Although highly trained medical professionals will care for your loved one during treatment, most CAR T-cell programs require patients to identify a family member or friend who can serve as their caregiver 24/7 for approximately four weeks after the infusion of CAR T-cells.
If the patient develops symptoms such as fever, confusion, or disorientation, having a 24/7 caregiver on hand is critical to alert the medical team and get help quickly.
Being a Caregiver is a Big Job.
Caregivers must juggle many tasks, including:
- assuming some of the medical duties that were previously handled by nurses
- ensuring the patient follows the treatment plan prescribed by the medical team
- acquiring and dispensing medications the patient needs daily
- scheduling and coordinating transportation to the clinic and specialist visits
In addition, caregivers must:
- monitor the patient for new or worsening symptoms
- communicate any change in the patient’s condition to the healthcare team
- protect the patient from sources of infection
- prepare nutritional meals
- provide the patient with emotional support
These tasks are in addition to managing usual household chores such as paying bills, childcare, home maintenance, running errands, as well as maintaining a job.
Watch for Neurological Problems
While recovering at home, patients may show signs of neurological problems such as:
- confusion
- memory loss
- disorientation
Observing these changes can be very worrisome for a caregiver. It's important to write down any neurological problem you observe, including when it began, how long it lasts, and when it ends, so that you can accurately and promptly report it to the medical team.
If the patient experiencing neurological difficulties, try to:
- establish a daily routine and make as few changes each day as possible
- create reminders about when certain tasks need to be done or events will occur
- use automatic timers to turn appliances and electronic devices on and off
- keep rooms well-lit and free of clutter
- put important items in the same place after each use so that they can be easily found
- close drapes and shades at night and open them during the day to keep the patient oriented to the proper time
Take Care of Your Physical Well-Being
If you will be the caregiver for a CAR T-cell patient, it’s important to make plans to take care of yourself so that you remain well and strong through the weeks and months ahead.
To be an effective caregiver, you will need to keep yourself in good physical condition. This includes eating well-balanced meals, getting daily exercise, and getting sufficient sleep each night.
Although it can be hard, pay attention to your own health. If you have any health issues, don’t ignore them or put off seeing a doctor. Remember, if you become ill, you won't be able to care for your loved one.
Try to create a daily routine, with time built in to do things that will keep you strong and healthy, both mentally and physically. Think about ways to:
- burn off stress with physical movement, such as walking or yoga
- turn off stress with meditation or prayer, journaling, spending time in nature, listening to music, or watching a show that makes you laugh.
Even simple things like a favorite snack midday, five minutes on your favorite website, or two minutes of stretching can help relieve stress.
Gather a Team of Helpers
Don’t try to go it alone. It is hard to manage all the things you need to do for the patient as well as address your own needs. A good support network is very valuable.
People are often eager to help if they know exactly what you need.
- Make a list of all the activities that could be done by someone else like shopping, meal preparation, or yard work, and then reach out to family and friends to see who can help.
- Line up ongoing support, if you can, so that you don’t have to keep asking.
Ask a family member or friend to organize the help for you. Many programs are available online that make it easy to organize volunteers to provide meals and other help for people with health issues. Some to check out include:
Changing Relationships
Being the caregiver can create a different relationship between you and your loved one, at least for a time.
- If you are caring for a spouse or partner, you may find yourself in a nurse/patient role instead of being equal partners.
- It’s common for differences to arise over how much care you should be providing or how much you should be pushing the patient to do various activities, which can lead to frustration, resentment, and anger for both parties.
Communication is key. Bottling up frustration is not healthy. Try using ‘I’ statements such as ‘I am feeling frustrated’ rather than ‘You’ statements such as ‘You make me mad’.
Think about caregiving as ‘care-partnering’. Work together to name challenges and problem-solve them together.
Encourage the patient to do what he or she can without help, so that you both maintain as much independence and self-identity as possible.
Don’t forget to spend time together doing things you enjoy that are not medical in nature.
Caregiver's Emotional Well-Being
Caring for someone who is recovering from CAR T-cell therapy can be stressful. Fear of the unknown, unexpected complications, frustration over things like getting appropriate medical help, wanting support from family and friends, and just plain exhaustion can put your emotional health in jeopardy.
Don’t ignore your feelings. If you don’t deal with them, they will deal with you.
Please find someone with whom you can honestly express your feelings and talk about your worries. This could be:
- a trusted family member, friend, or religious counselor
- another caregiver of a CAR T-cell therapy recipient (find one through BMT InfoNet's Caring Connections Peer Support Program)
- a mental health professional (find one in BMT InfoNet's Directory of Mental Health Providers)
- a Facebook group
Give Yourself the Credit You’re Due.
You are a vital member of the healthcare team working to help your loved one recover.
- Acknowledge and appreciate the hard work you are doing.
- Take pride in mastering the many tasks that you once may have thought you’d be unable to do.
Sometimes, despite your best efforts, problems like an infection may occur, or things don’t go as planned. It can be easy to question yourself and wonder if something you did caused the problem.
Resist the urge to blame yourself. Like everyone involved in patient care, you are doing your best and not everything is within your control. Try to show yourself the same compassion as you would show for a friend.
Watch a video about being a caregiver for a CAR T-cell patient. Click here to read the transcript.
Next: Financial Considerations
Updated November 2024
