Your world with Dr. Beatrice Hyppolite
Hello,
I am Dr. Marie Beatrice Hyppolite. I hold a doctorate in Health Science with emphasis on Global Health and master’s degree in social work. I have over 14 years of experience in the field of health and human services.
This podcast is primarily focused on mental health and the quality-of-life elements that affect it such as divorce, death, domestic violence, trauma, toxic relationships, and single parenthood to name a few. It is no secret that mental health challenges continue to profoundly impact modern society although not enough discussion is given due to stigma. Research has shown an increase of 25 % in mental health crises after COVID-19. It is important to have honest, uncomfortable conversations about mental health while being supportive. Although we are interdependent, change begins with the individual, hence “your world.”
I welcome you to join me on my journey and look forward to your responses.
Your world with Dr. Beatrice Hyppolite
Caregiver Burnout: The Silent Crisis
The emotional and physical toll of caregiving remains largely invisible in our society, yet affects millions of Americans who find themselves responsible for aging parents, chronically ill spouses, or disabled children. This powerful conversation exposes the hidden realities of modern caregiving and offers practical guidance for both caregivers and the professionals who support them.
Dementia caregiving presents particularly profound challenges, as caregivers simultaneously manage daily care while grieving the gradual loss of the person they love. The scope of caregiving has expanded dramatically beyond companionship and basic assistance – family members now routinely perform complex medical procedures like administering injections, managing feeding tubes, and even giving intravenous medications. This medical responsibility creates significant stress and anxiety, especially during nighttime emergencies or complications.
Healthcare providers can play a crucial role in supporting caregivers through validated assessment tools that measure caregiver burden. These assessments can identify dangerous levels of stress requiring immediate intervention, whether through respite care, mental health services, or additional assistance. Faith communities, local organizations, and better family communication all serve as vital resources for overwhelmed caregivers – yet many struggle to ask for help, viewing it as personal weakness rather than necessary self-care.
The conversation highlights the profound relationships that develop between patients and both family and professional caregivers. These bonds often transcend traditional boundaries, creating family-like connections that benefit patients tremendously while also requiring emotional support for caregivers, particularly after patient loss. Simple strategies like journaling, short breaks, and honest communication can make a significant difference in caregiver wellbeing.
Whether you're currently caring for someone, supporting a caregiver in your life, or working in healthcare, this episode provides essential insights into caregiving's challenges and rewards. Share your caregiving story with us or let us know which strategies have helped you maintain balance while caring for others.
Hello everyone. I'm Dr Beatrice Ippolit and this is your World.
Speaker 2:So, as I mentioned, dementia is one of the big ones, right? I mean, if you're taking care of somebody who has the cognitive skills to understand you and listen and you can, you know, engage in problem solving together, that's obviously better. But when there's dementia involved, it's often deteriorating, the person's deteriorating too. It can be very, very frustrating for the caregiver to watch, and they're also grieving. They're grieving for the loss of this family member too, because they're now no longer the same person. So dementia is particularly difficult.
Speaker 2:But there are a lot of other situations too where caregivers are doing actual medical procedures, medical where they actually have to do a lot of medical care, give medications or give injections. Or I even know one caregiver who got trained how to give her mom IVs, you know. So there's a lot of situations now where caregivers are doing something that may have been done in the past by a nurse or you know, clinic. Now they're doing things at home feeding tubes, giving medication through injection or through the tube or whatever. So there's a lot of caregivers are not just making sure the family member's safe and clean.
Speaker 2:They're also doing actual medical procedures or medical care. So that's another type of caregiver. So they get trained and you know they get trained by the hospital or trained by the provider, but then they're on their own right. So I like to think the agency that I work for, the agencies I have worked for like we're there to support somebody like that, to make sure we give them a break. We come in and do some of these things. You know the nurses come in and help because that's a huge responsibility.
Speaker 1:It is. But you know what I think you know because I'm not in the field. I probably will be scared. You know to do certain things that I know that nurses normally do.
Speaker 2:And I think it could be very rewarding for a caregiver to get that experience and be able to accomplish this and be able to do it right. But often they get incredibly burdened by that and also the stress of what if I'm doing it wrong.
