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Are you struggling to manage the challenges of caring for a loved one? Feeling overwhelmed or exhausted by juggling family, work, home and caregiving responsibilities? Are you a Health or senior care professional witnessing your patients’ families struggling and wonder how to help them? When facing challenges, resilience provides the capacity to handle tough decisions, to persevere and prevail. When tapping resilience, the daunting becomes do-able; difficult experiences turn into learning experiences.
Both family caregivers and the professionals who support them are invited to view this free webinar. This workshop includes 6 parts that will teach you empowering and sustaining resilience-building strategies:
- Defining resilience and why it is important for family caregivers
- How lack of resilience impacts health care and home care organizations
- A method for assessing caregiver resilience
- Practical ways to build caregiver resilience
- Effective strategies professionals use to promote caregiver resilience
- Helpful resources caregivers can use to build resilience
Meredith: Good afternoon, everyone. Let me take a moment to introduce myself before we get started. My name is Meredith Collins. I am the engineer of the entire Solutions Series workshop, in addition to leading all the learning and education programs for Griswold Home Care.
Welcome to today’s Solutions Series webinar, entitled “Building Caregiver Resilience.” Griswold Home Care Solutions Series webinar program is a quarterly workshop designed to provide tactical solutions to professional and family caregivers to families dealing with these conditions and the health care professionals helping them.
An integral component of the Solutions Series webinar program is learning from you, the audience. Throughout the webinar you will have several opportunities to share your thoughts, experiences, and insights on the topic of building caregiver resilience via our brain writing exercise. Which can further promote today’s topic and support your peers.
First, before we begin, a few housekeeping items. All phone lines are muted. The audience will have several opportunities to interact with the panelists, and we’ll also have a formal Q & A session at the end of the webinar.
The powerful components of this workshop are the presented tools to address the topic of caregiver resilience. This presentation, recording, and all tools with web links will be made available and emailed to registrants, with a complete transcript a few days after the webinar.
Caregiver resilience was chosen for the Solutions Series program because November is Caregiver Awareness Month. Now that we’re getting started I’d like to introduce Jane Hamilton, our guest and speaker for today’s webinar.
Jane is an entrepreneur, consultant, educator, and author. A nurse for 40 years and family caregiver for 20, Jane is the founder of Partners on the Path, a certified woman-owned business which provides caregiver support programs to businesses and non-profits, health care and faith based organizations.
Her expertise in caregiver stress, resilience, and compassion [inaudible 00:02:08] are unmatched. Jane is consulting with Griswold Home Care to create webinars and online CE programs. Thank you, Jane, for joining us. Are you ready to get started?
Jane: I sure am, Meredith. And thank you very much for that wonderful introduction. And thank you all for joining us for today’s webinar, “Building Caregiver Resilience: Preserving your capacity to care.” And I’d like to just flip back to the cover slide which was so beautifully created for us, and call your attention to the picture of the flower which is bursting forth from the asphalt of the road.
What we want to talk about today is how the energy, that you and I as caregivers have, can help us to come through difficult situations and flower just as beautifully as this one.
We’ve chosen, as Meredith said, to highlight resilience of caregivers because November is National Family Caregivers Month. Family caregivers make such important contributions to health care and to their families, to long term care systems, and to society at large. The care and the commitment of family care givers is a gift to us all.
I have a quote here from John Schall, who is the executive director of a national advocacy organization called The Caregiver Action Network. In this quote, John says:
‘It was not so long ago that patients and family caregivers who, too often felt cast adrift by their health care professionals, who were trained in the science and jargon of medicine. Health care works best when the patient or family caregiver is not simply an interested bystander, but an integral part of health care. Patients and families are vital voices in improving the provision of quality health care.’
I agree with John. Both professional and family caregivers are vital voices, having important things to contribute to the wellness of patients and loved ones. We at Griswold Home Care thank you and honor you both as capable, committed, and compassion partners with us in providing quality patient care.
We all know that although it’s meaningful, caregiving isn’t easy. It takes a toll on body and mind, on heart and soul, on finances, family, and work life. And this is why we’re presenting today’s webinar on resilience.
During our time together we’ll focus on six specific objectives. The first, we’ll define resilience and why it’s important for family caregivers. Secondly, I’ll explain how the lack of caregiver resilience impacts on health care, home care, and senior care organizations.
