Caring for Alzheimer’s Patients and Family Members

Caring for Alzheimer’s Patients and Family Members

Nurses often care for patients with Alzheimer’s disease, and they also help families who are looking for guidance and resources. But many nurses also care for their own family members who have Alzheimer’s disease, and the high amount of energy spent caregiving on the job and at home is often challenging and can leave nurses depleted at home and at work. Designated as World Alzheimer’s Month, the focus on Alzheimer’s disease in September helps call attention to this devastating disease.

Cindy Keith, RN, BS, CDP, owner of M.I.N.D. in Memory Care, and author of “Love, Laughter & Mayhem – Caregiver Survival Manual for Living with a Person with Dementia,”offered some tips to nurses who also act as caregivers to loved ones with Alzheimer’s disease or dementia.

  1. Realize This Is a Delicate Balancing Act

“This type of caregiving is likely the toughest thing they will ever have to do,” says Keith about nurses who care for family members. “Not only must they balance their jobs with the ‘work’ at home, but they must also be cognizant of the fact that they may be (likely are) running themselves ragged trying to keep all the balls in the air.” Keith advocates for building mental health breaks into your schedule so you can continue to find the energy for so much. “Nurses cannot be a good caregiver when they are running on empty,” she says.

  1. Accept You Aren’t Superhuman

There is virtually no one who can take on the role of caregiver at work and at home singlehandedly without losing something in the process. “Get others to help,” she says. “Do not be shy about asking for help and then schedule that help in.” If a neighbor offers help, ask them to take the elder for a walk or just sit with your loved one while you go for a walk or run an errand. If you’re able to hire any kind of help, doing that will free up some time, and therefore, energy for your own life.

Keith says looking into resources including Meals on Wheels or something similar can take a big load off a caregiver. Faith communities often have members who drive elders to appointments, cook occasional meals, or offer companionship while you run an errand, catch up on laundry, or just take time for a cup of coffee. When you have others help you, make sure you use some of the time to recharge your own energy. “Just be sure to schedule in some time for yourself to do something you like that will reset your brain,” says Keith. Caregiving is exhausting.

  1. Gather Information Everywhere

Keith says you’ll find information in all kinds of places and in formats most useful to you. “Join a support group,” says Keith. “So many of my clients have been dragged kicking and screaming to support groups only to find they are a lifeline for them—and some continue to go to help others even after their loved one has passed on.” Sometimes a group may not be the right fit—for example you may want a group where the majority of the members are at a similar stage as you. If you find one group isn’t helping you, find another one and give it at least three tries, she says.

Keith also says the Alzheimer’s Foundation of America has excellent information for caregivers and there are many books that offer targeted information. Keith wrote her first book, “Love, Laughter & Mayhem – Caregiver Survival Manual for Living with a Person with Dementia,” to help answer some common caregiver questions. She also says “Elder Rage or Take My Father…Please!” is helpful for if a loved one is abusive or combative.  “Creating Moments of Joy” by Jolene Brackey is also one she recommends.

  1. Take Care of Yourself

The constant demands of caregiving are stressful and can lead to burnout. Your level of stress has nothing to do with your love of the person you are caring for, it has to do with your need to take care of your own physical and mental health. “Don’t be afraid to seek professional help for yourself or your loved one,” says Keith. “This is a life situation that can quickly become a crisis and the more you know about it, the better prepared you will be when. not if, the crisis hits.”

Community Health Centers Offer a Lifeline

Community Health Centers Offer a Lifeline

Community health centers have taken on a big role in the nation’s healthcare as the COVID-19 pandemic has continued to impact the nation. Nurses who work in these centers find their skills in high demand.

According to the National Association of Community Health Centers (NACHC), federally funded centers provide essential access to primary care for people who may not be able to access it through traditional means. Whether there are barriers from language, income, lack of insurance, or transportation, these centrally located health centers remove many of those barriers to care.

