Clinvest: Clinical Rheumatoid Arthritis Study
Rheumatoid Arthritis: When and How to Hire Help
Needs change over time, and sometimes people living with RA require assistance beyond family members.
By Linda Foster
Medically Reviewed by Alexa Meara, MD
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As a person living with rheumatoid arthritis or an RA caregiver, how do you know when you need outside help? "Knowing when and how to hire outside help is often confusing and difficult," says Jonathan Krant, MD, the medical director of CreakyJoints and the chief of rheumatology and chief of medicine at Adirondack Health System, Saranac Lake, New York. And while adjusting to new circumstances in life with rheumatoid arthritis may seem overwhelming at first, the best thing to do is take things step by step.
The first step is to look at the specific "activities of daily living" that you or your loved one are able to handle alone. Ask yourself the following questions:
- Do you/does she need assistance with eating, dressing, bathing, or going to the bathroom?
- Do you/does she need help safely getting up and down steps?
- Are you or others afraid to leave the person home alone?
- If you or he falls, are you/is he unable get up without help?
- Are you or the person in question unable to dial 911 when alone?
- Are there other physical or medical problems to consider?
- Are you or the person in question taking many other medications, some of which can cause mental fuzziness?
- Are you or your helpers feeling exhausted physically or emotionally?
If your answer is "yes" to any of the above questions, it might be time to consider seeking outside help. Don't feel guilty: Self-care and independence are important to maintain, and caregivers deserve and need to be as physically and emotionally "fit" as possible in order to do their best work.
Get Input From the Doctor
Remember that a doctor can give her opinion and help identify if and when outside resources may be needed, but she can also offer other support. Ask your doctor what she knows about local sources such as reputable agencies, potential insurance benefits, or financial aid.
Considering Outside Care for Rheumatoid Arthritis
Dr. Krant says that once you have decided that you want outside help, it may be a good idea to hire an RN (registered nurse) for a consultation to assess such factors as living conditions, other illness(es), daily needs, and the psychological states of both the caregivers and the person with arthritis.
The RN will make professional recommendations on what assistance may be needed. An RN is generally recommended over an LPN (licensed practical nurse) because of the higher degree of education and expertise. Call the insurance company to find out what expenses are covered under what conditions. If the RN recommends in-home assistance from a CNA (certified nurse aide), have a face-to-face interview with everyone present, since the person living with RA, as well as his family members, should all be comfortable with the CNA.
Amanda Booze has had rheumatoid arthritis her entire life, along with three hip replacements and one knee replacement. She says people with rheumatoid arthritis feel more positive about life in general when they believe they have some control over decisions about their care. Make sure the CNA is comfortable with meeting the person's daily needs — assisting with everything from bathing and toileting to food preparation.
Krant recommends, if possible, finding a CNA who has experience working with RA patients (or who has a relative with rheumatoid arthritis). It's also important to check the CNA's references and make sure he or she has a reliable car and is willing to take you or your loved one to the doctor and on other errands.
At-Home Help vs. Facility Care
Research suggests that day outpatient care can be as effective as inpatient programs and also costs less. A CNA can take on some rheumatologist responsibilities, such as drug monitoring, recommending changes in drug treatment, and referring the person with RA to other health professionals to help fill in the gaps.
According to Booze and Krant, people with rheumatoid arthritis are more comfortable in general at home. But sometimes, moving to a facility is the right option. For more on when and how to find a facility, read up on rheumatoid arthritis care facilities. You can also go to CreakyJoints for information about putting together a healthcare team and to find support groups.
Taking care of yourself, or caring for another can be — but does not have to be — daunting. Knowing your limitations and recognizing that help is readily available is key in securing the necessary care for you or your loved one.
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