Thirdly, I’ll provide a method for assessing caregiver resilience, and then I’ll offer practical ways that caregivers can build their resilience. Fifth, I’ll offer you some effective strategies as professionals that you can use to promote caregiver resilience.
And I will close my component of the session with a list of helpful caregiver resources that you can use in your practice or in your personal life. And we will close the end of the session with a Q & A period, as Meredith mentioned.
She also mentioned the brain writing activity that we’ll use throughout the webinar. I’ll be asking questions and making suggestions as I go along, and brain writing is the thing that allows this to be an interactive process.
As listeners, you can respond when I ask a question or when you have something to share; in real time instead of having to wait until the end of the webinar.
You’ll see at the top right side of your screen, there is an orange button with a white arrow in it. There is a brief tutorial on the body of this slide. And when you have something to contribute or to communicate, you can click that arrow and you’ll see a chat bar which then you can type your ideas, your thoughts, your questions, your experiences, your suggestions into.
I’ll let you know as we go along through the seminar and ask you to contribute through brain writing. And so as we get started, here’s my first brain writing activity. Take a moment, how would you define or describe resilience? What images come to your mind? I’ll pause a moment for you to think.
When envisioning resilience, I think of first of all inanimate objects, like a spring or, remember those old Slinky toys that would fall down the stairs? Rubber balls, pliable plastic of any kind, elbow straws. Or I think of living systems like the forest after a forest fire that comes back to life after a number of months or years. Or a garden in the springtime that buds and blooms after the dormant period of winter.
I think about trees and bushes that are pruned and grow back even stronger. Or the United States after September 11th of 2001. We were all traumatized by that, but as a county we have rebounded and come back to life.
Researchers think of both living systems and inanimate objects when they define resilience as having the ability to withstand, to recover, or to grow in the face of stressors and changing demands.
As this image illustrates, the parachutist has left the jet and is coming down to safety. And when we are resilient, we leave a period of stress or uncertainty and come back to a place where we’re able to function in a safe and effective way.
Resilience is not being the Energizer bunny or being invincible. It’s not breezing through challenges without any kind of concern at all. It’s not being always competent when we face adversity. And it certainly isn’t returning back to live a life exactly how it was before we were challenged with a difficult situation or traumatic event.
But what resilience is is the capacity to bounce back after being faced with something that is a challenge. Or even bouncing forward to a new normal, a different level of functioning. Resilience is an active process of enduring, adapting, growing, and coping successfully. It is struggling well with what life sends our way.
Here’s another question for you, if you want to do brain writing: why is resilience important for you and for other caregivers? Think a moment. Why is this important?
When I think of why resilience is important to me as a caregiver, I think of psychiatrist and author, Viktor Frankl, who survived a World War II Nazi concentration camp and went on in subsequent years to write the famous book called “Man’s Search for Meaning.”
Dr. Frankl reminds us that resilience is important for every single human being. He says, “The forces of fate that bear down on man” or woman, I would add, “and threaten to break him” or her, “also have the capacity to ennoble.”
Caregivers can feel like this person that we see, hanging on the edge of the cliff. We sometimes say, “I’m hanging on by my fingernails.” Or we sometimes say, “I’m at the end of my rope.” We get to points in life where there are difficulties, there are moments of uncertainty, challenges, crises that are very difficult to handle. We all, in these moments, have the potential for adaption, for repair after a breakdown. For growth, for survival.
But we also have the potential for stagnation and breakdown. We have the potential to descend into dysfunction and sometimes to die. So as caregivers, for us the question is, “Will we be victims or victors when we are faced with adversity?”
It’s in our hands: what we think, what we choose, what we do. How we marshal our resources determines whether caregiving challenges will break us or ennoble us. Whether we’ll pull ourselves back from the edge of whatever cliff we happen to be hanging on.
So let’s think a moment, why is it that resilience matters so much for caregivers? Why are we participating in this particular webinar? Resilience is important on an individual level for caregivers because the personal toll caring takes on caregivers’ strength and stamina is very, very high.
The ability to bounce back and cope with adversity and challenges is crucial. Here are some telling statistics on the chronic stress of caregiver and how it erodes the immune system and well-being of caregivers.
Caregivers are at a risk for developing physical ailments like acid reflux, headaches, muscle aches, more frequent infections. They have slower wound healing rates. Caregivers report significant conditions like heart disease, cancer, diabetes, arthritis at twice the rate of people who are non-caregivers. Forty-five percent report one or more chronic condition.
