00061 Tiredness Of The Caregiver Role

Domain 7: role/relationships
Class 1: caretaker roles (a)
Diagnostic Code: 00061
Nanda label: tiredness of the caregiver role (a)
Diagnostic focus: Fired Role
Approved 1992 • Revised 1998, 2000, 2017 • Level of evidence 2.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « tiredness of the caregiver role (a) is defined as: difficulty satisfying responsibilities for care, expectations and/or behaviors required by the family or significant people.

Definite characteristics

Care activities

  • I suspend on the future ability to provide care
  • I suspend on the future health of the care receiver
  • I suspend on the potential institutionalization of the care receiver
  • I suspend on the well -being of the care receiver if the caregiver is unable to provide care
  • Difficulty completing the required tasks
  • Difficulty to perform the required tasks
  • Dysfunctional change in the activities of the caregiver (a)
  • Concern for care routines

Status of health career: physiological

  • Fatigue
  • Gastrointestinal discomfort
  • Cepaleas
  • Hypertension
  • Eruption
  • Express alteration of the sleep-vigilia cycle
  • Changes in weight

Status of health career: emotional

  • Depressive symptoms
  • Emotional lability
  • Express anger
  • Express frustration
  • Impatience
  • Insufficient time to meet personal needs
  • nervousness
  • Somatization

Status of health career: socioeconomic

  • Alteration in leisure activities
  • Isolation
  • Low labor productivity
  • Reject professional promotions

Caretock-Receptor Relationship

  • Difficulty watching the care receiver with a condition
  • Sadness related to the alteration of interpersonal relationships with the careful person
  • Uncertainty related to the alteration of interpersonal relationships with the careful person

Family processes

  • Family conflict
  • Concern report for family members

Related factors

Caregiver factors

  • Implications of contradictory role
  • Depressive symptoms
  • Inappropriate compliance with the expectations of others
  • Inappropriate compliance with personal expectations
  • Inappropriate knowledge about community resources
  • Inadequate psychological resilience
  • Inappropriate entertainment
  • Ineffective coping strategies
  • Inexperience in the role of caregiver (a)
  • Insufficient physical resistance
  • Insufficient intimacy
  • Not being in a development phase prepared for the role of the caregiver (a)
  • Physical problems
  • Social isolation
  • Stressors
  • Inappropriate use of substances
  • Non -realistic own expectations

Care Receptor Factors

  • High home with important care needs
  • Increase in care needs
  • Loss of independence
  • Problematic behavior
  • Inappropriate use of substances
  • Unpredictability of the condition of the condition
  • Unstable health status

Caretock-Receptor Relationship

  • Abusive interpersonal relationships
  • Codependence
  • Inadequate interpersonal relationships
  • Abuse not attended
  • Non -realistic expectations of the care receiver
  • Violent interpersonal relationships

Care activities

  • Change in the nature of care activities
  • Care responsibilities for 24 hours
  • Complexity of care activities
  • Excessive care activities
  • Expansion of the duration of care required
  • Inadequate assistance
  • Equipment to provide inappropriate care
  • Inappropriate physical environment to provide care
  • Rest for the caregiver (a) inadequate
  • Insufficient time
  • Unpredictable care situation

Family processes

  • Family isolation
  • INEFICA FAMILY ADAPTATION
  • Family dysfunction pattern
  • Family dysfunction pattern prior to the care situation
  • ineffective family adaptation pattern

Socioeconomic

  • Difficulty accessing assistance
  • Difficulty accessing community resources
  • Difficulty accessing support
  • Inadequate community resources
  • Inadequate social support
  • Inappropriate transport
  • Social alienation

Risk population

  • Care receiver with developmental disabilities
  • Caregiver (a) in charge of your partner
  • Caregiver (a) with disabilities of development
  • Women’s caregiver
  • People who provide care to premature infants
  • People who experience financial crisis

Associated problems

Caregiver factors

  • Deterioration of health status
  • Psychological disorder

Care Receptor Factors

  • Chronic disease
  • Cognitive dysfunction
  • Congenital disorder
  • Severity of the condition
  • Mental disorders

Suggestions of use

The tiredness of the caregiver role focuses on the cargo of the caregiver who has to assume the care of a relative. It can affect the physical and psychic health of the caregiver and the family. Family diagnoses (family coping and interruption of family processes) focus on the family system and the way in which family functioning has been altered due to a stress factor. In these diagnoses, the stressful factor is not necessarily the obligation to take care of a relative. It should be differentiated between tired of the caregiver role and chronic affliction that caregivers can present when a loved one suffers a severe chronic disability. If the defining characteristics are not given, but the risk factors are observed, a risk of tiredness of the caregiver role should be used.

