Taking Care of Caregivers: Wellness for Everybody

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Taking Care of Caregivers Wellness for Everybody

• Susan S. Aronson, MD, FAAP

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Objectives Identify how to

• Promote adult health
• Prevent work-related injuries illness
• Address caregiver mental health
• Use modeling to teach children healthy behaviors
  and attitudes
• Use publications, OSHA, NRC, AAP as sources of
  help

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The health status of adults who work in the child
care setting is a critical component of quality.
Quality child care requires consistently
supportive human relationships. When caregivers
and supervisors are ill, relationships and
performance suffer.
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Caregivers/Teachers Matter!

• Caregivers work in a physically demanding and
  stressful work environment every day.
• Caregivers lift, bend, stoop, crawl, climb,
  reach, pull, and push
• Caregivers have limited control over the demands
  for interaction from young, energetic children
  and their families
• Practice of healthy behaviors has personal and
  professional benefits
• Feel good
• Improve/maintain your health and your familys
  health
• Do a better job in child care

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Occupational Health Issues for Teachers/Caregivers

• Infectious diseases
• Musculoskeletal injuries
• Falls
• Environmental hazards
• Pregnancy risks - 97 of providers are women in
  childbearing years
• Stress
• Nutrition
• Physical conditioning and fitness
• Development implementation of staff health
  policies

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Documented Increased Risk

• Increased exposure to infectious diseases (Reves
  and Pickering, 1992 Churchill and Pickering,
  1997)
• Musculoskeletal injuries of back, neck, and limbs
  (Owen, 1994 U. S. National Institute of
  Occupational Safety and Health NIOSH, 1997).

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http//nrc.uchsc.edu National Resource Center for
Health and Safety in Child Care www.aap.org Americ
an Academy of Pediatrics
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Wise Moves
Lifting children, toys, supplies Avoid lifting. Have children climb steps with help. To lift, pull child or object to be lifted as close as possible directly in front of you squat and wrap your arms around whatever you are lifting, then tighten stomach muscles and use thigh muscles to raise yourself and your load. Slide objects and children down your body to a level where you can squat or kneel to lower whatever you are putting down to its destination.
Alicia M. Wortman, MPT (EXCHANGE - July 2001)

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Wise Moves
Inadequate work heights Store frequently used objects where you can reach them easily. Store heavy objects at waist height Adjust diapering and other work surfaces to waist height Use adult-sized chairs whenever you can Squat or kneel on a kneepad if you cant sit next to children when helping them Use step stools to reach high places.

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Wise Moves
Lifting infants in and out of cribs Do not use cribs with floor level mattresses or those that do not have a side you can drop when putting children in or out. Get you and the child as close to the crib side as possible before you lift.

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Wise Moves
Frequent sitting on the floor without back support Sit against a wall or furniture that supports your back Sit with a little pillow in the small of your back when you can Stretch when you get up

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Wise Moves
Carrying heavy objects or children Use carts and strollers Let children climb up with a step stool Divide heavy loads into several smaller loads use carts that can be slid under the load, and then tilt the load onto the cart

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Wise Moves
Awkward posture to open windows or adjust objects Move objects away from the window to get as close as possible to it Put one foot on a step stool for better leverage Lubricate the window mechanism to make opening it easier Ask for help from a co-worker when the job is hard

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Wise Moves
Picking up crumbs and small toys from the floor Use a long-handled dustpan and broom to pick up small objects Keep a separate dustpan and broom for toys (clean) and for things going into the trash
Caring for children with special needs Get specific training from the childs physical therapist about how to move and carry the child

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Wise Moves
Caring for children during active play when sudden moves may be needed Avoid twisting Practice turning and bending to intercept a running or falling child so the move becomes natural Bend knees when pushing children in swings Use good body mechanics to help children on and off equipment

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Staff Health Assessment

• NAEYC Accreditation requirement
• Caring For Our Children standards provide
  expectation and rationale for job-related health
  screening
• Model Child Care Health Policies appendix has
  staff health assessment form

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Mental Health

• Tune in to stress behaviors
• Trouble concentrating
• Inexplicable sadness
• Trouble sleeping
• Fatigue even with 8
• hours of sleep
• Irritability
• Loss of appetite
• Self-medicating with
• alcohol other drugs

