There is no question - being a primary caregiver is a tough job. Whether you're a family member solely caring for an aging relative or a paid in-home aide, you are at risk of "caregiver burnout." Yes, caregiving can be stressful and anxiety producing; it can be physically taxing; and it can often mean social isolation, but we probably don't have to tell you that. No matter how much time you are in the presence of your senior, chances are you are always worrying about his care. And if you don't care for yourself and give yourself breaks, this job can have a real negative impact on your mood, spirit, even your overall health.
The State of the Constant Caregiver
"Caregiver burnout is a state of physical, emotional and mental exhaustion that can be accompanied by a change in attitude - from positive and caring to negative and unconcerned," says Alexis Abramson, Ph.D., renowned author of The Caregiver's Survival Handbook and expert on aging and caregiving. "Burnout usually occurs when caregivers don't get the help they need, or when they attempt to do more than they are able - either emotionally, physically or financially."
Research from the 2006 Assessment of Family Caregivers: A Research Perspective has shown that burnout affects many caregivers. In some studies, "40% to 70% of family caregivers have clinically significant symptoms of depression with approximately a quarter to half of these caregivers meeting the diagnostic criteria for major depression." It has also been shown that caregiving can have serious physical health consequences. In one recent study 11% of family caregivers reported their physical health deteriorated because of their caregiving duties. In a study from the National Caregiver Alliance, 17% of caregivers reported that their general health had worsened as a result of their caregiving.
Is there no hope? Does being a primary caregiver mean you have to sacrifice your emotional and physical health? Absolutely not! As Dr. Abramson says, "perhaps the most effective way of preventing caregiver burnout is by taking care of the caregiver." Mary Stehle, Senior Care Advisor at Care.com agrees. "Many caregivers feel guilty about any kind of self care since they believe their time and attention is better spent on others. However, caring for yourself enables you to be a more attentive caregiver and, most importantly, be fully present with the person you are caring for," she explains.
The following tips, culled from Dr. Abramson's work, are designed for you, the primary caregiver, to help you also take care of yourself:
- Set priorities. When first establishing yourself as the primary caregiver, determine what duties and responsibilities you can handle and those you cannot. Write these down and share with the family, highlighting the areas (including days) you'll need help. Though many caregivers feel as though they should do everything, this can cause frustration, resentment and stress.
- Reach out to others. Though caregiving can feel all-consuming at times, it's very important for you to maintain your friendships and to continue to reach out to others for support, consultation, and perspective. At times you may benefit from reaching out to a counselor or other primary caregivers, as caregiving for seniors can stir up unresolved family conflicts and other challenging family dynamics. An outside professional can bring great objectivity and insight to a challenging situation.
Note: The Care.com Senior Care Questions Group is a helpful resource.
- Exercise and diet. Yes, we've all heard it before, but the evidence is overwhelming: regular exercise and a good, nutritious diet do wonders for your overall health. No matter how busy you feel, you need to make time for these things and incorporate them into your daily routine. If you can leave the house, take a daily walk or go to a gym. If you can't leave your house, consider an exercise video appropriate for your fitness level. Programs that emphasize stretching, muscle toning, and relaxation are generally good for all levels of fitness. As for a healthy diet, consult with your physician or nurse practitioner for what is best for you.
- Share the load. While you may be the primary caregiver, you should not be the only caregiver. Work with family, friends, and paid caregivers to establish an ongoing 'care team,' which will allow you to take breaks, recharge your battery, and share the burden, both physically and emotionally. Even if you can manage all of the responsibilities, it is important to your health that you share them with others.
- Keep your medical appointments. It seems obvious, but many caregivers neglect themselves and then eventually pay the price. If you get sick or become infirm, you can hardly look after someone else. Be sure to keep up with your routine preventative health screenings as well as specialist visits. They are an incredibly important part of a healthy lifestyle.
- Take breaks. Every caregiver needs a break, a respite from the seemingly endless tasks of caregiving. On a regular basis, take time for yourself; engage in healthy activities and hobbies that recharge your body and your spirit. To do this, consider scheduling a regular "respite care" break through a local agency or senior care institution, which can take place at your home or in a specialized facility. For more information as well as local respite options in your community, go to the ARCH National Respite Network.
- Plan ahead. To be an effective caregiver you need to be more than reactive; you need to be proactive. Caregiving is not a fixed activity. A patient's condition and needs are changing nearly all the time, and it's imperative for you and your caregiving team to try to anticipate and plan for as many different scenarios as possible.
Being able to deal with the inevitable stresses and strains of caregiving is part of the complex task of being a truly effective caregiver. Understanding the potential for burnout, recognizing your limitations, and making a point to care for yourself - are also all critical parts of the puzzle of being a first-rate caregiver.
Remember: keep caring for yourself so you can keep caring for another.