Care for the Caregiver: The Need and the Reality

Caring for an ailing loved one can lead to increases in stress, anxiety, and depression. It can also be incredibly rewarding

More than 50 million Americans care for a family member or friend with a chronic illness, disability, or advanced age during any given year (National Family Caregivers Association, 2000). Caregiving costs $306 billion annually (NIH, 2000) Caregivers are at greater risk of illness and/or death (JAMA)

Signs that caregiving may be becoming too risky (adapted from caregiverstress.com) Missing or delaying own doctor’s appointments Ignoring own health problems or symptoms Not eating a healthy diet Overusing tobacco or alcohol to deal with stress

Giving up exercise habits Losing sleep Losing connections with friends Bottling up feelings of anger and frustration Feeling sad, down, depressed, or hopeless much of the time Loss of energy Loss of interest in things that used to give pleasure

Blaming ill person for the situation Feeling that people ask more than they should Feeling like caregiving has affected family relationships in a negative way Feeling annoyed that others don’t help out Feeling annoyed that others criticize caregiving Feeling resentful towards ill person

CAREGIVER STRESS SELF-ASSESSMENT

“If you don’t take care of yourself, you will never be able to continue taking care of your loved one. This means eating right, getting adequate rest, building exercise into your schedule, and keeping up with your own medical appointments.” (caregiverstress.com)

Ways to avoid and manage caregiver stress (adapted from caregiverstress.com) Work out Meditate Ask for help (even of ill person) Take a break

Indulge – massage,manicure, etc. Find support Laugh Eat well Take care of yourself Adult day care Respite care Challenge irrational thoughts

Irrational beliefs – albert ellis It is a dire necessity for adult humans to be loved or approved by virtually every significant other person in their community. One absolutely must be competent, adequate and achieving in all important respects or else one is an inadequate, worthless person.

People absolutely must act considerately and fairly and they are damnable villains if they do not. They are their bad acts. Emotional disturbance is mainly externally caused and people have little or no ability to increase or decrease their dysfunctional feelings and behaviors.

It is awful and terrible when things are not the way one would very much like them to be. If something is or may be dangerous or fearsome, then one should be constantly and excessively concerned about it and should keep dwelling on the possibility of it occurring.

One cannot and must not face life's responsibilities and difficulties; it is easier to avoid them. One's past history is an all-important determiner of one's present behavior and because something once strongly affected one's life, it should indefinitely have a similar effect.

One must be quite dependent on others and need them and one cannot mainly run one's own life. Other people's disturbances are horrible and one must feel upset about them. There is invariably a right, precise and perfect solution to human problems and it is awful if this perfect solution is not found.

Rational emotive behavior therapy A – activating event or potentially stressful situation B – beliefs, thoughts, or perceptions about A C – emotional consequence that results from holding these beliefs A potentially stressful situation + your perceptions = your stress level

Caregiving example

SELF CARE Prevention and Management of Burnout

Stages of Burnout

Prevention of Burnout

HOW MANY HOURS IN A WEEK?

SLEEP MEALS COMMUTING ERRANDS FAMILY TIME GROOMING CAREGIVING RECREATION MAINTAINING RECORDS MEETINGS UPGRADING SKILLS COMMUNITY SERVICE SPIRITUAL/RELIGIOUS PRACTICES

SETTING PRIORITIES WORK FAMILY FRIENDS COMMUNITY SPIRITUAL/RELIGIOUS RELAXATION HEALTH

WORK PRIORITIES COMPETENCE TRAINING PROMOTION RECOGNITION INCOME

FAMILY PRIORITIES NURTURE RELATIONSHIPS TIME WITH PARTNER TIME WITH CHILDREN RESOLVE CONFLICTS HAVE FUN TOGETHER

FRIENDSHIP PRIORITIES DEEPEN RELATIONSHIPS SPEND TIME TOGETHER PARTY

COMMUNITY PRIORITIES VOLUNTEER ACTIVITIES CLEAN-UP CAMPAIGNS SPECIFIC CAUSES

SPIRITUAL/RELIGIOUS PRIORITIES DEEPEN SPIRITUAL LIFE FELLOWSHIP WITH OTHERS PRAYER MEDITATION STUDY BALANCE

RELAXATION PRIORITIES VACATION MASSAGE PERSONAL DEVELOPMENT HANG OUT

HEALTH PRIORITIES EATING HABITS SLEEPING HABITS EXERCISE PHYSICAL RENEWAL MENTAL/EMOTIONAL RENEWAL

PUTTING IT ALL TOGETHER

GOAL SETTING: WHAT DO I WANT AND WHY DO I WANT IT? When the WHY gets stronger, the HOW gets easier Goals need to be specific, doable, and measurable

GOAL SETTING GOAL REASON Objective #1 Objective #2 Objective #3 Example: Improve health in order to have more energy – Exercise 30 minutes 4 times/week – Lose 1.5 pounds/week for a total of 25 pounds – Eat calories/day

GOAL SETTING – do it yourself

SUCCESS QUESTION WHAT CAN I DO TODAY THAT WILL HELP ME TOWARDS MY GOAL? What can I do for exercise today? What can I do today to enhance my relationship with my partner? What can I do today to nurture myself?

Self-Care Exercise Make a list of at least 20 things you enjoy Put $ next to those that cost less than $10 Put “A” for those you prefer to do alone Put “T” for those you prefer to do together with someone Put “B” for those that you enjoy equally alone or together Put 15 for those you can do in 15 minutes or less Put an asterisk by those that have a $,15,and A

Self-Care Contract Pair up – share lists Develop contract for what you will do to have fun during the next week Is it specific? Measurable? Doable? Select someone in your life with whom to be accountable