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Family caregivers contribute services valued at $450 billion to the U.S. economy annually. Although family members frequently lack training in the techniques of health care, providers routinely turn to them to provide care when a patient's condition no longer meets criteria for hospitalization. This article explores the concepts of caregiver empowerment and disempowerment, offers strategies for enhancing caregiver empowerment, and describes actions that may unintentionally disempower those same individuals. Case examples are used to draw attention to cues health care personnel may encounter that signal a need to look deeper into the caregiver's capacity to provide the needed care. Early identification of barriers to capacity will permit the health care team to bring resources to bear on the patient's situation to facilitate safe transitions of care.Keywords: caregiver; chronic illness; empowerment; disempowerment; family caregiver"There are only four kinds of people in the world: those who have been caregivers, those who currently are caregivers, those who will be caregivers, and those who will need caregivers."-Rosalynn Carter, former first lady of the United States (Alzheimer 's Association, 1997)The relevance and accuracy of Rosalynn Carter's observation persisted more than a decade later in data published by the AARP Public Policy Institute (Feinberg, Reinhard, Houser, & Choula, 2011). These authors reported that, at any given point in time, more than 42 million family caregivers in the United States were providing care to an adult with limitations in activities of daily living. They went on to state that almost 62 million Americans had provided care at some time during the year. The average caregiver in their report was characterized as a 49-year-old woman (65% of caregivers are female) who worked outside the home. She spent nearly 20 hours per week providing unpaid care to her parent (80% of care recipients are relatives or friends older than 50 years) and would do so for an average of 5 years. With an estimated value of $450 billion annually, the contribution of family caregivers to the health care economy must be acknowledged (Feinberg et al., 2011). It reflects the commitment that many Americans have made to their family members, their partners, and their friends experiencing acute and chronic illness. That fully one in four Americans has taken on care responsibilities beyond their daily life commitments is a reminder of the complexity of life outside of public view.Becoming a family caregiver can be daunting. Becoming a competent and confident caregiver can be overwhelming. Yet, everyday conversations occur in hospitals and care facilities about who will be the support person or caregiver for a patient when he or she no longer qualifies for inpatient treatment. Families and friends may be willing but are unprepared for unfamiliar with the kinds of care the patient needs. They may lack knowledge about the illness, about strategies for disease management, or about the basics of providing care to an individual dependent on them for accomplishing activities of daily living (bathing, eating, toileting, dressing) or instrumental activities of daily living (transportation, financial management, shopping, housekeeping). As individuals with acute and/or chronic illness are discharged from the hospital with increasingly complicated care needs, that knowledge gap can be a barrier to caregiver empowerment.The other side of the caregiver challenge occurs when giving the responsibility for care back to the patient. Not to do so is disempowering to those individuals who may be able to assume more of their own care but who have grown dependent on others' caring for them. Worse, the care recipient may fear alienating the caregiver on whom he or she has depended for weeks, months, or years. There is no guidebook for successfully navigating the challenging waters of care transitions.BARRIERS TO CAREGIVER EMPOWERMENTStajduhar et al. …

In the practice of nursing, we bring our clinical knowledge and our humanity to the intersection of professional and patient. We have the opportunity to learn and grow from each of these encounters to improve our practice and our insight into the care we provide. However, such learning and growth requires intentionally reflecting on those interactions with the goal of identifying successful and unsuccessful strategies in care delivery. This article explores ways in which nurses can reflect on their practice, with particular focus on the nursing salon.