Thomas Jefferson University, Philadelphia, PA, USA.
Am Fam Physician. 2019 Jun 1;99(11):699-706.
Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase during the next few decades. Caring for loved ones is associated with several benefits, including personal fulfillment; however, caregiving is also associated with physical, psychological, and financial burdens. Family physicians can aid in the identification, support, and treatment of caregivers by offering caregiver assessments-interviews directed at identifying high levels of burden-as soon as caregivers are identified. Repeat assessments may be considered when there is a change in the status of the caregiver or the care recipient. Caregivers should be directed to appropriate resources for support, including national caregiving organizations, local elder care agencies, websites, and respite care. Psychoeducation, skills training, and therapeutic counseling interventions for caregivers have shown small to moderate success by decreasing caregiver burden and increasing caregiver quality of life. Additional research is needed to further identify strategies to offset caregiver stress, depression, and poor health outcomes. Support and anticipatory guidance for the caregiver is especially helpful during care transitions and at the care recipient's end of life.
目前,80%需要长期护理的成年人在社区的家中生活,而无薪家庭护理人员提供了他们 90%的护理。家庭护理人员是美国医疗保健系统的重要延伸,预计在未来几十年,对家庭护理人员的需求将会增加。照顾亲人与许多好处相关,包括个人成就感;然而,护理工作也与身体、心理和经济负担有关。家庭医生可以通过提供 caregiver 评估(旨在确定高负担水平的访谈)来帮助识别、支持和治疗 caregiver,只要识别出 caregiver即可。当 caregiver或护理接受者的状况发生变化时,可以考虑重复评估。应指导护理人员寻求适当的支持资源,包括全国护理组织、当地老年护理机构、网站和临时护理。针对护理人员的心理教育、技能培训和治疗咨询干预措施已显示出较小到中等程度的成功,降低了护理人员的负担,提高了护理人员的生活质量。需要进一步研究,以进一步确定减轻护理人员压力、抑郁和不良健康结果的策略。在护理过渡期间和护理接受者生命结束时,为护理人员提供支持和预期指导特别有帮助。