Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

• Do you agree with your peers’ assessment?
• Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
• Share your thoughts on how you support their opinion and explain why.
• Present new references that support your opinions.

Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Be sure to review your APA errors in your reference list, specifically you have capitalization errors in some words of the titles.Include the DOI. Also, be sure you are italicizing titles of online sources.No more than 200 words maximum.

These are the questions my peers had to answer:

Caring for an elderly family member can be overwhelming for families. If the stress of caregiving is left unchecked, it can take a toll on the caregiver’s health, relationships, and state of mind—eventually leading to burnout. Families may often be faced with a serious decision concerning the care of their loved ones.

• Discuss strategies that are proven to help families deal with caregiver stress and burnout.
• How can you assist them in making decisions about the care of their loved ones?
• Include a discussion on handling advance directives with families.
• Document your discussion with at least five evidence-based references on the topics.

Sarah’s Response:

Strategies

Being a caregiver is a difficult responsibility that too often results in stress and burnout from the constant demand of being responsible for another. If the stress of caregiving is left unchecked, it can take a toll on health, relationships, and state of mind, eventually leading to burnout, a state of emotional, mental, and physical exhaustion, and when that happens, both the caregiver and the patient suffer (Smith, 2019). There are strategies that can help mitigate caregivers from experiencing stress and burnout. Finding someone to confide in, setting realistic goals, utilizing respite care services, accepting disease processes, caring for one’s own health, knowing self-limits, accepting feelings, practicing coping skills, and joining a caregiver’s support group are all strategies that caregivers can utilize to reduce stress and burnout (Cleveland Clinic, 2019).

Provider Assistance

Caregivers can be reluctant to be honest about their struggles. The provider can offer support, resources, and education to caregivers, but there has to be an honest relationship built for receptivity to be attained. Providers should identify, assess, and support caregivers in the delivery of care, include caregiver experiences in quality measurement, support them through health information technology, and provide person and family-centered care (National Academy of Sciences, 2016). There is a definite need for education for the caregiver that goes beyond the provider level. The Center to Advance Palliative Care and the Gary and Mary West Health Institute are filling this resource gap by developing a series of courses and resources that assist the patient’s health care providers in supporting and educating caregivers to help them care for their loved one (Slaboda, Fail, Norman, & Meier, 2018). Proving the caregiver with resources such as this can help both the patient and the caregiver immensely.

Advanced Directives

One of the most difficult situations in life is making end-of-life healthcare decisions for another. Providers should be proactive and discuss end-of-life wishes for these patients. One way to establish this is to review advanced directives. Advance directives are legal documents that state the patient’s wishes for care and allow the patient to designate a decision-making individual (Premier Health, 2017). Establishing advanced directives help to avoid confusion and discrepancies of what the patient desires for their end-of-life healthcare. This discussion is most meaningful when the patient is still of sound mind to make their wishes known and documented. It is up to providers to have this candid conversation and incorporate it in the plan of care.

References

Cleveland Clinic. (2019). Caregiver burnout: Prevention. Retrieved from https://my.clevelandclinic.org

/health/diseases/9225-caregiver-burnout/prevention

National Academy of Sciences. (2016). Family caregivers’ interactions with health care and long-term

services and supports. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK396396/

Premier Health. (2017). Advance directives make life easier for loved ones. Retrieved from

https://www.premierhealth.com/your-health/articles/women-wisdom-wellness-/advance-

directives-make-life-easier-for-loved-ones

Slaboda, J., Fail, R., Norman, G., & Meier, D. E. (2018). A study of family caregiver burden and the

imperative of practice change to address family caregivers’ unmet needs. HealthAffairs. doi:

10.1377/hblog20180105.914873

Smith, M. (2019). Caregiver stress and burnout. Retrieved from https://www.helpguide.org/articles

