- Email: [email protected]
A commitment to professional caregivers
A Commitment to Professional Caregivers: The Rosalynn Carter Institute for Human Development Ronda C. Talley, PhD, MPH, and Shirley S. Travis, PhD, APRN, BC
When the term caregiver is used, one most often thinks about family caregivers and other informal providers of assistance to impaired individuals. The Rosalynn Carter Institute (RCI) is the only national institute or center to take a different approach to addressing the needs of the nation’s caregivers and caregiving teams. The universal psychosocial difficulties and shared rewards associated with all types of caregiving shape the research, education, and advocacy agendas of the RCI, founded in honor of former First Lady Rosalynn Carter. This article provides an introduction to the work of the RCI that may be of interest to gerontologic nurse caregivers. (Geriatr Nurs 2004;25:113-114)
I
n 1987, the Board of Regents of the University System of Georgia established the Rosalynn Carter Institute (RCI) for Human Development on the campus of Georgia Southwestern State University to honor former First Lady Rosalynn Carter, an alumna. For decades Mrs. Carter has been known for her commitments to human development and mental health issues. Her own history as a family caregiver and her passion for supporting the work of caregivers were natural segues to what became the mission and focus for her institute. Under her leadership as president of the board of directors, the institute has become a beacon for caregiver advocacy, support, and education. The past 15 years at the Institute resulted in several programs of national prominence. Among them are educational programs and demonstration projects that focus on the universal psychosocial difficulties and shared rewards associated with caregiving and programs to support and educate caregivers. With the assistance of an advisory committee comprising nationally prominent experts and advocates whose foci encompass caregiving across the lifespan, the RCI is making a difference in the lives of caregivers and the care they give to others. As noted in the introduction to the RCI Web site, www.rosalynncarter.org: “There are just four kinds of people in the world—those who have been caregivers, those who are caregivers, those who will be caregivers, and those who will need caregivers.” Gerontologic nurses have no problem understanding this message. This article describes two caregiver education and support programs developed at the RCI and used by staff for March /April 2004
national caregiver audiences. Since the implementation of the U.S. Administration on Aging National Family Caregiver Support Program in 2000, a great deal of interest has arisen in educational interventions that enable caregivers to do their jobs well. The RCI programs “Caring for You, Caring for Me” and “Caring and Competent Caregivers: Professionals Helping Families” were designed to do just that. The programs are likely to be of interest to nurses, in particular, because they are among the nation’s frontline professional caregivers, work closely with family caregivers, and often carry the dual roles of both professional and family caregiver in their personal lives. A brief history and overview of each program are provided. More detailed information about these programs and other initiatives of the RCI can be found at the Web site. CARING FOR YOU, CARING FOR ME The first educational program of the RCI originated approximately 10 years ago as a result of a comprehensive 16-county needs assessment in Georgia and the mandate of the RCI advisory committee to focus on the universal needs of all caregivers, whether professional or family caregivers. No models were available for this type of program because caregiver education was—and largely remains—segregated programming for professional and family audiences. The desire to bring family and professional caregivers together for a shared educational experience is a cornerstone of this multisession program.1 “Caring for You, Caring for Me”2 includes 10 hours of instruction conducted in five sessions or modules that are recommended for weekly sessions over a 5-week period. Each session is designed to capitalize on the experiences of both professional and family caregivers. The program leader’s guide3 makes it abundantly clear that participants must have ample opportunity to share feelings, value the roles of all caregivers, and nurture trust among caregivers during planned periods of sharing and self-disclosure. CARING AND COMPETENT CAREGIVERS The second educational pillar of the RCI, “Caring and Competent Caregivers: Professionals Helping Families,” features a workshop based on work done at the RCI to understand the dynamics of caring and caring relationships. 113
In particular, the programs help participants understand who provides care and why.4 The full-day workshop is designed to inspire and educate professional caregivers and affirm their important responsibility to the nation’s family caregivers. Although its objectives are standard across all audiences, this program is built on a model of flexible programming in which different objectives can be stressed more heavily than others, depending on the audience’s needs and characteristics. For example, a group of highly experienced professional caregivers, such as those attending a preconference session at a professional meeting, may desire advanced assessment content. Another group of caregivers who are new to their roles may need more emphasis on interpersonal strategies for forming effective partnerships between professional and family caregivers. The Caring and Competent Caregivers program allows these varying emphases to be addressed. The workshop includes comprehensive information about the nature and scope of family caregiving and the concept of “caring” as used by staff at the RCI in their national agendas. Participants are given the opportunity to use the RCI Family Caregiver Assessment instrument, a tool to gather data about the individualized psychosocial aspects of a caregiving experience. It is designed to be administered face to face in a structured interview format with opportunities for the caregiver to expand on issues of greatest importance to his or her situation. The instrument includes a section on basic demographic information for the caregiver and care recipient and information about the situation. Most care managers can complete the entire assessment in about 1 hour. Participants also are given time to assess the extent of their own capacity for caring in their professional relationships and understand how lack of attention to their caring needs can contribute to professional burnout.
