EBP for Caregivers

Powerful Tools Stress-Busting

• Helping with Depression, Stress and Confidence

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What is a “Caregiver”?

• Anyone who cares for and gives unpaid support to a family member, friend, or neighbor who is frail, ill, or disabled and who lives at home or in a care facility.

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Caregiver Statistics

• Family caregivers in the United States:

– Nearly one out of every four U.S. households is involved in care to persons aged 50 or over.

– 52 million family caregivers provide personal assistance to adults (aged 18+) with a disability or chronic illness.

– Caregiver services were valued at $450 billion in 2009

(Family Caregiver Alliance, 2011)

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Strains of Caregivers

• 25% of care receivers need to be lifted, moved which often results in muscle strain/back pain.

• 16% of caregivers indicate that their health has worsened since becoming a caregiver.

• 46% are clinically depressed.

• 2 to 3 times more likely to use prescription drugs for anxiety, depression, insomnia.

• 80% of working caregivers report emotional strain.

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Stress and Caregiving

• Feeling apprehensive, trapped or caught

• Financial strain

• Role change and reversal

• Breakdown of support network

• Caregiving skills / abilities

• Dealing with the disease itself

• Family conflicts

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• USC Gerontology: Family Caregiver Support Program or FCSP

• We are to provide support to an adult (18 or older) or another individual who provides unpaid care to an older individual (60 or older) or to an individual with Alzheimer’s disease of any age.

USC-Family Caregiver Support Program

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USC -FCSP Services

• Information and referral

• Support groups

• Short-term respite care

• Education and training events

• Other Services

Powerful Tools for Caregivers

• A six-week EBP

• Requires 2 facilitators

• Self-care behaviors

• Management of emotions

• Self-confidence

• Use of community resources

PTC Evidence-Based Outcomes

Train-the-Trainer Model

Class Leaders Class Leaders Class Leaders

Master Trainers

CLs

classes

CLsCLsCLsCLsCLs

classesclassesclassesclassesclasses

Success Factors

• Address universal caregiving challenges

• Encourage individual adaptation of tools

• Create opportunity for new approaches

• National Alliance for Caregiving / MetLife Foundation

• American Society on Aging / AARP

• Administration on Aging

National Recognition

Self-efficacy = Confidence

A person’s perception of his or her ability

to carry out a particular activity.

Self-Efficacy

• Making Action Plans

• Feedback

• Solution-seeking

• Modeling

• Reinterpreting beliefs and thoughts

• Persuasion

Strategies for Enhancing Self-Efficacy

• Leader Presentation

• Discussion

• Brainstorming

• Modeling

• Brief Dramatization

Key Teaching Techniques

• Class Leader Tips manual

• 2½-hour script for caregivers of adults with chronic conditions

• 90-minute script for caregivers of adults with chronic conditions

• 2-hour script for caregivers of children with special health and behavioral needs

PTC Tips and Script Manuals

• Guarantees success for Class Leaders.

• Removes need to be content experts.

• Ensures achievement of specific objectives.

• Increases consistency.

Reasons for Scripting

• Practice self-care

• Try new behaviors and skills

• Break down goals or problems

• Thrive as caregivers

Action Plans help Class Participants…

We’re in this together #3

RESPONSIBILITIES1 Come to every class.

2 Ask anything you want.

3 Carry out activities.

4 Try new tools.

5 Maintain confidentiality.

6 Take care of yourself.

Class 1 AgendaTAKING CARE OF YOU

1 Course Overview 15

2 Introductions: We are not alone 25

3 Challenges of Caregiving 45

BREAK 10

4 Managing Self-Care: Principles 10

5 Using Community Resources 10

6 Making an Action Plan 30

Closing 5

Focus on me

#1

• Prevents misunderstandings.

• Builds relationships.

• Increases chances of being heard.

• Reduces stress and frustration.

• Enhances problem-solving.

