How to recognize and manage caregivers’ stress.

Did you know that nurses are routinely forgoing their breaks and/or meal periods in order to provide patient care? Some researchers found that nurses took a break or ate a meal free of patient care responsibilities, in less than half the shifts they worked over a 1-month period. During the remaining shifts, they either worked nonstop throughout the entire shift, or were able to sit down for only a short period, while remaining responsible for patient care activities during their breaks or meals. As a nurse working in a long term care facility, I see this pattern first hand, as fellow nurses I work alongside routinely forfeit a break during their 12 or 8 hour shifts, due to the inability to get off the unit for a variety of reasons; too busy, short staffed or no one to cover for the patients.  Of course, when our shift is over and we nurse’s “hand off report”, we dash for the door and head home for a much deserved meal, rest and have a glass (or two) of something cold and bubbly.

But what about those caregivers who are unable to simply “hand off report” and head home for the night? Do they get a break? If you are someone living with or caring for someone with dementia or Alzheimer’s, chances are that you do not. What’s a caregiver to do? First, recognizing caregivers burnout and stress would be a great place to start.

So what are the signs? Here are the top ten. Can you identify with any of these signs of stress in yourself or others?

  1. Denial about the disease and its effect on the person who has been diagnosed. “I know Mom is going to get better”.
  1. Anger at the person with Alzheimer’s or frustration that he or she can’t do the things they used to be able to do. “He knows how to get dressed — he’s just being stubborn”.
  1. Social withdrawal from friends and activities that used to make you feel good. “I don’t care about visiting with the neighbors anymore”.  
  1. Anxiety about the future and facing another day. “What happens when he needs more care than I can provide?”  
  1. Depression that breaks your spirit and affects your ability to cope. “I just don’t care anymore.”
  1. Exhaustion that makes it nearly impossible to complete necessary daily tasks. “I’m too tired for this.”
  2. Sleeplessness caused by a never-ending list of concerns. “What if she wanders out of the house or falls and hurts herself?”
  1. Irritability leading to moodiness and triggers of negative responses and actions. “Leave me alone!”
  1. Lack of concentration that makes it difficult to perform familiar tasks. “I was so busy, I forgot my appointment.”
  1. Health problems that begin to take a mental and physical toll. “I can’t remember the last time I felt good.”

You may be so overwhelmed by taking care of someone else that you have neglected your own physical, mental and emotional well-being. If you find yourself not taking care of your own needs, you may be putting your health at risk.  You must make time for yourself and take regular breaks because this is the most important thing you can do for yourself, your sanity, and of course, the loved ones to whom you provide and care for.

Here are ten things to consider to help you manage stress and be a healthier caregiver.

  1. Find time for yourself. Consider taking advantage of respite care so you can spend time doing something you enjoy. Respite care gives caregivers a temporary rest from caregiving, while the person with Alzheimer’s disease continues to receive care in a safe environment.
  1. Know what community resources are available. Find dementia care resources in your area. Adult day programs, in-home assistance, companions and meal delivery are just some of the services that can help you manage daily tasks.
  1. Become educated in the care you provide. As the disease progresses, new caregiving skills may be necessary. Your community offers programs to help you better understand and cope with common behavioral and personality changes that may occur.
  1. Get help and find support. Seek out the support of family, friends and people who can relate to your situation. If stress becomes overwhelming, get professional help and hire a home care agency to help you and your loved ones.
  1. Take care of yourself. Try to eat well, exercise and get plenty of rest. Making sure that you are healthy can help you be a better caregiver.
  1. Manage your level of stress. Stress can cause physical problems (blurred vision, stomach irritation, high blood pressure) and changes in behavior (irritability, lack of concentration, change in appetite). Note your symptoms and discuss with your doctor, as needed. Try to find relaxation techniques that work for you.
  1. Accept changes as they occur. People with Alzheimer’s disease change over time and so do their needs. They may require care beyond what you can provide on your own. Becoming aware of community resources — from home care services to residential care — can make the transition easier. So will the support and assistance of those around you.
  1. Make legal and financial plans. Putting legal and financial plans in place after an Alzheimer’s diagnosis is important so that the person with the disease can participate. Having future plans can provide comfort to the entire family. Many documents, including advance directives, can be prepared without the help of an attorney. Seek assistance with someone who specializes in this matter if you are unsure.
  1. Know you’re doing your best. Remember that the care you provide makes a difference and that you are doing the best you can.
  1. Visit your doctor regularly. Take time to get regular checkups, and be aware of what your body is telling you. Pay attention to any exhaustion, stress, sleeplessness or changes in appetite or behavior. Ignoring symptoms can cause your physical and mental health to decline.

If you find yourself not taking care of your own needs, you may be putting your health at risk.  Remember, when you’re caring for someone with dementia, you’re likely to experience a wide range of emotions at different times.  From positive feelings; you get satisfaction from supporting the person, to other feelings of loss, grief, guilt, embarrassment and anger. Whatever your feelings, it can help to know that it is normal for most people caring for someone with dementia to feel this way. The old cliché that you “can’t take care of anyone else until you take care of yourself” is true. You have a very special person counting on you, and that is the best reason of all to take care of you!

Pamela Schutz, LPN