And despite their growing health problems, caregivers pay less attention to their own wellness. Studies show that 60% report moderate or significant decline in their own health, and a quarter say that they are in “fair to poor” health. Many self care and health behaviors suffer for caregivers, who find it hard to find the time to take care of themselves.
Eighty-two percent say that their sleep is worse. Sixty-three percent say that eating is not as good as it should be. And 58% tell us that they don’t exercise as much as they should. Seventy-seven percent report that they don’t go to the doctor as often as they should, and 55% say that they have missed their own medical appointments, even thought they’re very faithful in helping their loved ones get to the doctor.
About 60% of all caregivers report depression, and their use of prescription medication for anxiety and depression is two to three times higher than at the rate of the general population.
In addition, individual caregivers face financial challenges. The lower a caregiver’s income, the higher their stress level will be. More than a third report spending some of their savings on caregiver costs like medications or transportation or groceries for their loved ones.
And on average, caregivers spend annually $5,000 in out of pocket expense. They pay out of pocket to support their loved one, and that sum rises to $8,700 for people who are long distance caregivers.
So you see that there’s a tremendous amount of stress that takes a physical, emotional, and personal toll on the lives of caregivers. So resilience is crucial on the individual level.
But to shift focus now to organizations, we also know that resilience is important for organizations. Studies show that quality, cost effectiveness, satisfaction, and outcome all improve when resilient family caregivers engage with professionals in their caregiving organization.
Engaging family caregivers as partners on the health care team has never been more crucial. They share patient care responsibilities with professionals, but their work is carried out often behind the scenes in that home setting. We know that resilient caregivers are more effective in providing care and are better able to handle the challenges that will invariable arise as they care for loved ones.
Studies show that family caregivers can postpone and sometimes even prevent the use of costly institution based care. They help save the health care system costs by preventing hospitalization, hospital readmissions within 90 days of discharge that we all know Medicare no longer reimburses for.
And resilient caregivers help save patients from the costly complications and relapses that they can experience when the plan of care is not followed. So it is good for individuals and good for organizations when caregivers are resilient.
So let’s look now at what are the qualities of resilient caregivers. For this, we turn to the work of Steven Southwick and Dennis Charney, who are physicians, professors of medicine, researchers, and trauma experts.
In 2012 they published a wonderful book which I highly recommend called, interestingly enough, “Resilience.” And this is based on 20 years of their studying people who have survived trauma. They have looked to identify, how do people do it?
And there were three approaches that they used to compile their book on resilience. The first is that they examined a diverse set of literature, from psychology and medicine to endocrinology and sociology and neural biology. These men knew what they were looking at.
They also conducted their own research to answer some of the questions that they had. And finally they did in-depth interviews with people who had experienced trauma. They interviewed three populations. One, they talked with special forces instructors who actually train America’s special forces to go out into very threatening environments and survive.
They interviewed P.O.W.’s from the Vietnam era who survived the Hanoi Hilton and years in solitary confinement. And they also interviewed civilians, individual people who have survived incredibly traumatizing or difficult situations.
And through their study they have identified ten resilience factors that each of these survivors have used to cope. These are things that suggest what we need to do to be resilient.
I’d like to review with you the factors that Southwick and Charney have outlines. The first is having realistic optimism. This is viewing life in a hopeful and confident way, anticipating a bright future and believing that good things are coming, and that hard work will yield success.
Realistic optimism is not being Pollyanna and saying, “Oh, everything’s fine. Everything’s wonderful.” But it is a way of thinking that helps us to recognize the blessings and the good things in our life, to have the hope that more will come. And to have the confidence that, through my efforts I will be able to bring good things into my life.
What they’ve identified is that realistic optimism is the foundation of all resilience. And it fuels each of the following resilience factors that I’ll describe.
Their second factor is facing fear. It’s using our thoughts and our behaviors to triumph over our fear. When we’re resilient, it’s not that we aren’t afraid, it’s that we act in spite of our fear to accomplish our goals and to become stronger.
The third that they talk about is having a moral compass and to act in an altruistic way. That we engage in right actions and we avoid doing things that we believe are wrong. We think about serving others. And this connects with their point about social support. That’s another factor.
