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Guarding Against Caregiver Burnout in the Face of Alzheimer’s or Dementia
For some, caring for a family member with memory impairment (dementia) comes on gradually. For others, it can happen overnight. Dementia is caused by damage to the brain. Sometimes the damage can occur slowly and progressively, such as in Alzheimer’s, or with a series of small strokes. Sudden changes can occur with a major stroke, placing you in a caregiver situation overnight.
Either way, your situation is overwhelming, and it’s normal to feel scared, frustrated, sad, and alone. Change is difficult, for anyone. What’s important is remembering to be flexible and open to the possibilities, rather than the limitations. In doing this, you may find that along with the challenges, you will encounter some of the unexpected gifts of caregiving. There will be treasured moments with your loved one, as long as you are able to maintain some resemblance of balance in your life.
The Balancing Act
To maintain balance in your life, you must be realistic about what your limitations are, be flexible when faced with the daily challenges, and know that you’re not alone. Being flexible means to be open to what’s happening, then taking action to reduce the negative impact of any given situation. Actions that produce positive outcomes include:
- Active problem solving
- Finding the silver lining in all situations
- Acknowledging (not repressing) your feelings, and
- Seeking support.
Sometimes though, despite your best efforts, fatigue and burnout may sneak up on you. You’re not alone. According to a recent study, 50% of primary caregivers, caring for a loved one with memory impairment, suffer from anxiety and/or depression. You’re human, not superhuman.
Some symptoms of caregiver stress and burnout include:
- Sleep deprivation
- Constant low energy levels
What tends to lead to these symptoms are poor eating habits, not exercising, not taking care of yourself when you’re ill, and postponing your own healthcare and doctor visits. This, in turn, leads to high blood pressure, depression, heart disease, chronic illness, and even premature death. As a registered nurse, I’ve often seen primary caregivers in the hospital, now with the added stress of trying to figure out from their hospital bed, who’s going to take care of their loved one.
An Ounce of Prevention is Worth a Pound of Cure
You’ve heard the expression, “An empty pitcher can’t fill a glass”. If you don’t take care of yourself, you won’t be well enough, physically or emotionally, to take care of your loved one. You want to make the most of the time you have left with your family member. You must take care of yourself to do this. The following preventative self-care measures can improve your health, thus enhancing your ability to provide the best care you can for your loved one.
- Exercise daily. Just 20 minutes, 3 days a week, can improve your sleep, improve your perspective, reduce stress, increase mental alertness, and increase energy levels.
- Eat nutritious meals and snacks. It’s too easy to reach for the unhealthy snacks, or skip meals altogether, when you’re hurried and stressed. Make a conscious effort to choose something healthy to eat, three times a day. When you’re tempted to reach for a bag of chips or a candy bar for a snack, stop, think, and consciously choose a healthier option. If you feel you need to treat yourself to an indulgent snack every now and then, try to limit it to once a week.
- Get adequate sleep. As you know, most people need six to eight hours of sleep in a 24-hour period. This is minimal. Lack of sleep will make you more susceptible to illness. If you’re not getting enough sleep at night, take catnaps during the day. Make arrangements to get at least one full night’s sleep each week by arranging for someone to stay over, or hiring a professional home health aide overnight. Also, talk to your loved one’s physician about possible sleep medication for him or her.
- Get regular medical check-ups. Do not put yourself on the backburner. You deserve to be taken care of too. Be honest with your doctor about what you’re going through. Better yet, consolidate your and your loved one’s care, by having the same doctor for both your loved one and yourself. Tell your doctor about your caregiving role and how you’re coping. Don’t hold back. What you’re doing is hard, and no one escapes the feelings of being overwhelmed from time to time.
- Take time out. Yes, you can. It’s not an option if you plan on remaining healthy. Take at least 3 hours, once a week, to do something that renews you. Read, get a massage, or have dinner out with a friend.
- Get help in caring for your loved one. You don’t have to do it alone, and part of taking optimal care of yourself and your loved one is knowing your limitations. Find someone to help with tasks such as bathing, meal preparation, feeding, medication administration, running errands, and housekeeping. Even if you have to hire someone. I know, for some, hiring a professional caregiver seems like an option that’s too expensive. However, I encourage you to consider the long term financial implications as well.
Long Term versus Short Term Financial Wellbeing
Your long-term financial wellbeing can be negatively impacted if you take shortcuts in the interim. If you’re needing to call out of work often, this puts a strain on the relationship between you and your employer, even the most understanding employer. After all, your employer has a job to do as well, and if you can’t be relied on, it may place your job in jeopardy. Not only would this be detrimental to your financial situation, the added stress and energy drain would also be damaging.
If you hire a professional home caregiver, you won’t need to quit your job, or cut back on hours. This allows you to keep your employer-based medical benefits. It also allows you to continue making contributions toward your own retirement income.
Another thing to keep in mind, if you’re thinking about quitting your job, is the reality that re-entering the workforce, at the same level you left, may not be an option. Especially if you’re in a competitive career that requires you to be up to date.
Also, take into consideration that professional in- home support can delay nursing home placement by 1.5 years. A nursing home costs a minimum of $250 a day. The average cost of a professional home caregiver is an average of $20 an hour. This comes out to a savings of more than $49,000 in that 1.5 years.
Professional homecare can be a wise addition to your support system, allowing your loved one to remain at home longer, as well as helping you secure your own future. The added benefit is that it also gives you much needed moments of time to take care of yourself, so you can continue to take good care of your loved one.
I’m curious to know, in what ways have you placed yourself on the backburner, and how have you found time to make room to take care of yourself?
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1-2 Garcia-Alberca, Jose M, et al. “Anxiety and depression are associated with coping strategies in caregivers of Alzheimer’s disease patients: results from the M´ALAGA-AD study.” International Psychogeriatrics 24.8 (2012): 1325–1334.
3 Mittelman, M.S, W Haley and D Roth. “Improving Caregiver Well-being Delays Nursing Home Placement of Patients with Alxheimer’s Disease.” Neurology 67 (2008): 1592-1599.