Caring for someone with Alzheimer’s Disease can be overwhelming and seeing the person you love struggle with loss of memory, and eventual loss of identity, takes a huge enormous emotional and physical toll on caregivers.
If you are a caregiver, pay attention to the following signs of caregiver stress:
Excessive stress and tension
Persistent anxiety, anger, or guilt
Extreme irritability or anger with the person with memory loss
Change in sleep habits
Change in eating habits
Ways you can help avoid caregiver stress:
Walking, yoga and jogging are all great ways to help reduce stress. As your brain and heart receive the benefits of exercise, the caregiver will feel more relaxed and find they have more energy.
Keep a journal
Keeping a journal can help reduce stress and you don’t have to worry about being a professional writer. Your journal is for your eyes only, and gives you the opportunity to express your feelings and emotions. It can be very healing.
Talk to people you trust
Having a close friend or family member you can talk to, without holding back, can be very therapeutic. Turning to the people you trust will provide you with the emotional support you need while helping to reduce your stress and anxiety.
Learn to Relax
Taking the time to learn deep breathing techniques, meditation, and practicing mindfulness, can be very beneficial in reducing stress. They have both immediate, and long term benefits and can help you learn to relax when your stress and anxiety is at its highest.
Learn to Let Go
Be willing to let go and delegate some of your caregiving responsibilities to others. As you become more comfortable allowing others to chip-in and help you care for your loved one, you’ll discover that by doing so, you are taking better care of yourself. Use this time to exercise, talk with a friend or practice your relaxation techniques.
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This is a final article in a multi-part series to help in-home professional non-medical caregivers learn some practical non-clinical skills on how to approach their day to day professional life. You can see Parts I, II, III, and IV. Here in Part V, we will discuss care plans and caregiver stress.
What Is a Care Plan?
Let’s discuss an essential tool for effectively doing your job: the care plan. The care plan is the tool that helps you to understand how to care for each of your clients who live in the home. The plan also informs the other members of your professional caregiving team about the services that each client will need. It is your direct line of communication with other members of your care team. Think of it as a recipe card or blueprint for how to care for each client. Anyone should be able to pick up a care plan and know just how to care for the client. That is why they are so critical.The facility that hires you will specifically outline the tasks you are responsible for accomplishing while on your shift, as well as the special needs and services for each client. This includes medical, dental, vision, hearing, and mental health services. It explains the client’s ability to take their medications, and how staff should assist. The plan will explain if the client needs help to walk, bathe, or dress, and the type of help he/she needs. The plan will also explain the social activities and other services that are specially designed for each client. The care plan must be accessible by direct care staff persons at all times.
Understanding A Care Plan
You need to understand your client’s care plan. A care plan is created specifically for each client and describes exactly what services should be provided. Included in the care plan may also be 2 important terms that you may not be familiar with:
One is “DNR status”. DNR stands for “do not resuscitate” or “do not attempt resuscitation”. This refers to the older adult’s end-of-life wishes, and whether or not they would like CPR and a breathing machine if their heart stops, or if they stop breathing. Attempted resuscitation may, in many situations with older, ill adults, cause pain and suffering with little chance of recovery, so many older adults will request to have a DNR in place.
“Power of attorney,” “health care proxy” or HCP for short, or “health care agent.” This is the person that the older adult has legally designated to be their substitute decision maker, should they not be competent to make their own health care decisions. This may not be their next of kin, or even a relative. It is important that this is the person, and not another family member or friend, that you speak to about your client.
It is important to follow the elder’s directions when performing tasks, even if you know a better way. Plans may also change depending on his/her needs or health status.The care plan usually lists general tasks for what needs to be done (for example, cleaning the kitchen or washing the clothes). Follow the care plan. If an older adult wants you to do something that is not listed in the plan, you need to contact your supervisor. You may be held liable if you do something for the older adult that is not on the care plan and an accident occurs. With some services, you are only allowed to perform a certain scope of tasks for the older adult and not for family members (for instance, running errands). The best way to stay organized is to make a list of tasks that need to be done based on the care plan. Ask the older adult to prioritize the tasks that need to be done. Ask them, “Which ones are most important?” If the older adult lists more tasks than can be accomplished in your allotted time, speak with them about what can be done on another day or by another member of the care team.
What is caregiver stress?
Make Time to Take Care of Yourself
Caregiver stress and compassion fatigue are the result of the physical and emotional exhaustion experienced by those who care for people. It is the chronic stress caused by caregiving. Emotional impact of trauma and painful material can be contagious and transmitted through the process of empathy. If you don’t make self-care a priority, no one else will do it for you.
How do your recognize if you have caregiver stress or compassion fatigue?
Mental signs of caregiver stress may include recurring and intrusive thoughts such as paranoia, feelings of guilt or suicidal thoughts, limited attention span, difficulty concentrating, poor work performance, or becoming easily irritated or frustrated.Physical signs may include flare-ups of high blood pressure, diabetes, headaches, back aches, chest pains, stomach problems, trouble sleeping, change in appetite, chronic tiredness, or substance abuse.
How do you manage stress on the job?
A willingness to get help is the most important part of managing caregiver stress.