Speaker 1:Yeah, that would be my situation. The fear in the middle of the night there's nobody here but me.
Speaker 2:Those situations, you know, adds another layer of stress to the caregiver.
Speaker 1:You know, according to research, stress and anxiety are a big component among caregivers.
Speaker 2:Yeah, and there are some assessments that any provider can do, whether you be a social worker, occupational therapist, physical therapist, nurse.
Speaker 2:There are some assessments you can do on the caregiver to measure their, their, stress okay, so let me know there's three different that I found that are available online so you don't have to, like you know, pay for it or go out and get certification or whatever. But the most famous one is by Zaret the burden interview. So it started off with a longer 29 in 1980, but they've reduced it down to 22 questions and they even have a shorter version. So if you're not able to sit and spend a lot of time with the caregiver, they do. They do have some shorter ones. There's also one that's developed by the American Medical Association that you can find on their website the caregiver self-assessment questionnaire. Again a bit shorter 18 questions.
Speaker 2:So these are really good tools for you to really show the caregiver that. Number one you care and they're important, you want to help them. Number two, to look for red flags like is this caregiver stress, like on the highest level, then maybe they need some intervention, like very quickly. It's either immediate help for the, for the caregiving, or some, you know, mental health services, some way for them to to reduce their dangerously high stress level. So I definitely recommend that if you're working with caregivers, that when you get the chance, if you see that their burden and their stress level.
Speaker 1:To do one of these assessments short or long and, based on the result, to strongly encourage them to take action.
Speaker 2:Yes, and when you do these assessments with them, you're asking them the questions and you're scoring it, you do these assessments with them, you're you're asking them the questions and you're scoring it right there with them and you're showing them. You know, you're all. You know this is from zero to four and you've got most of your questions are answered before you know. You can even show them. This is, this is not, this is not good, this is. You know you're very much at risk, risk, but obviously you want to develop that. There's one of them. That's only four questions. So they've developed different ones.
Speaker 2:The Zaret, caregiver burden assessment. They've developed different lengths, obviously depending on how much time you have, how much time you can give the caregiver. So there's shorter ones and longer ones, kind of give you just a quick idea of what's really going on and then from there you can plan your interventions and bring in your social worker, recommend maybe mental health by telehealth, because they're obviously not going to be able to go out and go to see, most likely go out for counseling out of the home or out of the facility. But maybe they can have like telehealth, maybe help them connect them with mental health services.
Speaker 1:Pay, you know, for the therapies to come to your house too exactly, exactly.
Speaker 2:so really, if you see that very high level on your assessment, you need to notify your, obviously, your, your other members of the team. But you really you can't just sit back and say, oh you know, well, they've got a high stress level, Well, that's somebody else's problem, it's it's my problem. It's it's my problem. This is like 911. Like I've got to do something quickly. This could be an emergency.
Speaker 1:Yes, yes, definitely.
Speaker 2:Yeah.
Speaker 1:So, Dr Sheila, there's some of the risk factors if we were to consider lack of support.
Speaker 2:Right Lack of support, where they're not engaging or linked in with organizations that can help them, and maybe there's a lack of trust. But if you develop the trust with them and you know good organizations, you can lead them there. Once you've got the trust, I know this agency, I know they're very good, I know this place over here can help you. Another thing is to try to connect them maybe with the community resources that they do know they do have. Churches are a big one. Yes, I'll ask them is there? Did you get support from your church, from your synagogue? Um, you know, from your mosque, like from your you know what?
Speaker 2:especially if I'll be paying attention in the house to see any religious um, religious, you know things in the house. Also, you know, if they have things from the church, I'll be like, oh, you belong to such and such a church and say, have you had any support from the church? Well, no, I haven't called the priest, I haven't let them know, I haven't. They offered to come but I didn't. I didn't call them back. Why don't you call them back? Why don't you let them come and bring you meals, bring you support, help you with transportation? A lot of churches have volunteers that would be happy to drive people to appointments or bring some food, or, you know, or just even come for a visit. You know, if it's you know Catholic church or the Episcopal church that I belong to, they'll bring communion. You know they'll come and sit. Could be a lay person that will bring. These are really good resources. Or again, maybe other community organizations.
