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CARING FOR THE CAREGIVER As you learn to care for an aging relative, it becomes apparent that most of your day and energy could be spent in the daily tasks that become part of that care. Your stamina and patience can be pushed, at times, to the breaking point. Therefore, one of the best things you can do for your aging relative is to find ways to care for yourself in order to preserve your strength and vitality. The most common complaint of an overworked caregiver is a feeling of being discouraged trapped and overburdened. Frequently, the main reason for this is a lack of sleep, poor nourishment and not enough "alone time" that help to replenish the energies of the caregiver. It is quite possible for the caregiver to "burnout" or to feel very pressured under the burden of caring for a frail elderly person at home. But with proper motivation and planning, good respite (or relief) care can be found to free you from some of your responsibilities. As you begin to explore the possibilities in sharing the care and responsibilities you have undertaken, you need to accept the reality that others may not give the same care as you, and the elderly person may be upset by the change in routine. You may have to compromise as you reach out for assistance. In planning for respite care, help can often be found in family members (once they are asked directly), friends, neighbors, church groups, Offices on Aging, home health aides from professional agencies, and private caregivers in the community. If private caregivers are used, it is essential to check references and past experience in caring for others. It is important to have the person who will be staying with the aging relative in your absence to visit once or twice in order to familiarize the new caregiver with the routine. A list of important phone numbers as well as a list of the elderly person's medications, physical ailments and any peculiarities of behavior should be noted along with the name of the primary physician and left in a handy place. A system for medical information retrieval, such as a "Vial of Life" can be of great importance in an emergency. When you are ready to leave, tell your aging relative that you are going and when you will return. You might feel pangs of guilt as you leave, but try to remember that you are doing something important for both of you. Unless you take the time out for yourself to live your own life and be reenergized by your own interests and friends, you soon will have nothing left to give your aging person. Perhaps the most vita] need of the caregiver is finding enough time to sleep. Outside services can be hired for nights only and can make an enormous difference as they allow the caregiver time for uninterrupted sleep. At a time when you may feel too tired to consider your own needs, try to remember that you will have your own life, friends and interests again when you no longer need to care for your elderly person. It is, therefore, very important that you try to keep your friendships alive so they will be there when you have more time. Depending on your interests or time you feel you can spend, getting a part time job or volunteering one day a week may interest you. A club activity, shopping, or just getting you hair done may be enough to give you a new lease on life. Some caregivers enroll in courses at a community college that they always meant to take or merely plan to take a stroll with a friend. Whatever your interest is, it is important that you continue to work at good "get away" times for yourself so you have more to give. Sometimes, caregivers find support groups helpful. These are designed to bring people together who share common concerns and work towards creating solutions or merely listening and offering support to those in need. New friendships often spring from these groups as the members begin to learn about and care for each other, For longer term respite care, which would give you a chance to get away for a vacation, many nursing homes are offering respite care for your aging relative, if they have beds available. The cost is not covered by Medicare but may be worth it if your family needs time away together. This may be the best solution for someone who cannot be left alone and needs constant supervision in your absence. In the event that future plans must be consistently put on hold, caregiver may find a "wish list" helpful. The list can contain any or all of the large and small things you want to do when you have the time. In this way, you keep the perspective of your own life in focus and take your own needs seriously, even within the constraints of your current situation. An excellent way to reduce physical and emotional tension is to get enough exercise. In keeping the body moving through walking, running, swimming or housework, the muscles that may cause us pain when tense, learn to relax and ease the feelings of tightness that tension produces. Proper exercise also helps us to sleep more restfully, be more alert and to feel more completely in control of our lives. The following Tension Releasing Exercises can be used at any time to ease tightened muscles. 3. Pull shoulders back and rotate forward and back 5 times. Reverse direction and repeat 5 times. 4. Lie flat on floor. Inhale through your nose, with eyes closed using your stomach muscles as much as possible, to the count of 5. Then purse your lips and blow out to the count of 10. Try to clear your mind of all anxious thoughts and focus on how good this makes you feel. Sometimes the hardest part of beginning to care for yourself is getting started. Let people know that you need help, that you trust in their ability to help and you are grateful for the time to replenish yourself and your energies. WHEN CARING MEANS LETTING GO Living and coping with an aging parent or spouse can be difficult under the best of circumstances. It can be increasingly challenging to keep yourself and your family intact and healthy when an elderly person becomes progressively ill, dependent, anxious or demanding. Sometimes buried feelings, unresolved conflicts from childhood and even guilt can get in the way of good judgment. There are signs to watch for that might signal it is time for another solution to the management and care of your aging relative.
