December 10, 2014

Regular Stress for Caregivers + Holiday Anxieties = Potential Disaster

My internet explorations recently led me to the Minding Our Elders blog by Carol Bradley Bursack, a writer who also contributes to the online journal HealthCentral.

The particular piece I found concerned caregiving – a role that fate has spared me. My mother died of a heart attack at age 73. My father died at age 83, reading a book in a backyard lawn chair after playing a round of golf.  Over the years, I've often commented when talking with friends about the final exit, that it would be great to leave the way my father did, but perhaps a few years later than 83. Well, I got my wish as far as age goes, but I don't have a lawn or a lawn chair. I'll settle for the rocking chair on my back porch, overlooking the garden.

The fact that I’ve never had to assume the role of caregiver to a parent doesn’t mean my nearest and dearest will travel that same path. Yes, I’m feeling pretty good for an 85-year-old with Parkinson’s and prostate cancer… and a few other issues. I hope, one way or another, to spare my families the anguish of dealing with a demented father.

From comments and emails I’ve received, I know there are caregivers among the readers here. This past year I have also served as a guest blogger for Aging Care, a website designed to connect and support caregivers.

I also know that caregiving is hugely stressful, a constant challenge exacerbated by the normal anxieties we all feel at holiday time.

So, I offer this piece from Carol especially to them… and to all the others who may eventually find themselves in caregiving situations. Many of Carol's observations below might also have use for anyone, anytime.

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Acceptance of Change Important in Alzheimer's Caregiving
My dad went into surgery with a smile and hope. He came out with severe dementia. Something unexplainable at the time had happened and Dad became a statistic - one of those "poor outcomes" we hear about. My head knew this tragedy was permanent, but my heart wanted my "real" dad back.

The kind, loving, intelligent man whose love for me was steadfast. I wanted him back. Unfortunately, my family and I had to learn to accept the fact that Dad would never be the same. More of Carol's suggestions on this topic.

Are You a Caregiver? Coping with Holiday Stress
While many of us have spent years as family caregivers, some caregivers are new to this challenge. So new, in fact, that they have yet to realize that they are caregivers. So new that they haven't had time to even consider the stress that they are under - stress that will likely increase, rather than decrease, if they don't begin to develop some self-care strategies early on.

According to AARP and other resources, more than 42 million Americans are faced with the challenge of providing care to their older family members and/or friends. Caregiving can take a tremendous toll on the caregiver's personal health and overall wellbeing, and yet, according to the organization, many caregivers don't think of themselves as caregivers and can be reluctant to ask for help. More of Carol's suggestions on this topic.

Unearned Guilt Intrinsic to Most Caregiving
If ever there's a group of people who suffer deeply from unearned guilt it's caregivers. Whether you're the parent of a vulnerable adult, an adult child of aging parents or the spouse of a vulnerable adult, you are bound to have your "if only" times where you are sucked into the quicksand of guilt.

The reality is that most things you could have done differently wouldn't have made a huge difference overall. Even if another approach would have made a difference, you can't go back. Staying mired in guilt is counterproductive for you as well as your care receiver. More of Carol's suggestions on this topic.

Suggestions for Caregivers' Self Care
A recent study found that adult children caring for their parents, as well as parents caring for chronically ill children, may have their life span shortened by four to eight years. Caregivers could conceivably alter these statistics if they practice reasonable self-care.

  • Meditation and/or prayer. There are many kinds of meditation. Meditation can be a way to direct our thoughts in a positive manner, quiet our mind through guided imagery or incorporate other methods of quiet time. Many people include prayer during meditation, or they may pray before or after meditating. 
  • Attending to our own medical needs. Caregivers tend to put off their own physical examinations, mammograms and other general health updates because of shortage of time, shortage of money or simply because they are tired of sitting in medical facilities because of their loved one’s many appointments. 
  • Exercise regularly. Studies repeatedly confirm that regular exercise helps protect our hearts and our brains. Exercise helps us maintain a healthier weight and can give us a feeling of satisfaction from doing something for ourselves. Exercise can be done in short spurts and need not be excessive. A vigorous walk or bike ride counts as exercise.
  • Healthy Diet. Consuming a healthy diet can be harder than ever when we are busy caring for a vulnerable person. However, maintaining our health depends on eating the right foods. Like exercise, eating well can help us mentally as well as physically.
  • Maintain a social life. Even though it’s often difficult to find time to socialize away from our care receiver, we need to do so. It’s important to maintain at least a few outside relationships that mean something to us. 
  • Learn to include ourselves on pur priority lists. Most caregivers can prioritize quite well, however they frequently leave themselves off the to-do list. Our wants and needs must be part of that list - and not at the bottom.
  • Acknowledge the rewards of caregiving. Most of us gain in compassion and empathy for others and higher esteem for ourselves as we acknowledge the rewards of what we do. This practice can preserve or improve our mental, physical and spiritual health.
Caregiving can be exhausting, frustrating and even lead to occasionally cases of self-pity. All are acceptable short-term. However, if we are to live through our caregiving years and maintain our rightful hold on our own health, we need to practice self care, as well.

Photo Albums and Memory Books Helpful When Visiting Elders
Many people are reluctant to visit elders, whether they are in their homes or a facility, mainly because they wonder what they'll talk about. While this reluctance is more of a worry if the elder has memory problems from dementia, it's often a problem even when memory isn't an issue. Since elders by definition have many decades of life to their credit, they will likely enjoy looking back on the past.

Many people are reluctant to visit elders, whether they are in their homes or a facility, mainly because they wonder what they’ll talk about. While this reluctance is more of a worry if the elder has memory problems from dementia, it’s often a problem even when memory isn’t an issue. 

Since elders by definition have many decades of life to their credit, they will likely enjoy looking back on the past. This is especially important when people have Alzheimer’s disease, because their disease prevents them from forming new memories. Nearly everyone enjoys reminiscing to some degree. To help you kick off a nice visit with the elder you intend to spend time with try bringing some props. Physical reminders should help your visit go more smoothly.

These ideas are just a start. You know your elder. What hobby does/did he or she enjoy? If the person played a musical instrument, bring one along if possible. If the person read the Bible regularly, brush up on passages you think he or she would love to hear read aloud and then when you visit offer to do so. If you play an instrument that is portable, you may want to bring that. Most people like to be entertained. Just don’t make yourself the center of attention.

Many seniors, with or without dementia, can tell you interesting stories. All you need to do is stimulate a memory and open your mind long enough to listen. You may find that while you think you are doing the elder a favor by visiting, the elder has expanded your base of knowledge of the past. If not, you will still have brought some pleasure to someone who may no longer have much to look forward to. That, in itself, should make you feel good.

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A tip o' the hat to all the caregivers out there.

1 comment:

Anna said...

Thank you so much for this, John. I'm one of those caregivers. I have so many regrets about the quality of my caregiving of my PD baby, who departed at age 77 in June of 2014. It was hard to accept that a formerly brilliant engineer could no longer figure out how to us a toilet. There's a lot of healing to be done even after they're gone, too.

For me, the next chapter is to help my mother age in place. We just built a fully accessible "in-law" apartment extension to her house and I'll be moving into the main house. But that's the easy part. The hard part is continuing to feel loving, kind and gentle as the person becomes more dependent and (sometimes) demanding of the caregiver's time, resources, patience and even physical effort.

Your blog is such a blessing to those who are in process of "moving on" and their loved ones alike.