How to Manage Caregiver Stress

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Whether you’re caring for a parent, a spouse, a friend, or another loved one, being a caregiver is stressful, period. And as new problems and challenges come up, stress levels inevitably rise. People who take care of a loved one with dementia, in particular, face behavioral changes and new impairments that can increase stress levels. Caregiver stress is important to manage because it can lead to more serious problems, such as caregiver burnout and caregiver depression.

Adding to the stress is the feeling of having lost control over your own life and being trapped by the caregiving role. Amy Goyer, AARP’s family and caregiving expert and the author of Juggling Life, Work and Caregiving, stress how important it is to feel as though you have chosen to become a caregiver. “You go back to this choice over and over again and say I’m doing this and this is why I’m doing this. It helps with those sacrifices you make. In realizing them, you feel more empowered and that this is not something thrust upon me,” says Goyer, who lives with her 92-year old father, who has Alzheimer’s, and who took care of her mother before she died. (Related: The Collateral Damage of Caregiving.)

Prepare yourself for caregiver stress

The more prepared you are for the demands of caregiving, the better you’ll be at managing the stress that can come with it, says Tamara Griffin, MSW, with Duke Elder Family/Caregiver Training Center’s Social Work and Case Management Services. Griffin works with a program that focuses on empowering the caregiver to prepare for the short or long-term experience of caregiving. Creating a plan is key, she says. Griffin starts by asking caregivers to think through these questions:

  • Do you have the time? For a lot of caregivers, work is essential for financial stability and health insurance, but if you are also juggling your own household and children, topping it off with caregiving for an elderly parent or parents can be rough on your mental and physical health. “The combined responsibilities of a job and children and caregiving for a parent can wreak havoc in their lives and stress can take over,” she says, so she asks caregivers to prioritize — figure out which responsibilities are primary and which are secondary. It’s very individualized, based not on the need to do something, but the desire, she says. “For example, if on Tuesdays it’s a priority to attend your daughter’s ballet class, then on that afternoon, you’ll need to decide if you will reach out to a paid caregiver for Mom during that time, a family caregiver to come in, or maybe your mom is well enough to come along to the ballet class,” says Griffin.
  • Is your employer flexible?  “What is your relationship with your employer, what are your benefits, can you access them, will your employer be flexible? We start mapping out a conversation they probably should have sooner rather than later. We talk about their options, and knowing what they are,” Griffin says. Sometimes caregivers learn that they have paid family medical leave, or that they can telecommute, or that their employer offers mental health support services and daycare services for children.
  • Do you have a support network? “What is the immediate family network, then the extended network — neighbors, friends, and your church—that might be able to help relieve the pressures of work and small children?” says Griffin. She also recommends digging into “real tangible resources” — adult day care services and respite care services, for example — that can directly provide care to your elderly loved one.

Learn to recognize and acknowledge caregiver stress

After assessing your situation in terms of time, employer flexibility, and a support network, another important strategy is to acknowledge the inherent levels of stress. “Sometimes the simple act of giving a caregiver permission to say, ‘Yeah, I’m really stressed out and this is really hard,’ relieves stress,’’ says Tamara Griffin. As part of this acknowledgement, learn to set limits on on other expectations, such as your ability to participate in after-work social events or to host family gatherings. Only you can tell whether the additional burden of being a caregiver makes some of these formerly routine activities now feel overwhelming. Acknowledge your limitations and give yourself plenty of permission to decline other demands on your time.

You can get a snapshot of how stress is affecting you with the Kingston Caregiver Stress Scale, which measures not only your time constraints but also the emotional component of stress and its potential impact on other relationships. It asks such questions as whether you are feeling unconfident in your ability to provide care and whether there are conflicts within the family surrounding who is responsible for caregiving.

Remember that it’s okay to laugh and have fun

It may sound strange to recommend laughter when an older loved one is suffering in the hospital, or has Alzheimer’s or late-stage cancer, but humor can be a balm to mental health. “People who can laugh at their mistakes and who can enjoy that things are not perfect, those are the ones that can go the distance,” says Griffin.

And while it might seem hard to enjoy your loved one’s company in the same way, try to make the time you spend with them as enjoyable as possible.

“I used to do fun Friday adventures after my mom’s hair appointments on Fridays. That filled my tank and my parents’,” says AARP’s Goyer. “In summertime, we’d go to the mall and eat dinner and walk around inside the mall. We did Godiva chocolate club and once a month we’d get a chocolate. I tried to maintain the fun like we used to do, even though I was now their caregiver.” Watching a movie together or having a cup of coffee out can be a nice mini treat, too.

And of course, don’t neglect your own routine maintenance. “Exercise, nutrition, and my top priority is sleep. You can’t function or cope when you have not had sleep,” Goyer says, adding that a weekly Pilates class is her time to relax and recharge. “I really try not to skip.”

Avoiding a breaking point for caregiver stress

Every once in a while, a caregiver hits the breaking point. “Sometimes we’ll have a caregiver who says, ‘I’m not going to do this anymore.’ In that case, we try to give some sort of respite care, and either build services into their home or find a short term resource. At this point this caregiver is very fragile and vulnerable and at risk,” Griffin says. Stay open to revising your caregiving plans if your circumstances change.

It’s okay to say the words “make it convenient” and “make it enjoyable” for your life, says Griffin, and to be open to revising your plan if circumstances change.

If the stress of caregiving feels overwhelming or is impacting other parts of your life, reach out for help. AARP’s Family Caregiving site offers a “Prepare to Care Guide” (in several languages and an LGBT version) to help you develop a caregiving plan, as well as a plethora of other resources, including an online community and caregiving forums. The Alzheimer’s Association, for example, has a 24/7 Helpline (800.272.3900) and online resources at alzconnected.org. You might want to talk to your primary care doctor or a counselor as well. Nursing homes and other facilities often have a psychologist or clinical social worker who can help caregivers, or consider hiring an eldercare consultant with experience in helping both older adults and family members in managing the stresses of caregiving.

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