Running on Empty

 (Caregiver Survival Tools)

She awakens in the morning still exhausted after a fitful night of sleep and immediately feels overwhelmed.  There's the report due at work today that she's not had time to prepare, afternoon soccer practice for her son and a school board meeting that night.  Then, somewhere in the brief free moments of her day, she must find time for her mother:  Eighty-four-year-old mom at home alone, who can't drive anymore or reach into the cupboard to pull out a box of cereal or see well enough to take her correct dose of medication.  Today, like yesterday, there are no easy answers about how to fit her mom into the juggling act she calls a typical day.

This is the life of the family caregiver who represents one in four Americans, according to various studies.  New evidence and interviews of family caregivers reveal a disturbing trend of debilitating stress that can accompany this role, even though most still say that, in spite of the challenges, the job comes with many rewards.

Statistics from a recent report prepared with information collected through Home Instead Senior Care Web site www.caregiverstress.com tell the story.  More than three-fourths (76 percent) of the 8,000 family caregivers who took the company's stress test reported that their aging loved one's needs are overwhelming.  Furthermore, 91 percent of family caregivers who completed the test said they have episodes of feeling anxious or irritable; 73 percent have disturbed sleep patterns; and 56 percent seem to become ill more frequently. 

"Every day we encounter these family caregivers who love and want the best for their aging family members, but don't know how to fit it all in, "said Lucy Seger , owner of the Home Instead Senior Care office in South Hills.  "For these family caregivers, stress is a constant companion."  Consider these examples:   

• Arlene Romilly, a 51-year-old nurse practitioner from Pittsburgh, Pa., moved her parents in with her before her mother died in September 2005.  Her 90-year-old father still lives with her.   "It became stressful as my mom's memory faded and she could no longer cope with her daily activities without direction," Romilly said.  "And my father was just not capable of being a caregiver.  This created a distraction for me at work.  I was having problems sleeping and I was neglecting my own health.  For a while, I was treated for depression."  Romilly now has a Home Instead CAREGiver ^SM who looks out for her father while she's at work. 

And, in spite of the challenges, the joys of caregiving have outweighed the stresses, she said.  "I was pleased to be able to care for my family."

• Cat Tenorio, 44, of Grass Valley, Calif., gave up an accounting job to which she had just been promoted to care for her mother with Alzheimer's disease.  As her mother's illness worsened, "I had to move mom into my bedroom with me because she was wandering," Tenorio said.  "I didn't sleep at night, and when she would sleep during the day, I'd take sleep medication and gradually became addicted to it," she said.  "Finally, my husband had to say, "That?'s it.  We can't do it anymore.?" 

Tenorio moved her mother into a convalescent home, where she was comfortable until she died three months later.  Instead of going back to her accounting career, though, Tenorio became a Home Instead CAREGiver so she could help others like herself.

These examples illustrate the importance of support, which is one of the key survival tools for the family caregiver, typically a 46-year-old woman, according to Patricia  Volland, MSW MBA, senior vice president of The New York Academy of Medicine and director of the Academy's Social Work Leadership Institute.  "This generation of seniors is living longer and their children often are still raising families and not prepared for older parents with needs.  That dynamic is not simple "the relationship between adult children and their aging parents," she said.

In an effort to better prepare the social workers they train, Volland and her team commissioned a study, which was released late last year, entitled "Squeezed Between Children and Older Parents: A Survey of Sandwich Generation Women."  The poll, which surveyed women ages 35 to 54, showed that more than 60 percent of women concerned about an aging relative's health said they have difficulty managing stress, compared with 48 percent of women for whom an aging relative's health was not a concern. 

Furthermore, women concerned about an aging relative's health were about three times more likely (34 percent) to say they worry "a great deal" about having enough time for family than were those women not responsible for the care of an aging loved one (12 percent).

"Working through the maze of helping a loved one can be more than a full-time job," Volland said.  "Social workers are uniquely trained to provide comprehensive care coordination which begins with a comprehensive assessment and includes identifying resources, managing the complexity of the relationships between all of the care systems people encounter health, payment, and formal and informal supportive services and dealing with family dynamics."

Social workers and other senior-care experts often recommend resources to keep seniors independent and to help their family caregivers manage stress.   One such resource is Home Instead Senior Care, a company that employs non-medical CAREGivers to go into the homes or care communities of seniors.  The company's CAREGivers provide a variety of non-medical services to seniors.  These essential services "such as companionship, meal preparation, light housekeeping, medication reminders, shopping and errands " also include a respite for weary family caregivers.

"Our services can be just what harried family caregivers need to help fill in the caregiving gaps they may be experiencing, and to alleviate the stress and worry that caregiving can place on their lives," said Home Instead Senior Care's Seger.  "Most family caregivers agree that there are many rewards associated with this job, which is why additional support can make all the difference."

For more information about Home Instead Senior Care, call Lucy Seger @ 412-276-2400 Or visit, www.homeinstead.com.  To read the report "Squeezed Between Children and Older Parents: A Survey of Sandwich Generation Women"  log on to www.socialworkleadership.org.

  Caregiver Survival Tools

If you're under stress, consider the following survival tools from Home Instead Senior Care:

• Work out: Exercise and enjoy something you like to do (walking, dancing, biking, running, swimming, etc.) for a minimum of 20 minutes at least three times per week.  Consider learning a stress-management exercise such as yoga or tai-chi, which teaches inner balance and relaxation.
• Meditate: Sit still and breathe deeply with your mind as "quiet" as possible whenever things feel like they are moving too quickly or you are feeling overwhelmed by your responsibilities as a caregiver.  Many times you will feel like you don't even have a minute to yourself, but it's important to walk away and to take that minute.
• Ask for help: To avoid burnout and stress, you can enlist the help of other family members, friends, and/or consider hiring a professional non-medical caregiver for assistance.  There is no need to feel guilty for reaching out.
• Take a break: Make arrangements for any necessary fill-in help (family, friends, volunteers or professional caregivers).  Take single days, a weekend or even a week's vacation, just make sure you line up your support system so you can be confident that your loved one is safe and happy.  And when you're away, stay away.  Talk about different things, read that book you haven't been able to get to, see a movie.  Only a real break will renew and refresh you.
• Eat well: Eat plenty of fresh fruits, vegetables, proteins, including nuts and beans, and whole grains.  Indulging in caffeine, fast food and sugar as quick "pick-me-ups" also produce a quick "let-down."
• Take care of yourself: Just like you make sure your loved one gets to the doctor regularly, make sure you get your annual check-up.  Being a caregiver provides many excuses for skipping your necessary check-ups, but you cannot and should not compromise your health.
• Indulge: Treat yourself to a foot massage, manicure, nice dinner out or a concert to take yourself away from the situation and to reward yourself for the wonderful care you are providing to your aging relative.  You shouldn't feel guilty about wanting to feel good.
• Support: Find a local caregiver support group, which will help you understand that what you are feeling/experiencing is normal for someone in your position. This is a place to get practical advice from people who are in your situation and to bounce off those feelings of stress, since everyone is likely to be in the same situation and can empathize.

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For more information, visit www.caregiverstress.com.