NURSING INTERVENTIONS STROKE CAREGIVER

CARE GIVER STRESS &STRAIN

 Ascertain the caregiver’s knowledge and ability to implement patient care, including
bathing, skin care, safety, nutrition, medications, and ambulation.
 Encourage the involvement of other family members to relieve pressure on the
primary caregiver.
 Tell the caregiver to set aside time for self. Aid the caregiver in identifying those that
bring them peace and relaxation. Caregivers need may need reminders to attend to
own physical and emotional needs. This helps conserve physical and emotional
energy.
 Introduce stress-reducing methods to the caregiver. It is important that the caregiver
has the opportunity to relax and reenergize emotionally throughout the day to assume
care responsibilities.
 Allow caregiver to participate in in support group. Groups that come together for
mutual support can be advantageous in providing education and anticipatory
guidance.
 Allot time for the caregiver to discuss problems, concerns, and feelings. Ask the
caregiver how he or she is managing. Nurses are in an excellent position to give
emotional support and provide guidance throughout this challenging situation.
 Encourage the caregiver to know available family and friends who can assist with
caregiving. Successful caregiving should not be the sole responsibility of one person.
 Recommend the use of available community resources such as respite, home health
care, adult day care, geriatric care, housekeeping services, home health aides, Meals
On Wheels, companion services, and others, as appropriate. Resources grant
opportunity for multiple competent providers and services on a temporary basis or for
a more extended period.
 Provide safe and effective alternatives to medication.
FEAR
 Determine the type of the fear by thorough, rational questioning and active listening.
The external cause of fear can be known. Caregiver who find it unacceptable to
expose fear may find it convenient to know that someone is willing to listen if they
choose to share their feelings at some time in the future.
 Assess the behavioral and verbal expression of fear. This information provides a
foundation for planning interventions to support the Caregiver’s coping strategies.
 Evaluate the measures the Caregiver practices to cope with that fear. This information
helps determine the effectiveness of coping strategies used by the Caregiver.
 Open up about your awareness of the Caregiver’s fear.
 Discuss the situation with the Caregiver and help differentiate between real and
imagined threats to well-being.
 Tell Caregiver that fear is a normal and appropriate response to circumstances in
which pain, danger, or loss of control is anticipated or felt. This reassurance places
fear within the field of normal human experiences.
 Be with the Caregiver to promote safety especially during frightening procedures or
treatment. The physical connection with a trusted person helps the patient feel secure
and safe during a period of fear.
 Maintain a relaxed and accepting demeanor while communicating with the Caregiver.
The Caregiver’s feeling of stability increases in a peaceful and non-threatening
environment.
 Provide accurate information if irrational fears based on incorrect information are
present. Replacing inaccurate beliefs into accurate information reduces anxiety.
 If Caregiver’s fear is a reasonable response, empathize with him or her. Avoid false
reassurances and be truthful. Reassure Caregiver s that asking for help is both a sign
of strength and a step toward resolution of the problem.
 Use simple language and easy to understand statements regarding diagnostic
procedures. The Caregiver may find it hard to understand any given explanations
during excessive fear. Simple, clear, and brief instructions are necessary.
 Maintain a quiet environment whether at home or in a hospital setting. Drop any
unnecessary stuff around the patient. Caregiver’s fear is not reduced and resolved if
the environment is unsafe.
 Support the Caregiver in recognizing strategies used in the past to deal with fearful
situations. This method allows the Caregiver to think that fear is a natural part of life
and can be dealt with successfully
 As the fear subsides, encourage the Caregiver to involve himself or herself to specific
events preceding the onset of the fear. Recognition and explanation of factors leading
to fear are vital in developing alternative responses.
  Allow the Caregiver to have rest periods. Relaxation improves ability to cope. The
nurse needs to pace activities, especially to older adults to conserve the Caregiver s
energy.
