Caregiver Consultations and the Caregiver-Centered Approach
October 25, 2021
There are 48 million caregivers in the United States (AARP, 2020) and 16 million of these caregivers are providing unpaid care for someone with Alzheimer’s disease or a related dementia (Alzheimer’s Association, 2020). This year alone, caregivers of people with dementia will provide 18.6 billion hours of care (Alzheimer’s Association, 2020).
These statistics highlight the need for caregivers to get support to sustain them on the caregiving journey. To be sure, there are rewarding aspects to caregiving but there are also many challenges. Caregivers often need someone to walk with them on their journey who can provide guidance, counsel, and perhaps most importantly, someone to listen. That is where Care Consultation comes in.
Care Consultation is a service that assists caregivers to gain knowledge, skills, and tools that are tailored to their situation. The first session is devoted to identifying caregiver needs and values through a comprehensive, individualized assessment. From that, a caregiver-centered plan is developed. In subsequent sessions, I work collaboratively with caregivers to problem-solve, assist with finding resources/additional services, offer targeted education, and to provide ongoing coaching/support. I also facilitate family meetings to assist family members in working together to reach common goals. I have been honored to witness caregivers increase in their confidence, experience enhanced emotional well-being, and take time and energy to care for themselves.
Let me share some examples. I have worked with Mike, a caregiver for his wife who is experiencing cognitive changes but has no formal diagnosis of dementia. Mike wanted to meet for care consultation because he was concerned about his wife’s driving and safety due to wandering. He was also unsure about seeking a diagnosis.
After the initial assessment, a plan was put in place to address safety and driving that was successful. Mike made an appointment with a neurologist that may get his wife on the path toward a diagnosis. Mike also started to see that he has own needs as a caregiver. He has companion care coming in regularly so that he can have time away from caregiving to engage in activities that bring him joy. Mike continues to meet for care consultations, monthly, to check in about his goals and so he can have a safe place to express emotions related to caregiving.
Here is another caregiver’s story. Susan is the primary caregiver for her mother who she lives with. Her mother’s dementia has progressed significantly. Sundowning and evening agitation were Susan’s biggest concerns. Since COVID, Susan started to work from home. Working from home and caring for her mother was causing Susan to experience burnout. She wondered if she could continue to care for her mother at home but didn’t want to place her mother in a facility due to COVID restrictions and concerns about her mother getting the virus.
Together, we put a plan in place during care consultations to address sundowning and respite for Susan. Susan found activities to engage her mother that helped to keep her calm and less confused. The plan for Susan’s respite included bringing in other family members and companions in-home. This gave Susan time to exercise, go on long bike rides, and simply relax. The respite helped greatly with Susan’s burnout and her ability to continue to care for her mother at home. Care consultation also provided Susan an opportunity to talk about her grief in losing her beloved mother to dementia.
Finally, I have worked with Jean who is the care partner for her husband who has Alzheimer’s disease. She reached out for care consultations sessions so that she would have someone to talk to who would not try to talk her out of her grief and who would not try to fix her situation. Jean also wanted to learn how to best respond to her husband when he is confused.
Care consultation helped to validate that Jean has good instincts in regards to her reactions to her husband’s confusion. Jean was also able to identify activities that bring her joy and, because of care consultation sessions, she now takes time to pursue these activities. Most importantly, Jean had the opportunity to express her grief about the changing relationship with her husband because of his Alzheimer’s disease. She appreciated having someone listen and not give advice. At the end of the last session Jean stated, “This helped immensely.”
Care Consultation is available on a fee-for-service basis, based on a sliding scale. Alternative Care (AC) and Elderly Waiver (EW) are accepted upon authorization by a case manager.
During COVID-19, sessions are virtually either via Zoom, Facetime, or by phone. For more information, please contact Carol Ashwood, MSW, LICSW at (952) 697-5370 or email Carol.Ashwood@cassialife.org.
Alzheimer's Association (2020, March). Alzheimer's Association 2020 alzheimer's disease facts and figures:
https://www.alz.org/alzheimers-dementia/facts-figures
Caregiving and AARP (2020, May). Caregiving in the U.S.:
https://www.aarp.org/content/dam/aarp/ppi/2020/05/full-report-caregiving-in-the-united-states.doi.10.26419-2Fppi.00103.001.pdf
