Having a loved one that is dealing with an illness or disease is a hard pill to swallow. From the moment of diagnosis, your life is changed. The stresses and worries that plague a person with one of these conditions strike the caregiver as well. Your health and well-being is every bit as important as the health and well-being of the patient.
What is a caregiver?
A caregiver is anyone who provides help to another person in need. Usually, the person receiving care has a condition such as dementia, cancer, or brain injury and needs help with basic daily tasks. Caregivers help with many things such as:
Using the toilet
People who are not paid to provide care are known as informal caregivers or family caregivers. The most common type of informal caregiving relationship is an adult child caring for an elderly parent. Other types of caregiving relationships include:
Adults caring for other relatives, such as grandparents, siblings, aunts, and uncles
Spouses caring for elderly husbands or wives
Middle-aged parents caring for severely disabled adult children
Adults caring for friends and neighbors
Children caring for a disabled parent or elderly grandparent
What is caregiver stress?
Caregiver stress is a reaction to changes that overwhelm your emotional capacity and requires you to adjust or respond. Our bodies are designed to feel stress and react to it. Not always a bad thing, stress keeps us alert and ready to escape danger.
It’s not always possible to avoid change or the situations that can cause stress; as a result, you can begin to feel overwhelmed and unable to cope. When it persists, stress can affect the body’s immune system, leading to illness. The key to coping with stress is to identify the causes of stress in your life, then learn healthy ways to deal with them. It’s important to remember that stress comes from how you respond to stressful events. Therefore, you have some control over stress and how it affects you.
Caregiver stress can take many forms. For instance, you may feel:
Frustrated and angry taking care of someone with dementia who often wanders away or becomes easily upset
Guilty because you think that you should be able to provide better care, despite all the other things that you have to do
Lonely because all the time you spend caregiving has hurt your social life
Exhausted when you go to bed at night
Although caregiving can be challenging, it is important to note that it can also have its rewards. It can give you a feeling of giving back to a loved one. It can also make you feel needed and can lead to a stronger relationship with the person receiving care. About half of caregivers report that:
They appreciate life more as a result of their caregiving experience
Caregiving has made them feel good about themselves
Can caregiver stress affect my health?
Although most caregivers are in good health, it is not uncommon for caregivers to have serious health problems. Research shows that caregivers:
•Are more likely to be have symptoms of depression or anxiety
•Are more likely to have a long-term medical problem, such as heart disease, cancer, diabetes, or arthritis
•Have higher levels of stress hormones
•Spend more days sick with an infectious disease
•Have a weaker immune response to the influenza, or flu, vaccine
•Have slower wound healing
•Have higher levels of obesity
•May be at higher risk for mental decline, including problems with memory and paying attention
Part of the reason that caregivers often have health problems is that they are less likely to take good care of themselves. For instance, women caregivers, compared with women who are not caregivers, are less likely to:
Get needed medical care
Fill a prescription because of the cost
Get a mammogram
Also, caregivers report that, compared with the time before they became caregivers, they are less likely to:
Get enough sleep
Cook healthy meals
Get enough physical activity
What Causes Caregiver Stress?
Caregiver stress can be caused by anything that requires you to adjust to a change in your environment. Your body reacts to these changes with physical, mental, and emotional responses. We all have our own ways of coping with change, so the causes of stress can be different for each person. Becoming a caregiver is a common source of stress for many people.
When you are not sure of the exact cause of your stress, it may be helpful to know the warning signs. Once you can identify these signs, you can learn how your body responds. Then you can take appropriate steps to reduce the stress.
What Are the Warning Signs of Caregiver Stress?
Your body sends out physical, emotional, and behavioral warning signs of caregiver stress.
Emotional warning signs:
Inability to concentrate
Sadness and periodic crying
Frequent mood swings
Physical warning signs:
Chronic back pain
Weight gain or loss
Problems with sleep
Behavioral warning signs
Acting on impulse
Using alcohol or drugs
Withdrawing from relationships
Changing jobs often
Talk to a counselor, psychologist, or other mental health professional right away if your stress leads you to physically or emotionally harm the person you are caring for.
What Can I Do to Reduce Caregiver Stress in My Life?
To begin with, never dismiss your feelings as “just stress.” Caregiver stress can lead to serious health problems and you should take steps to reduce it as much as you can.
Research shows that people who take an active, problem-solving approach to caregiving issues are less likely to feel stressed than those who react by worrying or feeling helpless. For instance, someone with dementia may ask the same question over and over again, such as, “Where is Mary?” A positive way of dealing with this would be to say, “Mary is not here right now,” and then distract the person. You could say, “Let’s start getting lunch ready,” or involve the person in simple tasks, such as folding laundry.
Some hospitals offer classes that can teach you how to care for someone with the disease that your loved one is facing. To find these classes, ask your doctor, contact an organization that focuses on this disease, or call your local Area Agency on Aging (see below). Other good sources of caregiving information include:
Doctors and nurses
Websites of disease-specific organizations
Finding ways to reduce caregiver stress will help lessen the long-term emotional and physical toll. Tips for managing stress include:
Keep a positive attitude and try to keep your sense of humor. Also, believe in yourself.
