Teaching Plan:Name: Angie WalkoszFamily Background: This family is located in North Phoenix. The mother, Linda, has a great relationship with her daughter, Anna, and one of her sons, Derek. Linda does not suffer from any chronic health problems. She did have surgery in the past, including a cholecystectomy and a hernioplasty. She is active.
Her occupation consists of her approximately walking 4 miles a day. Linda learns about her body and her health through her daughter, Anna. As a studying technique, Anna teaches her mother on different medical conditions. Anna suffers from asthma and hypertension.
She has a bronchodilator medication that she uses when she has an asthma attack, but does not take regular medication each day. She is not very active. She lives a very stressful life as she is balancing work and working to achieve her Master’s degree at a university to pursue a career towards healthcare. She is very familiar with the healthcare industry and is knowledgeable about the best practices towards maintaining a healthy lifestyle. Whenever Derek or Linda have any symptoms that are bothering them, they turn to Anna to determine the cause and severity.
Derek, one of the sons of Linda and Andrew, lives with Linda, Anna, and Andrew. Jerry, the other son, lives separately. Derek suffers from hypertension, similarly to Anna, and anxiety. He does not take regular medications, but involves therapies and non-pharmacological methods to reduce his high blood pressure and anxiety, such as meditation and other relaxation techniques. Andrew, the father of the family, suffers from multiple health conditions. He is diagnosed with Type 2 diabetes mellitus, liver failure, congestive heart failure, gallstones, and possible dementia. He takes more than 10 medications every day. He does not attend regular doctor appointments.
Andrew does not have health insurance and believes that the hospital and healthcare team are greedy and want to receive money without treating him appropriately. Andrew’s personality is described as disrespectful, loud, and inconsiderate. In addition to his medical conditions, Andrew currently has two very large diabetic wounds on his lower leg due to his inability to control his blood sugar levels. Anna and Linda have switched to change Andrew’s dressing and clean his wound every day. They are mentally and emotionally exhausted with being the active caregivers towards Andrew’s wounds.
According to Anna, “My father is disrespectful. He won’t thank us after we are done cleaning his wound. Sometimes, there have been times where me and my mom have declined cleaning his wound for him just because he’s so mean to us. He has no respect for anybody”. Upon visualization of the genogram and the ecomap, it is seen that Linda, Anna, and Derek have a strong relationship amongst each other. Andrew does not get along with the rest of the family members.
Regardless of Anna’s background, her father is very stubborn and reluctant to her advice and opinions. Very little information was given on the other son of Linda’s and Andrew’s, Jerry. He does not live in the household and does not talk regularly to anybody in the family. He currently works as a sales associate and lives in an apartment. No information was given on Jerry’s health status. There seems to be a health problem of Caregiver Role Strain, as Andrew seems to not care about his health, whereas Linda, Anna, and Derek are exhausted having to take care of his health for him.
The environment in the household is not adequate, as there is an additional stressful aura and continuous tension. Goal Statement: Improve, increase, reduce a health practice or behavior Andrew and his family will improve their family dynamic within the household, while encouraging Andrew to be an active participant in his own plan of care eliminating the health problem of caregiver role strain among the family members. Learning needs assessed:Andrew – There is inadequate knowledge and education on his medical conditions. With a possible diagnosis of dementia, Anna has said that she tries to educate her father, but feels she is being repetitive with the information in addition to their unstable relationship. He did not finish high school and did not continue to achieve his GED.
Main person to have continuously re-assessed for learning. Anna – Anna has very strong knowledge on her father’s health conditions. She is a first generation attending college. She is continuing her education further towards healthcare. She knows what needs to be done to help her father’s overall life, but will not continue to help if her father does not care about his own health. Stated “If he doesn’t care, why should we care for him?”Linda – Linda has pretty adequate knowledge on her husband’s problems. She is educated continuously through her daughter, Anna.
She has similar feelings as Anna towards Andrew. She is very exhausted with caring for him. Her knowledge is dramatically higher than Andrews.Derek – Derek has the same knowledge as his mother. They are both educated by Anna. He does not have a career in healthcare. He might need additional learning, but minimal.
Objectives Content Outline Method and Activities Resources, Teaching materials Evaluation PlanAndrew (target audience) will verbalize a brief understanding of all his medical conditions and his treatment plan (do what) by the end of the week following the lesson (by when).The family (target audience) will identify at least 2 (how well) resources available to benefit them in offering care to Andrew (do what) by the end of the week following the lesson (by when).Andrew (target audience) will demonstrate at least 3 (how well) effective lifestyle changes to meet self-care needs (do what) by the end of the lesson (by when).The family (target audience) will communicate low or no (how well) feelings of burden or hardship by Andrew (do what) by the end of the week (by when). Teaching Content Includes:The nurse will educate Andrew on Type II diabetes mellitus.
Major details will be given to provide background of how the body is not producing enough insulin. Micro- and macro- vascular related complications will be discussed.The nurse will educate Andrew on the reason for all his prescribed medications and any side effects or possible adverse effects to recognize.
The nurse will educate Andrew on the causes of his liver failure, in relation to his alcoholism, and provide a list of techniques to stay sober from alcohol and the immediate effects of sobriety.The nurse will recommend the use of available community resources, such as assisted livings or home health aid services that might be available for the entire family. The nurse will aid each family member by individual therapy for the management of stressof caregiving.The nurse will collaborate with a social worker for additional resources to further aid.The nurse will increase every family member’s knowledge of caregiving strategies to improve Andrew’s and their own quality of life.The nurse will encourage Andrew to show gratitude and thankfulness to the rest of the family members when care is being given.The nurse will recommend to Linda, Anna, and Derek a local support group to manage their role strain and search for opportunities from other people and their individual stories and experience.
