As a caregiver for someone with rheumatoid arthritis, know when and how to seek help.

As a caregiver for someone with rheumatoid arthritis, how do you know when you need outside help? "Knowing when and how to hire outside help is often confusing and difficult," says Bill Guerra, RN, BSN, who works at the Parkway Surgery Center in Henderson, Nev., and has extensive experience in dealing with rheumatoid arthritis patients. And while it may seem overwhelming at first glance, the best thing to do is start at square one.

Your first step, according to Guerra, is to look at the "Activities of Daily Living" that your loved one with rheumatoid arthritis is able to handle on their own. Ask yourself the following questions:

• Do they need assistance with eating, dressing, bathing, or going to the bathroom?
• Do they need help safely getting up and down steps?
• Are you afraid to leave the one you care for home alone?
• If they fall, are they unable get up on their own?
• Are they unable to dial "911" when you are not there?
• Do they have other physical or medical problems?
• Are they taking many other medications, some of which can cause mental fuzziness?
• Are you feeling exhausted physically, or emotionally, meeting their needs?

If your answer is "yes" to any of the above questions, it might be time to consider outside help, without feeling guilty. As a caregiver, you deserve and need to be as physically and emotionally "fit" in order to do the best possible job helping your loved one.

Considering Outside Care for Rheumatoid Arthritis

Guerra says that once you have decided that you want outside help, it is often a good idea to hire an RN (registered nurse) for a consultation with you and the person with rheumatoid arthritis, to assess such factors as living conditions, the illness(es), the patient's daily needs, and psychological state.

The RN will make professional recommendations on what you need in the way of assistance. An RN is generally recommended over an LPN (Licensed Practical Nurse) because of the higher degree of education and expertise. Call the insurance company for your rheumatoid arthritis patient and find out what expenses are covered. If the RN recommends in-home assistance from a CNA (Certified Nurse Aide), have a face-to-face interview with several CNAs with the patient present, since you both should be comfortable with the CNA.

According to Amanda Booze, who has had rheumatoid arthritis her entire life, along with three hip replacements and one knee replacement, people with rheumatoid arthritis feel more positive about life in general when they believe they have some control over the decisions made about their care. Make sure that the CNA is comfortable with the patient and meeting the patient's daily needs — everything from assisting with bathing to toileting to food preparation.

Guerra recommends, if possible, finding a CNA who has experience working with RA patients (or has a relative with rheumatoid arthritis). It's also important to check the individual's references and make sure they have a reliable car and are willing to take your loved one to the doctor and on other errands.

At-Home Vs. Facility Care

Recent studies confirm that day outpatient care is as effective as inpatient programs and is lower in cost. And a CNA can take on some rheumatologist responsibilities, such as drug monitoring, recommending changes in drug treatment, and referring the patient to other health professionals to help fill in the gaps.

According to Booze and Guerra, 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 for your loved one with rheumatoid arthritis, visit Rheumatoid Arthritis Care Facilities.)

Caregiving can be — but does not have to be — daunting. Knowing your limitations and recognizing that help is readily available is key in providing the necessary care for your loved one.