Speaker 2:Well, that's always the hot issue, right, you have the situation where you might have one adult child that's taking care of mom or dad, and then the other adult children are other way, other places in the country or not, or they're busy, they're not helping. So it even makes the caregiver's job even worse because they're annoyed that they're not getting support. So, working with them on how to communicate with the other family members and let them know I need help One of the biggest things I think about all of these caregivers is just encouraging them to ask for help. Yeah, I'm not doing well, you think I'm doing great, but I'm burning out.
Speaker 1:Yeah, sometimes people tend to believe oh, if I ask for help, so I may be seen as being weak or helpless. No, if you are in need for help, just ask for it, absolutely, because you know, so I may see you. You look okay, but deep down I don't know what you are really dealing with. But you know it, you know yourself, you know your body. So if you have the need and you feel that you need assistance, go out there and ask for it.
Speaker 2:That's what I feel it's so important to develop that relationship with the caregiver. Important to develop that relationship with the caregiver. Even in the beginning. They might be a little bit defensive or private, or maybe they are proud of what they're doing and they really are doing a good job, but it's starting to take a toll on them. But you're just watching for the signs and developing that relationship. Show them that you want them to be a part of the care plan. You want them to be involved. That's another important thing anyway, because if you're going to make recommendations for the client, the caregiver has to be on board. So making sure you include them in everything. So if you're discussing something with the client like in my case, I might be discussing a piece of equipment or home modification for something they're going to change in their home I want you to also what do you think? What are you, you know? Do you agree with this? I want to hear your opinion.
Speaker 1:Bring the caregiver in on that as well because that person is the one dealing with the patient on a daily basis, and I will even do that a lot with paid caregivers.
Speaker 2:So there'll be, you know, a lot of my clients have 24 hour or, you know, many hours a day with the one caregiver or two caregivers. What do you think? Do you think this will work? Are you in? What do you think about this idea? Or do you? You know, how do you find things are going? I always ask them, ask their opinion. Most recently, a caregiver I never even met her before and I went in to see the client. She's like oh, help, help, I need help. This she's having a problem with her skin pressure pressure area. Like she was so glad to just have somebody to tell she was very worried about it and she wanted to share. And are you going to do something? Yeah, I'm going to do something right away. I'm going to get a better cushion, a better bed, thank you, thank you, I'm. I'm just she was actually very anxious, so really worried about the client. So again, just paying paying attention to having conversations with them.
Speaker 1:I like when you say that she was really paying attention to the patient. Yeah, Believe it or not, you know there are some caregivers who treat their clients as family.
Speaker 2:I know it's wonderful to see and I always encourage people who are afraid of hiring a caregiver. Oh, I can't, I can't have a stranger taking care of my mom. I was like start interviewing people, start finding, start getting getting some people from the agency to come or from another agency. Whatever agency you want to use, I guarantee you're gonna find that right person.
Speaker 2:I'm gonna and that person is gonna become a part of your family. I'm good cuz, without a doubt. They keep. They might not be the first person they have or the second person, but they will find somebody that will become a great caregiver. But they have to have patience and they have to try. You can't just say nope, there'll never be anyone that's going to be as good for mom dad as me. You know what You're burning out and you have to find somebody.
Speaker 1:Let me tell you I'm gonna share this with you Made. All her soul was in peace. That lady, before she die, had a caretaker. I don't know for how long, but they created such a healthy bond. It was unbelievable. During COVID so it's like you know the family decided that you know what it was scary due to her health condition. They didn't want to bring people around.
Speaker 2:They didn't want company. Everybody was afraid to have people come in and out.
Speaker 1:Exactly, and for the fact that you know so, you know in New York. So it's like the government pay, you know, can pay family members to take care of their loved ones. So somebody came with the idea for the daughter, who used to live at that time in the same building as her, to kind of take on the position. To make a long story short, bear in mind the daughter, every day, will go to her mother's house, you know, like more than once or twice a day. And when the idea of her taking the job came on the table, she's like are you guys crazy? If I send that lady out, my mother will die, because it's not a caretaker and a patient, it's a mother-daughter relationship that I've seen going on between those two. Yeah, and the daughter didn't take the job, said no, we're gonna manage what was best she exactly and she probably also knew her own limits too.
