Practice Self-Care: The Toll: Consequences of Caregiver Stress

Proven, practical self-care practices that preserve a caregiver’s health, well-being & capacity to care

C3: Care for Yourself As You Care for Others

Jane’s Story: Support Group

You want me to do what!? Attend a support group? Yeah, right! I could fit that in after my ten-hour day at work, just before I stop to buy the Depends for my mom, on the way to pick up the kids from practice and go home to make dinner. Or, maybe after dinner, when the dishes are cleared and I’ve finally managed to get the kids off the computer and phone and on to their homework. Or, perhaps between doing loads of laundry and calling my brothers to remind them that Mom is doing OK, but would really like to see them. You want me to take time for myself!? I don’t see how I could possibly do one more thing, even if it is something good for me. It would just stress me out more to try to make the arrangements.

Sometimes words like these form in my mind, or actually come out of my mouth when others suggest I take a break from the rigors of caregiving. I dismiss others’ suggestions for self-care. Why do I do this? Am I in such a rut that I can’t see even just a few ways to reprioritize, reorganize, or reschedule parts of life so I can grab some time for me? Am I feeling so unworthy that I believe everyone else’s needs really are more important than mine? Am I feeling so guilty to be healthy when Mom is suffering, that I won’t allow myself to stop; so blind to the consequences of living an overextended life that I can’t see the real possibility of becoming sick from too much stress?

Whatever the reasons, taking some kind of self-care action now is more important than understanding why I haven’t until now. What I need is some respite, a break that will help me relax and regain some energy. Maybe finding time to go out to a support group is beyond what I can do today. But I know there are lots of other things that can relieve my stress and give me strength for the journey ahead. I just need to do some of them.

How are you caring for yourself?

I went through a period during my caregiving years when I was always sick, nothing really serious but mostly annoying and inconvenient. A series of sinus infections plagued me for years. On the plane ride home from one trip to see my Mom, I contracted a nasty virus which was not diagnosed for three months, and which kept me sick and tired for another three months. I was depressed and my immune system was shot. I spent more days in bed that winter than I had since infancy! Feeling lucky that it was nothing more serious, I realized that caregiving had silently stolen my vitality. How are you? Are you experiencing any signs of strain? What have you done for yourself lately? If you need to take better care of yourself, here are a few ideas that might be useful.

Self-Care Recommendations

What is self-care and why is it important?

Relief from the stress of caregiving starts with recognizing the importance of self-care and practicing it regularly. What is self-care? Self-care is being concerned about yourself, as well as others; looking out for your own welfare, making sure that your needs are met, not only those of others. Self-care is that collection of choices you make and behaviors you practice that make you feel good, solve your problems and ultimately, relieve your stress. Managing stress by practicing self-care is important because it protects your health, helps you cope when the things that cause stress are beyond your control, and helps you maintain the balance you require to care in a loving and effective way.

How can I practice self-care? Use the six steps listed below.

1. Name your symptoms and sources of stress

All successful self-care follows from this first step. Use the checklists found in C2 for detailed descriptions that will help you name your symptoms and sources of caregiver stress

2. Adjust your attitude

You can control the wear and tear of distress you experience by adjusting your attitude in the following ways:

Using positive self-talk: Silently or aloud affirm your strength and ability to cope. Say to yourself, “I can do this!”

Challenging negative beliefs: Question negative assumptions. Consider possible positive outcomes. Ask yourself, “What is the worst that could happen? What is the best that could happen? What is most likely to happen?”

Relabeling: Think and talk about stress from a positive, not a negative perspective. Replace, “This is an awful problem.” Instead think, “This is a challenge or opportunity.”

3. Decide on a course of action'

Ask yourself: Is there anything I can do to change or eliminate the stressors in my life? A yes or no answer leads to different approaches to self-care. Here are two examples.

Imagine your stressor is a disagreement with others over the division of caregiving tasks. You are tired, have other pressing responsibilities, and need some help. In this case, your answer to the question would be, “Yes. If I take some action the stressor could be relieved, or will completely go away. My friends or family may help me if I ask them.” When you control or can influence stressors, the best course of action is assertiveness and problem-solving. This approach will yield relief and may even eliminate your stressors. Be sure to use a positive approach when solving problems.

