Caring for the Caregiver in the Emergency Department

Physicians all too often overlook the stresses and challenges caregivers face in the emergency department, writes Brown University Professor Jay Baruch in STAT . "Caregivers are individuals, usually family members, who regularly look after one or more sick, frail, or disabled individuals," he notes. Baruch also cites a broad spectrum of adverse biological responses among caregivers when their responsibilities cause psychological and physical distress. Examples include slower wound healing, high blood pressure, and an impaired immune response. "These can take a toll, leading to an overall increase in caregiver mortality," Baruch warns. He also says caregivers' tendency to drop off loved ones in the emergency department and leave "is typically the result of systems that don't provide enough resources for caregivers who often face daunting tasks. These obligations are equivalent to unpaid full-time jobs. Could anyone blame them for seeking a breather?" Baruch suggests social workers can play an essential treatment role in such situations. "A social worker can explore whether the individual is eligible for services and, if so, help arrange them." Baruch notes about 14.7 million older adults receive assistance with daily activities from spouse and family caregivers, but only 25 percent of caregivers leverage supportive services, "possibly because many of them may not perceive themselves as caregivers, a term with professional connotations. In the emergency department ... their assistance can be a treasure trove of information and insight when the individual has trouble communicating with the medical staff. But when the strain of caregiving reveals itself, clinicians like me have a responsibility to pursue those worrisome cracks."