It is important for you, as the caregiver, to recognize these warning signs and begin to consider an alternate form of care. There is a wide range of possibilities to be explored with a social worker, including retirement communities, assisted living apartments, board and care homes as well as nursing homes. Once you realize your limitations, you can begin the selection process with or without the assistance of the elderly person. If possible, it is suggested you offer the elderly person at least two possible solutions (which are acceptable to you) for the final choice. It might be wise to call a family meeting before decisions are made, but if you have reached your limit, you must let that be known. Guilt feelings and thoughts of abandonment are very normal and some elderly people may use these feelings to their best advantage. There is no mistaking; it is a hard decision to make and the adjustment to the new living situation might take months. However, you need to take solace in the fact that you and your family did all you could. This is a positive choice reflecting the needs of your family as a whole. There are many elderly people living well into their 90's and some past lO0. The reality of long term home care can be staggering for well intentioned caregivers. Don't be afraid to look into alternatives to home care when the stress signals are there. You have provided a wonderful service of loving care for your aging relative. Feel good that you have been able to extend yourself and your home for any period of time. The next stages of living arrangements can provide new ways and opportunities for your care and support.
Helpful Strategies for Avoiding Burnout During Caregiving Listen to your friends. If those around you have observed a change in your behavior or demeanor, take a minute and think whether what they are saying might me true. The first step in resolving burnout is to recognize that you are suffering form it. Be open to the observations of others. Let go. No one person can do everything. Acknowledge that in your humanness you have limitations. Allow others to help; delegate responsibilities. Practice asking for help and learn to say "no" occasionally. Lower your expectations of yourself and others; your health and well-being are more important than perfectionist caregiving. Set your priorities and guard your own personal time. Focus on your loved one's strength. Build on strengths and capabilities that remain. Rather than focus on what your loved one cannot do, allow him or her to do whatever is still possible, even if the doing is slower than you might want or not as well done as you might like. Learn relaxation techniques. Find some sort of relaxation outlet that works for you: exercising, listening to music, meditation, taking a walk, gardening, reading a book, taking a nap, talking with a friend. If necessary, find a nondestructive way to vent your very real frustrations. Take care of your health. If you ignore your own health you won't be much help to your loved one. Research indicates that situations of increased stress can lead to many unhealthful habits such as smoking, drinking, unwise drug use, overeating. It is essential that you maintain healthful eating, sleeping, and exercising habits and that you see a doctor when necessary. Maintain a life outside your caregiving role. The role of caregiving can swallow you up. Develop new hobbies or skills, take classes that provide intellectual stimulation and personal growth. Keep regular contact with other people. Keep a "burnout" role. Regularly record those events in your life that create stress. In a few weeks you will be able to identify your particular stressors, evaluate the situations and consider possible solutions. Build a caregiving team. It is not necessary to face caregiving all alone. Ask close family members, other relatives and friends for assistance even if you think they won't want to help. Have family brainstorming sessions to gather ideas that will only come out of group discussion. Work with the doctors, nurses, social workers, therapists and clergy to find workable solutions to your problems. Learn to trust others to help you. Rely on your sense of humor. Somehow laughter can warm the bleakest of situations. Whenever possible, look for the humorous side of the situation. Rent some funny videos, talk over funny memories. A good chuckle will make a real difference. Appreciate the benefits of leisure time. Savoring leisure is not selfish - it is life-affirming. How did you spend your leisure time before you became a caregiver? Can you adapt some of your former activities to include your loved one? Time constraints, other obligations and guilt may make leisure time difficult to find, so be creative. Find a support group. You may be struggling with so many confusing feelings: fear, frustration, anger, isolation, resentment, sadness, grief and so on. A support group can provide you with an appropriate place to work through those feelings. People who have similar situations can be an incredible source of support for one another simply because they understand. Shared tears and laughter help make burdens lighter. Seek professional help. If you have tried many of these suggestions to little or no avail, consider working with a therapist who specializes in stress reduction families with chronic illness. A counselor may be able to help you vent your feelings in a safe, non-judgmental environment. He or she may also be able to increase your awareness of unrealistic expectations and teach you new coping strategies. Appreciate your own efforts. The best caregiving in the world will not change the outcome of many illnesses. Frustration about your powerlessness in these situations can contribute to feelings of burnout. Rather than belaboring yourself for your inability to cure what is incurable, draw strength and comfort from what you can do. You can provide dignity, care and love. You cannot control the outcome; that rests in God's hands. Seek spiritual renewal. Many people find the deepest solace in their faith; this may be your source of help also. Religious services, conversations with clergy, individual worship and prayer - all may help to alleviate your stress and give you greater perspective, real strength and inspiration. A "different" idea. Consider thinking of your caregiving as a volunteer job. In this way you may feel more in control, creating the rules of your involvement and defining what constitutes success (which may be be nothing more than continuing to give care). You may wish to think of yourself as a manager of several persons who provide the total care, thus finding the delegating of certain responsibilities to others as acceptable and freeing. This new attitude can help you be open to other caregiver opportunities. Recognizing that there may be several ways to get things done, you can seek out support services. You can understand the value of peer groups, adult daycare and respite programs. Instead of viewing the use of these services as an admission of weakness or failure, you can call on the help that is available in your community so that you can continue in your caregiving role without experiencing burnout. It's All Right To...
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