The Physical Effect of Caregiving

About two-thirds of all family caregivers are women. It’s these tender souls who give up much in order to take care of those they love who are on their final journey in life. It’s also these gentle souls, and maybe you are one of them, who tend to put all their energy into taking care of everyone else and fail to take care of their own physical needs.

Let’s look at some statistics:

-  Female caregivers experience higher levels of depression and anxiety and also a lower level of general wellbeing than their male counterparts.

-  Twenty-two percent of female caregivers go to bed exhausted.

-  More than 1 in 5 women fail to get their regular mammograms on time.

-  Due to increased stress, 21 percent of all caregivers have a higher abuse level of alcohol and prescription drugs.

-  Female caregivers are more likely to smoke or consume fatty foods.

-  Female caregivers don’t fill their prescriptions on time and don’t go to the doctor as often as they should.

-  Female caregivers are more susceptible to heart disease and they don’t eat well or exercise regularly.

All of this neglect of their own physical needs often leads to higher mortality rates in women family caregivers; especially if they are over 65 and caring for a loved one.

So what is the message you should take from all this information? Well, it’s multi-layered.

Start by realizing that you are abusing yourself by neglecting your own physical needs. You can always say, “I just don’t have time for all those things.” Find a way to make time for yourself without feeling guilty.

Set goals and follow through with them. This might be a simple as saying “I will do one thing every day to take care of me.” That one thing might be a half hour walk, keeping a doctor’s appointment, shopping with a friend or going to your son’s baseball game. You will be happier and your quality of care will be better.

GET HELP!  Honestly, please get help. You must realize that it is possible that you can’t be all things to everybody. Call on family. Call on a friend. Get help from Hospice of Santa Cruz County, hospice can help support you as a family caregiver. Schedule a volunteer to come read to your loved one while you go to the doctor. Have a friend come over to visit the patient while you exercise for an hour. A family member might be willing to pick up your prescriptions if you don’t have time. You would be amazed at how many people are will and able to assist you.

It is important to you, the patient and your own family that you stay whole through this difficult time. That may take a little work on your part to coordinate and schedule with others, but it is well worth it if it means you maintain your physical and mental health.

“Health is the greatest possession. Contentment is the greatest treasure.” – Tao Tzu

Communication is Key to Being a Good Caregiver

 If you are the primary caregiver for your loved one, you might not be thinking about how communicating effectively might benefit your loved one or your ability to care for them well. However, as primary caregiver, you are the focal point for which all communications are channeled. Some of those conversations will need to be relayed to others involved in your loved one’s care such as a physician, a spiritual counselor, the hospice team and maybe family and friends who are also providing support. How effectively you communicate can make a difference in the quality of care your loved one receives.

Even if you have a close relationship with the person you are caring for, these discussions can be difficult and emotionally charged. Try a few of these suggestions and see if they help:

  - Calm yourself before beginning a discussion. Breathe deeply and settle yourself into a peaceful place before beginning. Your loved one will be able to sense if you are tense and upset. Remember to focus on what is best for your loved one. It might help to think of yourself in their position.

  - Really listen to what they have to say. Resist the urge to interrupt with thoughts of your own. Allow the person some silent time to think and to take time to form a response. Take it slow.

  - Use body language to communicate more effectively. Look your loved in the eye. Hold their hand or put your hand on their arm. Touch is an important part of communicating deeply.

   - Avoid trying to do other things while communicating. This can be distracting and you might miss something important. Also, it makes it look like you aren’t totally focused on what your loved one is trying to convey to you. This might damage trust in the long run.

         - Pay attention to details. Does their behavior match what they are saying? They might feel awkward or scared about saying what is really going on. They may be afraid of losing more and more independence. Make sure to double check gently with them if something doesn’t sound right. Assure them that you are there to do your very best for them.

           - Avoid arguing, as it will only lead to more tension and loss of trust. Use humor to dispel stress filled times. Laughter is a great way to make everyone more comfortable.

