inMotion: Survival Guide for Caregivers: De-stressing to Stay Healthy

image: woman comforting elderly man in wheelchair If you:

use prescription drugs for depression, anxiety or insomnia 2-3 times more often than the general population
lose an average of $659,000 in wages, pensions and Social Security benefits over a lifetime
are age 66 to 96 and have a 63 percent higher risk of dying than other people your age

what are you?

Answer: One stressed-out caregiver.

More than 50 million Americans are providing unpaid care for family members who are elderly, chronically ill or who have a disability. Sadly, studies show that these caregivers (also called informal or family caregivers) are less likely to take proper care of themselves. To focus on caring for their loved ones, these caregivers often feel little choice but to let their own health and well-being slide.

Much of the wear and tear on caregivers is linked to the stress their responsibilities place on them. In the Spring 2005 issue of Take Care!, Suzanne Mintz, president of the National Family Caregivers Association (NFCA), wrote of the dangers of stress to family caregivers. “We need to get family caregivers to recognize that they are at risk and that failing to acknowledge their severe stress will undermine their own health and, in turn, their ability to provide good care,” she warned.

Caring for Themselves

Although caregivers have many demands on their time, it is important that they allow for self-care periods and do some essential self-maintenance practices. Abigail Joyce, NFCA manager of communications, says that caregivers can practice self-care by adhering to the NFCA's Principles of Family Caregiver Self Advocacy.

These principles are:

Choose to Take Charge of Your Life.
Love, Honor, and Value Yourself.
Seek, Accept, and at Times Demand Help.
Stand Up and Be Counted.

(For a more detailed explanation of these principles, visit the NFCA Web site at www.thefamilycaregiver.org/about/philosophy.cfm)

“It is really up to the caregiver as to what helps them de-stress,” says Joyce. “But caregivers do need to remember that they need to take care of their bodies– whether it be alternative therapies or regular exercise or hot baths. Caregivers need to take care of themselves because the person they are taking care of relies on them.”

Getting Help From Others

Joyce further emphasizes that caregivers must remember that they are part of a community. “Many caregivers feel isolated and alone,” she says. “Caregivers should remember that they are not alone, that there are many other caregivers, and just like with anything else, tomorrow is a new day. As a caregiver you will have good days and bad days. Don't be so hard on yourself on those bad days.”

Zanda Hilger, LPC, a consultant with many years of experience in caregiving and a family caregiver herself, shares this sentiment. “This is not a ‘do-it-byyourself' job,” she says, noting that“asking for specific help from others, especially family members,” is crucial to caregivers having the necessary time to take care of themselves.

Organization Is One of the Keys

Getting organized is also a frequently cited way to lower stress. One of the most useful things caregivers can do is “prioritizing what has to be done while setting healthy boundaries and limits,” says Hilger. “What do you have control over and what can you influence?”

Joyce too acknowledges that getting organized is important, but she also points out the need for flexibility, saying,“Sometimes even the best-laid plans get pushed aside because unexpected situations come up when you are a caregiver.”

However, some parts of getting organized are simple to do, and, once done, they will help limit the stress of everyday tasks. The following three organizational ideas might be useful, for example:

Write down and prioritize your daily routine and eliminate nonessential, distracting elements in it.
Ensure that your care receiver's financial, legal and medical records are in order and easily accessible.
Post lists of phone numbers, medicines, and other important information where you can easily find them.

Staying Healthy

The NFCA and other caregiving organizations offer additional self-care recommendations for helping caregivers stay healthy and manage stress. Specific guidelines vary, but they have many basic points in common. The following guidelines should be beneficial:

Eat healthful meals each day.
Get sufficient rest and sleep.
Exercise regularly; monitor your physical health.
Accept and express feelings; monitor your emotional health.
Set aside time for yourself.
Seek and accept the support of others.
Sustain your spiritual side.

Following are some tips on these guidelines, compiled from numerous sources. In addition, several books, videotapes and Web sites on caregiver self-care are available, and organizations like the NFCA stand ready to help.