Social support is connecting with others by seeking out and accepting the help that’s offered. And they go on to say, also by giving help to those in need. So altruism and social support connect up in that, they have found through their research that people who give support actually do better than those who receive support. So that old adage, it’s better to give than to receive is borne out by the studies that they did.
Another of their factors is having meaning, purpose, and growth in our life. They talk about finding strength and courage by pursuing an inspiring goal, using adversity as a catalyst for growth. Actively seeking a purpose that’s greater than my self interests, and transcending what has traumatized me by helping others who have had a similar traumatic experience.
This is the act of choosing to be a victor rather than a victim. It’s sort of that old adage about turning lemons into lemonade.
They go on to suggest, their sixth item is having role models. I found this one really interesting. They said, imitating people who demonstrate a positive way of handling adversity is something that resilient people do.
We can identify real people in our lives, or people who are living, people who are dead, people who are fictional, people who are famous individuals or historic characters. They suggest that we look at their small behaviors, something that they’ve done that led them to positively handle a challenge similar to ours and replicating that.
They also talk about the value of training. Improving our physical health and preventing or diminishing the effects of chronic illnesses by staying fit. By master physical challenges we get a sense of mastery, a sense of strength and competence that reinforces, “I can do it,” which is very empowering.
The last three items they talk about are brain fitness, which is focusing our thoughts and challenging our mind so that our intellect is sharp and that our brain continues to grow. There is a concept called neuroplasticity, it’s sort of that, “Use it or lose it” idea, that our brain cells grow. And we can increase the number in our brain if we use our brain.
And so, when we promote brain fitness it allows us to stay functional and it also helps us to regulate our emotions and thereby eliminate some of those doubts and negative feelings that undermine our ability to cope.
Two more. Flexibility is that ability to use any of these different kinds of strategies. Not to just do one or two of them, but to create a whole toolbox full of things that will help me to survive and to thrive.
And finally, they say very clearly that research tells us that turning to God or to a higher power is a very, very strong and powerful way to promote our resilience. This can incorporate actual formal religious services, but if that’s not something that you are interested or feel comfortable with, we can engage in private spiritual practices, or commune with nature or find inspiration in the arts. Whatever touches your soul is a way to promote this spiritual or religious approach to building resilience.
So they’ve given us some clear guidelines. And what I want to highlight here is this visual. Here we see a model that draws a picture of what Southwick and Charney are describing. We know that coping with adversity, whether we’re caregivers or survivors of trauma, is not a linear process. And we know that it is cyclical, and that one intervention and one action builds strength that creates momentum and further builds resilience and wellness.
So let’s look here. If we start… Oh, I’m sorry. Uh-oh. What did I do? Sorry, everybody. Okay. Here we go.
If we’re facing adversity and bring to bear some healthy self care practices, that creates a greater sense of well-being in all aspects of me as a human being. Bio is my body, psycho is my emotions, social is my interpersonal. Spiritual has to do with my spiritual dimension.
When I practice self care, that helps me to adapt in a positive and healthy way, and have a positive mental attitude or view of the situation, which all brings me toward increasing my resilience, my ability to survive and thrive despite the fact that I’m having a difficult time with what I’m facing.
These will then increase and expand my ability to respond to stressors when they come into my life. And then I’m set for the next one when it comes. On and on and on it goes. This model shows us that self care and working to build resilience is a virtuous, positive reinforcing cycle. And the good news for us as caregivers is that resilience is within reach for everybody.
It’s not rocket science. In fact, though, there is a tremendous amount of science behind understand what it is that builds resilience. In addition to the work that Southwick and Charney have given us, we know from US Military leaders some more ideas about building resilience.
This model was developed in 2009, when the chairman of the Joint Chiefs of Staff and other military leaders were very concerned about the impact of intense and sustained conflicts on our US armed forces, and on their ability to continue to fight wars that went on and on.
They developed a new, holistic approach to preserving the health and accelerating the healing of soldiers, because they knew that focusing only on physical health was inadequate as a way to keep a strong, healthy, and responsive fighting force.
And so they commissioned research by the Rand organization and they came up with this model, which is called the Total Force Fitness model. And as this eight sided diagram indicates, there are eight inter-related and inter-dependent parts of every human being. And when we care for each part of ourselves, we nurture our whole self.
Like warriors, many caregivers handle intense situations over very long periods of time. So this military model is an evidence-based model, it is universally sound in its advice on how to build resilience and promote stamina, strength, and successful coping.
