1. THE IMPORTANCE OF THE CAREGIVER ROLE ANTONIA CAMPOLONGO HOSPITAL DE LA SANTA CREU I SANT PAU BARCELONA, SPAIN

2. PARKINSON ’ S DISEASE AND CAREGIVERS PD is a chronic, progressive neurological disease, characterized by tremor, rigidity, bradykinesia and postural instability. Lilienfeld estimates that by 2040 a 1,3 million will be affected by PD Only about 7% of PD persons are admitted to long-term care facilities; most are cared by families at home.

3. DEFINITION CAREGIVER A caregiver is a person who: Take care of someone who has a chronic illness or disease. Manage medications or talk to doctors and nurses on someone’s behalf. Help bath or dress someone who is frail or disabled. Take care of household chores, meals, or bills for someone who cannot do these things alone.

4. Caregiver. Who does it? Formal caregivers: These are individuals paid to provide basic daily living support to persons in need. Informal Caregivers: These are individuals that are not paid. In many cases, these are family members.

5. DEFINITION OF THE CAREGIVER BURDEN Caregiver burden refers to a high level of stress that may be experienced by people who are caring for another person (usually a family member) with some kind of illness. For example, a person caring for someone with a chronic illness may experience such stressors as financial strain, managing the person's symptoms, dealing with crises, the loss of friends, or the loss of intimacy.experience such stressors

6. THE STRESS IS INDIVIDUAL

7. CAUSES OF CAREGIVER BURNOUT Changing roles/ role confusion Unrealistic expectations Loss of control Isolation Financial demands Panic Denial

8. SIGNS OF STRESS

9. SIGNS OF CAREGIVER STRESS (I) PHYSICAL SIGNS OF STRESS Tension or migraine headaches. Muscle tension, aching shoulders and back. Gritting or griding the teeth. Palpitations with no story of heart disease. Changes in health status. Not feeling well with different symptoms every day.

10. SIGNS OF CAREGIVER STRESS (II) EATING AND SLEEPING BEHAVIOR Difficulty falling asleep, restless sleep, fatigue Loss of appetite or over eating Weight loss or gain Digestive problems, upset stomach. Use of alcohol or pills to sleep, stay awake, or relax.

11. SIGNS OF CAREGIVER STRESS (III) THOUGHTS AND FEELINGS No pleasure or interest in activities. Feeling guilty Socially isolated Irritable or short tempered Feeling emotional overwhelmed. Increased number of small accidents. Difficulty in focusing and concentrating Forgetfulness

12. THE CONSEQUENCE

13. WAYS TO PREVENT BURNOUT Exercise regularly Rest Relax Eat healthy food Identify negative emotions and practice coping skills Seek support from family, friends, a support group Learn to be assertive. Ask for help Accept help when offered Do good things for your spirit.

14. HEALING STRATEGIES Daily exercise Meditation Listening to music Taking a hot bath Getting a massage Practice stress management techniques.

15. What can the caregiver do if their needs a break? In-home respite. In this type of service, someone comes to your home to provide care. The type of care can range from simple companionship to nursing services.

16. What can the caregiver do if he/she needs a break? Adult day-care centers. Many adult day- care centers are located in churches or community centers. Some day-care centers provide care for both elderly adults and young children. During the day, the two groups meet for several hours to share in activities such as reading stories. This type of contact seems to benefit both young and old.

17. What can the caregiver do if he/she needs a break? Short-term nursing homes. If the patient needs occasional nursing care and the caregiver must leave town for a couple weeks, some nursing homes will care while the caregiver is gone.

19. MY ADVICES TO CAREGIVERS ARE…..

20. BATHING 1. Keep this time as pleasant and relaxed as possible. 2. Use less soap- too much soap increase the skin dryness 3. Keep the room confortably warm 4. Respect their privacy. Keep the patient covered when is possible.

21. SHAVING 1. Use an electric shaver. 2. If the patient wears dentures, put them in his mouth before shaving him. 3. Have him in a sitting position, if possible. 4. Do not press down hard or move the shaver too fast over his face. 5. Shave the most tender areas of the face ( the neck area) first and then move up to the tougher ears of the face between the eras, nose and mouth.

22. DRESSING 1. Let them choose what they want to wear. 2. Be flexible. 3. Consider easy-to-wear clothes with large front fasteners 4. If the patient has a weak side, put the painful or weak arm into de shirt before the strong arm.

23. HAIR CARE 1. Keep hair short and in a easy care style. 2. Wash hair in a confortable place. 3. Consider using one of the dry shampoo products found in drug stores if hair washing is impossible

24. THE CONSTIPATION 1. Get plenty of fluids. 2. Cut down on alcohol and beverages containing caffeine. 3. Make healthy food choices. 4. Relax. Don’t strain to empty the bladder or bowel or sit on the toilet too long.

25. CAREGIVER'S BASIC SURVIVAL TIPS

26. TIP 1 Keep them one involved as much as possible in...

27. TIP 2 Do not assume more responsibility or control than necessary.

28. TIP 3 Eat properly, …..

29. TIP 4 Caregiver needs……

30. TIP 5 The caregiver needs to take time off with friends or family who nurture them or make them laugh.

31. TIP 6 It’s important for the caregiver to find someone to trust

32. TIP 8 Learn all about Parkinson’s Disease…….

33. TIP 9 Remember daily to reward yourself for the positive difference you make in your loved one's life and the specific little things you did that day…..

34. AND AFTER THE WORK….

35. Video