Yes, You can Care too Much...

A family caregiver, according to the Caregivers Association of BC (caregiverbc.ca), is anyone who provides unpaid care and support to an adult friend or family member who is disabled, chronically ill, frail, or elderly.

Regularly chauffeuring Mom to medical appointments or caring for an adult daughter with disabilities takes time–and energy. As a result, caregivers caught in the middle–the so-called sandwich generation–find it challenging to get adequate sleep, exercise, and nutrition. But good health is what caregivers need most.

“You will be able to provide your best care as a caregiver when you are at your best,” says Dr. Vicki Rackner, a board-certified surgeon who provides advice to caregivers. “Get good nutrition, enough sleep, and regular exercise. Manage your stress and do a little something everyday to nurture your soul.”

These self-care strategies are good preventive medicine. So are regular mammograms, prostate exams, vision tests, routine physicals, flu shots, and dental cleanings. But many caregivers neglect these appointments. The more hours spent caregiving, the more appointments are missed, reports Evercare Health Plans in their Study of Caregivers in Decline, a report published in collaboration with the National Alliance for Caregiving in September 2006.

When caregivers learn techniques for doing caregiving tasks more efficiently, they free up time for self-care appointments. Doing caregiving tasks more efficiently also frees time for activities we enjoy, including meditation, gardening, socializing, walking, and other forms of exercise. All reduce the stress that comes with caring for others.

“Caring for yourself is one of the most important–and most forgotten–things you can do as a caregiver,” says the US Family Caregiver Alliance (caregiver.org).

Why do caregivers overlook themselves? Guilt often interferes with the freedom a caregiver needs for self-care. Rackner explains that we often have unreal expectations of ourselves–an “ideal you?against which we measure our real human and imperfect self. Combine unrealistic expectations with regret over what we could have done and you have a recipe for guilt. Recognizing guilty feelings is the first of Dr. Rackner’s tips for managing caregiver guilt. Identifying other unpleasant feelings and appreciating how well we tolerate them is also important. Why?

“Once you put feelings into words you will have a new perspective,” says Dr. Rackner. “You will also be reminding yourself of how fortunate you are to have what it takes to take care of a loved one.”

Taking care of a loved one involves a rare kind of compassion and commitment, one that should be valued and celebrated. But caregivers need to extend the same compassion to themselves. “When you give yourself permission to have negative feelings, and recognize that your feelings don’t control your actions, your guilt will subside,” Dr. Rackner says.

A Downward Spiral

Those who spend 20 or more hours weekly giving care are more likely than others to report the following:

• reduced energy and impaired sleep (87%)
• stress and/or panic attacks (70%)
• aches and pains (60%)
• depression (52%)
• headaches (41%)
• weight gain or loss (38%)

Source: Study of Caregivers in Decline, Evercare Health Plans in collaboration with the National Alliance for Caregiving, September 2006. EvercareHealthPlans.com/Caregiver

Two Strategies for Self-Care

1. Emotional support is critical. Seek the support of a caregiver support group, which can offer coping skills, up-to-date information, and personal support–either online or in person on a drop-in basis. Ask your community health nurse where to find a caregiver support group in your area.
2. Find a work setting that offers flexible work arrangements to support family caregivers. Options include flex-time at work, working part-time, job sharing, taking partial leave or gradual retirement, working from home, or taking compassionate leave.