significant, and providers may want to assess the caregiver both for their own health and for the safety and wellbeing of the individual with dementia.

Assisting caregivers through the course of the disease process may be the most important role providers can have, but can take considerable time for the provider and office staff. Below are links to pdfs you may want to have available to give to family members to assure a more effective patient appointment and follow-up, and to provide appropriate information at various stages.

To assure a more effective and efficient provider visit, front office staff can send the Preparing for Your Doctor’s Visit document to the family member at the time of scheduling an appointment. This will assist the caregiver to provide information over time, rather than having to recall issues at the appointment.  You may also want to have the caregiver complete the AD8 or another information survey prior to the visit to provide a more thorough picture of the individual’s cognitive state.

Once a diagnosis is made, it is important to address the most critical issues as soon as possible.

FIVE ACTION STEPS FAMILY CAREGIVERS SHOULD TAKE

  1. Establish legal responsibility and create legal documents that will be helpful to you and to your loved one.
  2. Understand the diagnostic process, symptoms, and course of memory loss and dementia.
  3. Care for yourself; a healthy, rested caregiver is a more effective caregiver.
  4. Join a support group.
  5. Plan for the future. Do research and know what lies ahead to plan accordingly.

The Clinical Roundtable, in conjunction with the County of San Diego Aging and Independence Services, compiled a listing of Resources for Caregivers. This handout can be printed and given at the appointment.

Other helpful tools are the handouts on Assisting Caregivers Plan through the Stages and Challenges of Caring for an Individual Living with Dementia.

For more information on many of the local organizations providing caregiver resources, your office can connect with the links at the bottom:

Caregiver Assessment

Due to the stress and strain of caregiving, the health and wellbeing of caregivers, particularly family caregivers responsible for daily care, is at risk. It may be important to periodically check in with the caregivers during a regular appointment, or suggest a separate appointment to discuss concerns.

The primary care provider is encouraged to utilize the clinical team to conduct caregiver assessments. A nurse, nurse practitioner, or the rooming staff medical assistant may be able to initiate the assessment.  If a social worker is available to the practice, that person may be best suited. If the patient qualifies for home health care services, the home health agency can provide a social work evaluation in the home.

There are a number of self-assessment tools (see Instruments at end of section) that may be sent to the caregiver to complete prior to the patient’s appointment, and bring to the appointment, similar to the use of the informant survey (AD8) to assess changes in behaviors in the individual with dementia. The Clinical Roundtable recommends the use of the ZBI-12 assessment. More important than the professional status of the assessors are their attitudes and ability to relate to the caregiver in a nonjudgmental and thoughtful way. Should a high level of stress or burden be detected, it is important to refer the caregiver to support groups, , mental health services, and resources that provide a wide array of supportive services through many of the organizations listed on the Resource sheet.

There are a number of San Diego based organizations with focus on assisting caregivers of individuals with dementia.