Access to healthcare is especially important right now, as the coronavirus is having a devastating impact on communities that are predominantly of people of color and immigrants, and where people live in densely populated neighborhoods and homes. Many of these communities also have a high number of essential workers who must be out in the community daily—increasing the risks to their health and that of those around them. Some community centers provide care for rural areas, where there’s little access to healthcare, but still a high need. The Rural Health Information Hub offers a toolkit for healthcare workers in these areas.

The NACHC states that with the effective preventative care and emergency care, community health centers are able to divert people away from the emergency departments which may be their only viable healthcare option. In addition to healthcare, community health centers also offer or coordinate much needed services such as translation or interpreter services, transportation, and the case management of complex issues and conditions.

Staff also act as excellent community advocates and work to explain, distribute, and educate patients on health conditions, treatment options, home care, and disease management. By doing this, patients and their families can have better outcomes as they know how to manage all aspects of their health. Patients learn about any conditions or symptoms through education provided with a focus of culturally competent healthy practices and behaviors that will work for them.

As an affordable and viable option for approximately 29 million people in the United States, the nearly 1,400 community health center organizations nationwide provide a place where residents go for healthcare delivered by a staff that understands the specific details of their community and how those details can impact their health. Some states have organizations devoted to community healthcare, such as the Massachusetts League of Community Health Centers, that offer more information, resources, and history of these vital centers.

Nurses interested in a career working in community health can find out more through the American Public Health Association, an advocate for providing high-quality and effective public health options. A healthy community allows residents many more options, and community health centers help provide that lifeline.

From pregnancy and neonatal care to addiction or heart disease, community health nurses will see it all in their practices. It’s an excellent role for those who are committed to both lifelong learning and the foundation of a healthy community that is focused on equity.

Understanding Psoriasis

Understanding Psoriasis

Summertime leads to lots of skincare challenges, but for people with psoriasis skincare challenges are a year-round effort.

August brings attention to this skin condition with Psoriasis Action Month and Psoriasis Awareness Month.

According to the National Psoriasis Foundation (NPF), psoriasis is an “immune-mediated disease (a disease with an unclear cause that is characterized by inflammation caused by dysfunction of the immune system) that causes inflammation in the body.” The American Academy of Dermatology Association (AAD) explains that psoriasis is the body’s too-rapid production of skin cells, which cause the cells to pile up and form itchy and painful patches.

For people who have psoriasis, the disease is hardly simple. It causes extreme itching and discomfort physically, but it also brings emotional struggles as the patches can be large and red and will appear almost anywhere on the body.

Psoriasis isn’t contagious so people can’t catch it; however most people can’t tell what is causing such an inflamed reaction and so may assume they will contract a similar rash if they get too close. Covering up the patches helps hide them, but it doesn’t soothe the emotional toll of having a very visible skin condition.

According to the NPF, instead of the typical 30-day cycle in which skin cells will develop and shed, those with psoriasis can have that happen in 3 or 4 days. The rapid buildup of cells looks different on each person (and can vary depending on the type of psoriasis a person has) and can come and go in severity. Like many other autoimmune-type diseases, stress, other infections, or even a skin injury can trigger a flare up of symptoms. Cold, dry weather can worsen symptoms as can too much drinking or smoking.

Because this condition isn’t entirely localized, like a poison ivy rash would be, the systems involved in psoriasis can also lead to other conditions such as psoriatic arthritis, which may affect up to a third of sufferers.

There is no cure for psoriasis, but there are many treatments that people can try. If any of your patients have the condition, encourage them to try as many therapies are they are able to. Each kind of therapy will have a different outcome for each person, so what worked for one might not work for another. Currently, psoriasis treatment therapies may feature light therapy or topical creams or lotions.

More severe cases of psoriasis may involve more pervasive treatments that could include oral medications or infusion therapies that treat a wider range of body systems. And whether someone has a mild case or a more severe case of psoriasis, additional alternative therapies that work to prevent a flare up, reduce inflammation in the body, or help focus on pain management techniques are often useful.