and the nursing profession are seen as key stakeholders and valued collaborators in this process. REFERENCES 1. Haigler D, Bauer L, Travis SS. Caring for you, caring for me: a 10-year caregiver educational initiative of the Rosalynn Carter Institute for Human Development. Health Social Work. In press. 2. Haiger D, Mims KB, Nottingham JA. Caring for you, caring for me: education and support for caregivers (participant’s manual). Athens (GA): University of Georgia Press; 1998. 3. Haigler D, Mims KB, Nottingham JA Caring for you, caring for me: education and support for caregivers (instructor’s manual). Athens (GA): University of Georgia Press; 1998. 4. Moroney RM, Dokecki PR, Gates JJ, et al. Caring and competent caregivers. Athens (GA): University of Georgia Press; 1998. 5. Partnership for Solutions. Chronic conditions: making the case for ongoing care. Baltimore (MD): Johns Hopkins Press; 2002. 6. Talley RC. The elderly and caregiving. Family Therapy 2002;16:17-9. 7. Travis SS, Piercy KW. Family caregivers. In: Lubkin IM, Larsen PD, editors. Chronic illness: impact and interventions. 5th ed. Sudbury (MA): Jones and Bartlett Publishers; 2002. p. 233-60.
RONDA C.TALLEY, PhD, MPH, is executive director of the Rosalynn Carter Institute for Human Development and professor at Georgia Southwestern State University, Americus, Georgia. SHIRLEY S.TRAVIS, PhD, APRN, BC, is Dean W. Colvard Distinguished Professor in the College of Health and Human Services of the University of North Carolina at Charlotte and immediate past president of NGNA. 0197-4572/$ - see front matter © 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.gerinurse.2004.01.009
CONCLUSION By all indications, the complexity of contemporary family caregiving is likely to extend well into the future.5 Empowering family caregivers to do their jobs well and work effectively with professional caregivers will be an important aspect of successful models for chronic care and long-term care.6-7 In addition, appropriately trained caring and competent professional caregivers will be necessary to maintain the quality and integrity of increasingly complex systems of acute, chronic, and long-term care. RCI staff are preparing for future trends and issues with a series of expert panels sponsored by a grant from Johnson & Johnson. These expert panels are helping the RCI create a long-term agenda that includes intergenerational issues, dementia care, needs of individuals with developmental disabilities, and caregiving across the professions. Always with an eye to the future, RCI staff are continuously updating and revising their caregiver educational programs to include new information. Nurses
114
Geriatric Nursing
Volume 25
Number 2
When the term caregiver is used, one most often thinks about family caregivers and other informal providers of assistance to impaired individuals. The Rosalynn Carter Institute (RCI) is the only national institute or center to take a different approach to addressing the needs of the nation’s caregivers and caregiving teams. The universal psychosocial difficulties and shared rewards associated with all types of caregiving shape the research, education, and advocacy agendas of the RCI, founded in honor of former First Lady Rosalynn Carter. This article provides an introduction to the work of the RCI that may be of interest to gerontologic nurse caregivers. (Geriatr Nurs 2004;25:113-114)
I
n 1987, the Board of Regents of the University System of Georgia established the Rosalynn Carter Institute (RCI) for Human Development on the campus of Georgia Southwestern State University to honor former First Lady Rosalynn Carter, an alumna. For decades Mrs. Carter has been known for her commitments to human development and mental health issues. Her own history as a family caregiver and her passion for supporting the work of caregivers were natural segues to what became the mission and focus for her institute. Under her leadership as president of the board of directors, the institute has become a beacon for caregiver advocacy, support, and education. The past 15 years at the Institute resulted in several programs of national prominence. Among them are educational programs and demonstration projects that focus on the universal psychosocial difficulties and shared rewards associated with caregiving and programs to support and educate caregivers. With the assistance of an advisory committee comprising nationally prominent experts and advocates whose foci encompass caregiving across the lifespan, the RCI is making a difference in the lives of caregivers and the care they give to others. As noted in the introduction to the RCI Web site, www.rosalynncarter.org: “There are just four kinds of people in the world—those who have been caregivers, those who are caregivers, those who will be caregivers, and those who will need caregivers.” Gerontologic nurses have no problem understanding this message. This article describes two caregiver education and support programs developed at the RCI and used by staff for March /April 2004
national caregiver audiences. Since the implementation of the U.S. Administration on Aging National Family Caregiver Support Program in 2000, a great deal of interest has arisen in educational interventions that enable caregivers to do their jobs well. The RCI programs “Caring for You, Caring for Me” and “Caring and Competent Caregivers: Professionals Helping Families” were designed to do just that. The programs are likely to be of interest to nurses, in particular, because they are among the nation’s frontline professional caregivers, work closely with family caregivers, and often carry the dual roles of both professional and family caregiver in their personal lives. A brief history and overview of each program are provided. More detailed information about these programs and other initiatives of the RCI can be found at the Web site. CARING FOR YOU, CARING FOR ME The first educational program of the RCI