Wednesday, March 12, 2014

Caring for the Caregivers Using THETR

Population health service providers may want to add this evidence-based JAMA review of "caregiver burden" to their educational resource library.


The numbers surrounding the hidden "caregivers" who assist homebound chronically ill elderly are staggering. 90% of the home care needed by elders in the United States has been provided for free by more 65 million family and friends. These caregivers provide care an average of 20.5 hours a week which, if were paid for, would amount to $56,000 per year per patient. Caregivers are typically female, socially isolated, financially stressed and feel trapped.

What can be done to assist these caregivers who may be the only person standing between a patient and an avoidable hospitalization?

Care managers need to regularly think about the care planning options using the handy "THETR" mnemonic:

Caregivers need to be a member of the care Team: Their perspectives count. They should be in the room, in on the call and included in the remote monitoring loop.

Caregiver health is important: Since they also may have significant health issues and are notorious for neglecting their care needs, they may warrant being fast-tracked to medical care.  After all, they're taking care of two people.

Education: Caregivers need to understand the patient's illness, prognosis and any special care needs.  The more they know, the better they can help.

Technology: There is a blue ocean market for caregiver monitoring assistance, such as intercom systems, webcams, lift devices, mobility detectors and live educational offerings.

Referrals: There are a host of public and private funded programs that can offer assistance, including respite care.

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