When your spouse, parent or another relative needs extra help as they get older, it’s natural, and expected, that adult children will step in to pick up the slack — whether the problems involve relatively minor ailments or serious illness and decline.
But as you step in, it’s important to keep a close watch on your health, both physical and emotional. As aging parents’ or other family members’ needs increase, so does the stress on the caregivers, particularly when they’re also juggling careers and children.
Recently, a survey done by the UCLA Center for Health Policy Research found that nearly a third of the estimated 3 million-plus informal caregivers in California reported emotional stress so severe it disrupted their lives.
“Caregiving brings up a lot of difficult emotions,” says Amy D’Aprix, a Toronto-based consultant specializing in gerontological social work. “There’s an ongoing grieving process. There’s guilt, especially for the `sandwich generation,’ about never doing enough for anybody. Anger and resentment are also very common as caregivers can end up caring for someone who wasn’t very good to them or maybe even abused them.”
Not surprisingly, high stress often leads to unhealthy coping habits — smoking, excessive drinking, overeating and eating unhealthful foods, not exercising, losing touch with friends, relying on prescription drugs to relax or sleep. “That’s the path of least resistance,” D’Aprix says. “As a culture, we often turn to substances because those things offer immediate gratification.”
Nearly 75 percent of the middle-age caregivers in the UCLA survey were overweight or obese. Sixteen percent copped to smoking. And nearly a third admitted binge drinking (that’s five-plus drinks a day for a man; four-plus drinks for a woman). Further, although middle-age caregivers in the UCLA study are “at least as healthy” as other caregivers their age, a proportion of them already have chronic health problems: Nearly 10 percent have diabetes; more than 6 percent have heart disease; more than 34 percent have hypertension. By engaging in unhealthful behaviors, these caregivers, in particular, are setting themselves up to need their own caretakers as their health continues to deteriorate.
“This is the next generation of care recipients, and it’s quite troubling,” says Geoffrey Hoffman, the researcher who led the UCLA study. “If this is where this group of caregivers is starting, and we’re seeing poor health behaviors now, what can we expect 18 months from now or three years from now? This is a perfect storm. We’re headed to a place with an aging society where a lot of people are going to be sick.”
That’s the sobering news. But while a certain amount of emotional, physical and perhaps even financial stress comes with caring for increasingly frail and infirm relatives, having social support systems in place — along with a steely resolve to take care of yourself — can ensure your own health doesn’t suffer in the process.
“It sounds so basic, but caregivers often don’t have good support, and people need to be more mindful about getting it,” D’Aprix says. “We know that people who do have good emotional support live longer and healthier, both mentally and physically. They recover more quickly from illness and are less likely to end up in a nursing home. Social support is huge.”
These strategies will help make caregiving easier so you can eliminate health-sabotaging coping mechanisms.
List your tasks — and get help when you need it. Get it all down on paper so you can clearly see the big picture — food shopping, bill paying, taking Mom or Dad to doctor’s appointments. “If it takes more than 20 minutes, write it down,” D’Aprix says. Then ask for help with specific tasks from a sibling, a neighbor, someone in your synagogue, church, temple or mosque — odds are good that one day you’ll be able to gladly return the favor when they need a hand. “We say we don’t want to bother people, but it’s easy for a friend to pick up some items for you when they’re shopping to save you a trip to the grocery store,” D’Aprix says.
“You need to put self-care on your `To Do’ list and treat it like any other appointment,” says Barbara Ensor, a psychologist at the Baltimore-based longterm care center Stella Maris. “We tend to say, `I’ll do ____, if I have the time.’ What we have to say is, `I’m doing it.’”
To make sure you get it done, job out tasks so you can carve out that `me time.’ Ask your sister to take on Mom’s bill paying. Hire someone to do some light housecleaning. Worried that it seems selfish to get someone else to clean Mom’s house so you can sit around and meditate? Don’t. It’s not selfish, Ensor says. It’s good health practice. She likens it to the classic airline safety instructions you hear before every flight. “They tell you to put your own oxygen mask on first because if you’re not alive, you can’t help anyone else,” Ensor says. “But we tend to lose sight of that fact when we’re caring for someone older. It’s not a sign of failure to get some help.”
Sign up for respite care — and use it. Every once in a while, you will need a few hours, a few days, a week — to decompress. That’s were respite care is invaluable, whether it means another relative who steps in temporarily, a professional aide who comes into the home for a brief time or a geriatric care facility that’s set up for short stays. The ARCH National Respite Network and Resource Center provides a searchable directory of respite services by state, age and health condition. “It can be hard to leave when you’re so involved in your loved one’s care, but it’s necessary,” D’Aprix says.
If what’s holding you back is the fear that the person you’re caring for will have a health crisis or die when you’re away, “say what you need to say and get closure before you leave so you don’t feel like you missed your opportunity,” D’Aprix says.
Take mini breaks during the day. Don’t wait for respite care to give yourself a breather. “We get into this all or nothing thinking about taking time off, but you don’t need a week off,” D’Aprix says. “You can find 10 minutes. Building a few 10-minute breaks into your day lowers your stress bit by bit.” Use the time to meditate, listen to music, take a quick walk (even just around the house) and you may be less tempted to reach for booze, junk food or pills when things get rough.
Don’t short-change your self-care. “There’s a kind of cowboy-style I’ll-do-it-myself ethic that permeates our culture,” explains Barbara Ensor, PhD, a psychologist at the Baltimore-based longterm care facility Stella Maris. We tend to think we can and should manage our own house, laundry, shopping and other tasks — and do the same for the person we’re caring for. But our own health can suffer when we cut corners on our own self-care practices, like exercising or meditation, to make time for all the other things we’re trying to juggle.
Find a sympathetic ear. Simply venting the frustration, anger, worry, sadness and other emotions that caregiving brings up relieves an enormous amount of pressure, D’Aprix says. Talk to a friend. Talk to a therapist. Better still, join a support group so you can connect with others in your same position. You’ll also find Internet-based groups through ElderCare Online’s Caregiver Support Network and the National Family Caregivers Association.
Strengthen your relationship with the person you’re caring for — before you need to. Hard conversations (and decisions) go easier when adult children and parents feel like they’re on the same page, Ensor says. “Develop a real close friendship with your parents long before you need to do any of this,” she says, “then when you need to, you’ll be able to work together.”
It’s also a good idea to shore up your connections with your siblings (or other family members who could have buy-in on your parents’ care), particularly if these relationships have been prickly in the past. When bolstering those relationships, include frank discussions about caregiving and end-of-life wishes, so you don’t have to embark on them during an emergency.
“In times of crisis, families either become closer together or further apart,” Ensor says. “But if you at least have a minimum level of comfort with each other, you can reach a place where you can respect that you each have different talents, strengths, weaknesses and personality characteristics that will cause each of you to see issues a little differently. But you can respect your differences without tearing at one another or accusing each other of unkind things.”
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