Caregiver stress in body language
by Carol Bradley Bursack, Editor-in-Chief
Our body language affects those we care for. If we are stressed and our movements show it, our care receiver is likely to feel that stress. That, in turn, can make the care receiver more stressed and cranky. We then can create a negative cycle. Ideally, caregivers will learn to work off stress away from the care receiver, so that he or she can present a calm and loving presence for his or her loved one.
Have you ever had a day where you realize, after the fact, that your movements were jerky, you were hurried with everything you did, your teeth were clenched, perhaps your breathing was shallow? If you haven't, most caregivers would like to know your secret. A perfect caregiver would never let his or her stress be evident around the care receiver. However, we are imperfect human beings.
Coping with the needs of an elder or a spouse with dementia can be especially stressful; however, any long-term caregiving is something that can take a physical, mental and emotional toll on nearly anyone.
When dementia is part of the picture
People with dementia, particularly advanced dementia, are often only able to comprehend the here and now. Therefore, the fact that this person may have asked the same question of the caregiver every five minutes for an hour is just a reflection that this is what is going on in the care receiver's mind.
So, if your dad asks, "When's Henry picking me up?" that's just what your dad is thinking. He doesn't remember asking you about it. He's just pondering the fact that Henry is his old friend who he went to a men's coffee group with during their work years. He can't remember that not only is the group no longer meeting, but that most of the attendees, including Henry, are deceased.
The first time, today, your dad asks this question, you answer sweetly and with compassion, "Dad, I'm afraid Henry can't make it today." You've already made peace with the fact that you can't go into why Henry can't "make it", since your dad can't remember the reasons anyway.
Five minutes later, your dad once again asks, "When's Henry picking me up?" Again, you say, sweetly, but with a little edge in your voice, "Dad, I'm afraid Henry can't make it today."
Five minutes later - yes, the same thing. Each time you dad asks that question, you feel your muscles tighten. Your answers may sound the same to you, but your voice tone is less patient. You start moving around the house in a fashion that shows that you are feeling stress and then you may suppress anger out of proportion to what is going on. You find yourself wanting to say, through gritted teeth, "Dad, Henry is not going picking you up because Henry died five years ago."
Distraction can help but you still need to de-stress
Of course, you don't say that. You've already that tried and it accomplishes nothing. You've learned that your dad can't keep the information about Henry in his memory long enough to process it. It's not his fault. It's the fault of the disease that is eating away at his brain.
Yet you are human. Your nerves get rattled. You are likely tired - even exhausted if you haven't had time to yourself for awhile.
Yet, you swallow your response and practice the distraction techniques you learned from the Alzheimer's Association. This is all good. You convince your dad to watch a DVD of some past TV shows he used to like, and for the moment, he forgets about Henry.
All is well, right? Well, kind of. If your dad is able to watch the DVD, and you get some time to de-stress, say by enjoying the same shows as he does and laughing with him, or taking some time for yourself in another room to exercise or call a friend, you may do very well. These are self-care practices that will help you, and in the process, help your dad.
However, if you swallow the stress from the repeated questions, yet still feel angry or frustrated because you just can't relax, you are likely to hear once again, "When's Henry picking me up?" Or, you may just see that rather than relaxing and enjoying the DVD, your dad is agitated and cranky and nothing can soothe him.
You find yourself wondering why your dad's so agitated, when this activity is something he generally enjoys. One reason he's agitated could be that your real feelings are showing through your body language, even though you are saying the "right" words.
Your dad doesn't know what is "wrong" in the atmosphere of the home, but he's feeling anxious. In other words, your clenched teeth, your jerky movements and your general tenseness may actually trigger agitation in your elder, which in effect triggers more tension in you and the cycle continues.
It's not your fault
In no way is my description of this scenario meant to place blame on you, the stressed caregiver. I'm wholeheartedly sympathetic. I'm only suggesting that cyclical agitation, and stress on your part and that of your elder (or spouse) with dementia, may be a clue that you need some outside assistance in order to get a break, however short, from your care routine.
This solution may seem obvious, but impossible for a lot of people. However, there are sometimes options caregivers may not know about. Just a small break in routine can be enough to let you refresh yourself so you can go back to caregiving without adding to the already challenging behavior patterns of your loved one.
- Try searching your state website. Find the main website of your state and type "aging" in the search box. You should come up with a long list of resource leads. One of those choices may be something like "health and human services." Look for names of agencies that indicate human services and click the link. There are free in-home care hours in my own community that don't get used because people don't know about them. These are government funded hours, not income based, yet lack of publicity indicates they aren't needed and these hours are lost. I'm not making a promise that you'll find this service, but you won't know if you don't try. Alternately, you could call your local county Social Services to see if they know what agency you should contact.
- Check with your elder's neighbors or members of your faith community. Maybe there's a way you can swap care, or maybe there are retired people who are willing to come and sit with your dad and, because they are "fresh," they won't be so stressed by his repeated questions. They may even enjoy themselves.
- See if there's a Retired Senior Volunteer Program (RSVP) in your area. Many RSVPs have Senior Companions, who will sit with your elder for free. These folks aren't heavy-duty caregivers, but they are trained to be compassionate listeners, and they provide a primary caregiver with some "off time," so that caregiver can refresh and relax.
- Hire in-home care help for a few hours a week. Even three hours during an afternoon can be rewarding. Many in-home agencies work in blocks of time, and your health is a good reason to spend some money. Use that time for yourself.
Remember that getting outside help for your loved one is not a selfish act. You, as a refreshed caregiver, will come back with a more relaxed attitude, and yes, your body language will reflect that. Your dad may even have enjoyed a nice long chat with a Senior Companion close to his own age. This guy may not be Henry, but he could be a good substitute. Try it and see.
Your relaxed attitude may help your care receiver be more relaxed, as well. Is this magic? No. Your dad still has dementia. He'll still repeat his questions. He'll still get agitated. But if you are more relaxed because you are refreshed, this behavior may be more tolerable to you. The behavior may even be reduced in degree, as your dad's anxiety-induced behaviors level out from the good vibes in the air.