Should All Doctors Screen for Caregiving Stress?


Should All Doctors Screen for Caregiving Stress?

man-390339_640One of our members posted about his stress earlier this week. His post led me to think about all the undiagnosed cases of family caregiver stress in the world. And, that thought led me look for the Caregiver Health Self-Assessment Questionnaire developed many years ago (15??) by the American Medical Association. An AMA researcher had contacted me when she began to develop the self-assessment. I then connected her with family caregivers who tested the questionnaire for her.

The AMA developed the questionnaire for physicians to use during a caree's appointment; the family caregiver was to complete the assessment while waiting. I'm not sure exactly what happened but what could have been a great initiative obviously hit a brick wall.

Most of the initiatives to reach family caregivers at the doctor's office hinge on reaching a family caregiver during the caree's appointment. I understand the thinking--the family caregiver is there with the caree, let's capture that moment to see how the family caregiver is doing. But, often, the caree's doctor is not the family caregiver's doctor. So, the caree's doctor assesses the family caregiver but the family caregiver is not the doctor's patient. How effective is that?

I wonder: What if all doctors screened each patient for family caregiver stress? What if all doctors (pediatricians, internists, primary care physicians, dentists, ER doctors, hospitalists) recognized that all their patients could potentially be caring for a family member or friend with a chronic illness? What if, while you complete the insurance paperwork and HIPAA compliance form, you also answered a few questions about whether or not you care for a family member or friend? If you do, then you're prompted to take the self-assessment and you're given a more exhaustive list of resources that can help. You also receive prompts to create an action plan (like our family caregiver care plan) to cope with stress.

What if the Centers for Disease Control took on this initiative? The CDC could require doctors to track the number of patients who report they experience stress from caring for a family member or friend. The doctors would share monthly numbers (just numbers, not names or personal details) with the CDC. We'd have a much better idea of how widespread caregiving stress is and then, perhaps, access to more funding to help family caregivers. If this is a health crisis, then perhaps more dollars would be available to support family caregivers. (Maybe the CDC could work with the World Health Organization to get worldwide statistics.)

I appreciate that this idea has some challenges. Many family caregivers can't get to their own doctor because of their caregiving responsibilities. Some family caregivers may feel such a questionnaire and assessment is an invasion of privacy and decline to participate. Getting doctors offices to comply and report details may be difficult, as well.

What do you think?

And, take a look at the Caregiver Self-Assessment Questionnaire and share your thoughts about its effectiveness. I would change the title simply because "caregiver" isn't a term many family caregivers relate to. In addition, I think the assessment needs to be inclusive of all family caregivers, not just those who care for aging parents. We know family caregivers care for children, spouses, siblings, parents, grandparents, friends, aunts, uncles, cousins.

I look forward to reading your thoughts.

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