So now let’s look closely at the specific ways that you and other people can use this model to help you build resilience.
The first set of strategies is physical in nature. These are anything that you do to build strength and stamina in your body. Exercise, both for strength and endurance. Whatever you do, just do it. Get adequate rest and sleep. We know that seven to eight hours of sleep a night is recommended. It is not a waste of time.
We know from research that it is during this time that our brain and our body physically recharges. Practice good hygiene, grooming, dress. It doesn’t cost any money to comb our hair, to wash our face, to put on a nice outfit. When we look good we know that that helps us to feel better.
We need to use medications as prescribed and limit our use of alcohol so that we are making healthy choices. And avoid using drugs and alcohol because these undermine our health.
Nutrition. There are many strategies, but we need the input of healthy, balanced diet. I suggest that you go to the website ChooseMyPlate.gov,* where they have a tremendous amount of information about diet. They suggest envisioning you diet as having a half of it bright and well colored fruits and veggies, eating lean protein rather than high fat foods. When you’re having dairy, having it be 1% or no fat, and making sure that our grains are whole grains.
We need to get adequate fluid intake. Six eight ounce glasses of water a day is really important to keep our tissues and our muscles working well. And we want to limit sugary drinks.
We want to avoid empty calories. All that white flour and sugar is non-nutritious. And we want to limit the amount of salt that we take. A teaspoon of salt per day is what’s recommended. And we need to be conscious of the fact that there’s a tremendous amount of sodium in canned foods and prepared foods. And so think about that when you’re making your choices.
The fats that you choose should be vegetable fats rather than animal fats. Olive oil, safflower oil, corn oil, rather than butter, lard, etc. And when we snack we want to make sure that it’s healthy foods: fruits, nuts, yogurt, low-cal options. And P.S., portion control on all those great treats.
Some other strategies, medical in nature, are things that take care of our body. We need to find that we have access to care. We need help in handling physical problems. Most of our health care comes either through employer-based or government-based health plans. Medicare, Medicaid, the Children’s Health Insurance plan, or the VA are all places that we know we can go to for health care.
Now, with the Affordable Care Act, people can go to the health exchanges to sign up for health insurance and the enrollment period for 2015 is going to start again on November 15th of this year. It’s important to go for health care so that we get preventive screenings like blood pressure, cancer checks, weight checks, testing our eyes, going to the dentist, having hearing tests.
We need a medical strategy to prevent injuries and make safety a priority. Wear your seat belts. Make sure you know how to lift people properly without straining your back. Make sure guns are stored away if you even have them in your home and that locks are on them. And that when people ride bicycles or motorcycles, that they wear helmets.
All simple medical strategies that help us to prevent injuries. But when we are injured, we need to get a plan of care and follow it so that the complications can be avoided and that healing can occur.
Environmental strategies are things that we do to eliminate stressors in our environment and allow ourselves to relax. Things like recognizing when it’s hot, when it’s humid, when it’s cold, when it’s snowing, when it’s rain, we need to do things to handle those. We also need to make sure that we control for pollution. That is, smoking. Or being in a place where there is clean air.
Making sure that we take measures to assure safety in our workplace and in our home. Do you have a first aid kit? Do you know where the emergency exits are? Do you know how to turn off the gas and the electricity in case of an emergency? Do you have a list of emergency numbers?
These are all simple things that are environmental ways to take care of ourselves. We need to limit our risks and think before acting. And I think the last thing I’d like to suggest is to just organize and beautify your environment. It’s nice to come into a place that looks good. It helps us to relax and feel well.
Psychological and behavioral strategies are things that have to do with believing in myself. Talking positively to myself so that I have some ideas that are encouraging. When I…
Jane: Technical difficulty here. Just one moment.
All right. Here we go. Psychologically, do things that boost your confidence. That little voice that talks to you in your head needs to be whispering affirmations and words of encouragement, not criticisms and put-downs.
Thinking in optimistic ways, which we talked about already. The idea of practicing mindfulness means that I sit and focus on the moment. My breathing, my eating, my walking. And that focusing allows us to decrease stress.
Accepting ambiguity in my life. We are not in control of everything. And mentally I have to get to that point, using relabeling. If something is bad, to say, “This is manageable. My response is understandable, given the situation.” Or, “Given the circumstances, I’m doing the best that I can.” So those kinds of relabeling things strengthen us and help us to be resilient.
