CareAcademy Blog

How to Handle Care Plans and Caregiver Stress

This is a final article in a multi-part series to help in-home professional non-medical caregivers learn some practical non-clinical skills on how to approach their day to day professional life. You can see Parts I, II, III, and IV. Here in Part V, we will discuss care plans and caregiver stress.

What Is a Care Plan?

Let’s discuss an essential tool for effectively doing your job:  the care plan.  The care plan is the tool that helps you to understand how to care for each of your clients who live in the home. The plan also informs the other members of your professional caregiving team about the services that each client will need. It is your direct line of communication with other members of your care team.  Think of it as a recipe card or blueprint for how to care for each client. Anyone should be able to pick up a care plan and know just how to care for the client. That is why they are so critical. The facility that hires you will specifically outline the tasks you are responsible for accomplishing while on your shift, as well as the special needs and services for each client.  This includes medical, dental, vision, hearing, and mental health services. It explains the client’s ability to take their medications, and how staff should assist. The plan will explain if the client needs help to walk, bathe, or dress, and the type of help he/she needs. The plan will also explain the social activities and other services that are specially designed for each client. The care plan must be accessible by direct care staff persons at all times.

Understanding A Care Plan

You need to understand your client’s care plan. A care plan is created specifically for each client and describes exactly what services should be provided. Included in the care plan may also be 2 important terms that you may not be familiar with:
  1. One is “DNR status”. DNR stands for “do not resuscitate” or “do not attempt resuscitation”. This refers to the older adult’s end-of-life wishes, and whether or not they would like CPR and a breathing machine if their heart stops, or if they stop breathing. Attempted resuscitation may, in many situations with older, ill adults, cause pain and suffering with little chance of recovery, so many older adults will request to have a DNR in place.
  2. “Power of attorney,” “health care proxy” or HCP for short, or “health care agent.” This is the person that the older adult has legally designated to be their substitute decision maker, should they not be competent to make their own health care decisions. This may not be their next of kin, or even a relative. It is important that this is the person, and not another family member or friend, that you speak to about your client.
It is important to follow the elder’s directions when performing tasks, even if you know a better way. Plans may also change depending on his/her needs or health status. The care plan usually lists general tasks for what needs to be done (for example, cleaning the kitchen or washing the clothes). Follow the care plan. If an older adult wants you to do something that is not listed in the plan, you need to contact your supervisor.  You may be held liable if you do something for the older adult that is not on the care plan and an accident occurs. With some services, you are only allowed to perform a certain scope of tasks for the older adult and not for family members (for instance, running errands). The best way to stay organized is to make a list of tasks that need to be done based on the care plan. Ask the older adult to prioritize the tasks that need to be done.  Ask them, “Which ones are most important?” If the older adult lists more tasks than can be accomplished in your allotted time, speak with them about what can be done on another day or by another member of the care team.

What is caregiver stress?

Make Time to Take Care of Yourself

Caregiver stress and compassion fatigue are the result of the physical and emotional exhaustion experienced by those who care for people. It is the chronic stress caused by caregiving.  Emotional impact of trauma and painful material can be contagious and transmitted through the process of empathy. If you don’t make self-care a priority, no one else will do it for you.

How do your recognize if you have caregiver stress or compassion fatigue?

Mental signs of caregiver stress may include recurring and intrusive thoughts  such as paranoia, feelings of guilt or suicidal thoughts, limited attention span, difficulty concentrating, poor work performance, or becoming easily irritated or frustrated. Physical signs may include flare-ups of high blood pressure, diabetes, headaches, back aches, chest pains, stomach problems, trouble sleeping, change in appetite, chronic tiredness, or substance abuse.

How do you manage stress on the job?

A willingness to get help is the most important part of managing caregiver stress.  
  • Recognize high stress as a normal, expected response to your work  
  • Use your supervisor for support
  • Attend training on a regular basis  
  • Network with other professional caregivers
  • Set clear boundaries and maintain limits . This is really important. Know what your job limits are, and keep your work within your work hours. Clients and families shouldn’t be calling you outside of your work hours. If that happens, let your supervisor know.
  • Connect with clients. Know that you are doing important work and think about how it must feel like to suffer the disabilities and inconveniences your older adult client does. But, even as you do this, know that it is your job and not your family – when you leave work, it’s important to then focus on yourself and your family to keep yourself well. Maintain that work/personal life balance.
  • Find meaning in your work
  • Start or join a Support Group
Other tips to taking care of yourself include: exercise (even a few minutes a day that elevates your heart rate has been shown to decrease anxiety, depression, and stress), mindfulness and meditation, deep breathing, writing in a journal, playing a musical instrument or engaging in another creative hobby, taking a hot bath, and use of aromatherapy. Spirituality, prayer, and religious gatherings can help. Get therapy from a trained professional if you find that you are unable to control your caregiver stress alone. High levels of stress can lead to job burnout, but learning to manage your caregiver stress can be a lifelong benefit.  

Earn your certification demonstrating your knowledge as a Professional Caregiver for Older Adults. Learn more, do more, care better.

 

Dr. Reddy is a specialist in Internal Medicine & Geriatric Medicine. She holds appointments at Harvard Medical School & Hebrew SeniorLife in Boston, MA. She has seen the struggles that families and caregivers go through when caring for adults. Through CareAcademy, she intends to improve people's lives. Dr. Reddy's research is published as journal articles and book chapters. She has also authored a book for family caregivers.

Madhuri ReddyHow to Handle Care Plans and Caregiver Stress

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