If any of your patients have psoriasis, offer support through resources and compassion throughout the year. If you don’t know much about this condition, do some investigating in your daily nursing approach so you’ll understand it and can help educate others.

 

August Is National Breastfeeding Month

August Is National Breastfeeding Month

August is National Breastfeeding Month and is a good time for nurses to offer support and resources for families who want to make breastfeeding part of their lives.

According to the United States Breastfeeding Committee, “83 percent of U.S. infants receive breast milk at birth, only 25 percent are still exclusively breastfed at six months of age.” And while the benefits of breastfeeding are widely touted by the American Academy of Pediatrics and other organizations, not every family has equal access to resources or has a supportive environment in which breastfeeding can be sustained.

This month calls attention to the disparities that exist and can help families who choose breastfeeding to have better opportunities for education, support, and resources.

On August 27, from 11:30 am to 1 pm EDT, BirthNet will host the lunchtime discussion, Celebrating Black Breastfeeding and How Doulas Can Help. The panel discussion will address using doulas to help families through some of the challenges they find, especially during the times when COVID-19 can bring even more barriers to finding support when they need it.

Most babies and mothers reap health benefits associated with breastfeeding. According to the American Academy of Pediatrics those include some infant and childhood protection against:

  • bacteremia
  • diarrhea
  • respiratory tract infection
  • necrotizing enterocolitis
  • otitis media
  • urinary tract infection
  • late-onset sepsis in preterm infants
  • type 1 and type 2 diabetes
  • lymphoma, leukemia, and Hodgkins disease
  • childhood overweight and obesity

Mothers also find benefits include a faster uterine recovery, decreased bleeding, faster postpartum weight loss, and some risk reduction of ovarian and breast cancer.

Nurses can continue to offer support to moms who are beginning the process or those who want to continue and are having a hard time doing so. While breastfeeding is a natural method of feeding, it isn’t always easy. Frustration, pain, and exhaustion can derail even the most determined parent. But supportive care—from a nurse, a friend, family member, or a professional—can make the path to continue a little easier. When parents find reliable and effective advice, emotional support, and encouragement, they may be more inclined to continue.

As a nurse, even if you aren’t an ob/gyn specialist, you can help support families who want to breastfeed by helping them find resources within your organization. General supportive conversation if they are finding breastfeeding more challenging than they realized or guiding them toward breast pumps, pillows, nursing clothing, salves, or support groups can sometimes be all that’s needed.

As a professional, you can also advocate for breastfeeding rights including workplace rights for working parents, equal access to resources and support, and general acceptance of breastfeeding.

The Healthy Newborn Network offers a Breastfeeding Advocacy Toolkit that offers ideas on everything from funding to workplace policies aimed at making breastfeeding easier and more sustainable for many different lifestyles and scenarios.

Celebrate and support families this week during National Breastfeeding Month.

Job Search: What to Know Before You Begin

Job Search: What to Know Before You Begin

Embarking on a job search is often an exciting, and yet exhausting process. Beginning a new role, especially one that matches your professional and personal goals, reminds you of why you started a career in nursing and can restart your passion for what you do.

But a job search takes a lot of work, so some preparation before you begin will save you time and will help you find a good match for your skills and your own needs (a higher salary, a shorter commute, a new location).

Minority Nurse recently caught up with Anne Jessie, DNP, RN, and president-elect of the American Academy of Ambulatory Care Nursing (AAACN), for some tips for nurses who are thinking of making the big move and starting a job search.

Q: Should nurses do any kind of self-evaluation or career evaluation before they begin a job search?

A: Yes. Self-reflection is always helpful. It is important to spend time thinking about why you think a job change may be needed or desired. Are you stuck in a place without opportunity? Is the company you currently work for unstable? Is there an unanticipated career opportunity that is too good to pass up? Once you determine your motivation for doing a job search, ranking the following areas in order of importance can be helpful in narrowing your search.

