Developing the Tracheostomy Care Anxiety Relief Through Education and Support (T-CARES) Program

Home care of a patient with a tracheostomy after surgery for head and neck cancer requires caregivers to be comfortable with handling medical equipment and to be competent and proficient with completing many new and complex tasks. However, the responsibility of managing an artificial airway may increase caregiver anxiety, which may subsequently lead to improper care of the patient with head and neck cancer and increase the risk for complications and rate of readmission to oncology units. This article describes the development and outcomes of the Tracheostomy Care Anxiety Relief Through Education and Support (T-CARES) program, developed in response to high readmission rates for patients with head and neck cancer discharged with a tracheostomy. T-CARES consists of an 18-minute video demonstration, group discussion, return demonstration, and skills assessment. The course also incorporates hands-on practice on a low-cost anatomical task trainer created by the authors. A significant reduction in caregiver anxiety was noted after participation in the T-CARES program. T-CARES and similar programs can be developed to teach self-care for a variety of conditions that patients and caregivers are expected to manage at home.