Caregiver Stress: Caregivers Need Care Too

June 5th, 2016   •   no comments   
Caregiver Stress: Caregivers Need Care Too

A caregiver cares (either paid or unpaid) for someone (usually a family member) with an impairment with his or her daily activities. Caregiving is most typically used to address impairments related to old age, illness, injury, disability or mental disease. Caring for a loved one can be very rewarding, but it can also be challenging and stress from caregiving is common. Research suggests that women are especially at risk for the detrimental effects of caregiver stress. (1),(2).

 

Sources of stress can be for example household disruption, changes in the family dynamic, the added workload and financial pressure. Caregiver stress is particularly damaging as it is usually a permanent, long-term challenge. If you are a caregiver, you may face several years or even decades of caregiving duties. It can be very disheartening as there’s no hope that the person you care for will get better. If the stress you receive from caregiving is left unchecked, it may take a toll on your health, state of mind, relationships and ultimately leading to burnout.

 

When you put your own health at risk, it hurts both you and the person you are caring for as it affects your ability to provide care. The key takeaway from this article is that caregivers need care too! Taking care of the stress levels in your life is equally important as making sure the person you care for gets to her doctor’s appointment or takes his medication on time.

 

Do you know the safety warning in airplanes before take-off? Do you know what it tells you? Put the oxygen mask on yourself first and THEN you can help others.

 

Your family member needs you. Please take care of yourself!

Are You At Risk For Caregiver Stress?

 

A report from the National Alliance for Caregiving (3) suggests that in 2014 there where approximately 43.5 million Americans that provided unpair care for an adult or child. The majority of the caregivers are female (60%), but 40% are male. Most caregivers are taking care of one person (82%) and the average caregivers is 49 years of age. The majority of caregivers provide care for a family member (85% ) while 49% of cares for a parent or parent-in-law.

 

The number of people that are at risk for caregiver stress are significant. We just saw there are approximately 43.5 million Americans that provide care and about 20% of the caregivers report a high level of physical strain resulting from caregiving. Approximately 40% consider their caregiving situation to be emotionally stressful. That’s well over 17 million caregivers! According to The Home Instead Senior Care Network and Dr. Peter Vitaliano, stress expert at the University of Washington, there are several risk factors for caregiver stress (4). Persons who suffer from caregiver stress are likely to be:

 

  1. Female caregivers: Women report more psychological stress than their male counterparts. (however men experience more negative physiological effects to caregiving, such as elevated cholesterol, immune impairment and risk for obesity). Female caregivers may also be less likely to get regular screenings, and they may not get sufficient sleep or regular physical activity (5).
  2. Caregivers suffering from chronic illness: Chronic illness (such as cancer, coronary disease, hypertension) places caregivers at risk for poorer physiological health when compared to healthier caregivers.
  3. Caregivers who lack adequate financial resources: Adequate financial resources enable family caregivers to develop several options to better cope.
  4. Caregivers who are not comfortable to ask help: Caregivers that will not ask for help are vulnerable to the kind of exhaustion that follows from stress.
  5. Caregivers who lack coping skills: Avoiding issues, blaming others or blaming themselves can make caregivers more vulnerable.
  6. Caregivers of a spouse with Alzheimer’s disease: Research conducted by Dr. Vitaliano suggests that caregivers who care for a spouse with Alzheimer’s disease or another form of dementia may face an increased risk of mental deterioration themselves.
  7. Caregivers who have difficulty solving problems: Caregivers who try to work out their problems or to find ways to make caregiving easier find themselves better off.

 

Other vulnerable groups for caregiver stress include older caregivers, higher-hour caregivers (those providing more hours of care weekly) and caregivers who don’t have a choice in taking on their caregiving role.(6).

 

What Are Sources Of Caregiver Stress?

