A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 Coping Caregivingwith HOW TO MANAGE STRESS WHEN CARING FOR OLDER RELATIVES PNW 315 Reprinted June 2003 A Pacific Northwest Extension Publication Oregon State University • Washington State University • University of Idaho A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 Authors Vicki L. Schmall, Extension gerontology specialist emeritus, Oregon State University; Ruth E. Stiehl, professor of education, Oregon State University. A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 Coping Caregivingwith HOW TO MANAGE STRESS WHEN CARING FOR OLDER RELATIVES Vicki L. Schmall and Ruth E. Stiehl PNW 315 • Reprinted June 2003 A Pacific Northwest Extension Publication Oregon State University • Washington State University • University of Idaho A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 Contents Who are you, the caregiver? __________________________________________ 2 What is caregiving? _________________________________________________ 3 Caregiving stress: symptoms and causes _____________________________ 4–5 Strategies for managing stress _______________________________________ 4 Set realistic goals and expectations _________________________________ 6 Establish your limits ______________________________________________ 8 Ask for and accept help ____________________________________________ 8 Take care of yourself ______________________________________________ 9 Involve other people _____________________________________________ 13 Caregiving from a distance__________________________________________ 19 Placement in a care facility __________________________________________ 22 Conclusion _______________________________________________________ 22 For more information _________________________________ inside back cover A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 amily members who play a major role in caring for Felderly relatives frequently ignore their own needs. Some find themselves virtually homebound and consumed by caregiving tasks. When caregiving is prolonged over months and years, the self-sacrifice is particularly harmful. We have prepared this publica- tion to help you maintain your personal well-being while pro- viding quality care for an elderly relative. We will discuss the sources of stress and how you can master stress for your own benefit and that of the person for whom you are providing care. COPING WITH CAREGIVING 1 A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 Remember, it’s just as important another person. This can create to take care of your own needs areas of conflict and high levels as to provide the best care for of stress in your life. Many nursing your family member. As a care- If you’re young, you probably giver, ignoring your own needs is home have competing responsibilities not only potentially detrimental for children, spouse, and job. If placements to you, but also can be harmful are you’re older, you may be adjust- to the person who depends on ing to age-related changes precipitated you. Many nursing home place- including retirement, reduced by the ments are precipitated by the income, widowhood, declining caregiver’s caregiver’s exhaustion, illness, or health, or different living exhaustion, death. This publication can help arrangements. At any age, you illness, or prevent such a situation for you probably have important goals and your family. death. This and plans that are interrupted or publication Who are you, postponed because of caregiving can help the caregiver? responsibilities. prevent such You may be a spouse, son, As a caregiver, you may be a situation daughter, neighbor, close friend, providing care out of love or out of a sense of obligation. More for you and or distant relative. You may be often than not, you feel both love your family. young or older yourself. No matter your relationship or age, and obligation. You may be as a caregiver you are making providing the support alone or concessions and a personal coordinating the work of others. sacrifice to provide care for You may find caregiving tasks satisfying and rewarding or completely frustrating. This publication will help you under- stand your responses and will show you ways to reduce the conflict and stress caused by the demands of caregiving. 2 COPING WITH CAREGIVING A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 What is caregiving? well-being. You may feel a sense of accomplishment in helping Caregiving can evolve slowly, your dependent relative and may over a long time, or suddenly, in experience a new closeness in the case of illness or accident. your relationship. Often a parent Caregiving can mean having the and child reach a higher level of older person live with you, near acceptance and understanding you, or hundreds of miles away. when the child provides care for Your older relative may be physi- the mother or father. However, cally disabled, mentally inca- no matter how loving the rela- pacitated or both. Depending on tionship, caregiving almost the specific need, caregiving can always involves some personal be a lot of different activities, sacrifice and stress, which can be including: seen in the following symptoms: • Round-the-clock supervision • Emotional or physical • Supervising others who exhaustion Caregiving can provide direct care • Depression mean having • Shopping • Marital problems the older •Telephoning •Family problems person live •Traveling to and from your • Alcohol or drug misuse with you, near relative’s home • Conflict among life roles— you, or • Maintaining two homes— spouse, employee, parent, and hundreds of yours and your relative’s caregiver miles away. • Lifting, bathing, dressing, and • Neglect or abuse of the older feeding person • Managing incontinence • Managing financial and legal You may feel that there are too affairs many expectations and not • Providing social activity enough time and energy to meet them all. Unresolved, excessive, • Supervising medication or prolonged stress results in • Arranging for health care what often is called burnout. • Listening, talking, and When challenges and demands providing emotional support are too great, they drain our physical energy, time, health, Whether you are providing and money. Becoming aware of round-the-clock direct care or how stress takes hold is the first coordinating others who provide step toward coping with it. direct care, you are still the caregiver: You are responsible to some degree for another person’s COPING WITH CAREGIVING 3 A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 Strategies you can develop skills for coping for managing stress with the changes brought on by Once you know the sources of his illness. stress, you must determine which Usually some action can be ones you can do something taken to decrease stress. Changes about and which ones are do not need to be major to make beyond your control. Successful an important difference. Some- coping involves accepting what times letting go of unrealistic you can and cannot change. expectations or adjusting your For example, you will not be standards of how frequently or able to change a parent who has how well you perform a task always been demanding and (such as housekeeping) will inflexible, but you can control make a big difference. how you respond to your parent’s In general, professionals who demands. If your father has a have extensive experience work- progressively debilitating illness, ing with caregivers agree on five you can’t change that. However, basic strategies to help control Caregiving Stress: Symptoms When you experience an unusual level of stress, certain warning signals occur. Answering the following questions will increase your awareness of these signals. Yes No ❏❏ 1. Do you feel a loss of energy or zest for life? ❏❏ 2. Do you feel out of control, exhibiting uncharacteristic emotions or actions? ❏❏ 3. Do you lack interest in people or things that formerly were pleasurable? ❏❏ 4. Are you becoming increasingly isolated? ❏❏ 5. Are you using more sleeping pills, medications, alcohol, caffeine, or cigarettes? ❏❏ 6. Are you having increased health problems; for example, high blood pressure, ulcers, or difficulties with digestion? ❏❏ 7. Is it hard to fall asleep at night? Do you awaken early or sleep excessively? ❏❏ 8. Are you experiencing appetite changes? ❏❏ 9. Do you have problems with concentration or memory? ❏❏10. Are you increasingly irritable or impatient with others? ❏❏11. Do you have thoughts of suicide? A “yes” answer to even some of these questions can indicate stress that has become debilitat- ing. Recognizing the source of this stress is the next step in dealing with its destructive effects. 4 COPING WITH CAREGIVING A more recent revision exists, For current version, see: https://catalog.extension.oregonstate.edu/sites/catalog/files/project/pdf/pnw315 the destructive effects of stress. 4. Take care