And behavioral strategies, avoid stress numbing. Those things that are not healthy. Drinking, eating junk food, spending too much time in front of the screen; all are things that dull the pain, help us to forget things, but can generate more problems.
We need to use problem solving, active coping, and to keep on keeping on. We need to persist and keep moving forward, even when things get difficult.
And finally, here are some ideas in terms of social strategies for building resilience. Reaching out and accepting help is not a weakness, it is as my friend and colleague Barry Jacobs says, “A means to maintaining that important mission to care for those who we love.”
We need also to imitate those people who are role models, which we’ve mentioned before. And enjoy things that are fun. Take time off. It’s not a waste of time, it’s not a nicety. These breaks are necessities.
And finally on a spiritual level, as I mentioned already, we have great research that says when we feed our spiritual selves, either with prayer or worship, meditation, or linking with the arts or nature, we are able to build resilience and expand our capacity to care.
What I want to encourage you to do is to practice healthy self care on a daily basis. We know that even small things, just like that circular diagram indicated, build wellness in ourselves.
So just like we brush our teeth every single day with a little toothbrush and a little floss and a little toothpaste, we prevent dental decay and we promote dental health. Those little things that you and I do every day to take care of ourselves promote our own wellness and health.
So now I’ve given you a whole lot of ideas about building caregiver resilience. And I’d like to just shift here and spend a moment to emphasize that it is critically important for professionals to support family caregivers. It’s important to assess the needs of family caregivers. What is their health? How resilient are they? How much are they able to do? Are they available to provide care? What can they do?
We need to assure the family caregivers understand and can work with patients. And work to implement the plan of care before we discharge them. With the advent of shorter hospital stays and longer survival for many diseases, the home and family caregivers are primary in the delivery of care.
But family caregivers are untrained, they’re unpaid, and they’re often unsupported. They take on daunting, complex tasks like managing incontinence, providing wound and ostomy care. Managing multiple medications which include IVs and injections, and special diets, and medical equipment and assistive devices. All things that we as professionals know about, but which may be tremendously foreign and uncomfortable for the family caregiver.
In the home setting, family caregivers need to know how to watch patients’ responses. How to assess and intervene early when problems arise to prevent relapses, complications, and readmissions.
We need to help family caregivers learn necessary skills for their role, engaging family caregivers in care coordination, and decisions about transitions in a care setting can help. It can help effectively implement a care plan, it can help prevent problems.
Professionals need to identify, when getting ready for discharges, who actually is the family caregiver in the setting. The person in the patient’s room may not be the one who will be providing assistance. The person who is identified as power of attorney or next of kin may not be the one providing care.
The family caregiver may not be a blood relative. They may be a neighbor or a friend or somebody from the faith community. And they may not self identify as a caregiver. “Well I’m not a caregiver, I’m just his daughter.” But in fact they may be. And so in a few minutes I’m going to give you some tools for helping to reach caregivers.
These tools will fall into two separate categories. One category has to do with caregiver engagement. These are things that you as a professional can use to draw a caregiver into his or her role. The other set of tools are going to be highlighted with blue text, and these are caregiver resilience tools. These are things that you and family caregivers can use for yourselves as a set of guidelines for building resilience.
I’d like to highlight here the website Next Step in Care. This is a major advocacy website that, for us as professionals, is useful in that it will help us to foster the movement from the hospital or a long term care setting into the home.
Next Step in Care offers tools and guidelines that are provided, as you can see here, in wording for family caregivers, as well as versions for professional caregivers. The Next Step in Care site, as it shows, provides guides to help family caregivers and health care providers come together, work as a team to coordinate and plan transitions in care.
You see over here on the right side that there are care coordination guides for families. And a couple of them are identified here. A family caregiver’s guide to care coordination. And here’s a link to a professional version. So for you as discharge planners or people in a long term care facility, this may be a place for you to look.
What we can see is… Let’s see if I can come up to this. There are a set of guides… Can we click on that one? Okay. Well let’s see here. Let’s try that one.
So when you come to this page on their website for family caregivers, here’s one example of the guide to coordinating care. And you can see here that it can be downloaded in English, Spanish, Chinese, or Russian.
So when you are working with families on moving from one care setting to a next, this is a site that I would highly recommend.
Another advocacy site that I suggest is one that is… These are just some more highlights of what you can find on the Next Step in Care site. So when you go, check these out. And we’ve been here already.
