Taking Care of Caregivers: Wellness for Everybody

1. Taking Care of Caregivers: Wellness for Everybody Susan S. Aronson, MD, FAAP

2. 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

3. 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.

4. 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 family’s health • Do a better job in child care

5. 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

6. 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).

7. http://nrc.uchsc.eduNational Resource Center for Health and Safety in Child Care www.aap.org American Academy of Pediatrics

8. Wise Moves Alicia M. Wortman, MPT (EXCHANGE - July 2001)

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16. 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

17. 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 Mental Health

18. 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 Mental Health Exercises

19. 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

21. 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

22. 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

23. 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)

24. Adult Immunization www.cdc.gov/nip Special Risks for Pregnant Women • Chickenpox • Cytomegalovirus • Fifth Disease • Rubella

25. 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

26. 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

27. Publications • Model Child Care Health Policies – hard copy from NAEYC; electronic copy at www.ecels-healthychildcarepa.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

28. OSHA – www.osha.gov Description for 8351: Child Day Care ServicesDivision 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

29. Sources of Support • National Resource Center for Health and Safety in Child Carehttp://nrc.uchsc.edu (University of Colorado Health Sciences Center) • Health and Child Care Partnership Program –Healthy Child Care America www.healthychildcare.org (American Academy of Pediatrics)

30. 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