Nursing Care Plan: Caregiver role strain related to illness severity, unpredictability of illness course, knowledge deficit, and increasing clients care needs.

Scientific Basis:

The focus of this care plan is on the supportive care rendered by family, significant others, or caregivers responsible for meeting the physical and/or emotional needs of the patient. With limited access to health care for many people, most disease are diagnosed and managed in the outpatient setting.

Today’s health care environment places high expectations on the designated caregiver, whether a family member or someone to hire. For many older patients, the only caregiver is a fragile spouse overwhelmed by his or her own health problems. Even in cultures where care of the ill is the anticipated responsibility of family members, the complexities of today’s medical regimens, the chronicity of some of disease processes, and the burdens of the caregiver’s own family or environmental milieu provide and overwhelming challenge.

Caregivers have special needs for knowledge and skills in managing the required activities, access to affordable community resources, and recognition that the care they are providing is important and appreciated. People undergoing the role strain are frustrated because they feel inadequate or unsuited to a role.

Gulanick, 2007; Taylor, et al, 2005; Gulanick, 2007

Intervention and Rationale

I: Establish relationship with the caregiver and care recipient.
R: This facilitates assessment and intervention.

I: Assess caregiver-care recipient relationship.
R: Dysfunctional relationship can result in ineffective, fragmented care or even to neglect or abuse.

I: Assess family communication pattern.
R: open communication in the family creates a positive environment, whereas concealing feelings creates problems for caregiver and care recipient.

I: Assess family resources and support systems.
R: Family and social support is related positively to coping effectiveness. Some cultures are more accepting of this responsibility. However, factors such as blended family unit aging, geographical distances between family members, and limited financial resources may hamper coping effectiveness.

I: Assess the caregiver’s appraisal of the care giving situation, level of understanding, and willingness to assume caregiver role.
R: Individual responses to potentially stressful situations are mediated by an appraisal of the personal meaning of the situation. For some, care giving is viewed as a “duty”; for others it may be an act of love.

I: Assess for neglect and abuse of the care recipient and take necessary steps to prevent injury to the care recipient and strain on the caregiver.
R: Safe and appropriate care are priority nursing concerns. The nurse must remain a client advocate.

I: Assess the caregiver’s health.
R: Even though strongly motivated to perform the role of caregiver, the person, may have physical impairments or cognitive impairments that affect the quality of the care giving activities.

I: Encourage the caregiver to identify available family and friends who can assist with care giving.
R: Successful care giving should not be the sole responsibility of one person. In some situations there may be no readily members hesitate to notify other family members or significant others because of unresolved conflicts in the past.

I: Encourage involvement of the other family members to relieve pressure on the primary caregiver.
R: Caring for a family member can be a mutually rewarding and satisfying family experience.

I: Suggest that the caregiver use available community resources.
R: This provides opportunity for multiple competent providers and services on a temporary or more extended period.
I: Encourage the caregiver to set aside time for self. This could be simple as a relaxing bath, time to read a book/newspaper, or going out with friends.
R: Having own time helps conserve physical and emotional energy.

I: Teach the care giver stress-reducing techniques.
R: It is important that the caregiver has the opportunity to relax and reenergize emotionally throughout the day.

I: Encourage the caregiver in support group participation.
R: Groups that come together for mutual support can be quite beneficial in providing education and anticipatory guidance. A group can meet in the home, social setting, by telephone.

I: Acknowledge the caregiver’s role and its values.
R: Caregivers have identified how important it is to feel appreciated for their efforts.

I: Encourage the care recipient to thank the caregiver for care given.
R: Feeling appreciated decreases feelings of strain.

I: Provide time for the caregiver to discuss problems, concerns, and feelings. Ask the caregiver how he or she is managing.
R: As a caregiver, the nurse is in an excellent position to provide emotional support and provide guidance throughout this challenging period.

I: Provide information on the disease process and management strategies.
R: Accurate information increases understanding of the care recipient’s condition and behavior. Caregivers may have an unrealistic picture of the extent of care required at the present time.

Gulanick, 2007; Doenges, et al, 2002; Kruse, et al, 2003

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Nursing care plan: caregiver role strain related to illness severity, unpredictability of illness course, knowledge deficit, and increasing clients care needs. 1

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Nursing care plan: caregiver role strain related to illness severity, unpredictability of illness course, knowledge deficit, and increasing clients care needs. 2
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