 Access community resources to meet the fearful needs of the Caregiver and family
(e.g., spiritual counselor, social worker). Appropriate resources render organized
and regulated Caregiver that indicates supportive healthcare service.
 Initiate alternative treatments. Provide verbal and nonverbal (touch and hug with
permission) reassurances of safety if safety is within control. Meditation, prayer,
music, Therapeutic Touch, and healing touch techniques help lighten fear.
HOPELESSNESS
 Assess physical appearances such as the grooming, posture, and hygiene. Caregiver s
who are experiencing hopelessness may not have the urge to participate in Patient-
care activities.
 Ascertain the role that illness presents in the Caregiver’s hopelessness. Caregiver’s
current situation may affect his or her physical functioning.
 Assess the Caregiver’s understanding of the situation, belief in self, and his or her
own abilities.
 Encourage a positive mental perspective, discourage negative thoughts, and brace
patient for negative results.
 Provide openings for the Caregiver to verbalize feelings of hopelessness.
 Manage to have consistency in staff appointed to care for the patient.
 Assist Caregiver with looking at options and establishing goals that are relevant to
him or her.
 Encourage the Caregiver to recognize his or her own strengths and abilities.
Work with the Caregiver to set small, attainable goals.
 Render physical care that the Caregiver is unable to achieve and respect Caregiver’s
abilities.
 Stay and spend time with the Caregiver. Use empathy; try to understand what the
Caregiver is saying, and communicate this understanding to the Caregiver.These
approaches can inspire hope. Experiencing warmth, empathy, genuineness, and
unconditional positive regard can greatly reduce feelings of hopelessness.
 Assist the Caregiver in establishing realistic goals by recognizing short-term goals
and revising them as needed.
  Provide time for Caregiver to initiate interactions.
 Strengthen Caregiver’s relationship with significant others; allow them to take part in
Caregiver’s care.
 Encourage family and significant others to display care, hope, and love for Caregiver.
 Encouraging the family to present Caregiver support, to understand Caregiver’s
feelings, and to be physically present and involved in care are approaches that allow
the family to change Caregiver’s hope state.
 Practice touch, if appropriate and with authority, to show care, and encourage the
family to do the same. This approach provides comfort and is necessary for the
development of hope.
 Present opportunities for the Caregiver to manage care setting. When a hopeless
Caregiver is given opportunities to make choices, his or her perception of
hopelessness may be reduced.
 Promote the use of spiritual resources as desired. Religious practices may provide
strength and inspiration.
 Provide plant or pet therapy if possible. Taking care of pets or plants promotes
redefining Caregiver’s identity and makes him or her feel needed and loved.
 Refer Caregiver to self-help groups such as I Can Cope and Make Today Count.
INSUFFICINET KNOWLEDGE AND SKILLS
 Caregivers need open and honest communication about their role and stroke
survivors’ abilities
 Conducting a comprehensive predischarge nursing assessment of caregiver physical
and psychological health and social, financial, and spiritual needs initially and during
follow-up is essential
 nurses should develop a highly individualized case management plan to help
caregivers attain skills and services necessary to facilitate success and seamless
postdischarge transition
 basic information should be provided throughout acute and chronic care in both oral
and written formats, with frequent reinforcement of specific information in the
caregiving trajectory.
 caregivers need tailored nursing interventions that develop and reinforce requisite
information and skills (including handling techniques and assisting with activities of
 daily living), while being attentive to caregiver responses during teaching and
allowing time for return demonstration of skills and care.
 Telephone follow-up by nurses to monitor how caregivers are coping with physical
and emotional aspects of caregiving is important.3
 caregivers need suggestions for setting realistic goals to improve their physical (time
to exercise, eating a heart healthy diet) and psychological (time alone to do enjoyable
activities, such as reading, church, or social activities) well-being.
 Skills training to offer support and teach effective coping skills, such as relaxation
techniques and problem-solving techniques, are useful in lessening negative caregiver
outcomes.