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Helping caregivers of patients with dementia: Strategies for family nurse practitioners

Date: December 5, 2017

An estimated 47 million senior citizens worldwide are living with dementia, according to research from The World Health Organization (WHO). These individuals are not alone in their struggle against this deadly disease. Family members and friends provide support, devoting considerable amounts of time to ensuring their loved ones can navigate life safely. Caring for someone with dementia is no easy task. Caregivers themselves often experience adverse health effects due to the stress of caring for loved ones with deteriorating psychological capacity. Many people caring for individuals with dementia develop a formal condition called caregiver strain. Symptoms of caregiver strain include anxiety, depression and social withdrawal, according to the Alzheimer’s Association. Some caregivers even develop physical symptoms as a result of burnout.

In cases of caregiver strain, family nurse practitioners (FNPs) can offer invaluable assistance, providing caregivers with the essential guidance they need to support patients with dementia without a negative impact on the caregiver’s own well-being. Here are some of the ways in which medical professionals can help those individuals caring for seniors with dementia.

Bolstering medical skills
One of the most effective methods for assisting caregivers is helping them build their technical skill sets, according to one study from health care researchers from Michigan State University and The State University of New Jersey published in the journal “Patient Safety and Quality: An Evidenced-Based Handbook for Nurses.” Data shows that caregivers who are more confident in their abilities are less likely to develop stress.

FNPs should focus on teaching caregivers how to administer medication and deal with infections or other illnesses that can materialize in individuals with dementia. Patients often develop urinary tract or sinus infections due to dementia-related apathy, according to the Alzheimer’s Association. Additionally, the disease can cause eyesight and hearing issues.

Working on communication competencies
Patients with dementia often experience difficulties communicating as their disease progresses. Most individuals have trouble finding the right words during conversations or organizing coherent sentences. Some patients may find that describing familiar objects becomes difficult. Multilingual patients with dementia sometimes revert to speaking their native languages. In addition to these cognitive issues, individuals coping with dementia may develop behavioral problems that can further impede communication. Patients with dementia might disengage when spoken to due to apathy or become agitated as the result of disease-related personality changes.

Together, these complications can weigh on caregivers and lay the groundwork for strain. FNPs can help individuals with dementia overcome communication roadblocks by providing caregivers with actionable techniques for forming and maintaining functional connections with the individuals in their care.

The National Center on Caregiving advises people supporting patients with dementia to set positive moods for interactions to avoid conflict, limit distractions that might pull charges out of conversation and use simple language. The group also advises caregivers to practice empathy and keep the needs of the patient in mind, even when problems arise.

FNPs can help caregivers hone these skills and improve their bedside expertise to provide hands-on insight into patient communication.

Addressing problem-solving abilities
Caregivers will likely encounter a myriad of problems when supporting patients with dementia. Abnormal social behaviors can give way to public and private interpersonal conflicts. The psychological breakdown that develops as a result of dementia can lead patients to make errors big and small, from mismanaging large amounts of money to forgetting to bathe, noted an article from nursing researchers at the University of California, San Francisco published in the journal “Clinical Nurse Spec.”

FNPs can help caregivers prepare for these situations by working with them to develop easy-to-deploy problem-solving techniques. When individuals supporting patients with dementia have the skills necessary to think through these issues, stress is less likely to build. This methodology also has a clinical component: Common dementia medications such as cholinesterase inhibitors and memantine can cause side effects like dizziness and vomiting, according to Mayo Clinic. Caregivers must have the mental wherewithal to address these issues, along with more serious complications.

Providing insight into care delivery
In addition to helping patients with dementia get through daily life, caregivers also shuttle their patients through the health care system, offering counsel and support throughout treatment. Caregivers should develop a keen understanding of modern care delivery, most notably the local health service options that normally work best for patients with dementia who cannot stray too far from home. Both state and federal agencies sponsor such programs.

FNPs are perfectly positioned to provide this insight, as they know the ins and outs of the health care system and can offer firsthand knowledge on how best to serve patients in an increasingly complex care environment. Apart from helping caregivers understand how treatment is administered, these medical professionals should address the caregiver’s role and responsibilities, according to research from ethics experts at the American College of Physicians published in the journal “J Gen Internal Med.”

In the era of patient-centered care, caregivers and patient advocates have gained great power and now work side by side with doctors and other clinicians to design and deliver care. It is possible for these medical professions to overstep their boundaries and begin speaking for, rather than advocating for, patients. Any medical professional speaking for a patient is problematic on multiple fronts and stands in violation of laws that govern patient privacy and autonomy. FNPs can prevent these problems up front by helping caregivers understand the care delivery environment and how they fit within it, legally and practically.

Combating dementia via caregiver support
With these strategies, FNPs can empower caregivers of patients with dementia, an act that ultimately benefits individuals with the disease. Such a task requires formalized advanced-practice instruction.

Registered nurses (RNs) can gain the skills and knowledge needed to better support dementia caregivers by enrolling in Bradley University’s online Master of Science in Nursing — FNP program. As students, RNs gain knowledge on a wide range of topics, from advanced health assessment techniques to health care policy, all without stepping foot on campus. The 67-credit-degree track ends with a capstone research project, followed by five preceptor-supervised clinical practicums, which can be administered in any location.

The online MSN-FNP program at Bradley University is the ideal choice for RNs hoping to move upward mid-career and expand their skill sets so as to better serve their patients and the people who support them at home.

Recommended Readings:
Managing conflicts with patients: Strategies for FNPs
Why FNPs are a good fit for underserved communities

Sources:

http://origin.who.int/features/factfiles/dementia/en/

http://www.alz.org/care/alzheimers-dementia-caregiver-stress-burnout.asp

https://www.ncbi.nlm.nih.gov/books/NBK2665/

http://www.alz.org/alzheimers_disease_treatments_for_behavior.asp#non-drug

http://www.cdss.ca.gov/agedblinddisabled/res/VPTC2/12%20Working%20With%20Consumers%20with%20Disabilities/Ten_Tips_Communicating_Dementia.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943420/

http://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/treatment/txc-20198533

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2839338/

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