Find alternative caregiving arrangements

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Question

Betty Carlson is a healthy 65-year-old woman who still works full-time and lives alone. Her mother, Anna, is 83 years old, lives alone, and takes numerous medications for heart disease. Recently, Anna has fallen several times, but has sustained only minor bruising. Betty and her brother have been discussing whether or not Anna should continue to live alone. Anna is quite independent although she no longer drives and is occasionally "forgetful" about family birthdays and appointments. Anna has expressed her concerns about retirement communities, assisted living, and nursing home living. Betty's 25-year-old single niece has voiced an interest in living with Anna and providing basic care in the evenings, during the night, and on weekends. Betty approaches you as Anna's nurse at her primary care office and as a volunteer at the city senior center that Anna attends every week. Betty asks for your advice and help regarding the potential choices of caregiving and living arrangements for Anna. Betty wonders if she should decrease her work hours in order to spend more time at her mother's house. Betty wonders about payment fees to her niece and about information and referral resources to assist the family's informed decisions.

1. What are examples of crucial questions and conversations that you should use to gain better insight into the full situation?

2. The decision about where and how to provide care for family members who have chronic conditions is emotionally charged and multifaceted. Reliance on family members as care providers creates multiple stressors for the family. What types of stressors might Anna, Betty, and other family members experience?

3. What motivations might encourage Betty to become an informal caregiver? What are her possible motivations to find alternative caregiving arrangements for her mother? What are potential challenges/barriers to her decisions?

4. What types of care will Anna require and/or will family caregivers likely provide? How might the caregiving situation become a "blended approach" to caregiving?

5. What histories and maturation process do you foresee in Anna's situation? What are potential transitional points of care?

6. What are potential/actual policy, legal, ethical, emotional, financial, and spiritual issues that Anna's family may experience? What resources can you offer to them?

7. What caregiver strain, burden, and/or burnout might the family experience (either during their own caregiving activities or at residential living settings)?

8. What models of care can guide your interventions with Anna's family? What nursing interventions might be most appropriate to Anna's situation? How will you incorporate evidence-based practice into her plan of care? What are the expected outcomes of Anna's caregiving situation and experiences? How will you measure those outcomes?

Reference no: EM133844735

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