An article published in last week's Journal of the American Medical Association suggests that the provision of affordable, quality, patient-centered care will require "unprecedented" caregiver education.
According to the article, 42 million Americans are caregivers, and each spends on average 20 hours per week assisting with "independent activities of daily living," including shopping, cooking, bathing, dressing, and providing medical treatment of the level usually performed by nurses or technicians.
The majority of caregivers are middle-aged women caring for aging parents, who are often in the last stages of life and able to express but not execute preference. This type of disability and frailty demands direct and ongoing caregiver engagement.
The study author, Muriel R. Gillick, MD, noted that some studies find caregiver education both decreases caregiver burden and increases patient satisfaction, all while decreasing healthcare costs. In order to stage a successful caregiver intervention, Dr. Gillick suggests the following steps:
1. Ensure the caregiver and patient understand both the patient's diagnosis and prognosis. This full understanding can allow both parties to have a realistic idea of the patient's trajectory.
2. Create and prioritize goals of care. Caregivers must understand what a patient wants, whether it's quality, prolongation of life or comfort.
3. Design a plan of care that stems from the patient's diagnosis and goals. To do so requires an assessment of the patient's surroundings as well as a method for comprehensive transmission of the care plan to other caregiving individuals or to medical professionals.
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