Caregiver stress, fatigue and burnout are an ever present threat. The demands on a family caregiver are great and the responsibility can sometimes seem overwhelming.
That is why it is important for you the caregiver to know the signs of stress, fatigue and burnout. Managing stress must be one of your top priorities as a caregiver. If you don’t keep yourself healthy and fit you will not be much help to anyone else.
If you see it developing in yourself you can cut it off at the pass, so to speak. You can take steps (presented later in this article) to do something to keep positive your mental, emotional and physical state.
Signs and symptoms of caregiver stress and burnout
Caregiver stress, fatigue and burnout all have pretty much the same symptoms and can be considered different words for the same thing. From this point on I’ll put it all under stress.
Emotional Symptoms of caregiver stress are likely to include:
- Temperament changes.
Frustration. You may find yourself frequently feeling frustrated, perhaps agitated by things that used to never bother you. Or at least they used to not bother you very much.
Agitation. You might find yourself more agitated more often, perhaps about seemingly trivial causes.
Moodiness. We all have mood shifts and changes, but more stress than you can handle can cause greater, longer lasting swings in mood that are likely to be negative.
- Coping changes. A lasting, ongoing feeling that you are overwhelmed and out of control.
- Tense, unable to relax.
- Drop in self-esteem. You may feel bad about yourself, like you are worthless, probably accompanied by feelings of despondency.
- Social isolation. Avoiding contact with other people.
Physical symptoms that caregiver stress might include:
- Sleep pattern disruption, including insomnia or wanting to sleep too much.
- Chronic low energy, both physical and mental fatigue.
- Prolonged aches and pains, including headaches and muscle aches from tenseness.
- Stomach upset, can include diarrhea, constipation, and sometimes recurring bouts of nausea.
- Chest pain, rapid heartbeat (normal adult heart rate is considered to be 60 to 100 beats per minute).
- Increased nervousness indicated by symptoms like shakiness, cold hands or feet, ears ringing, dry mouth, or sore jaw from teeth grinding (awake or asleep).
- Unusual pessimism and poor judgment.
- Trouble focusing mentally.
- Worrying all the time, unable to control it.
- Memory lapses and mental disorganization.
Behavioral symptoms of caregiver stress often include:
- A noticeable increase in the consumption of alcohol or drugs, tobacco.
- Eating abnormality, eating too little or too much.
- Increase in nervous behaviors like nail biting, pacing the floor or fidgeting.
- Procrastination. Putting things off, avoiding responsibilities.
You will undoubtedly have some of these symptoms sometimes. That does not mean you are broken.
It goes without saying that everyone experiences stress because it is just a part of ordinary life. This is especially true for a family caregiver.
You will never be able to completely avoid stress. The most important thing is how you handle it.
If you are feeling overwhelmed by stress, talk to your doctor about it. Chances are, your stressed-out feelings are temporary and can be relieved by some of these steps.
1. Seek professional help.
Just about every aspect of caregiving (except the loving part) can be outsourced. Sometimes it helps to jot down a basic list of your caregiving responsibilities. Examine each item and analyze the possibility of hiring someone or an agency to take care of it.
- Hire a cleaning service for your home or theirs. The cleaners you hire might not do as good a job as you would, but having yours or your parent’s home cleaned certainly lightens your load.
- Hire a handyman to take care of the odds and ends of routine maintenance. Even if it means paying to have something done that you could do yourself, just keep reminding yourself that your objective is to lighten your load and free yourself to do those things only you can do. Or that you feel you must do yourself.
- Hire a financial advisor, or perhaps a bookkeeper to keep all the bookwork straight and perhaps pay bills.
- Hire a professional lawn service. Taking care of a lawn and other gardening duties can be very fatiguing. This is especially true if there is more than one lawn to care for. Gardening chores that were once a pleasant and rewarding activity might now be an emotional and physical drain on you. The more you can let go of obligations like this, the less you will suffer from caregiver stress and fatigue. Remember, it is the sustained overload of mundane chores, coupled with the stress of taking care of someone else, that most often leads to caregiver burnout.
- Hire a professional care coordinator to complete periodic assessments of needs and to provide advice for service that could help or even arrange needed services.
- Look in your community to see if there is a village model where older adults help each other stay independent and engaged in their communities. For a modest fee you can access volunteers, services and discounts. The Village-to-Village Network map will show you if there is a village in your community.
Nice, you might be thinking, but who can afford it? Most people can’t afford this level of help. If that’s you, there is still plenty you can do to avoid or alleviate caregiver stress and burnout.
2. Get unpaid help from others
- Ask family members and your parents’ friends to share the load. Sometimes it is as simple as asking. There are often family members and friends who would like to help but they don’t know what to do. Plus they might avoid offering to help for fear of offending you.