In a second scenario, the stressor is your loved one’s Alzheimer’s disease, the progression of their illness, and the suffering that goes with it. Here your answer to the question would be, “No. No matter what I do the diagnosis won’t change or go away. I need to find some way to live with this.” When you have no control or influence over your stressor, the best course of action is using healthy self-care practices. Problem solving or assertiveness won’t have an effect. Self-care helps you retain energy and feel better when stressors are beyond your control.

One caution: Take care that you don’t reply “no” to the question of your ability to change or eliminate stress when, with courage, you could answer “yes.” Check your perceptions with a reliable person.

4. Use healthy self-care practices daily, and at times when you lack control

Loss of control is very stressful. When there is nothing to be done, the thing to do is to care for yourself. And don’t wait until you have already worn down to practice self-care; make it a priority in your daily routine. Choose things that are self-soothing–whatever helps you calm down, have fun, relax, enjoy, or feel pampered. When called for choose things that involve self-discipline; although less pleasurable, in the long run, disciplined self-care practices lead to a greater sense of well-being. For examples of healthy self-care, check out C3 Activity #2: What healthy self-care practices do I currently use?.

5. Avoid stress-numbing behaviors

Stress-numbing behaviors include: complaining and blaming; drugs and drinking; overeating and consuming junk food; buying sprees; smoking; sleeping to avoid stress; burying yourself in television, video games, the computer, or other distractions; or avoiding action on problem-solving. These behaviors numb the distress of being a caregiver, but do nothing to help body, mind, or spirit cope in a healthy way with caregiving challenges. By promoting a sense of release or relaxation, they give the illusion of self-care, but if overused, or used in place of problem-solving action, can actually create more stress than they relieve.

What stress-numbing behaviors do you use? How much do you rely on them to dull the pain or discomfort in your life? Make sure that these are not big parts of your approach to self-care. If you are too reliant on any of these practices, look for alternatives that are healthier and more effective.

6. Use problem-solving skills when you have control

When some action on your part can ease or eliminate your stress, take problem-solving action by using The Four Step Process.

The Four Step Process
  1. Figure out what your problem is.

    Name the challenge, opportunity, difficulty, or situation that needs improvement. If emotions or confusion makes this difficult, ask those you respect and trust for help. Organize your facts:

    • WHO contributed to this problem? WHO was affected?
    • WHAT happened to create this problem: violated expectations or promises, bad behavior, something else?
    • WHEN did this happen?
    • WHERE did this happen?
    • HOW do you and others feel in response to this problem?
    • WHY is this important?
  2. Develop a problem-solving plan.
    • Consider options. Ask: What can be done to resolve this problem? Brainstorm to develop possible solutions; the more options you create, the more likely you will identify an effective solution.
    • State desired outcomes. Ask: What do I want to achieve? What are short and long-term goals? What rewards will I get if this problem is solved?
    • Write an action plan. Create a three-column chart with these headings and fill in the details.
      • WHAT: Name each step and the tasks for accomplishing it. Think about what difficulties might arise and how you could handle them.
      • WHO: Name the person(s) who will be responsible for doing each step of the plan.
      • WHEN: Identify deadlines for completing each task.
  3. Carry-out your plan.

    Take action and check for progress. Tracking progress is critical; it motivates people to follow through on the plan. Remind those involved of the deadlines for each step and for the whole plan, the desired outcomes, and rewards for success.

  4. Evaluate your plan.
    • Did we solve the problem? Did we achieve our goal?
    • Did we change the situation? What worked? What didn’t work?
    • Are we listening to all feedback, both positive and critical? What have we learned?
    • Does anything more need to be done?

References, Resources, and Links

Caring for the Caregiver: C3: Care for yourself as you care for others

Self-Care: Practical Advice for Your Caregiving Journey-AAMDSIF Webinar

Caregiver Questions

What is self-care?

Why is self-care important?

What makes self-care difficult?

How do I find the time for self-care?

Do little things really make a difference?

Making it Personal: Activities for Caregivers

Next Chapter: Three Things That Every Caregiver Needs

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