  • Company culture
  • New level of responsibility
  • Opportunity for growth within the new company or new job role
  • Pay and benefits
  • Company stability

 

Q: What is the best way to get organized and think about a job search?

A:  Ask yourself what you have enjoyed doing most throughout your career, what you’d prefer never to do again, and what areas of career growth opportunities you may have identified. This self-exploration should help you to picture your ideal role more clearly.

  • Browse job postings for the different types of roles that align with your identified career goals. Are the responsibilities described in the postings appealing and do you meet most of the qualifications?
  • Edit your resume so that prospective employers will understand what type of position you are seeking and how your experience aligns. You may need to edit the content depending on the job you are seeking. Highlight accomplishments and experiences that are most transferrable, listing the most recent and pertinent to the posting at the top of your resume.
  • Create a one-page cover letter template that identifies the position you are applying for and clearly demonstrates that you have done research on the company–for example, mention a recent company accomplishment or news story. This template can easily be customized to each job role you apply for. Address the letter to the hiring manager, recruiter, or human resource representative at the company.
  • Identify 3-5 people to be your references and ask them if they would be willing to speak to your skills. Consider present colleagues, professors, or supervisors.
  • After participating in a job interview, write an amazing thank you note within 24 hours of the interview.

 

Q: What are the best tools to use in a job search and what makes each one distinctive — for instance LinkedIn, networking, job boards, alma maters.

A:  First, consider all your resources: General nurse recruiting websites or agencies, and nursing specialty job boards like AAACN’s Career Center, or those offered by the Organization for Nurse Leaders. Networking is, of course, one of the best ways to find a new position. I’ve heard our AAACN nurses say they found a new job after they joined one of our Special Interest Groups (SIGs), and I see job discussions frequently in our online community. Such new connections can help a nurse discover an area of practice they didn’t know about or had never even considered.

Second, create or optimize your LinkedIn profile. It should be an extension of your resume and cover letter, and should include a professional profile photo and engaging summary that highlights your skills, career achievements, and accomplishments. Also, include volunteer experience as appropriate, as well as education and professional certifications. Maintain your presence by regularly posting and commenting so you appear active and engaged.

Social media can also be a positive platform if used to contribute to conversations regarding timely health care topics. Ensure that you refrain from engaging in conversations that could be considered controversial. Also, make sure your profiles on Facebook, Instagram, and other platforms are set to private.

 

Q:  Should recently graduated nurses conduct a job search in a different way from a more experienced nurse? Are there better approaches for nurses in different stages of a career?

A:  While knowledge, skills, and attitudes are important, a positive attitude and ability to communicate flexibility in the acceptance of job assignments is key for the new grad. Content and processes can always be taught, but a positive attitude in an employee can sometimes be hard to find. Take full advantage of job fairs that are organized by your nursing school as well as healthcare systems recruitment events. Employers who offer nurse residency programs as part of orientation and onboarding are committed to hiring new graduates and investing in them as long-term employees.

 

Q:  Is there anything about this time when so many processes are remote, that can impact a job search positively or negatively?

A:   The biggest impact is the uncertainty of the impact from COVID-19 on the job market. Many organizations have suspended hiring and have temporarily furloughed nurses. That said, facilities that offer remote work such as nurse call centers have been vital to providing virtual clinical support to vulnerable populations and have expanded during this unprecedented time in health care.

We’ve seen this trend reflected in a jump in demand for AAACN’s telehealth resources and the networking among our AAACN members who practice telehealth. I think telehealth is going to continue to grow significantly in coming years because its value will remain even when COVID-19 has been tamed.

 

Q:  How can a nurse prepare to use this time as an advantage?

A:  Self-educate and develop skills that support patient engagement, mutual goal setting, and motivational interviewing that promote patient self-care management. AAACN’s Care Coordination and Transition Management (CCTM) resources can assist in developing these skills and competencies. These skills are especially critical when working with patients virtually but can translate to any work environment to ensure improved disease management and quality outcomes.