/stress/caregiver-stress-and-burnout.htm

Latara’s Response

Caregiver stress syndrome is a condition characterized by physical, mental and emotional exhaustion. It typically results from a person neglecting their own physical and emotional health because they are focused on caring for an ill, injured or disabled loved one. There are a number of factors that can play a role in caregiver stress syndrome. For some caregivers, the constant demands of caring for a person who has a serious illness can result in burnout. For others, the lack of boundaries between their roles as a caregiver and a spouse, child, or other loved one can be challenging. Still other caregivers put unrealistic expectations on themselves, thinking that they can do it all and refusing to ask for help. This may often be because they don’t want to be a burden on anyone else. Other caregivers are simply frustrated by the overwhelming needs of their loved one, or the financial and other resources needed to care for someone with a long-term illness or disability (Chen, 2016).

Too often, caregivers neglect their own well-being as they turn their focus to taking care of a beloved spouse or another family member. This self-neglect, particularly over a long time period, can cause increased illness, loss of physical strength that makes caregiver duties even harder, and potentially, permanent damage to the caregiver’s health (England, 2017). For example, people with dementia require high levels of care and support, which unfortunately can result in elderly caregiver stress. In fact, such caregivers are sometimes referred to as invisible second patients, because of the negative physical and psychological impact of the caregiver role.

Once the caregiver has recognized the signs of caregiver stress syndrome, the next step is to manage it. Having this condition isn’t unusual, the key is for them to make their own health a priority so that they can continue to provide care for their loved one. If a patients loved one is struggling with caregiver stress syndrome, one of the first things that they can and should do is to take a break. While they may believe that they can handle it all by themselves, the reality is that nobody can. Contact local agencies, family members, friends, or support groups to set up some respite care. This may look different depending on the patients situation: a home health nurse, a personal care assistant, or an adult day program (Mott, Schmidt, & MacWillaims). Each individual’s needs are varied but extremely important for the health and wellbeing of both the caregiver and care recipient. Caregivers who find effective coping tools are better able to see their role in a positive light and recognize the significant impact they have on the loved one in their care.

Living wills and other advance directives are written, legal instructions regarding the patients preferences for medical care if they are unable to make decisions for themselves. Advance directives guide choices for doctors and caregivers if the patient is terminally ill, seriously injured, in a coma, in the late stages of dementia or near the end of life (Banja & Sumler, 2019). Advance directives aren’t just for older adults. Unexpected end-of-life situations can happen at any age, so it’s important for all adults to prepare these documents.

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. You also help reduce confusion or disagreement about the choices you would want people to make on your behalf. The patient and their family should be advised that deciding and communicating your wishes for health care in the form of an advance directive can be very valuable. It helps ensure you get the health care you want in the event you have a serious illness or injury and cannot communicate your wishes. It’s also a valuable tool for families as they face difficult decisions about caring for a loved one in a serious situation or in the final phase of life (England, 2017). Studies show that people who talk to their family members, friends or doctors about their wishes have less stress, confusion and guilt about their decisions. In most cases, family members are grateful to know the type of medical care a loved one wanted.

Banja, J., & Sumler, M. (2019). Overriding advance directives: A 20‐year legal and ethical overview. Journal of Healthcare Risk Management, 39(2), 11–18. https://doi.org/10.1002/jhrm.21388

Chen C. (2016). Experience helping a caregiver reduce stressors. Journal of Nursing, 81–86. Retrieved from https://search.ebscohost.com/login.aspx?direct=tru…

England M. (2017). Caregiver strain: considerations for change. Nursing Diagnosis, 11(4), 164–175. Retrieved from https://search.ebscohost.com/login.aspx?direct=tru…

Inoue, M., Ihara, E., & Terrillion, A. (2019). Making Your Wishes Known: Who Completes an Advance Directive and Shares It With Their Health Care Team or Loved Ones? Journal of Applied Gerontology, 38(12), 1746–1762. https://doi.org/10.1177/0733464817748778

Mott, J., Schmidt, B., & MacWilliams, B. (2019). Male Caregivers: Shifting roles among family caregivers. Clinical Journal of Oncology Nursing, 23(1), E17–E24. https://doi.org/10.1188/19.CJON.E17-E24