The nurse will teach Linda and Anna about making their own health and wellness a priority to avoid future or current stress issues in their own lives.The nurse will educate Linda and Anna on different strategies and techniques to maintain their own health, such as getting adequate sleep, enjoying their own hobbies, or eating healthy. The nurse will incorporate cognitive-behavioral therapy to Andrew and help with restructuring his current beliefs and thoughts on his plan of care. Method: Print MaterialsActivity: For Linda, Anna, and Derek to complete the caregiver self-assessment questionnaire and MCSI found in the 4th column. Method: DemonstrationActivity: The nurse will educate Andrew on proper wound dressing changes on one wound. Andrew will safely demonstrate how to change own wound dressings without further contamination on his second wound. Method: Teach-backActivity: After the nurse properly educates on the risks associated with caregiver role strain, the nurse will allow the family members to re-educate the information back to the nurse by answering several questions that were mentioned in the lesson. The nurse will correct any spoken errors if needed.
Method: Video Activity: The nurse will show all the family members, specifically Andrew, a 2:15 minute video on the importance of being an active participant. Assessment Tool For Caregiver Role Strain: (to be completed by nurse to assess Anna, Linda, and Derek) HYPERLINK “http://www.csicaregiver.com/blog/5-signs-of-caregiver-burnout-and-how-to-avoid-it/” http://health.umt.edu/ipharm/Documents/Assessment%20of%20Caregiver%20Strain%20IPHARM%20FINAL2.pdfSigns of Caregiver Burnout: (teaching material)http://www.csicaregiver.
com/blog/5-signs-of-caregiver-burnout-and-how-to-avoid-it/Caregiver Self-Assessment Questionnaire: (to be completed by Linda, Anna, and Derek) HYPERLINK “https://www-tc.pbs.org/wgbh/caringforyourparents/handbook/pdf/cfyp_self_assessment.pdf” https://www-tc.pbs.org/wgbh/caringforyourparents/handbook/pdf/cfyp_self_assessment.
pdfSupport Group Finder: (teaching material for family) HYPERLINK “http://www.pbs.org/wgbh/caringforyourparents/handbook/caringcaregiver/supportgroups.html” http://www.
pbs.org/wgbh/caringforyourparents/handbook/caringcaregiver/supportgroups.htmlANDhttp://azcaregiver.org/Teaching material to use frequently through lesson: (for Linda, Anna, and Derek)https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/caregiver-stress/art-20044784Modified Caregiver Strain Index: (for family members)https://consultgeri.
org/try-this/general-assessment/issue-14.pdfVideo: (Information that is easy to understand in video format for all family members)https://www.youtube.com/watch?v=rO3fOTGCeEwAndrew did verbalize a brief understanding of all his medical conditions. Some further education needed to be said to fully understand. There were some discrepancies, but were corrected.
Objective was met.The family did identify at least 2 resources available to benefit them. They recognized a home health aide company that is available to come assist in Andrew’s care. Derek was active in finding support groups that were locally to their neighborhood. Objective was met.Andrew demonstrated 2 lifestyle changes, stating that he would join his wife in exercising regularly and verbally agreed that he will routinely take his medication daily without skipping a day or a dose.
He has no desire to stop drinking and stated that him drinking would be effective personally for him. This is considered an ineffective lifestyle change. Objective was partially met. The family communicated lower feelings of burden on Andrew.
They were motivated to encourage Andrew and help with his cleanings as long as there was gratitude shown by Andrew continuously. Andrew had shown an increase in interest in his lifestyle, which was something that made the family members happier and thankful. Objective was met. References:Friedemann, M.-L., & Buckwalter, K. C. (2014).
Family Caregiver Role and Burden Related to Gender and Family Relationships. Journal of Family Nursing, 20(3), 313–336. http://doi.org/10.1177/1074840714532715Gordon, J., Pruchno, R., Genderson, M.
, Murphy W., & Rose, M. (2012). Balancing Caregiving and Work: Role Conflict and Role Strain Dynamics. Journal of Family Issues.
33(5), 662-689. doi: 10.1177/0192513X11425322. Honea, N., Brintnall, R., Given, B.
, Sherwood, P., Colao, D., Somers, S., & Northouse, L.
(2008). Putting Evidence into Practice: Nursing Assessment and Interventions to Reduce Family Caregiver Strain and Burden. Clinical Journal of Oncology Nursing. (12)3. Retrieved from https://cjon.ons.org/cjon/12/3/putting-evidence-practice%C2%AE-nursing-assessment-and-interventions-reduce-family-caregiver/html/fullHsin, L., Ching, Y.
, Yu W., Wen, H., Tzu, H., Yueh, L., Chin?Yi, L. & Yea?Ing S.
(2017). Balancing Competing Needs Mediates the Association of Caregiving Demand with Caregiver Role Strain and Depressive Symptoms of Dementia Caregivers: A cross?sectional study, Journal of Advanced Nursing, 73, 12, (2962-2972).Parks, S.
& Novielli, K. (2000). A Practical Guide to Caring for Caregivers. American Family Physician. (12): 2613-2620.
Retrieved from https://www.aafp.org/afp/2000/1215/p2613.
htmlReinhard SC, Given B, Petlick NH, et al. Supporting Family Caregivers in Providing Care. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Agency for Healthcare Research and Quality (US); 2008 Apr.
Chapter 14. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2665/Schulz, R., & Sherwood, P.
R. (2008). Physical and Mental Health Effects of Family Caregiving. The American Journal of Nursing, 108(9 Suppl), 23–27. http://doi.org/10.1097/01.NAJ.0000336406.45248.4c