Caring for the Caregiver

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With Mother’s Day approaching and May being Older Americans month, I started thinking about caregivers at the beginning and at the end of life, for those young and old. People most often associate caregiving with the harried young mother who has no time to shower or get dressed as she feeds, bathes and runs after little ones. However, those who care for seniors are often just as stressed, pressed for time and tied to their charges.

Caring for aging loved ones was never an easy prospect. However, up until now, caregiver stress was not much of an issue. Families lived in multi-generational households and together they shared the burden of their sick and elderly. Today, families are scattered and the responsibility for care usually falls on the spouse to shoulder almost alone. But, the spouse usually has their own physical problems of decreased mobility and strength as well as pain discomfort. Paying for outside help can be quite expensive and unless proper planning took place years before, funds are often not available for full time relief. It’s clear that these caregivers need help.

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Caregiving is exhausting business. Seniors needing care often have complex health problems warranting total care. Though it may be a labor of love, there is the routine activities of daily living (ADLs) such as bathing, grooming, dressing and feeding. Days may be centered around the need to properly nourish, ambulate and stimulate the patient. Those are all physically demanding activities that become even more so if the patient has dementia or a personality shift due to a disease such as Alzheimer’s.

Caregiver burnout is all too common. There is juggling the errands such as grocery shopping, pharmacy trips and laundry – all must haves. Except, seniors needing care are not as portable as infants, making the situation more stressful and coverage even more crucial. No matter how well intentioned the caregiver, a difficult situation may spark feelings of fear, resentment and frustration and, if left to fester, can easily turn into full blown depression.

Caregivers are often confined and isolated with no one on hand to ask questions to; day-to-day decision making can become burdensome. In a facility, the staff have each other. At home, there is only the caregiver and patient with short interludes of other family members, doctors and allied health professionals. Furthermore, the social support system for caregivers shrinks due to their responsibilities which in turn can contribute to a budding depression.

Almost as much of a problem is the tendency of caregivers to push their own health under the rug. They are notorious for skipping their own doctor appointments and ignoring their own aches and pains hoping they just disappear. Denial might make the short term easier, but may be detrimental in the long run preventing them from seeking appropriate care and properly plan. In fact, there is a higher incidence of health issues associated with caregivers than non-caregivers probably due to a combination of stress, age and a certain degree of self-neglect. All too often, caregivers reach damaging and unhealthy levels of stress before they come to the point of reaching out for help and support.

The same dangers of fatigue apply to hired home health aides as they too are vulnerable to stress and isolation. Additionally, since they are often from entirely different cultures, varying priorities and expectations on the part of the patient, their family and caregiver may cause tension. Even the most caring aide can transfer this back to the senior or even his family which is why it is important for the aide to work no more than 5 days a week on one case and for the family to have relief aides on hand.

This leads me to my next point, relief for family members. It is so important to care for the caregiver. Family and friends need to be offer practical support and watch for signs of caregiver stress. Here are some suggestions:

  1. Help with meals once a week or once a month. Even frozen food can be a help in a pinch.
  2. Run an errand sporadically or on a regular basis. Do the trip to the drug store or the like.
  3. ‘Senior-sit’ even one hour a week so the caregiver can get to the gym or a weekly class they enjoy.
  4. If you can afford it, pay for a cleaning service once in a while to pinch hit.
  5. Last, but not least, make a regular visit or just phone to show you care.

By the same token, caregivers must take steps to prevent any negative effects from their truly admirable work. Caregivers must seek the help of a friend, support groups or a physician, before their struggles become severe. Here are some steps to take:

  1. Keep in contact with friends, neighbors or relatives. Though they feel pressed, they need to maintain their ‘social contract’ with friends. Keeping active socially reduces stress and provides an outlet for the rollercoaster of emotions that come with caregiving.
  2. Seek out a support group. Many of the various associations that deal with diseases endemic to the elderly have regular, often local, support group meetings, even online.
  3. Get active. Ride a bike. Go for a run. Put in an exercise video. Keep the blood circulating and the mind sharp.
  4. Carve out ‘alone time’, even in the corner of the house, to read a book or watch a movie in peace. Some people find journaling daily thoughts and activities helps relieve stress.
  5. Seek help immediately if depression is suspected. Talk therapy with a social worker or psychologist can help work through the unique challenges felt by caregivers. Remember, care must be taken to avoid what has become all too common – prescription drug abuse.
  6. Keep your own nutrition up. That is the best way to maintain your health and energy level. You are a priority too!

Caregiving is praiseworthy, but lonely and challenging business – not for the faint of heart. However, if you make efforts to protect yourself while reaching out for help at the appropriate times, you will emerge healthy and fulfilled. Let me know if I can help!

Anita Kamiel, R.N, M.P.S. is the founder and owner of David York Home Healthcare Agency and is fully acquainted with all factors related to eldercare services and the latest guidelines for seniors.  She holds advanced degrees in gerontological administration and has experience in the field as a Nursing Supervisor in a nursing home.  Anita has been in the business of home care for over 40 years starting out in an NYC Medicaid agency.  Thirty years ago she realized the need for affordable, quality home health aide services provided and supervised by caring individuals, so she boldly opened David York Home Healthcare Agency in Brooklyn, New York. She is the mother of 4 and the grandmother of many and when she is not on adventures like safaris in Africa, she still works 6 days a week and runs to her workout classes 3 of those nights.  You can contact her at 718.376.7755 or at www.davidyorkagency.com where she is happy to share her experience and help you through your home healthcare issues.