Good Communication…

Benefits both listener and speaker

Find common ground Harmony #47

1 Align – What does the person need?

2 Agree – Look for areas of agreement.

3 Redirect – Move the conversation forward.

4 Resolve – Seek to resolve differences.

AIKIDO COMMUNICATION

#57

Keep up the good work #75

PLANNING FOR THE FUTURE

My next goal is…

Specific steps I can take toward this goal are…

This week I will…

• Improving caregiver:

– self-efficacy

– management of emotions

– self-care behaviors

Outcomes for Caregivers of Children with Special Needs

Stress-Bustinghttp://www.caregiverstressbusters.org/for-organizations/cost-information

• For Family Caregivers (G-SBP)

• For Family Caregivers of People with Dementia (D-SBP)

History

• Created by Dr. Sharon Lewis University of Texas Health Science Center, San Antonio TX

– Distributed by WellMed Charitable Foundation

• 2002 develop multi-complnent program for support group

– 9 weeks 1.5 hours

• 2010 Funded by Administraion on Aging to disseminate using master trainer/lay leader model

Multi-Compones Focus

• Support

• Problem-Solving

• Education

• Stress Management

Color-Coded Programs

• For G-SBP the key color is GREEN

• For D-SBP the key color is BLUE

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Success Outcomes

• Decreases in

• Stress

• Depression

• Caregiver Burden

• Improvements in

• Quality of Life

• Sense of Control

Why a G-SBP?

• How many family caregivers in the U.S.?

– More than 65 million people, 29% of the U.S. population

• Many caregivers are taking care of someone who does not have dementia

• The needs of these family caregivers are going unmet

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General Stress-Busting Program (G-SBP)

• G-SBP for Family Caregivers is an adaptation of the evidenced-based Dementia SBP (D-SBP) for Family Caregivers

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People with Multiple Chronic Illnesses

• Having multiple chronic illnesses (e.g., diabetes, heart disease) is very common in older adults

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Percentage of People >65 Yr with Chronic Illnesses

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People with Multiple Chronic Illnesses

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Major Challenge of G-SBP• Facilitators need to deal with various types

of caregivers of care recipients with different diseases

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Common Chronic IllnessesArthritis

2 Types

Osteoarthritis

Rheumatoid arthritis

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Common Chronic IllnessesOsteoarthritis

Osteoarthritis - most common type of arthritis

Often related to aging or to an injury

Most often affects the fingers, knees, and hips

Over time, in some people the joints involved can become severely damaged

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Changes in Content

Week and Chapter

Title and Content Major Changes

1 Getting Started No changes

2 Stress: Effects of Mind, Body, and Spirit

No changes

3 Caregiver Stress and Relaxation

No changes

4 Facing Challenges MAJOR changeTitle change

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Changes in Content

Week and Chapter

Title and Content Major Changes

5 Grief, Loss, and Depression

Content on "What is Loss" (p. 72) has been changed to focus on losses experienced by loved one as well as losses experienced by caregiver.

Content on "Who Can Help with Depression" (p. 83) has been changed. The subheading and content on Other Specialists has been deleted.

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Changes in Content

Week and Chapter

Title and Content Major Changes

6 Coping with Stress No major changes Case scenarios using

dementia have been changed (e.g., Family in Crisis - patient has advanced cancer [p. 97])

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Changes in Content

Week and Chapter

Title and Content Major Changes

7 Positive Thinking "Ways to Untwist Your Thinking" (pp. 115-117) content has been changed to reflect the new example.

"Preserving Memories Promotes Positive Thinking" (old p. 130) has been deleted. New content on Life Review has been added to the new Chapter 4.

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Changes in Content

Week and Chapter

Title and Content Major Changes

8 Taking Care of Yourself: Healthy Living

No major changes

9 Choosing a Path to Wellness

No changes

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Implementing G-SBP

• With the implementation of G-SBP, data (pre and post) will continue to be obtained on the efficacy of the program

• This includes short surveys:

– Participant information, PSS, CES-D, and ZaritBurden scale

• Zarit being used instead of Caregiver Burden

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Implementing G-SBP

– Separate password needed to access G-SBP forms on SBP website

– Handbook cost is $20

– Fidelity – Cannot combine G-SBP and D-SBP groups and separate out the groups at week 4 and 7

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One person caring about another represents life’s greatest value.

• John Rohn

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