Practice Self-Care: What Causes Caregiver Stress?

Jane’s Story: Lost in the Line of Duty

Just this morning, I had a startling realization: I am lost! I usually know where I am going, and I generally reach my goal. But for the first time, I see that I am lost, not in a geographical sense, but in other different and disturbing ways. I have lost my zest for life; my energy is low and I am grief-stricken about Mother’s dementia. I have lost my confidence about the future; I have no idea where this disease will take Mom and the rest of us, too. I am often lost in thought, preoccupied with how to get everything done and keep all the balls in the air. I have lost important parts of my life: my image of my parents as strong, vibrant people; my illusions of immortality and invulnerability; my hope that good people will be spared suffering; my sense of being someone’s child.

In giving of myself to help my parents, I have lost parts of myself. What are the costs of trading off parts of my life over an extended period of time? What are the benefits? What choices do I have? I am betting that I won’t always be lost. I want to help because Mom and Dad won’t always need me as they do now. I am gambling that important parts of me can be revived. I hope I am right.

Where are you on your caregiving journey?

When I wrote “Lost in the Line of Duty” I was just waking up to the fact that caring for my parents had become a chronic source of stress. It was beginning to take a toll and I was starting to see my need for help. What had begun as a natural desire to give something back to my parents had silently morphed. Unbeknownst to me, I had become a caregiver. I was beginning to notice other caregivers, many who were doing much, much more than I was. That gave me hope. If they could manage, so could I.

The people or diagnoses in your circumstances may be different than mine, but like me, you are a caregiver. Where are you on your caregiving journey? Are you lost in the line of duty? What might be the costs and benefits of trading off parts of your life over an extended period of time? Though meaningful, caregiving is stressful and can take a toll on your physical and mental health. Explore the facts about caregiver stress found in C2 and the many self-care suggestions found throughout the 7C’s. These ideas can strengthen you and help preserve your capacity to care.

Self-Care Recommendations

Why do I need to understand caregiver stress?

Though it can be deeply rewarding, giving care is not easy; over time, it can make you sick. Family caregivers face a litany of challenges: physical demands, financial pressures, emotional ups and downs, major changes in roles and responsibilities, unfamiliar patient care duties, and worries about a loved one’s welfare, 24/7. When caregiving goes on for a long time, it erodes your immune system and increases your susceptibility to disease; it increases your risk for depression and hospitalization. It is no wonder that 20 to 30% of family caregivers suffer from psychological and mood disturbances. Caregivers use prescription drugs for depression, anxiety, and insomnia two to three times as often as the rest of the population. For your own health and quality of life, it is important that you understand and learn to handle caregiver stress.

What is caregiver stress?

Life’s demands, called stressors, cause stress. Stress is how the body responds to stressors. Caregiver stress is how you respond to the demands of being a caregiver. When viewed positively, the demands of caregiving are rewarding or challenging, and actually give you positive energy, but when experienced as negative, caregiver stressors create wear and tear on your body, mind, and spirit. Whether your perceptions are positive or negative, the stress response unfolds as a self-protective process of adaptation that safeguards you and keeps you alive. The nature of your adaptation changes during each phase of the stress response diagrammed below. No matter how different, each phase of the stress response is protective.

Caregiver stress, your health, and the quality and length of your life are all tied together, so it is very important to learn how to handle stress effectively. You have only one body and one life to live. In addition to interfering with your health, mismanaged stress also interferes with your work life, personal life, and caregiving relationships. Using effective stress management techniques protects you from some of these negative effects of stress.

What are the symptoms and sources of caregiver stress?

Recognizing stress in your life requires assessment of two key factors: the symptoms and the sources of stress.

The symptoms of stress are a defensive early warning system, your body’s way of signaling that you are endangering yourself by remaining in contact with stressors. Symptoms occur while you are in the resistance phase of stress. They foreshadow the illness or burnout that occurs during the exhaustion phase. Stress symptoms are grouped into six categories–physical, emotional, mental, social, occupational and spiritual. Everyone manifests symptoms of stress in each of these six categories, but because every human being is unique, each person experiences their own distinct set of symptoms.

Stressors are life’s challenges and demands that cause stress. Some come from within you, while others come from your relationship with the environment and people around you. Internal stressors are the physical aspects of your own body, the emotions you experience or the demands which you place on yourself. External stressors arise from physical aspects of your environment–a wide range of factors like storms, traffic jams, power outages, crowded or dirty living arrangements. They also come from the needs, expectations and behaviors of other people. Every human being experiences a mix of internal and external stressors every day.

As a caregiver, you deal with an additional collection of stressors that arise from the responsibilities of helping your loved one. When you have completed the assessment of your symptoms (Self-Care Activity #1), stressors (Self-Care Activity #2), and needs (Self-Care Activity #3) found below, proceed to C3, which will show you practical ways to care for yourself as you care for others.