Ideas for Dealing with Caregiver Stress

August 6, 2018 | by the National Care Planning Council

Family caregivers and others who provide eldercare for aging seniors will always, at some, point, face a mental challenge that is inevitable for caregivers. The constant burden of caregiving over a period of time will eventually create chronic stress. We are not talking about the kind of stress that comes and goes on a daily basis. We are talking about a constant level of stress that does not go away and that can have serious life-threatening consequences. We have discussed the debilitating effects of stress in previous articles. Here are some common strategies that caregivers can use to help reduce the level of stress.

Ask for help

Most caregivers are reluctantly thrust into their role without preparation because the need for care usually comes with little warning. Caregivers end up operating in a "crisis" mode--arranging medical care and living arrangements, scheduling care time, providing meals and household chores and so forth. Because they are so stressed and burdened, they rarely take time to find out what resources are available to help them. Ironically, caregivers often sever ties with family, friends and support groups about this time just when help from these people is most needed.

As a caregiver you must ask for help. The stress of going it alone is dangerous to your health. If it's difficult to ask for yourself, use an advocate--a sibling, friend or professional care manager --to arrange a meeting and get formal, written commitments from those people who are willing to help you. The extra help will give you breathing room to find all those resources that are there to help you.

Seek care management advice

You should pay for a formal assessment and care plan from a professional geriatric care manager. Even though it may cost you a little money to hire a care manager, this could be the best money you will ever spend. Care managers are valuable in helping find supporting resources, providing respite, saving money from care providers, finding money to pay for care, making arrangements with family or government providers and providing advice on issues that you may be struggling with.

Take time off--find temporary substitutes

Taking a break from caregiving is just as important as taking a break at work or taking that long-awaited vacation. A care manager may be of help in selecting the best temporary help to give you a break. Or you may make arrangements with family or friends to give you a break from caregiving.

Make plans for funding future care arrangements for you or for a healthy parent

The analysis of data from three national surveys (Mature Market Institute, National Alliance for Caregiving and LifePlans, Inc) points out that employees caring for disabled elders who have long term care insurance (LTCI) are nearly two times more likely to be able to continue working than those caring for non-insured relatives. In addition, working caregivers of those with long term care insurance said that they were less likely to experience some type of stress, such as having to give constant attention to the care recipient or having to provide care while not feeling well themselves. Also, the group with insurance devoted more "quality time"--more companionship and less hands-on assistance--than the group without.

See if your healthy parent can still buy insurance. If he or she can't afford it, see if other family members might contribute to premiums. There are also useful strategies using a reverse mortgage to buy long term care insurance and life insurance for your loved ones. You should also consider insurance for yourself so when you need care someday, it won't be so stressful on your caregivers.

Use assistive technology

There are a number of technologies to make sure your loved-ones are safe while you're away. Such things as emergency alert bracelets and pendants, GPS tracking for wandering, remote video surveillance, telehomecare, sensory augmentation and all sorts of assistive devices to help disabled people cope on their own.

Remove non-caregiving stress from your job or at home

It's obvious if you can remove other stressors in your life, you can cope better with the stress of caregiving, which you may not want to or can't remove. The internet is your best resource here. Go to www.google.com, the most relevant non-commercial search engine on the net. Type in "work stress" and you can browse 3 million plus URL's. For home stress type in "home stress" and browse 4 million plus URL's. Everything you ever wanted to know is buried somewhere in those millions of pages.

Attend workshops or seminars to uncover additional strategies

National Care Planning Council support teams in various geographic areas offer worksite or community presentations on various eldercare issues. These learning experiences are an opportunity to find help with your own caregiving situation.

Exercise

Exercise is a powerful and effective way to fight stress. It is recommended you do about 30 minutes of moderate exercise at least 3 days a week. Here are a few reasons why exercise works.

• Distraction--Exercise provides time away from the stresses of the day.
• Endorphins--Endorphins are opiate-like chemicals that the body produces naturally during periods of stress or physical exertion to relieve pain. Some evidence suggests that they may be involved in the regulation of mood.
• Neurotransmitters--During exercise, the body releases higher levels of dopamine. These hormones improve the thought process by facilitating transfer of information between neurons.
• Self-esteem--Exercise can be a gratifying and fulfilling activity for people. The act of doing something good for self can promote self-esteem.
• Reduces IL-6--Although muscles temporarily produce IL-6 during heavy workouts, exercise tends to lower levels between workouts.

Do a better job of managing time

In our modern world, one of the most prevalent threats to our well-being is the improper use of time. Not meeting deadlines may cost us a promotion or our career. Failure to make appointments or to meet obligations threatens our self-image or social standing. These and many more time-related threats cause stress. Finding help with managing your time would probably go a long way to relieving your stress.

Develop a support group and maintain social contacts

Participating in a support group can help manage stress. Sharing coping strategies in a group setting lets you help others while helping yourself. It may also help you to realize that some problems have no solutions and that accepting the situation is reality. Social support has a huge impact on reducing stress. Many studies show that social support decreases the stress response hormones in our bodies. In his book, Love and Survival (Harper Perennial, 1998) Dr. Dean Ornish notes that people who have close relationships and a strong sense of connection and community enjoy better health and live longer than those who live in isolation or alienation. People who suffer alone, suffer a lot.

Get adequate sleep

The catch-22 with sleep is that if you are over-stressed, you are likely to experience a disturbed sleeping pattern, and if you are experiencing a disturbed sleeping pattern, you are likely to become over-stressed! Research also shows that abnormal sleep increases levels of IL-6 while normal sleep decreases IL-6.

