How can I learn how to do the medical/nursing tasks I’m expected to do?
By Amy Goyer
More than half of family caregivers in the U.S. perform complicated medical/nursing tasks, often with little or no instruction from healthcare professionals. It’s a lot of pressure since most of us do not have a background in the medical field. We are expected to do things like:
- Manage multiple medications, including looking out for side effects and drug interactions.
- Perform wound care for injuries, such as skin tears, incisions after surgery, diabetic ulcers, and pressure sores (also known as “bed sores”).
- Assist with bladder and bowel incontinence.
- Assess and monitor pain and administer pain medications and other treatments.
- Manage mobility challenges, including finding, maintaining, and using medical equipment such as walkers, wheelchairs, lift chairs, and lifts.
- Support special diets, make meals and snacks that adhere to nutrition plans, puree foods, track sugar and sodium levels, and manage low appetites.
- Operate and maintain specialized medical equipment like oxygen equipment, infusions (medications being administered through a vein via an IV line), dialysis equipment, nebulizers, mechanical lifts (such as a Hoyer lift), and feeding tubes (G-tubes).
Caregiving is stressful, and when you add these medical tasks to the mix it’s even more intense. The responsibility can feel overwhelming. We worry about doing something wrong, and we feel like we need to have a medical degree to gain adequate skills. Read more about how to manage the stresses of caregiving in our article, I’m exhausted and stressed out…how can I cope and get help? and our Real World Health Care blog article, 5 Tips to Manage Caregiver Anxiety and Depression.
My Dad had a feeding tube for two months while awaiting throat surgery. I received about five minutes of training from the nurse at the hospital and then they sent us home. It was a nightmare, and we were back in the hospital at least four times with the clogged tube; it even had to be removed and replaced once. My saving grace was that I knew to call the home health agency and ask for the nurse to come to our home to advise, help, and provide me and my family with more training.
If you find that you are expected to perform these and other medical/nursing tasks, here are some steps you can take to get more support and learn how to manage them.
- Find out if there is a law in your state requiring hospitals to provide you with instructions before hospital discharge. AARP reports that the CARE Act has been signed into law and is either in effect or will be soon in 42 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. The CARE Act requires hospitals to:
- Record the name of the family caregiver on the medical record of your loved one.
- Inform the family caregiver when their loved one is to be discharged.
- Provide the family caregiver with education and instruction on the medical tasks he or she will need to perform for the patient at home.
- Arrange for home health support when preparing for hospital discharge. Work with the doctors and hospital social worker or discharge planner to set up home health services that will start immediately upon arriving home. Find out what insurance will cover and for how long, as well as any out-of-pocket expenses you will incur. Have medical equipment delivered to the home and ready for your loved ones upon discharge. Ask for nursing assistance with medical/nursing tasks, and home health aides if they would be helpful and covered by insurance—either for the short term, as you get used to your new responsibilities, or on an ongoing basis. Request a consultation with a dietician for help with special diets. Also, set up in-home or outpatient therapies if needed, such as:
- Physical therapy and occupational therapy for help with evaluating the home for safety and more independence for your loved ones. These therapists can help your loved ones learn to perform everyday tasks and help you both learn how to safely operate medical equipment. They generally help those you care for with exercises to build strength and help you learn how to lift them or help them transfer from their bed, wheelchair, or standard chair.
- Speech therapy to assist with communication and swallowing disorders, including recommendations around adapting liquids with thickeners or pureeing foods to prevent choking and aspirating.
- Respiratory therapy to help with oxygen administration, tracheostomy care, and managing ventilators.
- Be a strong advocate – for your loved ones and yourselves. Ask questions at the hospital, in the doctor’s office, or with home health providers—and don’t stop asking until you feel that you have the information you need. Be persistent. You will learn as you go along, and new questions will arise. Don’t let healthcare professionals intimidate you or dismiss your concerns—these tasks may seem easy to them, but they’re all new to you. Ask for instructions in writing and use your phone to make videos as the providers demonstrate. Get more tips on coordinating medical care for your loved ones in our Real World Health Care article, Organization Skills Required: Coordinating Medical Care for Your Loved One.
- Seek out educational articles, websites, books, and how-to videos. From the simplest tasks to the most complicated, you can find an article or video that informs you how to do almost any medical/nursing task. You’ll find information about how to help your loved ones walk with a walker, transfer from a wheelchair to a bed, and bathe. There are demonstrations and cookbooks for pureeing food. Information about medication interactions and side effects is readily available (or call your local pharmacist). You can even find videos that demonstrate every type of medical equipment.
- Connect with other caregivers. We learn the most from each other, so connecting with other caregivers dealing with similar tasks can sometimes be incredibly helpful. Caregivers have hard-earned tips from practical experience; there is likely someone out there who has been in a similar situation and can tell you how they learned to manage the medical/nursing tasks. Connect with other caregivers through in-person caregiver support groups or virtual/online caregiving groups.
Resources
Amy Goyer is a nationally known caregiving expert and author of Juggling Life, Work, and Caregiving. A passionate champion for caregivers, she has also been one her entire adult life, caring for her grandparents, parents, sister, and others. Connect with Amy on Facebook, Twitter, and LinkedIn.</em