 

Being a caregiver can put a great deal of pressure on you and many caregivers are often times surprised by the amount of stress they experience. Some of the pressures that caregivers may face are:

 

Shift in Roles

 

When you provide care for an elderly parent, it may be difficult to see someone who used to be caring for you now in need of help, this often involves basic activities such as driving or getting dressed. In general, it’s very difficult to see a loved one in a vulnerable position and it’s also difficult for a care recipient to be feeling helpless. This shift in roles can take a toll on the parties involved.

 

Fear or Uncertainty

 

Being a caregiver comes with heavy responsibility and sometimes frightening situations. If you are caring for someone with a serious disease such as cancer, you are probably also dealing with worries about the care recipients future. Also when you provide care for a child with special needs, you may feel uncertain on how to proceed.

 

Demands of Continous Care

 

A lot of caregivers provide round-the-clock care, or spend almosy every free moment to attend to the needs of the care recipient. Other caregivers consider their responsibilities less constant, but still they feel like they need to be constantly available, as they never know if they’ll be needed at one particular moment or the next. This feeling of being “on standby” or “always on duty” can place a heavy load on a caregiver.

 

Financial Pressure

 

When medical bills and other treatment bills accrue, and there is less energy available for work, caregivers frequently experience financial pressure too.

 

Little Time Alone

 

While they often experience social isolation, it’s also common for caregivers to have very limited time alone. Not getting enough alone time can impact you physically and emotionally. Especially for introverts being alone with their thoughts is as replenishing as sleeping and as nourishing as eating. The stress of having little time alone can be confusing if you also feel isolated, but these feelings can coexist within caregivers, both adding to their stress level.

 

Guilt

 

At times the responsibilities combined with feelings of isolation can be overwhelming leaving caregivers feel burned-out. Feelings of guilt may then arise as well, as if you are being disloyal when you feel isolated and overwhelmed. Guilt may also arise if caregivers feel they are’re not making their care recipient as comfortable as possible, even if they already did everything they could.

 

Above are just some of the sources of stress that caregivers commonly experience and because many feel enormous amounts of stress they think they are not doing things as right as they should. If you feel that way too, I hope my article puts you a little at ease. You and other caregivers do face a lot of pressure and stress is only a natural reaction to it. While it may be difficult to find the time, energy and resources to take good care of yourself, it’s important to make a priority out of self-care. Please read on to get some great tips on managing stress and preventing caregiver burnout.

 

Tips For Overcoming Caregiver Stress: Tip 1

 

Identify Personal Limitations

 

Often your attitudes and core beliefs form personal limitations that prevent you from caring for yourself. Not looking after yourself could be a lifelong pattern, while looking after others comes easier to you. But, as a caregiver you should always ask yourself “How good can you care for someoneone else if you become ill yourself?” It’s not easy to break old patterns and overcome obstacles, but it can be done, you can do it – no matter what your age is or what situation you find yourself in. Your first step to removing personal limitations to self-care is to analyse what specifically is in your way. For example: 

 

  • Do you believe it’s selfish if you put your own needs first?
  • Is it frightening even to think about your own needs? So what is this fear about?
  • Do you have trouble asking for what you need? Do you feel incompetent if you ask for help?
  • Do you believe you have to demonstrate that you are worthy of the care recipient’s affection? And as a result, do you do too much?

 

In some cases caregivers have (developed) misconceptions that add to their stress and prevents proper self-care.

Below you find some of the most commonly expressed:

  • Personalization: I’m responsible for my family member’s health.
  • Fortune telling: If I don’t do it, no one will. Or: If I do my best, I will get the love, attention, and respect I deserve.
  • Overgeneralization: Our family always takes care of their own.
  • Emotional reasoning: I made a promise to my Dad I would always take care of my Mom.

 

Another possible barrier that can cause unnecessary stress and anxiety is negative self-talk. Examples of negative self-talk are “I’m too tired to exercise” or “I never do anything right”. Rather, try positive self-talk that empowers you such as “I can exercise for 20 minutes a day” or “I’m great at giving Mary a bath”. Your mind believes whatever you tell it!