Accept that there are events you cannot control.
Be assertive instead of aggressive. “Assert” your feelings, opinions, or beliefs instead of becoming angry, combative, or passive.
Learn to relax.
Exercise regularly. Your body can fight stress better when it is fit.
Limit yourself to moderate alcohol and caffeine intake.
Get enough rest and sleep. Your body needs time to recover from stressful events.
Don’t rely on alcohol or drugs to reduce stress.
Learn to use stress management techniques and coping mechanisms, such as deep breathing or guided imagery.
Find out about caregiving resources in your community (see below).
Ask for and accept help. Be prepared with a mental list of ways that others can help you, and let the helper choose what she would like to do. For instance, one person might be happy to take the person you care for on a walk a couple times a week. Someone else might be glad to pick up some groceries for you.
If you need financial help taking care of a relative, don’t be afraid to ask family members to contribute their fair share.
Say “no” to requests that are draining, such as hosting holiday meals.
Don’t feel guilty that you are not a “perfect” caregiver. Just as there is no “perfect parent,” there is no such thing as a “perfect caregiver.” You’re doing the best you can.
Identify what you can and cannot change. You may not be able to change someone else’s behavior, but you can change the way that you react to it.
Set realistic goals. Break large tasks into smaller steps that you can do one at a time.
Prioritize, make lists, and establish a daily routine.
Stay in touch with family and friends.
Join a support group for caregivers in your situation, such as caring for someone with dementia. Besides being a great way to make new friends, you can also pick up some caregiving tips from others who are facing the same problems you are.
Make time each week to do something that you want to do, such as go to a movie.
See your doctor for a checkup. Tell her that you are a caregiver and tell her about any symptoms of depression or sickness you may be having.
If you work outside the home and are feeling overwhelmed, consider taking a break from your job. Employees covered under the federal Family and Medical Leave Act may be able to take up to 12 weeks of unpaid leave per year to care for relatives. Ask your human resources office about options for unpaid leave.
Relaxation Techniques for Caregiver Stress
Most people don’t have a plan for coping with caregiver stress. Fortunately, there are a number of relaxation techniques and coping mechanisms that you can use to help deal with stress, such as:
Two-minute relaxation. Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.
Mind relaxation. Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word “one,” a short word such as “peaceful,” or a short phrase such as “I feel quiet.” Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.
Deep breathing relaxation. Imagine a spot just below your navel. Breathe into that spot, and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed.
Guided imagery. Guided imagery is a meditative technique that involves focusing on a particular sensory image to create a specific physical reaction. Guided imagery (also called guided meditation) is a form of mind-body therapy that can bring about deep relaxation and positive focus, the state of mind and body most conducive to healing. Guided imagery also can be used to release tension, anxiety, and stress.
Biofeedback. Biofeedback helps a person learn stress-reduction skills by providing precise, immediate information about muscle tension, heart rate, and other vital signs as a person attempts to relax. It is used to learn total body relaxation and also to gain control over certain physiological functions that cause tension and physical pain.
Behavioral changes. Changing certain thought patterns and behaviors can help you better manage difficult situations and stress. Examples include checking your assumptions, sharing your expectations with others, being assertive, exercising and eating healthy, focusing on positive relationships, forgiving, communicating feelings, listening, and rewarding yourself and others.
What can I do if I need a break?
Taking some time off from caregiving can reduce stress. “Respite care” provides substitute caregiving to give the regular caregiver a much-needed break. Below are the various types of respite services that are available:
In-home respite. In this type of service, someone comes to your home to provide care. The type of care can range from simple companionship to nursing services.
Adult day-care centers. Many adult day-care centers are located in churches or community centers. Some day-care centers provide care for both elderly adults and young children. During the day, the two groups meet for several hours to share in activities such as reading stories. This type of contact seems to benefit both young and old.
Short-term nursing homes. If your loved one needs occasional nursing care and you must leave town for a couple weeks, some nursing homes will care for your loved one while you are gone.
Day hospitals. Some hospitals provide medical care to patients during the day and then at night, the patient returns home.
How do I find out about caregiving services in my community?
Contact your local Area Agency on Aging (AAA) to learn about caregiving services (e.g., meal delivery, in-home nurse) where you live. AAAs are usually listed in the city or county government sections of the telephone directory under “Aging” or “Health and Human Services.” The National Eldercare Locator, a service of the U.S. Administration on Aging, can also help you find your local AAA.
By recognizing your warning signs and taking steps to reduce the stress in your life, you should be able to cope more easily with the pressures of being a caregiver.
Dr. Bahareh Talei received her Doctorate of Psychology (Psy.D.) from Pepperdine University, Graduate School of Education and Psychology. Dr. Talei is a licensed psychologist and is co-founder of Diagnostic & Counseling Center (DCC). Her experience has primarily been in working with children and adolescents with various disabilities such as autism and difficulties with learning and attention. Throughout her career, Dr. Talei has been actively engaged in the assessment of a diverse population (e.g., pervasive developmental disorder, learning disorders, central nervous system damage) and training of other professionals. Her experience and interests also includes conducting individual and group psychotherapy with family members of children with developmental disabilities and other populations (e.g., depression, anxiety disorders, and infertility).