Tuesday, 5 September 2017

THE REAL COST OF CAREGIVER EXHAUSTION



A new University of Michigan study suggests that tired family caregivers are associated with more frequent ER visits and higher overall health care costs for the person they care for. 

Emergency room staff call this 'Pop drop' - when medical staff sense that the real reason for the hospital visit is hope for an in-patient stay and respite for the family. 

That's a harsh and unfair judgement on caregivers. And to me, it's one that reveals the disconnect between health care systems and families. Caregivers are working way too many hours without oversight or relief and often, we are dangerously exhausted. 

There are laws against excessive overtime hours for truck drivers and health care workers. And those laws exist to protect employees as well as their potential victims should functional capacities on the job be compromised by severe exhaustion. But there are no laws against exceeding maximum overtime hours worked by family caregivers. So when we need a break because we know that errors will occur in our caring or we will suffer illness from fatigue, we take the only responsible action available: we bring our loved one to the ER.

It amazes me how little health care providers know about the daily life of caring, the tasks we perform and the daily waking hours that are required to do our job well. But the costs of sleep deprivation are high. In my family, our son requires frequent repositioning for pain, nighttime tube feeds and medications as well as seizure and apnea monitoring and management. In the 23 years we cared for him at home, we had a monitor which beeped if our son momentarily stopped breathing - that sound cue sent us running to his room to rub his cheek or tilt his chin down to reset respiration. 

The cost of so many sleepless nights in our family: many minor car accidents with dented fenders, medication errors, frequent bouts of crying, a short temper with my husband and daughter, diminished awareness of the world around me and other peoples' feelings, and almost worst of all - no laughter. Nothing is funny without sleep. 

This University of Michigan study found that the measurement of fatigue, which can result from both the strain of caregiving and poor sleep, was clearly associated with both higher rates of emergency department visits and higher overall health care costs. That's a very good reason to use this evidence to better support exhausted caregivers in the community. 
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