• Monitor for physical symptoms of stress
• Headaches
• Neck pain
• Backaches
• Stomachaches

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Mental Health Exercises

• Provide mutual support
• Be alert to the needs
• of others (on call)
• Share cause of
• personal stress when
• signs of stress are
• obvious it is
• appropriate
• Offer sources of professional help

• Promote Pleasure
• Have fun
• Physical activity
• Stretching
• Imaging
• Relaxation exercises
• Enjoy the value of
• your work

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Promote Wellness

• Rest
• Go to bed on time, without TV
• Avoid late nights on weekends
• Plan some mini-rest stretch breaks
• Take off time to get well when illness occurs
• Exercise
• Control sound pollution
• Plan healthful meals snacks use MyPyramid
• Breakfast, lunch, dinner (eat your colors)
• Mid-AM, mid-PM protein snacks

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Promote Wellness

• Manage temperature and humidity
• Dress for comfort and body care
• Layer when it is cold
• Sun-protective clothing outside
• Well-fitted, low-heeled shoes
• Limit exposure to chemicals
• Indoors and outdoors (cleaning products, art
  supplies, mold, pesticides)
• Outside and inside your body

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Promote Wellness

• Daily health maintenance
• Oral health
• Bowel routines
• Motor vehicle and pedestrian safety
• Hand hygiene
• Routine preventive health care
• Checkups
• Vaccines
• Health Insurance for well and sick care

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Preventive Health Care

• American College of Preventive Medicine and the
  U.S. Preventive Services Task Force (USPSTF),
  based at the Agency for Healthcare Research and
  Quality, have each developed evidence-based
  recommendations regarding the delivery of
  clinical preventive services
• At www.acpm.org, look up recommendations for
• Screening
• Counseling
• Chemoprevention (vaccines, aspirin, hormones)

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Adult Immunization www.cdc.gov/nip
Special Risks for Pregnant Women

• Chickenpox
• Cytomegalovirus
• Fifth Disease
• Rubella

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Staff Health Policies

• Pre-employment job-related health assessment
• Benefits
• Breaks
• Ongoing health requirements
• Daily health check (visual, verbal)
• Emergency contacts
• Modeling healthful behavior monitored in
  performance evaluation

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Publications

• Caring for Our Children National Performance
  Standards, 2002 AAP/APHA/NRC
• Stepping Stones (to CFOC) - NRC
• Health in Child Care Manual for Health
  Professionals AAP
• Healthy Young Children NAEYC

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Publications

• Model Child Care Health Policies hard copy from
  NAEYC electronic copy at www.ecels-healthychildca
  repa.org
• Managing Infectious Diseases in Child Care and
  Schools - AAP at www.aap.org
• Posters www.globalhealthychildcare.org
• DVD/Videos Health and Safety Consultation in
  Child Care includes staff health observation
  segment, electronic CFOC, MCCHP
  www.ecels-healthychildcarepa.org or www.aap.org

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OSHA www.osha.gov

• Description for 8351 Child Day Care Services
  Division I Services Major Group 83 Social
  ServicesIndustry Group 835 Child Day Care
  Services
• Establishments primarily engaged in the care of
  infants or children, or in providing
  prekindergarten education, where medical care or
  delinquency correction is not a major element.
  These establishments may or may not have
  substantial educational programs. These
  establishments generally care for prekindergarten
  or preschool children, but may care for older
  children when they are not in school.
  Establishments providing babysitting services are
  classified in Industry 7299. Head Start centers
  operating in conjunction with elementary schools
  are classified in Industry 8211.
• Child care centers
• Day care centers, child
• Group day care centers, child
• Head Start centers, except in conjunction with
  schools
• Nursery schools
• Preschool centers
• OSHA requires Communication about hazards
  safety Controls for blood-borne pathogens

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Sources of Support

• National Resource Center for Health and Safety in
  Child Care http//nrc.uchsc.edu
• (University of Colorado Health Sciences
  Center)
• Health and Child Care Partnership Program
  Healthy Child Care America www.healthychildcare.o
  rg
• (American Academy of Pediatrics)

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Summary Identified How To

• Promote adult health
• Prevent work-related injuries illness
• Address caregiver mental health
• Use modeling to teach children healthy behaviors
  and attitudes
• Use publications, OSHA, NRC, AAP as sources of
  help