Managing caregiver stress and preventing burnout.

Why is managing stress so important?

http://www.webmd.com/balance/stress-management/effects-of-stress-on-your-body

Stress that continues without relief can lead to a condition called distress — a negative stress reaction. Distress can lead to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and problems sleeping. Research suggests that stress also can bring on or worsen certain symptoms or diseases.

How does stress affect the immune system?

Stress can make up ill as it affects out immune system.

http://www.apa.org/research/action/immune.aspx

“For stress of any significant duration – from a few days to a few months or years, as happens in real life – all aspects of immunity went downhill. Thus long-term or chronic stress, through too much wear and tear, can ravage the immune system.

The meta-analysis also revealed that people who are older or already sick are more prone to stress-related immune changes. For example, a 2002 study by Lyanne McGuire, PhD, of John Hopkins School of Medicine with Kiecolt-Glaser and Glaser reported that even chronic, sub-clinical mild depression may suppress an older person’s immune system. Participants in the study were in their early 70s and caring for someone with Alzheimer’s disease. Those with chronic mild depression had weaker lymphocyte-T cell responses to two mitogens, which model how the body responds to viruses and bacteria. The immune response was down even 18 months later, and immunity declined with age. In line with the 2004 meta-analysis, it appeared that the key immune factor was duration, not severity, of depression. And in the case of the older caregivers, their depression and age meant a double-whammy for immunity.

Emerging evidence is tracing the pathways of the mind-body interaction. For example, as seen with the college students, chronic feelings of loneliness can help to predict health status — perhaps because lonely people have more psychological stress or experience it more intensely and that stress in turn tamps down immunity. It’s also no surprise that depression hurts immunity; it’s also linked to other physical problems such as heart disease. At the same time, depression may both reflect a lack of social support and/or cause someone to withdraw from social ties. Both can be stressful and hurt the body’s ability to fight infection.

Managing stress, especially chronic or long-term stress (even if it’s not intense), may help people to fight germs. When burdened with long-term stressors, such as caring for an elderly parent or spouse with dementia, health can benefit from conscientious stress management.

Finally, the newest findings on social stress underscore the value of good friends; even just a few close friends can help someone feel connected and stay strong. Social ties may indirectly strengthen immunity because friends – at least health-minded friends — can encourage good health behaviors such as eating, sleeping and exercising well. Good friends also help to buffer the stress of negative events.”

Preventing and dealing  with caregiver stress.

I first want to clarify what I mean when I say “caregiver.” I’m talking about the main person who is doing the hands on care. The wife, husband, mother, father, daughter, son or other people who is the number one person caring for someone.

Lot’s of people interface with caregivers. We do as nurses. You do as friends, family and neighbors. We get to go to the house, spend an hour, do our assessment, say what we think and then leave the person behind to deal with this on their own.

My general attitude is everyone is different, every one has different coping skills and styles. It’s our job as nurses, friends, families and neighbors to be accepting and to be helpful. Everyone copes with this differently but the needs still remains the same.

The one point I always try to make is this: This will end and at the end of the day when you have to make peace with yourself and move on in your life will you being to look back and say “I did everything I could and I am at peace.” I think the best way to get to that place is not getting burnt out.

The most important thing that a caregiver can do for themselves is to make sure they leave time for themselves and do something, even if its the littlest thing, every day. Being a martyr is a sure road to burnout and feeling like your stuck in a situation.

I know it hard. Sometimes there is no one around to relieve you and you feel like this is on your shoulders. Some places have great resources and some places have next to none.

In this day and age unless you can afford it there’s not a lot of help out there and if there is the older person living by themselves they get addressed first before the person with a caregiver. (Unless the person is under Hospice)

I thought instead of just googling I’d ask my friends first what they thought. So here goes. Some of these folks are in the medical field and some are or have been the main caregivers for a family member.

This is what they had to say:

Carol said “Get help!”

I know that’s a tall order sometimes. Many people can’t afford help. The first thing you should do is call your Elder Hotline. Our number around here is 866-684-5884. There is a process and it takes a while  to this so don’t wait until you need something. Do it now so by the time you need it the information is there.

Call the local chapter of the appropriate disease and see if someone can come out and talk to you about the disease and what is available to you. Often they have respite set up and know everyone who is available.

Call your church or temple and ask if there is anyone available to help. Many times they will mention this at services and people will volunteer.

