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Published on October 15, 2018

Caregiver Week: Caring for the Caregiver, Advance Directives and Aching Joints


In this Fox 8 House Call series, Cone Health experts discuss tools for caregivers, including:

Caring for the Caregiver

Stepping into the role of caregiver can be rewarding and also, at times, overwhelming. All too often, caregivers begin neglecting their own health when caring for the health of others. Being so focused on the care of someone else can be stressful by itself, but unavoidable changes in care often add to it. In addition, some caregivers start to feel out of control when needs change or they hit a bump in the road, further increasing their stress. This is why it is extremely important for caregivers to figure out what they need to maintain their own health and well-being while serving in this role and finding support through friends, family or community.

It is essential for caregivers to seek support—from family, friends and/or other individuals or families in the community also going through similar situations. It’s easy to focus so much on providing care that you forget yourself. Finding other caregivers who understand what you’re going through and can relate to your experiences can be a source of relief. It’s also important to find some time to rest and recharge outside of your role as caregiver. This can look different for each person, but taking some time to yourself can decrease the feeling of fatigue or burnout that many caregivers face.

Caregiving has to be a balancing act of taking care of your own needs as well as the person you are caring for. If you or someone you know that is currently serving as a caregiver are beginning to feel overwhelmed or like you need help, talk with your primary care physician or seek out support services at your local health system.

Jonathan Freeman, DMin, is the director of the Employee Assistance and Counseling Program for Cone Health.

Importance of Talking About End-of-Life Wishes and Advance Directives

Ninety percent of people think it's important to talk about loved ones' wishes for end-of-life care, as well as their own wishes, but less than 30 percent have actually done it. They're difficult talks to have, but also meaningful, important and rewarding. By planning ahead, you can get the medical care you want, avoid unnecessary suffering and relieve caregivers of decision-making burdens during moments of crisis or grief.

Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself. Advance directives guide choices for doctors and caregivers if you're terminally ill, seriously injured, in a coma, in the late stages of dementia or near the end of life. By creating these documents, you can help reduce confusion or disagreement about the choices you would want people to make on your behalf.

Consider setting up an appointment with your health care provider to create or review your advance directives. When you have completed your documents, you should:

  • Keep the originals in a safe but easily accessible place, and give a copy to your health care provider and health care power of attorney.
  • Talk to family members and other important people in your life about your advance directives and your health care wishes.

Discussing your wishes with your family and health care provider beforehand can help everyone come to an understanding of what your expectations are.

Elizabeth Golding, DO, is the medical director of the Palliative Medicine Team at Cone Health.

Caring for Someone with Aching Joints

Millions of Americans suffer from joint pain and often let that pain prevent them from participating in everyday tasks. Arthritis is a common cause of joint pain, and the two primary forms it comes in are osteoarthritis and rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disorder that causes the body to attack the inner lining of the joints, causing pain. Osteoarthritis involves the wearing down of the cartilage at the ends of the bones over time and is often associated with aging. Each type of arthritis requires different treatment methods.

For patients with joint pain, day-to-day tasks can become more difficult or painful to do. Fortunately, there are many tools and devices that can help decrease the stress on joints, such as:

  • Lumbar support – using a lumbar support can help relieve back pain in those that sit for long periods of time. A rolled towel placed between the lower back and the chair back can help support the back and relieve discomfort.
  • Electric jar opener – helps keep stress off of hand joints.
  • Toilet seat riser – helps individuals with knee and hip pain.
  • Long-handled sponges – makes bathing simpler.
  • Sock aides, zipper pulls, long-handled shoe horns, large buttons or Velcro instead of small buttons – all simple solutions that make dressing easier.
  • Canes and walkers – take pressure off of knees, hips or ankles.

Caregivers can play an important role in helping manage joint pain for a patient with arthritis by encouraging the patient to move. Consistent physical activity can help reduce joint pain, but sometimes arthritis patients need encouragement or help practicing it. Many times, when the person is hurting they don’t want to move when movement is exactly what they need. Avoiding motion and activity may decrease their pain momentarily, but it increases the stiffness of the joint and further limits motion over time. Movement actually increases movement and low-impact exercises actually strengthen the joints while reducing pain.

First, they may need to loosen up or relieve some discomfort in the joint. Caregivers can help patients by applying ice or heat to the area, depending on the type of ache they are feeling. If the joint is swollen and warm to the touch, an ice pack can help reduce the inflammation. If the joint is neither but still achy, applying heat to the area can help loosen up the muscle and get the blood flowing.

Then, the patient can start incorporating short periods of activity throughout the day to improve muscle strength. Patients are encouraged to start slowly and to stop when it starts to get uncomfortable before it becomes painful. A few ideas for in-home exercises that caregivers can help with include:

  • Short walks across the room – even if it’s for as short as 30 seconds a few times a day.
  • Hand exercises – practice stretching and flexing the fingers.
  • Ankle pumps – sit in a chair and alternate flexing your foot up toward you and down away from your body.
  • Knee extension – sit in a chair and extend one leg in front of you, parallel to the floor, until your knee is straight, with toes pointed toward your head. Lower your leg back to the ground.

Before beginning a regular exercise routine, it is always important to be assessed by a medical professional to ensure that the exercises are appropriate and to avoid injury.

Cynthia Russell, PT, is a physical therapist at Cone Health Outpatient Rehabilitation Center at Reidsville.

2 Your Well-Being

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