Caring for the Caregiver
By: AGING ARKANSAS newspaper
There are about 15 million caregivers in the United States---that 10% of the adult population. Family caregivers provide at least two-thirds of all home care services in the US.
Caregivers provide critically needed care that allows inform older people to remain in their homes longer. Caring for an elderly family member can be very rewarding but often frustrating. It creates conflicting emotions. If, as a caregiver, you neglect yourself, the stress of caregiving can take its toll.
Seek help early. Don’t wait until you are totally burned out.
Educate yourself about the disease or disability you are working with, its progression and how to adapt to the various stages. Learn about the losses to come so they will not be unexpected.
Don’t neglect to plan for the future. Good planning includes getting a power of attorney, accessing community care early and filling out placement papers before they are needed.
Recognize the hidden grief component of your anger, anxiety, guilt and depression. Expect adaptation, but no resolution of your grief.
Make sure you have a family doctor who is willing to listen and understand. Establish good communication with all your health care providers.
To avoid burnout and thus be unable to fulfill your caregiver duties, find someone to talk with and discuss your feelings. Join a caregiver support group---call your local Area Agency on Aging to locate one in your area.
Set realistic goals. Don’t try to be Superwoman or man. Determine your priorities and ask others for help when needed.
Take time for yourself even if it is only an hour or two at a time. Take advantage of respite care. This is a service that provides temporary care for an older person so you can have a break.
Talk to a professional. Clergy, social workers, psychologists and nurses are often trained to provide counseling on caregiving issues.
Above all, take one day at a time. Both you and the person you are caring for will benefit once you learn your limits and how to meet your own needs.
Kansas Senior Press Service
For More Help
Major sources for information and referral on family caregiving include:
-Your local Area Agency on Aging---toll-free numbers and the counties serviced are listed on pages 22-25 of this newspaper.
-National Alliance for Caregiving, 4720 Montgomery Lane, Suite 624, Bethesda, MD 20814 or visit their website at www.caregiving.org
-Call the National Eldercare Locator, a free service of the Administration on Aging, toll-free at 800-677-1116 weekdays 8:00 AM to 7:00 PM.
-The Administration on Aging’s website is www.aoa.gov/wecare/default.htm
-Other helpful websites include:
www.geocities.com/Athens/1330/
Eldercare Web: www.elderweb.com/
Senior-Site: http://seniors-site.com/
-Contact national organizations focusing on your patient’s needs, such as the Alzheimer’s Association at 800-272-3900 or on the web at www.alz.org
-National Association of Professional Geriatric Care Managers can locate private geriatric care managers at www.caremanager.org
-Helpful books include:
The 36-Hour Day by Nancy Mace and Peter Rabins
Caregiver’s Handbook: A Complete Guide to Home Health Care by the Visiting Nurses Association
Caring for Yourself While Caring for Your Aging Parents: How to Help, How to Survive by Claire Berman
Surviving Your Spouse’s Chronic Illness by Chris McGonigle
Exercise Benefits Health of Caregivers
Older women caregivers slept better and lowered their blood pressure in response to stress tests after participating in a moderate exercise program compared to a group of women who only received nutrition counseling. Results of the study were published in the November issue of the Journal of Gerontology: Medical Sciences.
Caregivers who exercised four times a week showed significant improvements to their health, according to the results of a randomized study headed by Abby King, PhD at the Stanford University School of Medicine. This is the first investigation of the effectiveness of a physical activity intervention tailored specifically to the needs of caregivers.
One hundred women ages 49 to 82 volunteered to participate in either a moderate exercise or a nutrition counseling program. The women averaged 72 hours a week caring for demented family members, 63% of whom had Alzheimer’s disease. Participants lived with their care recipients either all the time (92%) or most of the time (8%) and had spent an average of four years caring for their impaired relative.
Each week, 51 women in the exercise group engaged in four 30 to 40-minutes sessions of aerobic exercise, such as brisk walking. The 49 members of the nutrition group learned about nutrition topics, discussed benefits of good nutrition and kept daily diet logs. Telephone calls of 15 to 20 minutes were used to monitor progress of both groups, answer questions and provide individualized feedback.
At the end of the study, the exercise group showed significant improvements in stress-induced blood pressure levels and sleep quality compared to the women who only received nutrition counseling. Exercisers spent five hours a week in physical activity by the study’s end compared to the nutrition group who spent less than three hours per week in all forms of physical activity. The exercising caregivers showed significantly lower 12-month systolic and diastolic blood pressure levels in response to an emotional stress test. Reduced blood press reactivity in response to stress is associated with fewer heart and blood pressure problems. Conversely, the nutrition groups’ diet improved but the group showed no changes in either resting or reactive blood pressure.
The home-based exercise program was particularly important to the participants who could no leave or find coverage for their care recipients for 30 minutes during the day. A health educator worked with them to develop an indoor exercise program based on their preferences.