 

Your behavior is based on your thoughts, beliefs and attitudes. So misconceptions like those we talked about can cause you to continually try to do what can’t be done and to control what is outside of your control. As a result you may experience feelings of continued failure, frustration and develop a tendency to ignore your own needs. So, ask yourself now what is getting in your way and keeping you from self-care?

Tips For Overcoming Caregiver Stress: Tip 2

 

Reduce Personal Stress

 

The way we perceive and react to a situation is a key factor in how we adjust and deal with it. Transferring this to caregiver stress: The stress you experience is not just the result of your caregiving situation, but also the result of how you perceive it. Do you see the glass as half full or half empty? What is important to realize is that you are not alone in your experiences.

The amount of stress you experience is influenced by a lot of factors, such as:

  • Wether or not there is support available.
  • Whether caregiving is voluntary. If you feel there was no other option than for you to take on the responsibilities of caregiving, chances are greater that you will experience stress, resentment and strain.

But also:

  • Your specific situation. Obviously not every caregiving situation is the same, some are more stressful than others. As an example, caring for a person with a physical limitation is often less stressful than caring for someone with mental health condition.
  • Your coping abilities (the methods you use to deal with stress). How you coped with stress in the past is an indicator of how you will cope now. Find out your current coping behavior so that you can adjust negative coping behavior and try to adopt healthier behaviors instead.

 

Tips For Overcoming Caregiver Stress: Tip 3

 

Set Goals 

 

Most successful people have a plan for what they are doing. For example, an architect has blueprints, which are plans, to construct all sorts of buildings. Business people have their own business plans to monitor whether they are achieving their business objectives and to identify where they are now and in which direction they want their business to grow.

 

In order for you to learn to take better care of yourself it’s good to have a plan too! Set goals, decide what you want to achieve in the next 3 to 6 months. To give you an idea I have listed a few sample goals below that you may set:

  • Get involved in a stress management course.
  • Start with a support group.
  • Take a break from caregiving (consider respite care).
  • Get help with caregiving tasks like preparing meals and bathing.
  • Take on activities that will make you feel more healthy.

 

In general, goals are too big to go after all at once, but you can break them down into smaller action steps. As soon as you are clear on your goal(s) you can ask yourself, “What smaller action steps can I take to reach this goal?” Start writing down a detailed action plan and decide on your goals and action steps. Once you are done, get started working towards your goals!

 

Example:
Goal: Feel healthier and more energetic.
Possible action steps:

  1. Schedule an appointment for a physical check-up.
  2. Schedule 30 minutes “me time” every day.
  3. Walk three times a week for 20-30 minutes.
  4. Eat a nutritious and healthy diet.
  5. Learn to take time off without feeling guilty.

 

Tips For Overcoming Caregiver Stress: Tip 4

 

Ask For & Accept Help

 

A lot of caregivers don’t know how to leverage the goodwill of other people and they are unwilling to ask for help. You may not want to “trouble” others or show that you can’t handle it all by yourself. So when people ask you if they can be of help, how often do you reply, “Thanks, but I’m OK”?

 

Help can come from friends, professionals, family and community resources. Just ask around. Don’t wait until you are overworked, burned out or your health is failing. Reaching out for help when you need it is not a sign of weakness or incompetence, but rather a sign of personal strength. When you break down the work in smaller simple tasks, it’s easier for people to help you. For instance, people can help you by going on a 15-minute walk  with the person you care for a few times a week. Your neighbor could stop by the grocery store to pick up a few things for you. Or a family member or friend could fill out a few insurance papers.

 

In addition, you can also follow the example of the many caregivers that seek support online. Make sure to search for groups that focus on caregivers only and not groups that combine family and patient. It’s important that you can be honest about your own issues, concerns and feelings without worrying that you hurt someone’s feelings.

 

Some good places to get started are Caring.com; this website officers caregiver support groups for a wide range of conditions at caring.com/support-groups. AARP’s online caregiving resource center provides a space to connect with others facing difficulties around caregiving for the elderly; for issues around caregiving with the elderly you may visit also the caregiver support section at AgingCare.com.