So this is the other website I’d like to suggest, which is the last engagement tool we’re going to talk about. It is the Boston University’s Project RED toolkit. RED stands for Re-Engineered Discharge. This toolkit was developed through the research of the Boston University and the Next Step in Care group, which we just were visiting.
The RED toolkit, in a randomized and controlled trial, was shown to reduce hospital utilization by 30% and it’s now used by over 500 hospitals across the United States. It was originally designed to facilitate hospital discharges, but now it’s also been demonstrated to be successful in helping people to transitions from skilled nursing facilities as well. And to prevent readmission to there.
So here’s a brain writing question: have you or your organization used the Project RED process or toolkit? And if so, what’s your experience been? The tools that they’ve outlines can be adapted to any setting in which caregivers play a key role in follow-up care.
If you look over here at this right side of the screen, there’s all kinds of information on how this tool was developed. And you can find background information. You can also see here that there’s a place for you to click to get access to the toolkit. And finally, on the right hand side, there’s all kinds of current news about this Project RED initiative.
So what I’d like to do now is to move on to a brief overview of some of the tools that are available for caregiver resilience and building that resilience. We’ve arranged for you to be able to download this free action planning worksheet, to guide you through assessing your current practices and come up with some new ones that you’ll be able to use.
I invite you to share this with other people as you discuss the concept of resilience. As you look over it, you will notice that it is organized to follow that Total Force Fitness model, which I used in my earlier comments.
Some additional resilience building tools. One is this Road to Resilience, which was created by the American Psychological Association. This tool is available in Spanish, and you can link to it through this bit.ly link.
This part of the American Psychological Association’s website covers a really broad array of resilience related topics in very succinct, easily understood language. Things like, “What is resilience?” And, “What are resilience factors and strategies?” Or, “How do you build resilience?” Stuff that we’ve covered in this workshop. But if you want resources for yourself to bring this material forward to other people, this is a good place to go.
And you will also see here on the right side of your screen four books, which I recommend as really being valuable tools if you want to learn more about resilience.
In addition to these four, I’ve written a book called “The Caregiver’s Guide to Self Care.” And if you want to learn some skills and some talents for building self care practices in to a family caregiver’s life, you might want to pursue that. All of these books are available at Amazon.com.
Also I would encourage you to pursue connecting with the Caregiver Action Network. This is a terrific advocacy organization that meets the needs of family caregivers. And we’ll show you one of these moments. Here we go. There. That’s it. Yeah. That’s fine. We’ve got it.
Okay. You can see here on this Caregiver Action Network. It’s at CaregiverAction.org, very simple to find. There is a tremendous number of resources that they provide. And I’ll show you over here that you can find that there is a story project, where you can hear stories of other caregivers.
Particularly, I want to highlight their caregiver toolbox. They teach us things about technology for family caregivers, how you communicate with health care professionals, addressing financial issues, how you build a community of support. And this Lotsa Helping Hands is a terrific resource for you to use.
They also link to the elder care locators if you’re looking for resources within your community.
I’d like to go to the Family Caregiver Alliance. No, we’re just going to go beyond this one now and to look at the Family Caregiver Alliance website. They are another terrific caregiver advocacy organization. They have a wealth of excellent online information, education and support.
If you come up to the section that says, “Caregiver Education” you see it’s a drop-down menu. They have all kinds of material on describing caregiver issues and strategies. And particularly, I’d like you to recognize that there are caregiver fact sheets, which cover a tremendous number of health topics, caregiving issues and concerns, strategies. And also statistics, demographics, and many of these are available in Chinese, Spanish, Korean, and Vietnamese.
There are lots to be seen. I want to bring this very quickly to a close by highlighting the resilience scale, which is available online. This is a link to an evidence-based tool that has 14 items. Very, very quick to take.
But there are a variety of valid and reliable assessment tools. And this is considered to be one of the most accurate instruments that is out there. It’s used by counselors, coaches, therapists, researchers. All kinds of people. Go online and take this.
You can get a score when you complete the test. And you submit the score for interpretation. And the scores are summed up to produce a total scale score. The higher your score, the more resilient you are.
So I would send you to that one and tell you that this was created in 1993 by Gail Wagnild and Heather Young. And you can get a licensing fee and have permission to use this more broadly.