Suggested alternative diagnostics

NOC Results

  • Acting of the caregiver: direct care: personal and health care made by the caregiver to a member of his family
  • Acting of the caregiver: indirect care: planning and supervision of precise care for the family member, by the caregiver
  • Alteration of the caretaker’s lifestyle: important changes in the lifestyle of a family member for caring for the patient
  • Welfare of the caregiver: measure to which the state of health and the life circumstances of the primary caregiver is positively valued
  • Role performance: congruence of the behavior of the role of an individual with the expectations of the role
  • Relationship between caregiver and patient: interactions and positive links between the caregiver and who receives care
  • Caregiver Resistance: Factors that favor the continuity of the family caregiver for a long period
  • Role of parents: actions of parents aimed at providing the child with a physical, emotional and social constructive and parenting environment
  • Emotional health of the caregiver: emotional well -being of a family caregiver while attending a family member
  • Physical health of the caregiver: physical well -being of a family caregiver while attending a family member

Evaluation objectives and criteria

  • Experiences relief of the tiredness of the caregiver role, demonstrated by an adequate level of emotional health, relationship between caregiver and patient, caregiver’s performance: direct and indirect care, physical health of the caregiver, well -being of the caregiver, role of the parents, and role performance
  • Demonstrates emotional health of the caregiver, which is manifested by the following indicators (specify from 1 to 5: severely, substantially, moderately, slightly or not affected):
    • satisfaction with life
    • Feelings of control and self -esteem
    • Perceived spiritual well -being
  • Demonstrates emotional health of the caregiver, which is manifested by the following indicators (specify from 1 to 5: severe, substantial, moderate, mild, none):
  • anger, resentment, guilt, depression, frustration, subjective overload and ambivalence with respect to the situation
  • Other examples

    The caregiver will be able to:

    • Verbally express that he knows the therapeutic regimes and procedures, the usual care and the care in case of emergency
    • Verbally express how to get and operate the necessary equipment and assistance
    • Verbally express that you feel supported
    • Express that you want to assume the caregiver role
    • Ensure that adequate care is provided
    • Achieve a balance between family and personal needs
    • Identify possible changes to relieve part of the overload and reduce stress factors
    • Identify and use personal strategies, social support and community resources

    NIC Interventions

    • Caregiver Support: Provide the information, aid and support necessary to facilitate the fundamental care of a patient, made by someone who is not a health care professional
    • Support in decision making: provide information and support to a patient who is making a decision regarding their health
    • Help in paternity: provide information, support and coordination of all services to high -risk families
    • Consultation: Use the knowledge of experts to work with those who seek help to solve problems, so that people, families, groups or institutions can achieve the objectives set
    • Care to give a break: to supply care in the short term to relieve the cargo of the caregiver
    • Teaching: prescribed diet: prepare a patient to correctly follow the prescribed diet
    • Teaching: Individual: Planning, implementation and evaluation of an educational program designed to address the specific needs of a patient
    • Teaching: prescribed medication: prepare a patient to correctly take prescribed medications and monitor their effects
    • Teaching: disease process: patient assistance to understand information related to the process of a certain disease
    • Attachment promotion: Facilitate the development of the parents/infant relationship
    • Anticipatory Guide: Prepare a patient for a situational or development crisis that is coming
    • Energy management: regulate the use of energy to treat or prevent fatigue and optimize operation
    • Nutrition management: help or provide a balanced diet in food and liquids
    • ROLES IMPROVEMENT: Help a patient, their family and nearby people, to improve relationships, clarify and explain concrete behavior of role performance
    • Improve coping: help the patient adapt to the factors of stress, changes or threats perceived, which interfere with the satisfaction of the demands and the roles of life
    • Orientation on the health system: facilitate a patient to locate and use the appropriate health services

    Nursing Activities

    In general, nursing activities for this diagnosis focus on evaluating contributing factors, giving encouragement and emotional support, helping the family to make a realistic assessment of the situation, as well as teach and derive when necessary < /p>

