Caregiver Stress - A respite can build your resilience

According to the results of a new study of the health of caregivers, there is mounting evidence that explains why caregivers often become patients themselves while caring for a loved one.

 Individuals caring for a spouse with dementia show four times greater annual increases than noncaregivers in interleukin-6 (IL-6), a key immune system molecule linked in previous studies to increased risk of cardiovascular disease, osteoporosis, arthritis, adult-onset diabetes, and a greater likelihood of death, Janice K. Kiecolt-Glaser and colleagues report in the June 30 edition of the Proceedings of the National Academy of Sciences.

Caregivers’ relatively higher levels of IL-6 may provide part of the biological explanation for a growing body of evidence implicating care giving as a risk factor for a variety of illnesses. In addition to showing accelerated increases in IL-6, caregivers report greater loneliness and feelings of stress and score higher on measures of depression than non caregivers.

 For caregivers whose spouses died during the study, elevated IL-6 and feelings of loneliness and depression persisted for at least three years following bereavement. One explanation for this persistence may lie in the well-documented social isolation and loss of support that result from extended care giving. Caregivers may emerge from their care giving responsibilities with many fewer social contacts than they had before their spouses developed dementia. Social isolation, which has also been linked to increased risk of illness and death, may be an important factor in perpetuating caregiver stress.

Often caregivers underestimate the demands of providing care for another can have on them.  While it is important to try to maintain a positive attitude, often caregivers experience feelings of helplessness and lack of control over their situation.  Caregivers who educate themselves about the diseases affecting their loved one will be better equipped to recognize and understand changes associated with progression of the disease and the aging process.  This way they can be more capable of anticipating and dealing with changes as they occur rather than being caught surprised and unprepared.

It is also important to set reasonable expectations.  A child can never change a lifelong relationship by taking on caregiver responsibilities as the need arises.  Be realistic and understand that if anything, the stress associated with caregiving can often expose already weak areas in a long term relationship in even the best of situations.  Appreciation for ones contributions should not be expected by the caregiver or from other family members.  Caregivers who provide care without expectation will be rewarded if gratitude is offered and not disappointed if it is withheld. Learn to take pride in your own accomplishments.

It is critically important to strive for balance in your life.  Personal fitness, good nutrition, and maintaining social contacts can all help keep caregivers energized.  If the caregiver is beginning to feel frustrated, angry or like a martyr, it may be time to consider a support group, or a respite.  Most communities, hospitals and churches host disease specific support groups where fellow caregivers can come together to share their experiences and help each other.  Sometimes it may be helpful to just come and listen to others and see how they have learned to cope with their caregiver responsibilities.  Often caregivers themselves can offer the best support to each other because of their own personal experiences.

Acknowledge your emotions and find an outlet for them.  Most caregivers will experience frustration, anger, guilt, resentment, self-doubt, and feelings of helplessness.  These can all lead to stress which as the study revealed can contribute to health problems of their own.  Caregivers need to find some time to nurture their own needs.  Better to consider lowering your expectations when they are unmet rather than allow yourself to become stressed out by them.  You can only do so much, better to say “no” if you can then have your own health slide attempting to do the impossible. Learn to ask for and accept help from others before its too late.  Most siblings will participate in solutions for the care of a parent if they are pushed, asking for help does not need to mean that the primary caregiver is relinquishing control or backtracking.  Its is better to teach others what the caregiver has learned and empower them to help than to try to do it all one’s self.

Maintaining a positive attitude is very important.  A stressed out caregiver is highly susceptible to depression.  Depression has been known to adversely affect the immune system.  This is why people who are left alone and isolated often suffer catastrophic health failures, while their socially active counterparts remain relatively healthy.  Learn to recognize when your care giving duties begin to drag you down and find a way to get away for some time alone or with friends. 
Day care, respite and other short-term stays in assisted living or memory care are available in most senior living communities at reasonable rates.  Residents who are around other people tend to perk up and complain less.  Most seniors find the experience very fulfilling after a short period of complaining about it.  It also introduces Mom to the concept and people living there and helps to derail her fears about it.

Mother may have “known best” when you were a child, but now that roles have reversed, it may be time for the caregiver to do what he or she thinks is best for them.  After all how often did your mother allow you as a child to talk her out of what she thought was best for you?  A short term stay can also afford the caregiver opportunity to recharge their own health and attitude treating both to a better situation.