     - Write things down if you need to. Your next step will be to communicate things to others on the caregiving team and you want to make sure you don’t forget anything. Use a Caregiver’s Notebook to record good notes.

The next step in communicating is to talk to other caregivers. Hopefully you have recognized that you are not the only one who can care for your loved one and you have a whole team of caring people willing and able to assist with patient care, running errands, organizing food and giving you a break.

Provide clear, accurate and consistent information to all caregivers involved.

Find a way to communicate with all caregivers in a timely fashion. Consider setting up a Facebook or email group in order to keep everyone current. This is especially a good idea when communicating with family and friends who are out of town. You can share video and pictures as well.

Clear, honest, timely communications will make you an excellent support person for that dear person you are caring for.

Care for Caregivers, Know Your Limits

As with any difficult period you go through in life, caring for a seriously ill loved one is a job you might gladly accept, but the impact on your physical and mental health and your relationship with your family, can be severe. The National Alliance of Caregivers has done extensive research on the subject:

“Nearly three quarters (72%) of family caregivers report not going to the doctor as often as they should and 55% say they skip doctor appointments for themselves.

63% of caregivers report having poor eating habits than non-caregivers and 58% indicate worse exercise habits than before caregiving responsibilities.

20% of employed female caregivers over 50 years old report symptoms of depression compared to 8% of their non-caregiving peers.”

By making you aware of these statistics, we hope you will take a few moments to reflect on just how important taking care of yourself is to the process of providing outstanding support to your loved one who needs you now.

Becoming a caregiver may or may not have been a conscious decision. You may be gladly caring for your spouse or partner out of love and dedication. You feel it is your choice and duty to them and you would not want to be anywhere else during this time.

On the other hand, maybe you are the only child living close to your parent who is facing the end of life. You may be feeling the weight of the responsibility that has become yours. Either way, the path you are on can be  a lonely and difficult one, so you should make a conscious effort to take care of yourself both physically and emotionally.

The real challenge is to know yourself and your limitations in order to take care of yourself. This precious time you have to spend with your loved one will be richer if you are healthy and whole.

Here are some ideas for doing just that. We hope some of them will spark your interest and provide you with avenues for caring for yourself in addition to your loved one.

First and foremost, give yourself and your loved one the best outside help and support you can find. You may feel like you have to do this all alone. That is a common misconception. You are most certainly not alone. Hospices, like Hospice of Santa Cruz County can provide a wide range of options for you and your loved one to choose from. A hospice nurse  will help develop a plan with you that is just right for your situation.

Educate your self about your loved one’s disease. The more you know, the less fearful it will seem and you will be better equipped to help your loved one if you understand what’s going on. Check out information from the library, online information sources and ask the doctor or your hospice team any questions about things you don’t understand.

Keep a Caregiver’s Notebook. Use it for record keeping or writing down those questions that come up so you don’t forget to ask them later. You can record when medications need to be taken by the patient or changes you notice.  The notebook can also include a calendar to keep track of your own appointments so you don’t miss medical appointments, exercise classes, group support meetings or therapy sessions.

On that calendar, make sure you schedule caregiver breaks, which can be provided by one of your hospice team members or family and friends. If you strive to follow your caregiver’s calendar, you will keep yourself healthier and be the best caregiver you can be.

The little things CAN make a difference; things like eating right, exercising, expressing yourself by writing or through art. Watch movies you like with your loved one and invite other family members or friends so you have others around you. If you love books, read them aloud or get books on CD. Your loved one will enjoy them and so will you.

Attend a support group. Emotional health is just as important as physical health. There are many organizations in your community willing to assist with emotional support. Your hospice team members can help you find them. If you don’t feel comfortable in a group setting, try one-on-one counseling through your church or a therapist.

Remember to follow the Cardinal Rule of Caregiving: Take care of yourself so you CAN take care of your loved one.

