Nursing diagnosis: risk for Caregiver Role Strain
Risk factors may include
Illness severity of the care receiver, duration of caregiving required, complexity or amount of caregiving tasks
Caregiver is female, spouse
Care receiver exhibits deviant, bizarre behavior
Family/caregiver isolation, lack of respite and recreation
Possibly evidenced by
(Not applicable; presence of signs and symptoms establishes an actual diagnosis)
Desired Outcomes/Evaluation Criteria—Caregiver Will
Caregiver Performance: Direct Care
Identify individual risk factors and appropriate interventions.
Demonstrate or initiate behaviors or lifestyle changes to prevent development of impaired function.
Caregiver Performance: Indirect Care
Use available resources appropriately.
Report satisfaction with plan and support available.
Nursing intervention with rationale:
1. Determine family/caregiver’s understanding of condition and expectations for the future.
Rationale: Identifies teaching needs. Provides opportunity to update information and clarify misconceptions. During the prolonged caregiving experience, 7 of 10 clients with Alzheimer’s continue to live at home, where family and friends provide almost 75% of their care. As the individual descends into the disease, he or she cannot translate a thought into a motor action, thus full-time supervision and care is required. For some family members and care partners, this supervision becomes overwhelming and exhausting (Rentz, 2008).
2. Provide bibliotherapy.
Rationale: Materials that can be reviewed as time permits or questions arise can be very helpful in expanding knowledge and providing on-going support.
3. Identify strengths of caregiver and care receiver.
Rationale: Helps to use positive aspects of each individual to the best of abilities in daily activities.
4. Facilitate family conference to share responsibilities as indicated and to stress importance of self-nurturing for caregiver, including such factors as pursuing self-development interests, personal needs, hobbies, and social activities.
Rationale: Helps family to focus on needs of caregiver as well as care receiver. When others are involved in care, the risk of one person becoming overwhelmed is lessened.
5. Determine available supports and resources currently used.
Rationale: Organizations including Azheimer’s Foundation of America, Alzheimer’s Association, NFCA, or local support groups can provide information regarding adequacy of supports, identify needs, and suggest possible options.
6. Identify alternate-care sources such as sitter or day-care facility; senior care services such as Meals on Wheels and respite care; and Alzheimer’s programs or a home-care agency.
Rationale: As client’s condition worsens, caregiver may need additional help from several sources to maintain client at home, even on a part-time basis.