Meals

Eat lots of fruits, vegetables and whole grains. Ask your physician about vitamin supplements.
Drink plenty of water and other nonalcoholic, noncaffeinated fluids.
Indulge in a favorite dish if you are stressed. “Comfort foods” like pasta and potatoes that are high in complex carbohydrates may actually make you feel better.
Prepare extra portions when you are cooking. Put leftovers in individual containers and place them in the freezer for quick, ready-to-heat meals; don't forget to label the packages.
For occasional time off from meal-making, take advantage of groups like Meals on Wheels that will provide nutritious meals to older people and people with disabilities for free or for a minimal charge.

Rest and Sleep

Maintain a regular sleep schedule, and follow a consistent bedtime routine if possible.
Don't exercise too close to bedtime.
Don't consume caffeine or alcohol in the evenings.
Turn down the thermostat. Cooler temperatures help induce sleep.
Listen to relaxation tapes to lull yourself to sleep.

Exercise and Physical Health

Schedule and keep regular physical checkups.
Make activities you enjoy your exercise regimen. Whether it's walking, swimming, biking, dancing, gardening or playing with children or pets, find an exercise outlet in a regular physical activity that already appeals to you.
If you enjoy participating in team sports or competitive sports, combine exercise and social interaction by making sports “dates” with friends.
Stretch. Stretching is a great physical picker-upper that can be done anywhere, even if you have only five or 10 minutes. Just a brief series of stretching exercises will help reduce tension and maintain muscle tone.

Emotional Health

Share your feelings. When a friend or family member asks how you are, answer truthfully.
Write your thoughts and feelings in a personal journal. This is a healthy way to both express and monitor your feelings.
Don't isolate yourself. As cramped for time as you may be, schedule visits with friends and family.
Develop your problem-solving skills. This will reduce your anxiety about issues confronting you.
Remember to laugh. Stock up on humorous books, magazines and videos, and build a list of links to humororiented Web sites and check them often. Strive to share a laugh with your care receiver at least once a day. (See related articles on pages 25-28.)
Learn calming exercises, such as deep breathing and meditation.
Develop the habit of embracing loved ones and friends and petting animals. Studies show that these behaviors lower the body's output of cortisol, a stress hormone. When cortisol dips, two “feel-good” brain chemicals – serotonin and dopamine – surge.
Pursue activities that offer emotional satisfaction and give you “time away” from yourself and your situation, such as listening to (or playing) music, reading poetry, meditating, communing with nature, or other creative pastimes.
Don't self-medicate with alcohol, overwork or drugs.
Common signs of depression include loss of appetite, sleeplessness, irritability, crying jags, inability to concentrate and forgetfulness. If you are experiencing these symptoms, contact a mental health professional for help. (See pages 14-18.)

Taking Time for Yourself

Accept that it's OK to do things that you enjoy. Whatever your favorite pastime may be, always take the time to engage in it, at least once a week and more often if possible.
Use family, friends, your religious group, respite care, home healthcare, or other services to arrange to take a break.
Reward yourself. Acknowledge that you deserve the occasional pampering.
Try to engage in activities that give your brain some “fun work” and that can be stopped at any time and resumed later. Reading a good book is one such activity. Jigsaw puzzles, acrostics, crossword puzzles, and similar brain teasers or chess and other games of strategy are others.

Accepting the Support of Others

When someone offers help, don't let shame or guilt stop you from accepting.
Keep a list of chores, errands and jobs you want to get done, and show it to people who offer to help.
Be clear, be specific, and keep requests simple. Break complex tasks into discrete steps. It's easier for others to help if the job doesn't seem overwhelming.
Match tasks to talents; ask the aspiring chefs who enjoy cooking for help with meals, green-thumb friends for help in the yard, and people who actually enjoy cleaning for help around the house.
Take comfort in knowing you are not alone. Join a caregiver support group.

Sustaining Your Spirituality

If you belong to a religious organization, attend services, talk to your spiritual guide, and ask for spiritual support from your group.
Find significance in your role as a caregiver by seeking positive meaning in it and considering how you may become stronger through it.
Whether religious or not, find faith in what you believe.

Survival Guide for Caregivers De-stressing to Stay Healthy

Survival Guide for Caregivers
De-stressing to Stay Healthy