Given all the advanced medical technologies of our modern age, we expect that a medication or a medical procedure will be the most important part of the treatment plan for a given disease.
You might not be surprised to learn, however, that for many common conditions, caregiving is the most important treatment.
November is National Family Caregivers Month. It is a time to recognize the extraordinary, complex and challenging role served by so many family, friends and neighbors in providing care for sick, elderly and disabled members in American society. It is easy to overlook the importance of caregivers unless we explore the scope of their service and the limited alternatives to the service they provide.
The American College of Physicians defines caregivers as relatives, partners, friends and neighbors of patients who assist with activities of daily living and complex health-care needs. According to estimates, more than 30 million Americans provide care-giving services to both acutely ill and chronically ill family members. More than 90 percent of dependent people receive care from a family member or friend.
Caregivers provide emotional and spiritual support, assistance with financial matters, transportation and a host of home- and health-related services. Assistance to disabled persons often includes tasks such as bathing, meal preparation, dressing and other so-called activities of daily living.
Caregivers often provide health-care-related assistance with medications, skin and wound care, blood pressure and blood sugar monitoring and other duties that would commonly be performed by a nurse. Caregivers also commonly assist with navigating our complex health-care system, from managing the schedule of medical appointments and tests to facilitating communication between patients and their medical providers.
The economic impact of family care-giving services has been estimated to exceed $500 billion annually in the United States. Of equal importance, is the fact that the capacity does not exist in the form of community-based home health services and skilled nursing facilities to accommodate the volume of dependent care provided to those disabled from acute and chronic disease.
There are illnesses for which caregiving is essential, such as dementia, advanced stage cancer and many terminal illnesses. It is notable that home-based hospice services targeting comfort management for the terminally ill require the availability of a home caregiver who receives training and support to provide the minute-to-minute care that is typically required. The result is enhanced quality of life and enhanced dignity for the dying patient.
Caregiving brings little reward beyond the satisfaction of providing a needed service to a loved one. Yet caregiver stress is common and can itself lead to anxiety, depression and ill health. This is especially challenging given the strong emotional ties between caregivers and those whom they serve commonly a parent, spouse or child. This is why many communities have developed respite programs to allow caregivers to recharge for their important role.
Hats off to all caregivers whose efforts enhance the health, well-being and dignity of so many members in our community.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Health Center in Towaoc.