Speaker 2:Like we all should, you know, know our limits. We're not always good at that, especially health providers. We think we could do it all, work and take care of everyone, but you have to know your limits and you have to put your hand up and say that's not for me.
Speaker 1:But she understood the relationship that her mother had with that home attendant right she understood and appreciated and valued and say you know what right and she knew and you know what there was. But she went and took on and say you know what Right, she knew what was possible and you know what there was parts. She went and took on the same job you know, with somebody else but because she saw the relationship that her mother had with her caretaker, she didn't want to get on the line.
Speaker 2:You didn't want to mess that up, no, which I always do. Encourage people, I'll say you know, let's start with a home health aide. Encourage people, I'll say you know, let's start with a home health aide, let's start with a couple hours a day. I don't usually recommend people because it's always difficult. You know, you should always try to keep your boundaries, like I might come across people over the years say, oh, if you know anyone you know, give them my number and stuff like that. But I'll encourage people to go through the agencies or other agencies because a lot of agencies out there now and just keep, you know, keep trying to you find the right person, you will find the right you will buy the white because there's there's good people out there that are really caring and they will be like family exactly, and they will be like family and you will be surprised.
Speaker 1:So it's like I understand we all go to work for the money, but there are people who don't make money their priority business, exactly. There are people who go who will go to those people house, will care for them and will invest in them.
Speaker 2:I've seen it yeah, absolutely yeah, and they'll be like family by the end and it can be really hard for them that caregiver when they lose the client the client passes away, whether it be a child who's very sick or adult it can be really, really difficult for them. So I've often met with caregivers or called them afterwards to say how are you doing? We just lost a client in 23 who I've been seeing for probably two years, who had a wonderful person from Haiti, young woman. She was young, she was only in her early twenties, she had little kids, but she came every day while the client's spouse was at work and she was. They just had such a good relationship while the client had Parkinson's and some other issues and they ended up in the hospital very ill and unfortunately never recovered and passed away in the hospital and I called her for several weeks just to see how she was doing.
Speaker 2:She was devastated, devastated. They were like friends, you Like. They became so close like daughter, mother, and the patient's daughter also got along very well with this caregiver. She lived a little way away. They just they kept the connection, they kept in contact and it can be really important to make sure that caregiver is okay after losing, whether it be a family, caregiver or unpaid. Make sure they're okay.
Speaker 1:Check in with them.
Speaker 2:Yeah, yeah Because they can be very attached, oh yeah. And now they are like what am I going to do?
Speaker 1:Oh yeah, and that lady that I was talking about earlier when she passed away last year, and that caregiver, that lady was crying so hard at the church. Somebody even asked oh, is she one of the daughters?
Speaker 2:yes, and she was.
Speaker 2:In the end she was and I turned around and I said yes it's wonderful it's wonderful to see that relationship I have had a couple of ALS clients which is, I think, for hardest. The hardest thing in my career is working with somebody with ALS ALS because typically they're younger and they're deteriorating quickly, you know. And one in particular I was very close with and his. When he passed away, his aid was there, his home health aid was there in the room with his wife and the kids. I had coffee with her two or three times after just to make sure she was okay, very traumatic and a big loss. And we're still in touch. On Facebook I notice that his wife posts things every now and again. This caregiver went on and got married and had kids, so she's moved in a different direction. I think she works at a hospital, but we still keep and every time the wife posts something about him and his memory, she's right on, she's right there and I'm there. We're still having the memories, you know.
Speaker 1:Okay.
Speaker 2:And it's been. It'll be six years, the end of this year. We're still in touch now.
Speaker 1:It is a very important topic and I'm glad that you were able to make it and have that discussion.
Speaker 2:Yeah, I think some of the things that you should just say to the caregivers you know, make sure you tell them to ask for help, maybe have them journal. You know, write things down. And you know, make sure they're taking care of their thoughts and writing things down if they can. And, you know, just tell them that they can make time for themselves, even if it's going for a walk for 20 minutes or going outside to sit outside or doing something that they can do.