- Get to know your parents’ neighbors. There are likely to be local residents– especially if your folks have lived in the same place for years – who will be willing to chip in and help.
- Look for community resources. Most utility companies offer rate reductions or other programs for the elderly. Banks and other financial institutions also have programs available. (Financial burdens are frequently cited as a big contributor to caregiver stress.) Meals and transportation are also often available free or at reduced rates. Find and take advantage of as many of these kinds of services as you can.
- Develop a care network of people who can help. Encourage them to communicate with one another. Make sure you stay regularly in touch with everyone in the network and keep them active (but not overactive; you don’t want them to burn out).
- Utilize a bill paying service. Surely by now every bank and credit union in America offers this, either free or for a few dollars a month. It is a great service to reduce your caregiver stress. If you are not familiar with this service ask your (and your parents’) bank about it.
3. Take a break.
Not only can you ask family and friends to help with daily needs of your parent, you can ask for support so that you can take a much needed break. Ask a friend to stop by to visit your mother for a few hours so you can go out to lunch, get a haircut or do something else you want to do.
There are very few circumstances that require you to be present at a specific time or or even all the time. Think about your parent’s needs and the things that are important to you. Plan a schedule that meets her needs as well as yours. Don’t hover all the time. That doesn’t help you or her. Even if your parent lives with you, there are quiet times when you can grab some time to yourself. Sit on the porch, talk with the neighbors, go out for coffee, watch a favorite television program.
4. Take care of your own health.
Staying healthy is very important. If you become ill you cannot effectively carry out your caregiving obligations and that will really up your caregiver stress level.
It is likely that your parent is not as healthy as she once was. That makes her more susceptible to anything you might catch.
As we all know, staying healthy is sometimes hard to do. And there is always a degree of luck involved. But at a minimum you should:
- Eat well and stay aware of your own nutrition.
- Get enough sleep. One of the most commonly cited causes of health breakdown is not getting enough sleep.
- Take time out for healthy group activity. Everyone has her own favorite (and unfavorite), but one of the more popular forms of group activity among caregivers is tai chi. Tai chi has been shown to be a strong help in the struggle against caregiver stress.
Find out if your community offers Powerful Tools for Caregivers, the self-care education program for caregivers. Look at www.powerfultoolsforcaregivers.org for more information. Check with your local office for aging to see if the program is available in your community.
5. Get more exercise.
Here’s an idea. Let’s say you like to walk or run in a nearby park. Your kids also like to go to the park – and so does your dog. Your mother does too but she can only walk a short distance. So you all go to the park. You take a short walk together to a place where your mom can sit comfortably on a bench and your children can play nearby. She can watch the children and enjoy the park while you continue on with your walk. By the time you return she will be rested enough to walk back to the car. It’s a win-win for everyone.
6. Plan nutritious meals.
When my husband needed some extra help recently I found getting meals ready was more challenging than I had expected. First I planned simpler meals with fewer ingredients and less preparation. And I doubled my usual recipes. I often make enough of a dinner entree to last for two meals but now I made enough food for three extra dinners. What a time saver that was.
If you are creative and think about all of the people connected to your parents you can come up with a variety of ideas.
Like one woman I know who did all of her mother’s weekly grocery shopping. Her mother appreciated this but she also wanted some social time and complained that she was lonely. The woman had to balance her own work and personal responsibilities with what she did for her mother. That didn’t leave much time for visiting.
The woman’s mother had been a talented classical musician, and the woman’s daughter was taking piano lessons. Putting two and two together, the woman solved her problem by dropping her daughter off at the grandmother’s while the woman did the shopping.
The granddaughter enjoyed demonstrating her progress by playing for her grandmother and received valuable tips from her on how to improve. The grandmother enjoyed the company and felt valued. Another problem solved that was a win-win for everyone involved.
Another woman felt tied down by her ailing husband. He didn’t need a lot of help but she never went anywhere because she worried too much about him when he was alone. So she did not get out much. Then she learned that their church had an elder visitor program. The woman arranged for a visitor once a week who would read the paper to her husband or discuss sports with him. That gave the woman a couple of hours to herself to run errands or meet a friend for lunch. Sometimes she just went to a quiet place in the house to rest and read. Her husband benefited too because he enjoyed the weekly visits. They made him feel like he was more connected to the familiar community of the church members.
With a bit of planning you can engage the help you need so you can do the things that are important to you. If you ask for help you will benefit with more energy, less caregiver stress and fatigue, and a better outlook on the future.
By Christine Klotz and Charles E. Henderson Ph.D.