According to Dr. Sidney Stahl, chief of Behavioral Medicine with the National Institute on Aging’s (NIA) Behavioral and Social Research Program, “Studies show that family caregiving accompanied by emotional strain in an independent risk factor for mortality among older adults. The study gives us some evidence that a self-directed exercise program can reduce stress reactions and perhaps improve the health of caregivers. This pilot intervention trial provides encouraging results and help for a low-cost, effective means to combat caregiver stress.”
The NIA, part of the National Institutes of Health, leads the federal effort supporting research on aging.
Tips for Working Caregivers
As the population ages, employers who want to retain good employees are going to have to implement strategies to help employees address the balance of their work and personal life. There is a rising number of dual-worker families and increased rates of absenteeism due to caregiving issues.
According to Margaret Neal, PhD, of the Portland State University Institute of Aging in Oregon, “Wives generally appeared to be fairing worse than husbands, with a significantly higher level of depression, more worry about working less effectively due to concerns about their children or aging parents, and a lower level of performance to taking care of themselves.”
Because there are an estimated 14 million full and part-time employed caregivers, 73% of whom are women balancing work with a demanding “other” profession---caregiving---organizations and human resources departments nationwide are making more effort to give caregivers the flexibility and assistance they need.
Here are some helpful tips if you’re a caregiver still in the workforce.
-Take advantage of the Family and Medical Leave Act (see below).
-Enlist the support of your employer for flexible, reduced or part-time hours.
-Work at home or telecommute.
-Take advantage of employee assistance programs (EAP) at your workplace. Ask the personnel director about what your employer offers.
-Access public senior service programs and check out resource and referral services for elder care on the Internet and through your local Area Agency on Aging---see pages 22-25 for toll-free number.
-See if your employer can set aside pre-tax dollars to pay for elder care.
-Have a support network of alternative caregivers.
-Seek out professional counseling before you get burned out and use support groups.
-Learn about Alzheimer’s and other dementias so you know what to watch for and how to react.
Help from the Family and Medical Leave Act
Caregivers who need to take time off from work to fulfill caregiving duties may be able to take advantage of the Family and Medical Leave Act (FMLA).
The FMLA is a federal law that allows caregivers to take up to 12 weeks of unpaid leave a year to care for ill family members, including spouses and parents with serious health problems. The law allows caregivers to take unpaid leave without fear of losing their job.
FMLA Basics:
-A caregiver must work for a company with 50 or more employees, have worked for his or her employer for at least 12 months and worked at least 1,250 hours during the previous year.
-FMLA leave may be taken intermittently or in specified blocks of time, such as half-day, full day, one week, etc.
-Employers can require employees to obtain a medical certification of the serious health condition from a physician.
For more information:
-One website, sponsored by the National Partnership of Women and Families, provides a basic fact sheet on the FMLA, a guide to frequently asked questions about the FMLA and a fact sheet on caregiving and the FMLA.
www.nationalpartnership.org/workandfamily/workmain.htm#fammed
-Sponsored by the US Dept. of Labor, this website provides basic information about the FMLA for employers and consumers, the text of the law and sample medical certification forms. www.dol.gov/dol/esa/fmla.htm
Reprinted from Advances, a publication of the Alzheimer’s Association, Fall 2001.
Signs of Caregiver Stress
A 1999 study examining the death rates for older people care for a sick spouse showed a significantly higher death rate when compared to non-caregivers. Authors said the higher mortality rate reflects the effects of chronic emotional and physical stress.
Depression is a major risk for caregivers under stress, especially among older caregivers, according to the Mount Sinai School of Medicine newsletter, “Focus on Healthy Aging.” All caregivers face similar stresses. These problems can be especially acute for those providing care to a person with Alzheimer’s disease or other dementia.
“A lot of studies show they can handle the physical deterioration much better than the mental deterioration,” according to Helene Ebenstein, CSW and coordinator of the Caregiver Resource Center at Mount Sinai Hospital. “They call it the long good-bye. You’re watching this person fade away right in front of you. And with Alzheimer’s, this can go on for many years.”
According to the Alzheimer’s Association, showing even one or more of these signs indicates that a caregiver is at risk for stress-related health problems.
-Denial about the disease or the symptoms your loved one is suffering: “I know mom’s going to get better.”
-Anger at the person with dementia or with others; anger at the lack of effective treatments and the perception that people don’t understand what you are going though.
-Social withdrawal from friends and activities that you once enjoyed: “I just don’t want to be around people.”
-Anxiety about facing another day or what the future holds for you: “What will I do when she needs more care than I can possibly provide?”
-Depression that begins to break your spirit and compromises your ability to cope: “I just don’t care anymore.”
-Exhaustion that makes it nearly impossible to complete daily tasks: “I’m too tired to handle this.”
-Sleeplessness caused by a never-ending list of concerns and pressures.
-Irritability that leads to moodiness and “snapping” at others.
-Lack of concentration that makes it hard to perform familiar tasks, such as remembering a doctor’s appointment.
-Health problems, mental and physical, that begin to take their toll on your life: “I feel tired and sick all the time.”
| |
| |
|
1-866-651-CARE (1-866-651-2273)
©2010 Arkansas Association of Area Agencies on Aging
Design & Programming by ®
|
