HJNO Sep/Oct 2019

Healthcare Journal of new orleans I  SEP / OCT 2019 41 The call came in around 3:30 p.m. on a Saturday afternoon. My 76 year-oldmother was on the phone. She said she was unable to breath very well. I live hours away, so I suggested that she and my father call 911. They were not convinced this was the right thing to do. I felt frustrated and helpless.As my parents age, these calls are becoming more frequent, and I know they will need more help in the future. When the normal progression of life for an aging person is met by a decline in physical and or mental abilities, adult children are often suddenly faced with assuming care of their parent(s). About 40millionAmericans of adult chil- dren provide unpaid care for their parents at some point in their lives, according to AARP. That is evident as I visit with friends and learn that many of them are in similar situations. Like myself, many adult children are left feeling unprepared for caregiving. “When we think of an adult child caring for a parent, what comes tomind is a woman in her late 40s or early 50s,”said Lynn Friss Feinberg, senior strategic policy adviser for AARP’s Public Policy Institute. “But it’s now common for people 10–20 years older than that to be caring for a parent in their 90s or older.” According to AARP, 7 percent of caregivers are 75 years of age or older.There- fore, the caregiver might be facing their own health and cognitive issues while managing care for their parent(s). As life spans length- en, adult children in their 60s and 70s are increasingly caring for frail, older parents— something few people plan for. Physicians and healthcare workers can aid in the identification, support, and column  Senior Health treatment of caregivers by offering assess- ments to identify high levels of caregiver burden. Repeat assessments may be con- sidered when there is a change in the status of caregiver or care recipient. The overall health of adult child caregivers needs to be supported to prepare them for what lies ahead. Physicians may only have time to identi- fy caregivers during an office visit, but may also refer them for full assessments. Refer- rals for an assessment may be triggered by a diagnosis of a medical condition associated with high burden for caregiving, or a change in the functional status of a caregiver. Prac- tical tools for physicians are available from national organizations, including a toolkit from the Family CaregiverAlliance. Specifi- cally, well-validated tools to assess caregiver burden are also available, such as the Car- egiver Burden Inventory and the Adapted Zarit Interview. As cited by the American Family Physi- cian, a majority of caregivers (81 percent) feel inadequately trained for the skills they perform, having never received any formal education in caregiving. The top unmet needs of caregivers include keeping care re- cipients safe at home, managing emotional and physical stress, finding easy activities to do with the recipient, and having enough time for themselves. Amajority of caregivers report needingmore information about sup- port services (77 percent), and they aremost likely to use the Internet (29 percent) or their doctors (28 percent) as primary sources of additional caregiving information. Primary care physicians are uniquely positioned to The Age of Caregiving and the Health Providers Role aid in the identification, support, and treat- ment of caregivers. Various studies document that caregiv- ers typically spend between 17 and 24 hours each week caring for the recipient. Many caregivers work outside the home, and 48 percent are employed full-time. Six in 10 employed caregivers report that caregiving forced them tomake changes at work, such as going in late, leaving early, taking time off, or leaving their jobs altogether. Employed caregivers have been shown to suffer from more stress-related illnesses and to utilize their company-provided health plans more often. As my own parents age and their health declines, like somany others, I am forced to ask some tough questions. Can I managemy aging parents? Will I have enough time to give?Will I look for a retirement community that offers professional caregivers for my parents? Will in-home care be necessary? Who will pay for all of this? As healthcare workers, you certainly cannot provide all the answers to the myriad of questions sur- rounding caregiving, but you undeniably play a central role in supporting an adult caregiver. Balancing communication be- tween the aging adult and their caregiver is vital. The caregiver is likely the person who will manage the information given by the healthcare provider. Recognize the car- egivers’needs as well as the patients’needs. A family member who accompanies your patient to the visit is a critical person in that patient’s care, and will value any help you can provide. n Carrie A. Mercer Lambeth House