Emotional stress is higher with dementia care

Staff members need extra support, guidance on self-care

[Editor's note: This is the second of a two-part article that discusses best practices for the care of patients with dementia. Last month, we looked at an overview of the challenges presented by dementia patients and techniques that improve care. This month, we look at additional tips to increase patient compliance and ways for home health workers to handle the stress of dementia care.]

It is not uncommon for a home health patient to have dementia in addition to the medical diagnosis that is the reason for admission to home health. Being able to recognize and overcome the challenges presented by dementia is important to being able to ensure a good outcome for the patient, according to sources interviewed by Hospital Home Health.

Taking care of home health staff members who care for patients with dementia is as important as taking care of the patients themselves, suggests Elizabeth Gould, MSW, director of quality care programs at the Alzheimer's Association. At least this is part of the input received from members of the task force that worked on the Alzheimer's Association's Dementia Care Practice Recommendations for Professionals Working in A Home Setting.

"Although the best practices suggested by the task force working on the recommendations focused on care for patients with dementia, several suggestions were made to include care for the home health provider," says Gould. Caring for a patient with dementia can be more challenging than most home health patients, so it is important to provide support to prevent home health provider burnout, she explains.

"I found it interesting that a number of people who reviewed the recommendations suggested inclusion of a section on provider self-care," says Gould. "Being aware of the stressful effects of caring for a patient with dementia is especially important for home care providers, because there are fewer boundaries between personal and professional relationships," she says.

Some of the tips for home care provider self-care include:

• Be aware of the physical and emotional impact of caring for someone with dementia.

• Talk to someone or write about your feelings to reduce stress.

• Regularly affirm your successes in improving your patient's quality of life, no matter how small the success might be.

• Nurture your sense of humor.

• Set boundaries between your professional and personal life by not sharing your home or personal cell phone numbers.

Because home care staff members can become close to the family, the last tip about setting boundaries is very important, points out Gould. "A nurse or aide may not want to offend the patient or family by refusing to give them a home phone number, but the agency should have a policy that does not allow staff members to do so," she suggests. "If there is a policy, the employee can explain to the family that it is not allowed by the agency, and the refusal is more easily accepted by the family," she adds.


To download a free copy of the Alzheimer's Association's Dementia Care Practice Recommendations for Professionals Working in A Home Setting, go to http://www.alz.org/national/documents/Phase_4_Home_Care_Recs.pdf.