Caring for the Caregiver, Part 2: Managing Caregiver Stress

Part 1: Caring for the Caregiver

It’s not stress that kills us, it is our reaction to it.
–Hans Selye

Life brings with it a few guarantees: death, taxes and stress. Stress is universal, and we all experience it from time to time. A reasonable amount of stress is actually thought to be helpful: it can be a source of energy that moves us toward change. Sometimes, however, circumstances are such that the stress involved seems almost overwhelming.

If stress is defined as the gap between our expectations and our reality, this is a constant for the Alzheimer’s caregiver. As any chronic and incurable disease progresses, new normals are a steady force that bring with them new realities that often defy our expectations. Chronic stress of this type can impact not just our emotional and mental health, leading to depression, anxiety, and more, but it also can have a profound effect on our physical well-being.

Stress and Your Physical Health

In a recent study, the stress of caregiving was found to have a significant negative impact on the physical health of caregivers. Three-fifths of all caregivers rated their physical health as “fair” or “poor” compared to one-fifth of non-caregivers. Caregivers also experience chronic conditions (including heart attacks or heart disease, cancer, diabetes or arthritis) at nearly twice the rate of non-caregivers. According to the National Center on Caregiving, the stress of caregiving also causes a decreased immune response. Studies indicate that caregivers have a 23% higher level of stress hormones, and a 15% lower level of antibody responses.

Although the perception of stress is subjective (what’s stressful to you may not be to somebody else), there are several factors that can influence our perceived level of stress in a caregiving context:

–Is the caregiving voluntary or not? Were you forced into the role because nobody else was available?
–How well have you coped with stress in the past? This is a strong predictor for how you will cope with it now and in the future.
–What was your relationship like with the care receiver before the diagnosis? If it was a difficult one, higher amounts of stress if more likely.
–What kind of support is available to you?

Caring for the Stressed-Out Caregiver: Steps

Clearly, stress management and reduction should be important goals for caregivers and for anyone who supports a caregiver. Though there is nothing that can be done to improve the long-term outcome of a care receiver diagnosed with Alzheimer’s or other type of dementia, there are definitely things that can be done to help reduce stress in the caregiver, which ultimately helps both the caregiver and the care receiver:

1. Learn to recognize the early signs of stress. Everybody’s different. What happens when you get stressed out? Is your sleep impacted? Your temper? Your eating habits? Are people commenting on changes in your appearance or behavior? Know yourself, and become familiar with how stress manifests for you, so you can recognize it while it’s still in a manageable stage.
2. Identify your sources of stress–even those not associated with caregiving, as these can directly impact your caregiving abilities. The possibilities are wide-ranging and very subjective, but can range from financial stressors to the care receiver’s diminishing abilities to the negative attitudes of people close to you and much more.
3. From this list, figure out the items you can change, and those you can’t. This one can be the most challenging, as most of us would like to believe we can change the unchangeable. Be willing to look objectively at those things you can’t change, and foster a sense of acceptance. Educate yourself on the disease and identify any unrealistic expectations you may have for the future. Focus on the things you still have, rather than what you don’t.
4. For those items that can be changed, take action. Try to make sure each part of you is being cared for: physical, emotional, mental and spiritual. Seek out resources and be willing to accept support. Take small steps. Seek meaning in the journey.
   

   Those who have a ‘why’ to live can bear with almost any ‘how.
   –Viktor Frankl

Give yourself permission to take care of you. In order to better care for your loved one, you must learn to first care for the caregiver, and this includes managing caregiver stress.

November is National Family Caregivers Month! If you know a family caregiver in need of support, now is a great time to offer a word of encouragement or even to ask how you can help to reduce their stress.

(Sources: The Caregiver Helpbook, 3rd edition, AGE of Central Texas)