Caring for the Caregiver

Caregivers really need to be encouraged by society to use respite care - to get out.  So many caregivers become ill and they're no longer able to care for the person they are working with.  We see that all the time.  We're having a big outing tomorrow and many of the caregivers aren't coming because they don't want to leave the person they care for home. 
-- Linda, Interfaith Volunteer Caregiver Program, Chippewa County, MN

By David Egner

Taking on the responsibility of caregiving is a uniquely challenging experience. The rewards and good feelings of spending more time with a loved one in need can be compromised by the time, planning, coordination, financial commitment and physical rigors that are commonly required. Often lost in the act of giving care is the health and well-being of the caregiver.

Chronic stress without relief can lead to more serious problems

A study of caregivers published in of the Journal of the American Medical Association (December, 1999) reported that those who provide support to their spouse and are under stress are more than twice as likely to die within four years than spouses who are not serving as caregivers.

When attending to a spouse or loved one, a familiar source of support and affection for the caregiver can suddenly become a source of frustration and worry. Stress in caregiving can come from numerous places, such as dealing with doctors, being isolated, experiencing tough decisions and significant life changes and simply facing an unknown. And it may not show up as the usual fast-beating heart or butterflies or sweaty palms or trembling.

Signs of chronic stress commonly include:

• Troubled sleep
• Fatigue and exhaustion
• Frequent headaches
• Mood swings
• Body aches
• Over-reacting
• Anger
• Changes in eating habits
• Recurring colds and flu
• Isolation from friends and family

Chronic stress without relief can lead to more serious problems, such as heart disease and depression. Caregivers also commonly experience constant sadness, a burden of obligation and feelings of guilt for not being able to do enough.

Where can you get relief?

• Seek out, delegate or accept assistance. You don't have to do everything yourself and simply being able to take breaks and share responsibilities is an important first step. Plus, people (especially family) may want to help but may not know how.
• Relax. This can be as simple as deep-breathing relaxation exercises, treating yourself to a bubble bath or reading a good book or magazine. Don't be hard on yourself. Laugh at yourself, too. In caregiving, as in life, there are events that are out of your control.
• Try to continue with hobbies and personal routines. Don't sacrifice things that bring you comfort and joy. Pacing and staying positive are very important in caregiving, so balance your own needs with those of the care consumer.
• Keep up with friends and social activities. Be honest with what you are going through, but do not burden acquaintances with accounts of sorrow and grief.
• Join a support group. Interact with people who know first-hand the same challenges you are experiencing. Read more below.

Good Health Basics

Taking care of yourself also means having good health habits. It's important to minimize or stop smoking, limit alcohol and caffeine consumption and pay attention to these basics:

• Eat regular, well-balanced meals. Think vegetables and fiber-rich foods. Vitamins will help boost your immune system.
• Exercise. Simply taking a brisk 15-minute walk every day can improve your energy, mental alertness and quality of sleep.
• Sleep well. This may be the toughest thing of all, but try to stick to regular bedtimes and wake times and get the sleep you need (8 hours is recommended for most people).

For help creating more structured diet and exercise improvements or if you have continued sleep problems, consult your personal physician.

Support Groups

Support groups may be able to provide something that close friends and family cannot - real-life confirmation of what it's like to face the fears and challenges of caregiving.

Where can you find support groups? Medical centers, nursing homes, senior centers, social service agencies, synagogues, churches and temples. National organizations and associations, such as the Alzheimer's Association and Children for Aging Parents, are also good resources for getting local information.

• Alzheimer's Association
• Children of Aging Parents
• More resources for caregivers

Professional Help Options

If and when your responsibilities as a caregiver become too much to handle, be open to the idea of professional help, whether it be respite care or personal counseling. The following are sound options:

• Adult day care programs. Adult centers provide meals, activities and exercises and can provide personal care. They can look after the care consumer for a full day or just a few hours and give you a needed break. Find a directory of local centers at www.NADSA.org, the Web site of the National Adult Day Service Association.
• Professional caregivers. Like an adult day center, professional caregivers provide basic meals and care but they do so in the comfort and familiarity of the care consumer's home. They could help for a day or a week, allowing you a longer break.
• Counseling. When routines become a burden or you, as a caregiver, are overcome by your responsibilities or suffer from depression, it's time to seek out professional help for yourself. Major (or clinical) depression is marked by acute feelings of hopelessness, loss of appetite, frequent crying, difficulty concentrating, loss of joy and thoughts of harm to the care consumer or yourself. If you experience any of these symptoms more than once, consult your doctor.

Caregivers need all the help they can get. The more you take on yourself, the more likely you are to succumb to its mental, physical and emotional rigors. And if you become ill, that will only further compromise your ability to deliver care to your loved one.