Recognize high stress as a normal, expected response to your work
Use your supervisor for support
Attend training on a regular basis
Network with other professional caregivers
Set clear boundaries and maintain limits . This is really important. Know what your job limits are, and keep your work within your work hours. Clients and families shouldn’t be calling you outside of your work hours. If that happens, let your supervisor know.
Connect with clients. Know that you are doing important work and think about how it must feel like to suffer the disabilities and inconveniences your older adult client does. But, even as you do this, know that it is your job and not your family – when you leave work, it’s important to then focus on yourself and your family to keep yourself well. Maintain that work/personal life balance.
Find meaning in your work
Start or join a Support Group
Other tips to taking care of yourself include: exercise (even a few minutes a day that elevates your heart rate has been shown to decrease anxiety, depression, and stress), mindfulness and meditation, deep breathing, writing in a journal, playing a musical instrument or engaging in another creative hobby, taking a hot bath, and use of aromatherapy. Spirituality, prayer, and religious gatherings can help. Get therapy from a trained professional if you find that you are unable to control your caregiver stress alone. High levels of stress can lead to job burnout, but learning to manage your caregiver stress can be a lifelong benefit.
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Madhuri ReddyHow to Handle Care Plans and Caregiver Stress
Caregiver fatigue is sometimes a difficult subject to discuss. This is especially true for family caregivers, who are taking care of a parent, a spouse, a sibling, or a child. Most family caregivers are dealing with a patient who they care about. This is someone that they love and respect. In the case of parents or spouses, the patient is often someone who has done a great deal for the caregiver in the past. So when you love someone, and they have done a lot for you, it can be difficult to admit to caregiver fatigue.
All Caregivers Experience Fatigue
Anyone who has been acting as a caregiver, especially a primary or live-in caregiver, for more than a few days, will admit that caregiving is a challenging and draining job. If your loved one needs high levels of help with activities of daily living, then caregiving can involve a lot of physical work. You may be lifting, bathing, and cleaning up toileting problems, on top of the daily work of keeping a house running. Even if your loved one is fairly independent, there is a level of awareness that caregivers need. Some part of a caregiver is always listening for problems and waiting to spring into action. Both of these aspects of caregiving, the physical work and the emotional alertness, require a continual output of energy from caregivers. In addition, many caregivers are working, raising children, and participating in other daily life roles. The energy output for caregiving, combined with the rest of your responsibilities, can lead to a deep fatigue.
Many Caregivers Struggle to Acknowledge Fatigue
While it is easy to see why caregiving is difficult, it seems tough for caregivers to acknowledge their own fatigue. I believe that the struggle to notice fatigue is caused by multiple factors:
Many caregivers see their own work as voluntary, while the illness that their loved one faces is not. This leaves them unsure about their “right” to experience fatigue in an activity that they “chose” to do.
Many caregivers contrast their own difficulties with the challenges faced by their loved ones, and they feel guilty that they’re “complaining” about fatigue.
Many caregivers feel isolated in their caregiving, and are not sure where they would get relief even if they did acknowledge fatigue.
Caregivers talk about not wanting to add to the burden of a sick loved one by admitting that caregiving is difficult.
The predominant theme I have heard from caregivers when they are in my office is a mix of guilt (because they are feeling caregiver fatigue when a loved one is ill) and isolation (a sense that there is no one to step in and assist them).
How to Avoid Caregiver Fatigue
If you have read through the first few sections of this article and found yourself nodding your head, or felt a sense of recognition, then this section is incredibly important for you. Many caregivers I have spoken with look incredulous when I bring up self-care. They have just told me how complicated and time-stressed their lives are. Then I ask them to fit another activity into their lives: time for themselves. I’ll ask you, as I ask my clients, to hang in here with me. I’m not saying that you need to go to the gym daily, or find an hour-long yoga class. Both of those would be great choices, but I recognize that time is one of the most precious commodities that a caregiver has. And right this minute, you may not be sure how to carve out an hour or two for yourself even once, let alone on a regular basis.I am asking you to pause and recognize that keeping yourself healthy is a huge piece of how you will continue to be available to your loved one as the caregiver they need. Keeping yourself healthy and your sense of self nourished will allow you to be a more present and engaged caregiver. Keeping yourself healthy will mean that you have a smile to share along with that meal. It will help keep the frustration that can be part of caregiving from turning into resentment for a person you love.Self-care can be done in small bites. In fact, you can do some while you finish reading this article.
Take a few deep, full breaths as you continue to read. Get the oxygen flowing in your whole body.
If caregiving has disrupted your exercise routine, google “chair exercise.” Maybe you and your loved one can do some together.
Choose foods that are bright and delicious.
Spend 10 minutes a day doing the crossword, reading a book, or otherwise participating in an activity that you enjoy.
If you want to go big, ask a friend or family member to sub in for you as temporary caregiver while you catch a movie, walk in the park, or have a meal out.
The next step would be to build in regular breaks for yourself, when you are officially “off-duty” as caregiver.
These small activities will go a long way towards pushing back some of the fatigue that comes with caregiving. If you still notice that you feel drained, frustrated, or resentful, please consider reaching out to a support group or seeking therapy to deepen your support.If you’re an eldercare agency, register for a demonstration and free class from Care Academy. Go to our site and click Request a Demo.