Home Safety - Lighting The Way

This is part three in our four part series on creating a safe environment for an aging love one. When it comes to safety in the home, prevention really is the best medicine. Elder-proofing will help your loved one maintain a sense of independence affording you the peace of mind that comes with knowing you’ve provided every safeguard for their wellbeing.

 Lighting is important safety consideration. The correct lighting can go a long way in helping protect your loved one against falling and ensure they feel more comfortable in their home. Here’s a few simple steps to take:

Lighting the Way

- It is easier for elderly eyes to adjust if there are consistent lighting levels throughout the house, so consider using low-glare bulbs and shades.

- Nightlights are helpful to guide your parent along stairways as well as from the bedroom to the bathroom and kitchen.

- Light switches placed at both the top and bottom of stairs will ensure good visibility also ensure there are switches at both ends of long hallways.

- Install a light switch that can be reached from the bed to prevent your parent from fumbling in the dark if they awaken in the middle of the night.

- Illuminated light switches are much easier to locate in the dark, or you may choose a clap-on, clap-off lighting system.

- Make sure light switches are located near the entrance to rooms or consider adding automatic lighting where lights turn on when your loved one enters a room.

- Flashlights should be easily accessible in all rooms of the home, especially the bedroom.

Staying Safe Outdoors

 - Outside the home, make sure all walkways, paths, steps, decks, porches and entranceways have good lighting, solid traction and handrails for support.

-Exterior motion sensing floodlights will light your parent’s way and avoid the necessity of fumbling with keys in the dark.

There are many lighting products on the market today that are easy to install. By taking these simple steps your loved one’s home can remain a place of safety and comfort and you can retain peace of mind.

Home Safety, A Look At The Bathroom

This is part two in our four part series on creating a safe environment for an aging love one. Most people are familiar with the concept of childproofing a home when a new baby arrives. There are several steps you can take to “elder-proof” your home and ensure a safe and comfortable environment for your parents in their later years. One of the key rooms of concern is the bathroom. The bathroom can be the most dangerous room in the house, with slippery surfaces that are easy to fall on and sharp or hard corners where someone can hit their head. Making the bathroom safe is an important step in helping your aging loved one to maintain their independence.

Here’s a few simple steps:

- Add an elevated toilet seat with handgrips on both sides. Ensuring that the toilet tissue is within easy reach can ease the strain on an aging parent’s back and legs, thus reducing the risk of falling.

- Equip the tub with a  grab bars or a handrail placed at both sitting and standing levels. When using a bath chair or shower chair make sure that there are rubber grippers on the chair’s feet. Also make sure the chair is at the correct height so your loved one’s feet rest on the floor.

- If using a bedside commode, place it as close to the bed as possible.

- Use secure non-slip mats in the tub or shower, along with a wall-mounted liquid soap dispenser to keep your parent from having to bend down to retrieve a dropped bar of soap.

- Consider changing to hand-held shower devices. They are much easier to use when mobility is limited.

- If your parent does happen to slip in the tub, a shower curtain securely mounted into the wall will offer more support than a pressure-hung curtain that will pull away easily.

With the right bath safety cautions and aids in place, one of the most dangerous rooms in the house can become one of the safest.

Tips On Making Home Safe For Your Loved Ones

Most people are familiar with the concept of childproofing a home when a new baby arrives. But what about bringing your aging parents in to live with you when independent living is no longer an option? There are several steps you can take to “elder-proof” your home and ensure a safe and comfortable environment for your parents in their later years. And when a parent, who is facing an advanced illness is living with you, home safety takes on a new level of importance.

A primary safety concern with the elderly is the prevention of falls. Falls are the leading cause of injury or even death among the elderly. This four part series will focus on ways to safeguard your home against potential falls.

General Tips For Preventing Falls

- Remove all tripping hazards such as books, shoes, toys, electrical cords, etc., from the floors.

