Driving Miss (or Mr.) Daisy

摘要

FROM MY OFFICE, I saw an unusual convoy passing through the hall. A middle-aged woman briskly pushed a wheelchair carrying an older man. Sitting straight up in the rolling chair, he kept a firm grip on the handle of a stroller he was pushing ahead of him. A toddler sat in the front row of this unique parade. Clearly, they were on a mission. Later I heard the woman say good-bye to an oncologist as he walked the multi-generational group to the elevator. The older man was the woman's father and the little girl, her 2-year-old granddaughter. She was the care-giver to her dad every day and to her grandchild while her parents were at work. I thought about how her morning must have started and how highly organized this family caregiver must have been to meet the needs of both her father and the toddler and to make this appointment. Now, when the older man was exhausted and the child cranky, she'd have to reverse the trip. She seemed to me the embodiment of those who care for both aging parents and children, and sometimes grandchildren as well. Like the woman in the hallway, many family caregivers find themselves "driving Miss (or Mr.) Daisy" to and fro, providing transportation, assistance with activities of daily living, and emotional support every day, sometimes for years. The arrangement is both rewarding and stressful.1'3"6 In this article, I share professional resources and personal experiences about successful informal (unpaid) family caregiving for older adults. Looking at caregiving A family caregiver can be defined as a spouse, adult child, other relative, partner, or friend who has a personal relationship with, and provides a broad range of unpaid assistance for, an older adult with a chronic disabling condition.1'8 In short, a family caregiver can be anyone the patient says that person is. Unpaid caregivers provide a broad range of assistance. This can mean something as simple as making a daily phone call to check up on an older neighbor or as comprehensive as providing total daily care, including administering medications and tube feedings to a parent or spouse with a debilitating chronic disease. Caregivers may or may not have the legal authority to make healthcare decisions for the recipient of their care.8 (These legal issues are beyond the scope of this article.) Family caregivers are increasingly needed at home because hospital stays are shorter, discharge planning time is limited, and consistent follow-up care is crucial.