Lisa Ray said

“#1 Take care of yourself first and foremost … it may sound selfish but it is not. If you are not emotionally and physically healthy then you can’t help the other person. #2 Ask or pay for help. Don’t turn away help … accept the gift. You are not the only one that can care for your loved one. Let other family members become involved in the care. Or pay someone to help. #3 Don’t take the mean things they say and do personally. They are sick and realize they have lost much of their independence, this is an expression of that frustration #4 Join a support group… you will learn things from others & help others with your experiences. #5 This also goes along with #2 Get out of the house and have fun, stay in contact with your friends, don’t become isolated.”

Aimee Said:

“For sure don’t become isolated. I broke free finally in June and took a long weekend to myself and went to Missouri and met up with some other ladies. It didn’t go over well but he survived it. Never had been away without him. I never let him play that card. He tries often but when there is something he wants to do he finds a way. Take time for yourself and do whatever it is you love to do. Meet up with friends, take that trip and take care of yourself. And try not to stress (easier said than done) about that next scan or blood test. It is what it will be and I can’t change that.”

Susan said:

“Take time for yourself. While helping with my father’s cancer and death I would get their local paper (very small town) and circle garage and estate sales.  Then I would steal away for a few hours every Friday to treasure hunt. Try to keep some of your own little routines and hobbies going during this time. It was fun to share my finds and create memories with my parents while giving me something else to focus on.”

Irene said:

“You must have someone to come in to give the caretaker a break from the emotional roller coaster”

Eileen said: Have a network of friends or support group to support you the caregiver.

What is caregiver burn out?

http://www.webmd.com/heart-disease/heart-disease-recognizing-caregiver-burnout

“Caregiver burnout is a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned. Burnout can occur when caregivers don’t get the help they need, or if they try to do more than they are able — either physically or financially. Caregivers who are “burned out” may experience fatigue, stress, anxiety, and depression. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones.”

What Are the Symptoms of Caregiver Burnout?

“The symptoms of caregiver burnout are similar to the symptoms of stress and depression. They include:

• Withdrawal from friends, family, and other loved ones
• Loss of interest in activities previously enjoyed
• Feeling blue, irritable, hopeless, and helpless
• Changes in appetite, weight, or both
• Changes in sleep patterns
• Getting sick more often
• Feelings of wanting to hurt yourself or the person for whom you are caring
• Emotional and physical exhaustion
• Irritability

What Causes Caregiver Burnout?

Caregivers often are so busy caring for others that they tend to neglect their own emotional, physical, and spiritual health. The demands on a caregiver’s body, mind, and emotions can easily seem overwhelming, leading to fatigue and hopelessness — and, ultimately, burnout. Other factors that can lead to caregiver burnout include:

• Role confusion: Many people are confused when thrust into the role of caregiver. It can be difficult for a person to separate her role as caregiver from her role as spouse, lover, child, friend, etc.
• Unrealistic expectations: Many caregivers expect their involvement to have a positive effect on the health and happiness of their loved one. This may not always be realistic.
• Lack of control: Many caregivers become frustrated by a lack of money, resources, and skills to effectively plan, manage, and organize their loved one’s care.
• Unreasonable demands: Some caregivers place unreasonable burdens upon themselves, in part because they see providing care as their exclusive responsibility.
• Other factors: Many caregivers cannot recognize when they are suffering burnout and eventually get to the point where they cannot function effectively. They may even become sick themselves.

I’ve heard many people say to me “She was the mother and I was the child now i’m the mother and she is the child.’ It may feel that way but it not. Your still the child taking care of your mother.

More Ways to Prevent Burnout.

1. Find someone to talk to. There is always someone to talk to and sometimes just saying things out loud can make you feel better.  If you have a computer there are many Facebook groups that you can join and speaks to others. In this day and age if you join a local support group online you can also benefit from the other member’s knowledge of resources.
2. Be realistic about your loved one’s disease.

http://www.helpguide.org/articles/stress/caregiving-stress-and-burnout.htm

A list much like the the one my friends made above.

1. Ask for help.
2. Give yourself a break
3. Practice Acceptance: Focus on the things you can control,find the silver lining,avoid tunnel vision.
4. Take care of your own health: Exercise, meditate, do yoga, eat well and don’t skimp on sleep.

Cyndi Lenz is a psychiatric home health nurse in the Treasure Coast.