Taking Care Of The Caregivers

By Jan Howard

There are between 18 and 25 million family caregivers in the United States, about ten percent of the adult population. They provide two-thirds of the home care services in this country.

The market value of the services that caregivers provide is over $190 billion a year.

However, caregiver burnout is often the cause for people entering nursing homes, rather than a worsening medical condition.

 Eighty percent of all family caregivers are women, and 70 percent are between the ages of 40 and 59.

It is important for the caregiver to take care of herself in order to have the capability to continue to care for her loved one.

“Making Sure to Take Care of the Caregiver” was the subject of a seminar by Vickie Santore, LCSW, clinical director of the Family Counseling Center of Newtown, on November 21 at the C.H. Booth Library.

Sixty-five percent of caregivers don’t get help from family or friends, Ms Santore said.

Frustration is the most frequently felt emotion expressed by caregivers, she said. They rate loss of leisure, the change in family dynamics, and feelings of isolation as the most burdensome aspects of being a caregiver. Caregivers often suffer from prolonged depression, she noted.

Some stress indicators are muscle tightness in the neck and shoulders, prolonged headaches, inability to sleep, pains that wander about the body, gastro-intestinal and stomach problems, restlessness, and gritting of grinding teeth. Numerous small accidents because of fatigue and lack of sleep, mood swings, increased outbreaks of arthritis or bronchitis, inability to do tasks, watching television all day, or being over-anxious are also signs of stress.

 These same symptoms, among others, can also indicate depression, Ms Santore said.

“Depression can decrease your ability to care for others,” she said.

Ms Santore said being an overachieving caregiver could result in burnout, depression, or illness.

Do you feel that no one can look after your relative as well as you can?

Do you go for weeks without taking even an hour off?

Would you feel you had abandoned your relative if you took him or her to a day respite program?

Do you feel that only you can understand him or her and that letting others provide care would hurt, frighten, or otherwise damage your relative?

Do you feel anxious, exhausted, or irritable most of the time?

Do you secretly feel angry with your relative, and then feel deeply ashamed of your unnatural feelings and become obsessed by guilt?

Have you dropped all your previous hobbies, friends, and interests?

Would you rather die than let your relative go into full-time professional care?

Do you avoid going to support groups because you could never share your feelings with strangers, and/or you are sure such groups are full of people who just make each other miserable?

Do you keep all your fears, needs, and feelings to yourself because you aren’t the kind of person who shares such things with others?

Are you sure that no good caregivers can be found?

“If you had two or more yes answers, it puts you as an overachieving caregiver,” Ms Santore said.

It is important to keep in mind the ability of the person being cared for, she said. “What do they want to see happen? Is it realistic?”

Caregivers also have fears, she said, such as the fear of financial problems – that money will run out. They also fear they will fail as caregivers, that they will be unable to handle emotional stress, or that they will make the wrong care decision.

Other fears of caregivers may include fear of dementia in their loved one, inability to handle the patient’s violence or aggression, and inability to advocate well enough for their loved one’s needs.

They also fear their own needs will be sacrificed, losing themselves, and having their own needs unfulfilled. They also have the fear of admitting to their emotions and the fear of facing life alone.

“How do you handle the holidays when you are a caregiver?” Ms Santore asked. “How do you work care giving into the holiday?”

It is important for caregivers to take care of themselves, especially during the holidays, Ms Santore said.

This includes exercising, eating right, shopping early, setting limits, planning ahead of time, and getting enough sleep.

“Don’t hesitate to change holiday traditions,” she said. “Change how you do things.”

Plan to be with people you enjoy, buy yourself something special, do something for others, and have someone do something for you, she said.

“On a daily basis, take a few minutes for yourself,” Ms Santore said. “Get up early and work out. Read poetry. Read poetry to the person you’re caring for.”

Add small amounts of time for meditation and relaxation techniques. Do breathing exercises for relaxation, she suggested. “Breathe in deeply through your nose and let it out slowly with your mouth. It sends oxygen to the brain. Do it three or four times. It calms you down. Part of the panic state is you forget to breathe.”

Find a comfortable chair and drink a cup of tea. “A rocking chair is a soothing place to sit. Rocking is soothing,” she said.

Break tasks down so they don’t look so large, she suggested. “Focus on the little pieces.”

If a caregiver is suffering any of the symptoms of depression, they should consult a therapist who understands a caregiver’s concerns. “Make sure the therapist knows what you’re going through.”

Depression of the caregiver can affect other family members more than the chronic illness of the patient, she noted. “You need to call other people in to help,” she said.

One of the most important things to do is to keep a journal of your feelings, Ms Santore said. “Keeping things inside can escalate into illness. Express your frustrations.” But keep the journal locked up so the person you’re caring for doesn’t see it, she added.

The most difficult thing about taking care of yourself is finding the time, she noted.

“If you’re looking to find time, it’s not going to happen. You have to make time,” Ms Santore said. “If you take time for you, there will be something that might not get done. Look at your expectations. Are they unrealistic? How much does it matter that everything gets done?”

A sense of humor will get you through the hardest times with your sanity intact, she said. “It relieves the tension.”

Relaxation is important. “Do something that’s fun,” she said.

“There is no manual on being a caregiver,” Ms Santore said. “You do the best you can.”