Prepare to care

The days leading up to a new job are always fraught with great anxiety and personal misgivings. Do I have the skills for this job? Will I be able to handle the day-to-day grind? What happens if I can’t cut it?  The application process should quell most of these fears – you’ve read the job description, checked your qualifications to see if they match the position and have taken part in a series of interviews that determines your suitability for the job.

With caregiving, however, there’s no such process. If serious illness suddenly strikes your family, you may be forced into the caregiver’s role without any warning. And it doesn’t matter if you lack the personal characteristics and practical skills to succeed in this assignment – the job is yours, no interview, no screening process and no time to weight the pros and cons.

So, in lieu of any formal preparation, we’ve developed a list of personal skills and characteristics that should help you succeed in your caregiving assignment. Assisting us in shaping this job description are two social workers from busy home-care referral agencies. Dr. Chaya Mannes-Milevsky is an intake social worker at SenioPeople’s Resources in North Toronto (SPRINT), and Angela Xavier is a social worker in client and family services at St. Christopher House in Toronto.

Stamina and endurance
Caregivers must be prepared to work long and irregular hours. Though it depends on the severity of the patient’s condition, both Mannes-Milevsky and Xavier say caregivers should expect to be available 24 hours a day, seven days a week – not just providing care, but also companionship.

To get an idea of this workload, look at the number of hours invested in caring for a higher-maintenance patient, such as a person suffering from dementia. A Health Canada survey says that people looking after a person with mild to moderate dementia should be expected to provide about 3.2 hours of care a day. But if the dementia becomes severe, the average can rise to more than eight hours a day. Remember, you’ll also have other demands on your time. “Caregivers are not just caring for the patient,” says Mannes-Milevsky. “Many of them are also looking after kids and trying to hold down a job as well.” In some regions, government and community organizations do provide some respite, but don’t expect more than one afternoon a week and don’t count on family members to help out.

A fast learner
You’ll be expected to learn all about your patient’s condition, including how to perform specific nursing duties, assist with daily activities (dressing, washing, feeding, toileting) and other duties, including lifting and transporting the patient, as well as completing handling any tasks that the patient is unable to handle on his or her own. Plus, you’ll need to supervise the patient’s medication needs and possibly master the use of some medical equipment (oxygen, blood-sugar testing, etc.).

“Unfortunately, caregivers are forced to learn much of this on their own,” says Mannes-Milevsky. Xavier agrees. “No one approaches them and says, ‘This is how you do it.’ A lot of people end up relying on their instincts to get them through the early stages.” Both social workers suggest that by listening closely to health professionals and taking careful notes, you can shorten your learning curve. You can also augment your education by attending caregiver support groups, going to community organizations for information and surfing the Net for information related to your patient’s ailment.

Next page: A stress-resistant personality

A stress-resistant personality
How well you manage the physical and emotional stresses of looking after a loved one will greatly influence the outcome of your caregiving experience. “Caregiving creates the highest level of stress,” says Mannes-Milevsky, who suggests that looking after a loved one can create higher stress levels than such occasions as your first day on a new job or moving house. Studies show that poorly handled stress can have dire consequences on your own quality of life, causing burnout, depression, even health problems. This anxiety comes from so many sources: watching your loved one suffer, inability to complete all of your tasks, and lack of support from health-care professionals or family members. “Often, it results because the burden of responsibility falls too heavily on the main caregiver,” says Xavier. Many community organizations offer workshops to teach caregivers how to deal with high stress levels.

A self-motivator
At many times during your caregiving phase, you’ll have so little enthusiasm for the job, you’ll just want to chuck it. This urge is common because of the many frustrations that arise, including lack of community or family backup, inability to navigate the complexities of the health system, isolation, lack of time for other family members, the sacrifice of personal goals, career advancement or social opportunities and, perhaps worst of all, dealing with angry, unreasonable and sometimes disruptive patients. Both Mannes-Milevsky and Xavier warn that caregiving can be a thankless job and that, often, the only thing getting you through these dark moments will be patience and a strong will.

A capable organizer
As there will be so many affairs to monitor – both the patient’s and your own – this is perhaps the most important skill you’ll require as a successful caregiver. You’ll need to keep up-to-date medical records for your patient, schedule and attend appointments with doctors and therapists, and monitor, supply and dispense medications at the right times. Plus, you’ll be co-ordinating visits to the house by nurses, social workers and other home-care support services, such as Meals on Wheels, not to mention lawyers and accountants. “You can’t afford to be disorganized,” says Mannes-Milevsky, who believes highly organized caregivers get the best results from the health system: “Doctors and nurses are inclined to share much more information if they see you’re on the ball,” she says. Xavier feels that the caregiver’s organizational duties should include developing both a daily care plan, as well as a long-term plan that takes into account changes to a patient’s health and where the patient will go if the home-care environment falls short.

A positive outlook
Though you can expect caregiving to be a dreary job, seeking out the positives can make it a highly rewarding experience. A recent Statistics Canada study showed that 64 per cent of caregivers nearly always felt that looking after a loved one strengthened their relationship with them. As well, 60 per cent agreed that caregiving allowed them to “give back some of what life has given you.”

Xavier says that a sense of accomplishment and pride often comes when people do something they didn’t think they could and discover “inner strengths” they didn’t know existed. And Mannes-Milevsky feels that when people put everything they have into it, the caregiving experience can be a joy to behold. “When children agree to provide care for a parent, and they manage to make it through all the rough times, it can be the most special job of their lives.”