Sleep isn't a luxury; it's a necessity. Sleep restores the body and mind and helps us maintain our mental and physical health. Studies have shown that people who get seven to eight hours of sleep each night enjoy better health and live longer than people who get less sleep. According to the National Institutes of Health, each year approximately 60 million Americans experience frequent insomnia, the inability to get adequate sleep.

To ensure that you get enough sleep, try some of the following suggestions:

• Develop a sleep schedule and stick to it.
• Try to go to bed at the same time each night.
• Wake up at the same time, too.
• Avoid sleeping in on weekends; sleeping in will reset your body clock, making it harder to wake up on time on Monday.
• Get 30 or more minutes of physical activity each day.
• Avoid working out during the three hours before bedtime. Working out close to bedtime will energize you and may interfere with your sleep.
• Avoid caffeine, nicotine, and alcohol. These substances rob you of quality sleep. Switch to decaf or herbal tea.
• Quit smoking. An alcoholic beverage (a "night cap") before bed may make you drowsy but it actually deprives you of deep, restorative sleep.
• Engage in relaxing activities before bed. Think of it as "wind down" time. Read a book. Soak in a hot tub. Avoid doing physically or mentally stimulating activities such as vigorous housecleaning or intense office work close to bedtime.
• Leave your troubles outside the bedroom door. Make your bedroom a worry-free zone. If you start to ruminate about problems when you are in bed, try relaxation techniques such as deep breathing or visualization (visualize that you are in a warm, breezy, tropical place, with the sun streaming down on you, nothing but sand, surf, and coconut trees for miles...).
• Create a cozy sleep environment: wear comfortable pajamas, make the temperature of the room comfortable for you, darken the room, use soft, comfortable bedding that enhances your sleep experience. If your bed is too hard or lumpy or soft, invest in a new one. If noise is an issue, try to get at the root of the problem: ask your snoring partner to seek evaluation and treatment, ask your neighbors to be quieter, etc.

Pursue diversions, hobbies and relaxing activities

Another simple way to reduce stress is to distract yourself -- go to a movie, play a sport, immerse yourself in a hobby, listen to some favorite music or take a walk. It cannot be emphasized enough how important it is as a caregiver you spend some quality time alone every week, doing exactly what it is you like to do.

Try taking anti-depressants and anti-anxiety medications

Dr. Kiecolt-Glaser points out that anti-depressants lower IL-6 levels in chronically depressed patients, so they might be useful. She also said there have been suggestions that cholesterol-lowering statins might reduce IL-6, because they seem to reduce inflammation.

Reduce Stress through Proper Nutrition

Being overweight (eating too much)
Many people react to stress by eating. Eating too much for a long period causes obesity. This causes your heart and lungs to work harder, overloads your organs and reduces stamina. Studies show that fat cells excrete IL-6 and that overweight people have high levels of IL-6 in their blood. This in turn leads to the IL-6-associated illnesses such as heart disease, immune disorders and diabetes.

Not eating properly
Some people react to stress and stress-induced depression by not eating or eating poorly. If you eat a good, well-balanced diet, your body will be receiving all the nutrients it requires to function properly. On the other hand, if you are eating an unbalanced diet or not eating enough you may be stressing your body and contributing to stress-related complications by depriving yourself of essential nutrients.

Coffee, tea, caffeine soft drinks and chocolate
Caffeine is a stimulant. One of the reasons you probably use it is to raise your level of activity. This chemical actually enhances the stress response and thus increases your existing stress. Small quantities probably do little harm but large quantities over a long period produce excessive stress and lead to many of the physical ailments attributed to chronic stress. Too much caffeine can be dangerous. If you are drinking many cups of caffeine products a day, then you may find you can reduce a lot of stress and save your health by switching to caffeine-free products for a portion of your daily intake.

Alcohol
Some people react to stress by imbibing in alcohol. In small amounts, spirits may help you relax. In larger amounts alcohol may increase stress as it disrupts sleep. Over the long term, alcohol will damage your body. Alcohol is also a depressant. If you're prone to depression, alcohol will only make it worse. Studies show that depressed people have eight times the level of IL-6 as compared to the general population. As we have seen, high, prolonged levels of IL-6 are a marker for debilitating illness and early death.

Tobacco
In the short-term tobacco use seems to relax people but the toxic effects of nicotine raise the heart rate and enhance the stress response. If you smoke, try taking your pulse before and after a cigarette, and notice the difference. After the initial period of giving up smoking, most ex-smokers report feeling much more calm.

Sugar and refined flour
Sugar can be a stimulant for people experiencing stress and stress-induced depression. Sugar-rich foods (the starch in refined flour is also a form of sugar) can raise your energy level in the short-term. The problem is your body copes with high levels of sugar by secreting large amounts of insulin, which in turn, quickly reduces the excess amount of sugar in your blood stream often causing blood sugar levels to swing too low.

These up and down spikes in blood sugar can cause agitation, mood swings, irritability and fatigue, which in turn can contribute to the creation of additional stress. The ups and downs of sugar spikes also contribute to depression. And of course, excess sugar is readily converted to body fat thus causing obesity. Consuming sugar in the form of complex carbohydrates--whole grains, fruits, vegetables and tubers--forces the digestive tract to release blood sugar more slowly and keeps insulin and blood sugar levels more normal. Avoid fruit drinks, sugar drinks, candy, pastas, white bread and pastries.

Nutritional supplements
There are thousands of supplement suppliers and scores of books that claim success with managing stress by using herbs, herbal extracts or synthesized biochemicals. These compounds often come with the claim of enhancing mood or strengthening the immune system. Since there are so many different competing claims, you must decide for yourself which supplements help and which don't.