Quality Improvement in the US Health Care

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Table of Contents

Introduction
Literature Review
Results and Discussion
Conclusion
Works cited

Introduction

Caregivers are very much in demand nowadays. The statistics below just prove how caregiving is put into good use:

All over the world, it is estimated that more than 50 million people are working as caregivers for people who are chronically ill, disabled, or aged family members and/or friends (US Department of Health and Services, 1998)
60% of the total population of family caregivers are women (National Alliance for Caregiving and AARP, 2004)
1.4 million children (with ages ranging from 8-18 years old) share the responsibility of caregiving to their adult relatives and 72% of which are caring for their own parents and/or grandparents (National Alliance for Caregiving and the United Hospital Fund, 2005)
From the population of family caregivers, 30% of them are seniors, with ages 65 and above while 15% of which fall under the ages 45-54 (US Department of Health and Services, 2001)
17% of the recognized caregivers are spending 40 hours of their time to care each week (National Alliance for Caregiving and AARP, 2004)
In the US, if the services rendered by the family caregivers for “free’ will be converted into monetary amount, it will reach $306 billion annually; an amount that is twice as “as much as is actually spent on homecare and nursing home services combined which is $158 billion (Arno, 2006)

These statistics show just how important caregivers are in today’s society. They play a major role in the continuous provision of healthcare services. Family caregivers are now recognized as part of the medical and health care providers. But despite the encouraging reports about the services rendered by the family caregivers, there are reports showing that family caregivers are facing problems related to psychological, emotional, and physical aspects of their work.

This paper is aimed at analyzing the challenges faced by the family caregivers in America, in relation to the commitment of this country to improving the quality of healthcare. Specifically, this paper is intended for:

Analyzing the types of services that family caregivers provide
Identifying the issues faced by family caregivers particularly in terms of emotional, psychological, and physical aspects
Categorizing the approaches that family caregivers can do with regards to their work as healthcare providers and the personal issues they face

Literature Review

The Beginning of Family Caregivers

In the US, more than 22.4 million people are providing informal caregiving services. It is so-called informal caregiving for it does not require any monetary value for the render of the help and/or assistance to the older members of the community. These older persons are assessed if they have at least one disability and that they are requiring assistance from other people to live normally (Reverby, 1987).

The provision of caregiving as a service started as early as the 18^th century alongside nursing as a form of service. It was during this time that women were trying to prove their importance as members of society by creating some works which they would claim as the “women’s work” (Reverby, 1987). During the start of the Civil War, women from both the southern and the northern moved out of the comforts of their own houses and volunteered their services (Maher, 1988).

“…Ladies Aid Societies sprang up all over the country and women volunteered to sew for the soldiers; collect necessary supplies, food, clothing, blankets; and care for the thousands of wounded soldiers…” (Maher, 1988)

Aside from taking care of the soldiers and other victims of the war, the women who volunteered to provide assistance to any form of health and medical concerns also took part in taking care of their own sick and/or medically ill families. Women’s responsibilities also covered the plight of their children, husband, and even the aging parents (Reverby, 1987). Women, during this time, were compelled to take care of their sick family members. They had to evaluate their family’s health conditions while ensuring that they were not neglecting the health conditions of other people such as the soldiers, friends, and other acquaintances.

“…This aspect of “women’s work” consisted of carefully watching others, preparing special foods and tonics, changing dressings, and applying plasters, poultices, and leeches…” (Cott, 1977).

Indeed, family caregivers are not considered a task or a paid labor job. There are thousands of family caregivers who are unpaid and are doing their adopted responsibility of taking care of the people they considered as family. The professional acceptance of family caregiving started during the time of the Civil War for it was very difficult back then to obtain medical assistance. Women who have a general idea on how to take care of the sick – soldiers, civilians, young and old, females or males – are accepted and were recognized as part of the caregiving team.

The Challenges Faced by Family Caregivers

There are different issues that family caregivers face concerning their “line of work”. Such issues are providing an astounding impact on the family caregivers’ emotional, physical, and psychological, and even to their financial state. There are times that however hard the family caregiver tries to understand the need of the ill and older family member, he/she will still fail to do so. This may be caused by the lack of training and or capability to really take care of the older persons.

As a whole, family caregivers are sometimes the subject of abuse, hurt, and trauma. The person they are taking care of may have hurt them emotionally and/or physically intended or not.

