"To care for those who once cared for us is one of the highest honors."
― Tia Walker, The Inspired Caregiver: Finding Joy While Caring for Those You Love

As a nurse who was once a caregiver for a family member, I have a unique and personal perspective on the needs of caregivers. I cared for my mother-in-law, who was also my best friend and mentor, during the last several months of her life. At the time I provided care for her, I hadn't yet started my education to become a nurse. Knowing what I know now as a nurse causes me to reflect often on the daily struggles I encountered performing the very basic elements of her care.

When my mother-in-law developed a stage IV pressure ulcer during a hospital stay, I was taught by home health nurses how to cleanse and redress her wound. Preventing further breakdown in other areas was not part of the teaching.

The Basics of Caregiving

While my mother-in-law did not ultimately develop any more pressure ulcers at home, I think back to how close she came. The concepts of turning, repositioning and offloading may seem very simple to those of us in health care. To the exhausted, overworked, confused, grieving family caregiver, these concepts rarely enter the mind. Her heels were in contact with the surface of the bed. Her elbows were reddened after a fretful night of trying to sleep. Her coccyx would ache and her occipital was red and sore. Turning her from one side to the other never occurred to me. I am deeply thankful as I wonder how it is that she did not develop more and even worse pressure ulcers than the one she acquired in the hospital.

Caring for my bedridden mother-in-law inspired me to become a nurse. The very first things I learned in nursing school made me realize that there are many tricks of the trade when it comes to caring for a bedridden patient. The tricks I am referring to include changing bed linens on an occupied bed, properly utilizing a bedpan, consistent turning and repositioning, and using pillows to offload an area of pressure. I had many "aha" moments in nursing school while being educated on these basics of caregiving. I often thought about how much easier things would have been if someone had taken the time to educate me on these simple aspects of care and wound prevention during my mother-in-law's illness.

What They Don't Teach You When You're a Caregiver

Home health nurses came to our home once or twice a week throughout my mother-in-law's illness. Unfortunately, they rarely shared any information that would have made being a caregiver less of a daily challenge. Perhaps these things become second nature to seasoned nurses. It is possible they forget there was a time when they too did not know. Maybe they assumed I already knew what to do when the bed needed to be changed but she couldn't get up, or how to alleviate the constant burning pain she had in her heels and elbows. Whatever the reason, they kept these tricks of the trade all to themselves.

If you are a home health nurse reading this, please understand the importance of educating family caregivers about offloading and positioning their loved ones. I guarantee you that many family caregivers are unaware of the need to relieve pressure intensive areas on the body.

Share the tricks of our trade with home caregivers. Doing so may provide them the ability to have just a few more pleasant moments with the loved one they are caring for.

About the Author
Terri Kolenich, RN, CWCA, AAPWCA is the clinical liaison at Select Medical Specialty Hospitals. Terri has extensive experience in long term care as a Wound Care Nurse and Program Manager. She is passionate about wound care education and has over nine years experience assessing, managing, and documenting wounds. Terri is also well versed in MDS 3.0. Her knowledge coupled with her skill as a public speaker, make her an effective wound care educator.