    Valuations

    • Find indicative signs of negligence or physical or emotional abuse in the person who receives care
    • Looking in the caregiver signs of tiredness of the role (for example, depression, anxiety, greater consumption or abuse of alcohol and drugs, frustration, despair, insomnia, demoralization, physical or emotional exhaustion, and personal health problems) Ly>
    • Evaluate the effect of responsibilities for care on personal and family life
    • (NIC) support the caregiver.
      • Determine the scope of the caregiver’s knowledge
      • Determine the acceptance of the caregiver role
      • Monitor possible family interaction problems related to patient care

    Patient and family education

    • Recognize and teach that caregiver’s work is both physical and mental and that includes (Bowers, 1987):
      • Anticipation of care (making decisions based on possible future needs of the patient, for example, place of residence)
      • Instrumental care (direct care, manual)
      • Preventive care (actions aimed at preventing diseases, injuries or complications; for example, changing the physical environment, preparing food)
      • Protection care (protect the patient from threats to their image, identity and change in the relationship with the caregiver)
      • Supervision care (plan and monitor care; for example, arrange appointments, get transport)
    • Facilitate coping and adaptation, teaching the caregiver and the patient how to do it (Chilman, Nunnally and Cox, 1988):
      • Manage pain, inability and symptoms of the disease
      • Bewords with the hospital environment, medical treatments and disease -related procedures
      • Establish and maintain a functional relationship with the health team
    • (NIC) support the caregiver.
      • Teach the stress management techniques
      • Instruct the caregiver about the grieving process

    Collaboration activities

    • Refer if necessary to orientation and support groups in moments of stress or crisis
    • Derive to obtain the necessary help with preventive, instrumental and supervision care (for example, Association of Home Nurses, care to give a break, residences, day centers, secondary caregivers)
    • Communicate to the authorities if there are signs that the patient is a victim of negligence or physical or emotional abuse

    Others

    • Help the caregiver identify problems or concerns regarding care (for example, lack of knowledge, skills and emotional disposition for care; lack of social support; economic loads; problematic behaviors; increasing need for physical care)
    • Prepare a care plan with the caregiver, to identify coping mechanisms, personal strategies, social support and recognized limitations. Consider the possibility of including:
      • Help for domestic tasks
      • Family therapy
      • Self -help groups and mutual support to receive information, help and emotional support
    • Explore with the caregiver the possibility of seeking institutional help (at that time or in the future) and the feelings associated with the admission to a hospital
    • Explore with the caregiver and the patient his previous and current level of closeness, the activities they share and mutual trust, as indicators of investment and emotional commitment to the role of caregiver
    • Facilitate the adaptation of the family to the disease of one of its members helping them (Chilman, Nunnally and Cox, 1988):
      • Be flexible with respect to future objectives
      • Prepare the duel for the loss of family identity prior to the disease
      • Maintain a sense of control over their lives
      • Achieve acceptance of changes
      • Cooperate in acute crises
    • Validate the feelings of the caregiver
    • (NIC) support the caregiver.
      • Accept the expression of negative emotions
      • Act as a caregiver if overload appears

    At home

    • In all visits, evaluate the quality of borrowed care and the quality of the careful-patient relationship. This includes assessing the caregiver’s skills and abilities to provide care
    • Derive to home health services to achieve home help for daily activities and domestic tasks
    • Explore the need for a day care for adults, if necessary
    • Monitor a possible worsening of the patient that may require hospitalization
    • Assess patient safety at home

    Babies and Children

    • Assess parents’ knowledge about child’s disease and the care they need
    • Provide what is necessary for parents of children with chronic diseases to receive training in areas of child education and development, as well as about behavioral problems related to accession to treatment
    • Encourage parents to meet the needs of healthy brothers (for example, they could feel angry, embarrassed or jealous of the care that the sick brother receives)
    • Suggest ways of helping the brothers adapt (such as including them in family decisions whenever possible, continue performing the usual family routines, spend time only with them, and encourage them to do activities with their friends) < /li>

    Older people

    • Look for signs of depression in the caregiver
    • Maintain the greatest possible congruence among caregivers, but dividing the workload among family members to prevent the overload of the main caregiver
    • Value security needs