 

Tips For Overcoming Caregiver Stress: Tip 5

 

Learn From Your Emotions

 

Your emotions are messages to which you should listen. They are there for a reason and it’s very benficial when you are able to recognize when your emotions are controlling you (instead of the other way around where you are in control of your emotions). No matter how painful or negative, your feelings are great tools to understand what’s happening to you. Feelings such as anger, guilt, resentment and jealousy all hold important messages. So learn from your emotions and take action.

 

Caregiving may bring a range of emotion and some feelings are more enjoyable than others. Whenever  you experience that your emotions are intense, they may mean the following:

  • You are experiencing heightened stress.
  • You should be assertive and ask for what you need.
  • You should make changes in your caregiving situation.
  • You are grieving a loss.

 

Tips For Overcoming Caregiver Stress: Tip 6

 

Start Exercising

 

You may be fearful to begin exercising, although you know that it’s very healthy for you to do so. Maybe you think that physical exercise is for the young who are able to do activities like jogging or that exercise might harm you even. Fortunately, research indicates that you can maintain or at a minimum partially recover balance, strength, flexibility and endurance through everyday physical activities like walking, cycling, vacuum cleaning and gardening. So as you can see, also household chores can improve your health.

 

Exercise has a lot of benefits for your health, it reduces tension and depression, it increases energy and alertness and it promotes better sleep. If you cannot find time for exercise, you can incorporate it into your daily schedule. Maybe your care recipient can walk or do flexibility exercises with you. You may also choose to engage in frequent short activities, instead of those that take larger amounts of time. Find and do activities you enjoy!

 

One of the best and easiest exercises is without a doubt: walking. Walkings is a great way to get started and it helps to reduce psychological tension besides the physical benefits it brings. Try to walk 20-30 minutes a day for three times a week. If that is too long or too often for you, go as long and on as many days as you can. Also try to incorporate walking into your life, walk to the store, around the mall or walk or take a walk around the block after lunch.

 

Summing It All Up

 

Remember, when you are a caregiver it is NOT selfish to pay attention to your own needs and desires. In fact, it’s a crucial part of the job. You are responsible for your own self-care needs. Make sure to focus on the following self-care practices:

  • Attend to your own healthcare needs.
  • Eat a healthy well-balanced diet and get enough sleep.
  • Exercise regularly, if only for 20-30 minutes at a time.
  • Take time off without feeling guilty.
  • Say “no” to requests that are draining and stressful.
  • Seek and accept the support of others.
  • Identify and acknowledge your feelings, you have a right to ALL of them.
  • Change the negative ways you view situations.
  • Set realistic goals. Break large tasks into smaller steps that you can do one at a time.
  • Take a break, while ensuring your loved one is well cared for. Use respite and healthcare resources available to you. 
  • Identify and focus only on the things you have control over. You can’t control someone else’s behavior, but you surely can change the way that you respond to it.
  • Join a support group for caregivers. If your care recipient has a particular health condition, such as dementia or Alzheimer’s search for a support group targeted at that disease.

 

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References & Further Reading

 

  1. National Alliance for Caregiving & AARP. (2004). Caregiving in the U.S. Washington, DC: Author
  2. Johnson, R.W. & Wiener, J.M. (2006). A Profile of Older Americans and Their Caregivers (Occasional Paper Number 8), Washington, DC: The Urban Institute
  3. National Alliance for Caregiving, in collaboration with AARP. (2015). Caregiving in the U.S., 2015
  4. http://www.caregiverstress.com/wp-content/uploads/2013/05/Caregiver-Distress-Risk-Factors_US.pdf
  5. American Psychological Association. (2012). Stress in America: Our Health at Risk. APA: Washington, DC
  6. National Alliance for Caregiving, in collaboration with AARP. (2015). Caregiving in the U.S., 2015

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