Family caregivers have to endure the hardship of taking care of sick and elderly loved ones while trying to maintain a balanced family life. They have to manage the financial matters which are normally hard to do because of the additional burden brought by the medical needs and supplies required by the sick and an older family member. They have to change their lifestyle in response to the extreme change of the way of life of the loved one who is diagnosed with various forms of illnesses.

“…Family caregivers were primarily responsible for an impaired family member 60 years or older who needed help with at least one “activity of daily living,” such as bathing or dressing, or at least two “instrumental activities of daily living,” such as paying bills or talking on the phone…” (Cunningham, 1994).

Also, family caregivers normally suffer from the physical abuse of the family member they are trying to take care of. It should be noted that when a loved one is diagnosed with age-related diseases such as dementia and/or Alzheimer’s disease, they normally forget their present situation. They have the tendency to go back and act like a child or at times, they will forget who their family members are. Needless to say, the family caregiver may sometimes become unknown in the point of view of the ill person. Hence, they can just show their grumpiness, act like a child and throw things at the caregiver, hurt the caregivers, and other factors that can cause physical harm to the family caregiver. What can the family caregivers do? They could not hit back their loved ones because of the fact they are basically not aware that they are hurting the people who are just giving care to them.

“…Caregiving is stressful, and it breaks down the people that are providing the care – they wear down,” (Cunningham, 1994).

Results and Discussion

Based on a study conducted recently, caregivers do really face various problems when attending to their own health and well-being while managing caregiving responsibilities. This they face, regardless of their age, sex, race or ethnicity, and even social status. Such problems include:

sleep deficiency
poor eating habits
failure to exercise
failure to stay in bed when ill
postponement of or failure to make medical appointments.

Aside from the problems stated above, there are also reports that revealed that family caregivers normally have an increased risk for excessive use of alcohol, tobacco, and other drugs for depression. This is because of the mixed emotions attached to providing care to the old and ill family member/s. taking care of the family member is a sign of love and commitment and will provide a fulfilling experience to the caregiver him/herself. However, the responsibilities attached to caregiving per se are a different story (Family Caregiver Alliance, 2006).

“…exhaustion, worry, inadequate resources and continuous care demands are enormously stressful. Studies show that an estimated 46 percent to 59 percent of caregivers are clinically depressed…” (Family Caregiver Alliance, 2006)

Conclusion

Caregivers are now considered important members of the healthcare industry. They serve to continuously maintain balance in the healthcare system. However, with the type of commitment they shared with the industry, it is no doubt that they, too, are facing hurdles brought about by the kind of services expected from them. Because of this, research revealed that family caregivers need some time for themselves to prevent too much aftermath of stress. At the same time, before taking full responsibility for the tasks related to caregiving, they need to at least be trained first on the basic do’s and don’ts of caregiving. They must know how to manage stress while managing the attending to the needs of the family members. They need to know the basic approaches of maintaining a healthy lifestyle while taking care of the ill and older family member so as to help in maintaining quality in the healthcare sector.

Works cited

Cott, N. (1977). The bonds of womanhood. New Haven: Yale University Press.

Cunningham, G. 1994. “Caregivers: how do you find the strength to carry on? (includes related article on resources for caregivers)” US Catholic. Claretian Publications.

Arno, Peter S., 2006. “Economic Value of Informal Caregiving,” presented at the Care Coordination and the Caregiving Forum, Dept. of Veterans Affairs, NIH, Bethesda, MD.

Family Caregiver Alliance 2006. “Taking Care of YOU: Self-Care for Family Caregivers”. Web.

Maher, Sr. M. 1988. To do with honor: The Roman Catholic sister nurse in the United States Civil War. (Doctoral dissertation, Case Western Reserve University, 1988). Dissertation Abstracts International.

National Alliance for Caregiving and AARP 2004. “Caregiving in the U.S.”

National Alliance for Caregiving and the United Hospital Fund. 2005. “Young Caregivers in the U.S.”

National Family Caregivers Association. 2000. “Random Sample Survey of Family Caregivers”.

Problems and tips for family care givers. [available online]. Web.

Reverby, S. 1987. Ordered to care: The dilemma of American nursing, 1850-1945. New York: Cambridge University Press.

U.S. Department of Health and Human Services. 1998. “Informal Caregiving: Compassion in Action”. Washington, DC.

U.S. Department of Health and Human Services. 2001. “The Characteristics of Long-term Care Users.” Rockville: Agency for Healthcare Research and Quality.

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