And the last tool I’d like to highlight is also related to the American Psychological Association. And this one is their caregiver briefcase. This was written for psychologists, but it provides a huge amount of information that any professional could use on how caregiving affects everybody. It gives us facts, assessment tools, problems caregivers face. You can find a tremendous amount of information here.
And I could go on and on, but I think probably we’re at a point where it would be much more helpful to engage you in the conversation. So I want to just close and say, the key takeaway that I want you to have is that although it’s meaningful, caregiving does take a toll on caregivers.
It is difficult for them to provide the care they want to provide, and the care that their loved ones and professional partners need them to provide.
Remember that with resilience, caregivers have a wellspring of energy to support their loved one’s wellness and recovery, and the energy and skill to help them provide the care in the home and avoid readmissions.
And finally, I want you to remember that engaging family caregivers is an increasingly important role for us as professionals in all settings and across the continuum of care. So we as professionals need to assess caregivers’ strengths and needs, and we need to support caregivers with education, with encouragement, and with helpful resources.
I’m confident that some of these resources are things that you’ll be able to take with you as you leave this webinar.
In the time remaining, I’d like to respond to as many questions as we possibly can. So let’s think about what it is that you would like to ask. Please send your questions to me.
Male: … [inaudible 00:56:50]
Jane: Yes. The question that I have been asked is, “Do you know of any caregiver support groups in Montgomery County, Pennsylvania?” So what you can do to find those groups, and you don’t need what I know, you need to be able to access these yourself.
I would go to the Caregiver Action Network to identify support groups. The second place that I would go would be to check in with your elder care locator and the Area Agency on Aging here in Montgomery County would give you information about caregiver support groups.
The other place I would suggest that you think about is to look at a disease specific website. Are you as a caregiver dealing with a loved one who has cancer, or Alzheimer’s, or multiple sclerosis? And you can contact those national organizations, which will then field the question to local organizations. And you can find some responses that way.
So what else would you like to know?
So I have a question about what it is that my experience was with caregiving and how did I get into doing this material on resilience?
I think that, for me, I spent 20 years doing family caregiving. My mother, my father, my husband, my in-laws. That personal experience has informed me, and I’ve combined it with my professional psychiatric nursing background. And so I encourage each of you to look at your own personal and professional experiences and see that those can enrich you.
And you can bring those to bear on your relationships with other caregivers. You can use your experience to teach others as I am.
We have another question. “Is it possible to have a copy of the circle chart that describes the important categories of everyone’s life?”
You mean the eight sided diagram that shows… Let me go back… Okay.
What I will say to you is this: I am blogging for Griswold Home Care. And I have created a series of blogs. I’m going through all of the elements of building resilience. And one of our great artists here at Griswold, whose name is Mike, created this tool from the research that was done on Total Force Fitness.
That diagram is going to made available in the resilience blog that’s going to be posted in November. And if you communicate with Griswold Home Care through Meredith she will send that to you.
So please, I’m seeing the person’s name here, if you will send that request to Meredith…
Meredith: @griswoldhomecare.com. Meredith is spelled M-E-R-E-D-I-T-H. Griswoldhomecare is one word. Dot com.
Jane: She will send that you. So we’re looking at 5:00. I think it’s time for us to bring this to a close. It’s been an honor and a pleasure to present this.
Meredith: Thank you for presenting today, Jane. If anyone has any additional questions, please feel free to email me. Again, the email address is email@example.com. Meredith is spelled M-E-R-E-D-I-T-H.
I’d like to thank Jane today for putting all the research together for this webinar. It was very informative. Thank you for all the audience participation and questions. I hope that the information provided will help you be a more resilient caregiver.
A little bit of information about Griswold Home Care. We are a mission driven care service company, doing whatever we can to advocate and support the choice to remain independent in your home. Our founder, Jean Griswold, was the wife of a Presbyterian minister. She actually founded Griswold Home Care after she personally was diagnosed with multiple sclerosis.
She saw the need for non-medical home care with her fellow parishioners and started it from the privacy of her own home. Today, Griswold Home Care is supporting aging adults with their needs and personal care requirements, companionship, and housekeeping services to help them remain safe and independent.
The caregivers we refer have experience supporting those with non-medical and chronic conditions. If this is something that you are interested in, please feel free to reach out to us after the webinar. We will put you in touch with the director nearest to your location. Thanks again, Jane, for sharing all your knowledge with us. And thank you everyone who participated.
Jane: Thank you.