The Health Affairs blog has an excellent post distinguishing between activities of daily living (ADLs)* and instrumental activities of daily living (IADLs)**. More importantly, A 21st Century Job Description for Family Caregiving explains why using either term in the context of family caregiving doesn't begin to explain the scope of what services these caregivers provide. I personally appreciated learning the two terms were developed more than 50 years ago to measure a person's recovery from a hip fracture or other condition. And I agree, something else is needed in today's complex healthcare environment as we continue to shift care out of the hospital and more responsibility to family caregivers.
I also agree a caregiver job description is a good idea, so the hospital administrator in me sat down and typed one up with my own knowledge as a family caregiver; and from what I've learned reading the challenges of others. The roles and responsibilities listed is a starting point for any family, and each job description should be customized to fit the unique situation of the loved one (patient) and resources. This is what should be done by any employer, and it should also apply to family units.
Sometimes the challenges I read from other caregivers are of stress and conflict in the family units. This is often caused by mis-communication or a lack of knowledge and understanding. In these cases, I believe a written and detailed job description for the primary caregiver, and those who also support the primary caregiver, could help establish expectations and responsibilities - facilitating more effective communication.
My version of a family caregiver job description includes a listing of potential nursing and medical tasks that family members sometimes perform; as well as, the need to exercise care for themselves. Given my interest in risk and safety, I explicitly mention the need to monitor the environment for safety, evidence of exploitation and when a loved one becomes a danger to self, others or gravely disabled. Given the reality that life does ultimately come to an end, I've recognized end-of-life activities. Download the template caregiver job description and let me know what you like, or think is missing. If you would like a Word version, just send me an email.
*Activities of daily living - eating, bathing, getting dressed, toileting, transferring and continence.
**Instrumental activities of daily living - cleaning/maintaining home, managing money, moving within community, preparing meals, shopping, taking prescribed medications, using communication tools.
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