- Remove all throw rugs.

- Remove furniture from high-traffic areas if possible, and pad any sharp edges with plastic bumpers.

- Remove the casters to stabilize movable furniture items.

- Remove unstable tables and stools to avoid tipping, and put fragile or breakable items away.

- If your parent uses a cane, you may also wish to attach a loose wrist loop to the handle. This will prevent your parent from having to bend down to retrieve a dropped cane.

- Polish linoleum and wood flooring using only non-slip floor wax.

- Textured strips can also be placed on linoleum to provide better grip, and all spills should be cleaned up immediately.

- Add grab bars or handrails along staircases and hallways to help prevent falls, and grab bars next to closet doors to support your parent while dressing.

- Place colored, non-slip strips along areas where floor levels change, such as stairs and doorway thresholds, to help clearly identify where your parent will need to step up or down and prevent stumbles.

- Make sure the bed and chairs are easy to get in and out of, and that chairs have solid and supportive arms and backs.

- Keep frequently used items such as glasses, water, phone, tissue, remote control, etc by bed or chair.

- If your loved one feels dizzy or light-headed after standing remind them to sit down or stay seated until their head clears or; call for assistance if available.  Have them stand up slowly after eating, lying down or resting to avoid unsteadiness.

Understand that as your loved one begins to loose their independence it is important to try and understand their desire for independence while still ensuring they are safe. Including them on decisions, asking their opinion, concerns will help. Remember, this is not an easy time for them and though your ultimate goal is their safety, bringing them into the decision process will go a long way to make them regain a sense of control.

These few simple steps can make a big difference in providing a safe environment for your loved one.

Remembering A Loved One During The Holidays

 Losing someone close to you is often a very painful experience. Holidays, anniversaries and other special occasions can intensify that pain, but planning a remembrance or ritual to celebrate your loved one’s life can ease the sorrow of these challenging times and help preserve memories of the affection you shared.

The holidays can be particularly difficult for those left behind, but may also offer a unique opportunity to honor your loved one. Placing a special ornament on the tree, setting out a cherished decoration or serving a favorite holiday meal can evoke fond memories. Friends and family may wish to share notes of remembrance placed in a stocking put up for your loved one. A candle might be lit in memory, or perhaps a toast or prayer can be offered in tribute before a meal. Money that would have been spent on a gift could be donated in your loved one’s name to a favorite charity, homeless or animal shelter, or a needy family.

Holidays can be special times to celebrate your loved one. Friends and family may come together to share stories and cherished memories, such as the way they laughed or their favorite quotes. Sharing these recollections with younger friends and family members is a wonderful way to honor your loved one, who may have passed before the children were old enough to know them. By gathering old photos, you can make a mosaic or a memory album of the times you spent together. Create a calendar from pictures or drawings with poems written to or about them, or simply write a letter to express your feelings.

Crafts offer many unique opportunities to remember those close to you who have passed. You might make a quilt from their favorite clothes, inscribe their name on a piece of jewelry, or compile treasured possessions and photos into a scrapbook that will be cherished for years to come. A wonderful way to remember a loved one who enjoyed cooking might be to create a memory cookbook. These favorite recipes can recapture loving memories of family dinners, picnics and holiday meals, especially if you include photos and captions with them.

Celebrating and honoring the memory of your loved one is an important part of coming to terms with your own grief and healing from your loss especially during the holidays.

As you make plans for these remembrances, be aware that we all respond to grief in our own way and have our own methods of coping. Communicate with your family and friends about how you want to remember and honor your loved one. During your grieving process, understand that you may continue to feel sad, angry or lonely for a long time. But you will also gradually experience increased periods of joy and happiness. These are all normal emotions, and feeling happy doesn’t disrespect your loved one’s memory. It simply reflects your progression from mourning to a celebration of the life you shared together as you journey through your grief toward healing, hope and renewal.