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Information and resources for today's
family caregiver.
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"Steps to Managing Stress"
"If you would like to live a quiet, peaceful life, you are living at the wrong time." -- Anonymous
One of the first exercises in the Powerful Tools for Caregivers (PTC) classes involves asking each participant to list "One problem I face as a caregiver." As people share their stories, there are lots of "me, toos" with each new addition to the list. It is quickly obvious that most caregivers face multiple anxiety-producing challenges. Caregivers who feel the least stress tend to be those who have:
- freely chosen their caregiving role rather than having it forced onto them
- a strong, loving relationship with the care receiver
- developed effective coping skills
- a strong support network of helpers to share the responsibilities
- the easiest responsibilities
The definition of "easy responsibilities" varies from person to person, but most people would agree that a person who helps to balance his parent's checkbook once a month is less likely to feel overwhelmingly stressed than someone who is responsible 24-hours a day for all aspects of a loved one's care. On the other hand, if balancing the checkbook always seems to result in arguments over how money is spent, that task too can be very stressful. Furthermore, a person who starts out feeling able to handle a spouse or parent's care may become more strained over time as the care receiver's needs increase. For example, some people with Alzheimer's disease may live 10 years or longer. It is natural for caregivers to wear out, especially if they do not have a strong support network. Neglecting stress can lead to:
- Physical health problems (headaches, backaches, digestive problems, etc.)
- Disrupted relationships
- Depression or other mood disorders
- Decreased quality of life and quality of care
The first step to finding relief in the midst of challenges you face is to
recognize your warning signs of stress. Here are some common warning signs:
- Over or under eating
- Physical discomfort (knots in the neck, stomach upsets, headaches)
- Change in sleep patterns or feeling exhausted
- Increased consumption of medications, alcohol, caffeine or cigarettes
- Overall "jumpiness" or anxiety
- Being short-tempered (something that may be pointed out to you by others if you don't notice it yourself)
Once you recognize your warning signs of stress, the second step is to look for the triggers. What are your sources of stress? Common answers include such things as:
- Too many demands on your time and energy
- Conflicting responsibilities such as balancing work and caring for others
- Financial worry
- Carrying an unfair share of responsibilities
- Conflict with others over how care should be managed
The third step is to recognize what you can change. Usually this involves:
- Changing a situation
- Changing your perception
- Changing your response
If you are overwhelmed by your caregiving responsibilities, you may be able to change the situation by getting additional help or taking the care receiver to an adult day center several times a week. For example, if you are upset that your disabled husband's friends no longer visit regularly, you can change your perception by recognizing that they may be grieving the loss of the type of relationship they had with him. (This is also known as "reframing" the situation.) If you are impatient with your parent's "organ recital," i.e., the litany of all that ails him or her, you can change your internal response by smiling inwardly and adding it to the list of things you vow never to do to with your own children as you age.
Ultimately, there are some things that cannot be changed. Many of us are caregivers of people who are stubborn, demanding and exasperating. Sometimes those are characteristics they have exhibited throughout life. Sometimes they are characteristics that have surfaced as they have lost control of their health and decisions affecting their lives. Either way, they aren't likely to change. Many of us are caregivers for people with diseases that have no known cure. Although medical research has made phenomenal advances, too many diseases are still unstoppable. It isn't easy, but it is best to let go of what cannot be changed. Therefore, the fourth step in reducing stress is to accept that what is, is. Identify your unrealistic expectations and give them up.
All of these steps will have little effect, however, if you don't practice the fifth step:Incorporate stress-reducers into your daily life. Weekly action plans are encouraged in the Powerful Tools for Caregivers classes because most of us do not automatically build pleasurable events into our lives. Indeed, many of us feel guilty for doing something enjoyable for ourselves. A stress-reducer is anything that:
- Helps you relax
- Is soothing and pleasurable
- Makes you feel good
- Can be built into your life on a regular basis
That last point is important. Most of us can't manage regular trips to the Riviera, and most of us don't need anything so elaborate. Many stress reducers are simple acts of self-indulgence: a cup of tea, a bubble bath, taking a walk in a park, reading a good book, visiting with a friend, going to bed early or laughing at a good joke. Yet far too many of us fail to incorporate even these simple things into our daily lives. Therefore, the next issue of Caring with Confidence will focus on how we can treat ourselves better.
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"Coping through Exercise"
by Daniel Kuhn, MSW, Mather Institute on Aging
Funny lady Lilly Tomlin once remarked that, "Reality is very stressful for those of us in touch with it." For individuals who care for a relative or friend with a chronic medical condition, life can indeed be very stressful at times. Among ways to alleviate stress, a wealth of scientific data support the fact that a regular exercise program is an effective means. As a caregiver, you may overlook the need for exercise when the needs of loved one with a chronic illness take precedence. Stress related symptoms often emerge such as anxiety, depression, insomnia, fatigue and other bodily ailments.
Exercise can help the human body maintain, repair and improve itself while giving the added benefit of easing one's mind of undue worry. A variety of physical activities can be carried out in the course of a normal day. One need not join a health club but that option can offer both a place and structure for a healthy routine. Exercise can be worked into daily tasks such as housekeeping, yard work, and personal grooming. Good old-fashioned walking has become quite popular in recent years. Jogging and aerobics are crazes that continue to grow for people of all ages. Exercise programs on television abound. Community centers and YMCAs typically sponsor exercise classes on a regular basis and many have well-equipped fitness rooms. There are also countless workout videotapes and books, even for frail, older people. There are many other indoor and outdoor activities such as swimming and golf that are therapeutic and fun.
Some of these activities can be done together with the person with a chronic illness. However, a separate exercise program is advisable so you can suit your own needs and preferences. A man who cares for his wife with Alzheimer's disease said the following about the importance of exercise: "I am 65 years-old and have been retired a few years so I have time to get out often while my wife is cared for temporarily by others. I try to do something for about an hour every day - mostly walking and bicycling along with canoeing and cross-country skiing as weather permits. I probably do more than necessary but it helps me to feel good. Doing something can start a cycle of feeling better, doing more, feeling even better and so forth."
Exercise is a simple and inexpensive way to promote health. Choosing the right kind of activities in consultation with your physician and arranging for relief from providing full-time care can set the wheels in motion. It is customary to experiment with different activities and schedules before exercise becomes a routine part of life. Within a relatively short time, the benefits of exercise will become apparent to you and others.
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