November is National Family Caregivers Month, a time to honor and appreciate the families and friends who provide the majority of long-term care in the United States and who are vital, yet often invisible, members of the health care team. We recognize that the past two years have been especially challenging-with the rise of the COVID-19 pandemic and the increased health inequities resulting from systemic racism. These forces have illuminated both the essential nature of family support and the ways our systems fail older adults and their families. If you are like many nurses, you have been involved in caregiving issues in your own family, either directly or in support of others. We appreciate the dual role so many nurses balance as family caregivers and trusted health care professionals.
In conversations with hospitals and nursing homes about family caregivers and COVID-19, we learned that leaders recognized the profound impact of the pandemic on patients, family caregivers, and staff. Some nurses gained a new appreciation for how much families are involved when the person they care for is in a health care setting and realized that they had taken for granted the multiple roles families play providing comfort and support. Many grappled with appropriate visitation policies-allowing family to be present with frail or confused older adults, providing a vital connection during times of chaos and in crises. Initially, most settings excluded all visitors, but with time, essential family members were allowed in under special circumstances, such as an end-of-life visit. Leaders adjusted ways of connecting with family caregivers, using technology for virtual connections, reassigning staff to focus on providing support and resources, and deepening partnerships with the community to address unmet social and financial needs.
The devastating consequences of racism and the disproportionate toll of COVID-19 on Black, Native American, and Latinx older adults, family caregivers, and staff are tragic. Family caregivers from these communities experienced cumulative challenges around health, food and housing security, employment, and schooling in addition to providing care. Hospitals, nursing homes, and communities are finding new ways to join forces to address the social determinants of health-such partnerships are key to promoting health equity and combating racism. These efforts align well with recommendations of the recent National Academies of Sciences, Engineering, and Medicine's Future of Nursing 2020-2030 report addressing health equity.
One unexpected benefit of recent challenges is a greater awareness of both aging health issues and the role of family caregivers, visibility vital to advancing better health outcomes and health equity. The John A. Hartford Foundation has a long-standing commitment to advancing health for older adults and supporting family caregivers while promoting age-friendly health systems. Over 2,000 hospitals, practices, clinics, and nursing homes have joined the movement and are transforming their care priorities to address the 4Ms of an Age-Friendly Health System: What Matters, Medication, Mentation, and Mobility. There is compelling evidence to focus on these issues: more appropriate health care utilization, fewer adverse drug events, earlier detection and effective treatment for delirium, and improved mobility with fewer fall-related injuries.
Research from the AARP Public Policy Institute and the Family Caregiving Institute at the University of California Davis revealed the large gap between what family caregivers need to know to provide complex care and what health systems do to prepare them. We have produced over 45 videos addressing issues that caregivers prioritized in our national surveys. AJN is a key partner in the development of these videos and has published nearly 20 articles that provide information to enable their easy use in practice (see https://journals.lww.com/ajnonline/pages/collectiondetails.aspx?TopicalCollectio).
Our latest series of six videos can be accessed in the new Supporting Family Caregivers series of articles that begins in this month's AJN. We hope you find this new series of videos useful in your interactions with the older adults and family caregivers you encounter. We encourage you to view the videos, then use them to engage family caregivers in conversations that build trust in your relationship and in their confidence and skill.
As the most trusted professionals, nurses have the opportunity to make a difference for family caregivers by engaging them, listening to their concerns and priorities, providing instruction and support, and linking them to the resources they need. Together, we can become age friendly in all we do!