Caregivers’ Little Helpers: How Can Social Robots Support Informal Caregivers with Monitoring the Health and Well-Being of Care Recipients?
26 February 2021
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Put yourself in someone else’s shoes: an empathetic mindset to communicate support to your loved one


By Giulia Ferraris Published 04.02.2020




In our daily lives, verbal and non-verbal communications are the vehicles by which we demonstrate support, care, and concern to our loved ones. Communication becomes even more crucial when it comes to informal caregivers, that is, individuals who provide care in response to a loved one’s health challenge or health decline. First, caregivers could be asked to assist their family or friends in need of care with medical and nursing tasks; they sometimes help with financial and administrative issues related to care, or help their loved ones in their daily activities or personal care tasks. And most important, caregivers are often relied on to provide emotional care, including listening to worries and providing companionship (Revenson et al., 2016).This task, that is communicating support, is extremely important in the caregiving context. Indeed, caregivers and care recipients’ communication patterns could influence the ways both members of the caregiving dyad manage their feelings during stressful situations. The way people interact with each other and behave together to deal with issues arising from the care context could provoke different outcomes in their emotional and relational wellbeing. For example, some studies conducted with patients diagnosed with different types of cancer and their caregivers highlighted positive effects on psychological wellbeing when both the partners were more collaborative and adopted an open and welcoming communication style, especially towards issues related to the disease (Dagan et al., 2014; Mallinger, Griggs, & Shield, 2006; Rottmann et al., 2015).



In health psychology, the term “dyadic coping” refers to the different ways that couples or dyads can interact (e.g. uninvolvement, support, collaboration, control, protective buffering, overprotection) as they manage illness-related stressors (Badr & Acitelli, 2017). And communication is one of the key aspects of dyadic coping. Researchers have adopted a number of theories to explain the interactions between the caregiver and the care recipient; for example, social exchange theory (e.g., Scharlach, 1987; Walker et al., 1992), equity theory (e.g., Wright & Aquilino, 1998), and communal relationship theory (e.g., Williamson & Schulz, 1990; Williamson, Shaffer, & Schulz, 1998). Despite the variety of existing theories and theoretical models, what is important to mention is the interdependence that exists between them. For instance, the care recipients’ adjustment to illness is influenced by the way in which they perceive the proximity of significant others (i.e., their caregivers); in turn, the caregivers’ psychological wellbeing is profoundly influenced by reactions and emotional experiences of the people presenting a specific health condition (i.e., the care recipients). What is clear from the literature and the clinical practice is that communicating support could be seen as an interactive process that depends on both members of the dyad and involves transactions that produce feelings of being supported (or not) in both.


Therefore, as researchers and health practitioners, we should investigate further the ways to improve communication of emotional support between caregivers and care recipients. Improving communication creates an interpersonal environment in which they can openly express their thoughts and emotions.



How can we help caregiving dyads to improve their communication of emotional support?
These are some strategies or communication dimensions that should be helpful while providing care to a family member:
1. self-disclosure or the act of revealing personal thoughts and feelings about one’s self to the other person;
2. perspective-taking the ability to adopt the subjective point of view of the other;
3. empathy is a consequence of the two previous behaviors and involves listening and accurately identifying the other person’s feelings.



Empathy is an especially important skill for caregivers and a fundamental resource for social relationships. Empathy has been effectively illustrated in a short-animated movie by the Royal Society of the Arts (RSA), based on a TED conference by Brené Brown, a researcher from the University of Houston:





Being empathic is something that may seem easy, but actually can be quite difficult to do. For example, mental health professionals, such as clinical psychologists or social workers, often spend years learning how to be empathic. Fortunately, the ability to communicate well with those who are suffering can also be learned and developed. Kayser et al. (2008) presented a quick and easy technique that could be used by clinicians (e.g., psychologists or therapists) to help caregiving dyads or couples to become more empathic to each other and to understand what makes some conversations helpful and supportive and others less so. The instruments needed to conduct it are simply a voice taper and a timer. Caregiver and care recipient are asked to hold a 10-minute conversation and record it. The care recipient will be the “discloser” or the person asked to openly discuss concern or feelings connected with the care context or the illness, and the caregiver will be the “helper” or the listener. It is important to record the conversation and, once it is over, re-listen segments of the tape. In this delicate phase, the clinician can facilitate the identification of reciprocal helpful responses to each participant’s disclosure or listening, such as listening without judging, expressing understanding or giving words of encouragement. To do this, some direct questions can help the process either for the discloser (e.g., How did you feel? In what way did you feel understood/not understood?) and the helper (e.g., What were you trying to do in making your response?). After reviewing the taped conversation, it is advised to do the same but reversing the roles, so that the caregiver becomes the discloser and the care recipient is the helper. Reversing role is likely the most important step of this technique. This is the exact moment when people learn and experience how to assume the others’ perspective and try to truly understand it.



It is advisable to learn and practice this technique with the help of a counselor or a therapist; the expert would be able to train the dyads and convey them some basic knowledge about communication and empathic listening. This is a needed starting point to really understand ways to show support. However, this exercise could be reproduced at home as a kind of “homework”; practicing how to be empathic and supportive to our loved ones could produce many beneficial effects in our lives and relationships, not only in the caregiving context. Try it yourself!



About the author
I’m Giulia Ferraris, a PhD student at University Medical Center of Groningen, The Netherlands. I am exploring dyadic relationships in the caregiving context, investigating which interactions and behaviors between caregivers and care recipients promote or deteriorate their relationship, and the caregivers’ willingness to provide care over time.
Want to connect? Find me on Twitter (@FerrarisGiulia) or send me an email at g.m.a.ferraris@umcg.nl



Recommend readings
[1]. Kayser, K., & Scott, J. L. (2008). Helping Couples Cope with Women’s Cancers. An Evidence/Based Approach for Practitioners. Springer.
[2]. Brenè Brown (2012). The power of vulnerability. Ted Talk: https://www.ted.com/talks/brene_brown_the_power_of_vulnerability/transcript



References
[1]. Badr, H., & Acitelli, L. K. (2017). Re-thinking dyadic coping in the context of chronic illness. Current Opinion in Psychology, 13, 44–48. https://doi.org/10.1016/j.copsyc.2016.03.001
[2]. Dagan, M., Sanderman, R., Hoff, C., Meijerink, W. J. H. J., Baas, P. C., van Haastert, M., & Hagedoorn, M. (2014). The interplay between partners’ responsiveness and patients’ need for emotional expression in couples coping with cancer. Journal of Behavioral Medicine, 37(5), 828–838. https://doi.org/10.1007/s10865-013-9543-4
[3]. Mallinger, J. B., Griggs, J. J., & Shield, C. G. (2006). Family communication and mental health after breast cancer. European Journal of Cancer Care, 15(4), 355–361. https://doi.org/10.1111/j.1365-2354.2006.00666.x
[4]. Revenson, T. A., Griva, K., Luszczynska, A., Morrison, V., Panagopoulou, E., Vilchinsky, N., & Hagedoorn, M. (2016). Caregiving in the illness context. In Caregiving in the Illness Context. https://doi.org/10.1057/9781137558985
Rottmann, N., Hansen, D. G., Larsen, P. V., Nicolaisen, A., Flyger, H., Johansen, C., & Hagedoorn, M. (2015). Dyadic coping within couples dealing with breast cancer: A longitudinal, population-based study. Health Psychology, 34(5), 486–495. https://doi.org/10.1037/hea0000218