originated approximately 10 years ago as a result of a comprehensive 16-county needs assessment in Georgia and the mandate of the RCI advisory committee to focus on the universal needs of all caregivers, whether professional or family caregivers. No models were available for this type of program because caregiver education was—and largely remains—segregated programming for professional and family audiences. The desire to bring family and professional caregivers together for a shared educational experience is a cornerstone of this multisession program.1 “Caring for You, Caring for Me”2 includes 10 hours of instruction conducted in five sessions or modules that are recommended for weekly sessions over a 5-week period. Each session is designed to capitalize on the experiences of both professional and family caregivers. The program leader’s guide3 makes it abundantly clear that participants must have ample opportunity to share feelings, value the roles of all caregivers, and nurture trust among caregivers during planned periods of sharing and self-disclosure. CARING AND COMPETENT CAREGIVERS The second educational pillar of the RCI, “Caring and Competent Caregivers: Professionals Helping Families,” features a workshop based on work done at the RCI to understand the dynamics of caring and caring relationships. 113
In particular, the programs help participants understand who provides care and why.4 The full-day workshop is designed to inspire and educate professional caregivers and affirm their important responsibility to the nation’s family caregivers. Although its objectives are standard across all audiences, this program is built on a model of flexible programming in which different objectives can be stressed more heavily than others, depending on the audience’s needs and characteristics. For example, a group of highly experienced professional caregivers, such as those attending a preconference session at a professional meeting, may desire advanced assessment content. Another group of caregivers who are new to their roles may need more emphasis on interpersonal strategies for forming effective partnerships between professional and family caregivers. The Caring and Competent Caregivers program allows these varying emphases to be addressed. The workshop includes comprehensive information about the nature and scope of family caregiving and the concept of “caring” as used by staff at the RCI in their national agendas. Participants are given the opportunity to use the RCI Family Caregiver Assessment instrument, a tool to gather data about the individualized psychosocial aspects of a caregiving experience. It is designed to be administered face to face in a structured interview format with opportunities for the caregiver to expand on issues of greatest importance to his or her situation. The instrument includes a section on basic demographic information for the caregiver and care recipient and information about the situation. Most care managers can complete the entire assessment in about 1 hour. Participants also are given time to assess the extent of their own capacity for caring in their professional relationships and understand how lack of attention to their caring needs can contribute to professional burnout.
and the nursing profession are seen as key stakeholders and valued collaborators in this process. REFERENCES 1. Haigler D, Bauer L, Travis SS. Caring for you, caring for me: a 10-year caregiver educational initiative of the Rosalynn Carter Institute for Human Development. Health Social Work. In press. 2. Haiger D, Mims KB, Nottingham JA. Caring for you, caring for me: education and support for caregivers (participant’s manual). Athens (GA): University of Georgia Press; 1998. 3. Haigler D, Mims KB, Nottingham JA Caring for you, caring for me: education and support for caregivers (instructor’s manual). Athens (GA): University of Georgia Press; 1998. 4. Moroney RM, Dokecki PR, Gates JJ, et al. Caring and competent caregivers. Athens (GA): University of Georgia Press; 1998. 5. Partnership for Solutions. Chronic conditions: making the case for ongoing care. Baltimore (MD): Johns Hopkins Press; 2002. 6. Talley RC. The elderly and caregiving. Family Therapy 2002;16:17-9. 7. Travis SS, Piercy KW. Family caregivers. In: Lubkin IM, Larsen PD, editors. Chronic illness: impact and interventions. 5th ed. Sudbury (MA): Jones and Bartlett Publishers; 2002. p. 233-60.
RONDA C.TALLEY, PhD, MPH, is executive director of the Rosalynn Carter Institute for Human Development and professor at Georgia Southwestern State University, Americus, Georgia. SHIRLEY S.TRAVIS, PhD, APRN, BC, is Dean W. Colvard Distinguished Professor in the College of Health and Human Services of the University of North Carolina at Charlotte and immediate past president of NGNA. 0197-4572/$ - see front matter © 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.gerinurse.2004.01.009
CONCLUSION By all indications, the complexity of contemporary family caregiving is likely to extend well into the future.5 Empowering family caregivers to do their jobs well and work effectively with professional caregivers will be an important aspect of successful models for chronic care and long-term care.6-7 In addition, appropriately trained caring and competent professional caregivers will be necessary to maintain the quality and integrity of increasingly complex systems of acute, chronic, and long-term care. RCI staff are preparing for future trends and issues with a series of expert panels sponsored by a grant from Johnson & Johnson. These expert panels are helping the RCI create a long-term agenda that includes intergenerational issues, dementia care, needs of individuals with developmental disabilities, and caregiving across the professions. Always with an eye to the future, RCI staff are continuously updating and revising their caregiver educational programs to include new information. Nurses
114
Geriatric Nursing
Volume 25
Number 2