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Depression in caregivers: Ways to refresh the reserves

by Carol Bradley Bursack, Editor-in-Chief

A multitude of studies have shown caregivers to be at high risk for depression. Caregivers also have a greater than a 30 per cent chance of dying before their care receiver. These studies point to the fact that caregiving is a stressful life and without a way to refresh themselves, caregivers may be in grave physical and mental danger. Okay, so we know that. How do carers get some respite so they can stay healthy?

Caregiving, whether you are caring for someone in your home, their home, assisted living or a nursing home, is a 24/7 job. Certainly, getting help with your loved one by helping them make the move to assisted living or a nursing home takes away some of the hands-on demand, but still, the weight of being the point person for the care of your loved one is always there.

For a time, I had my mom living in her apartment needing daily care from me, my mother-in-law living in her condo needing daily help and my uncle and dad living in a nursing home where I visited (with Mom in tow) daily.

Then, when I did have time in my own home, I was the one who got the phone calls that my mother's personal alarm had gone off, so could I go and check on her? My dad fell at the nursing home, so can I meet them at the emergency room? My uncle had another stroke, so could I meet the ambulance at the hospital? Yes, my friends, it's still 24/7, even if you are not doling out hands-on care all of that time.

However, in-home help, adult day care, assisted living and nursing homes can make a huge difference in your stress level. And stress is often what leads to depression and other health issues.

My family was fortunate, in that we had one of the best nursing homes in our community just two blocks from my home, and within a mile of the farthest apartment. Without that help, I don't know that I could have survived.

Even with the help I received in caring for my loved ones, the stress of never being able to fully let go was huge. I did manage to take one three-day trip with a friend before my mother became entirely dependent on me. The preparation for that trip was enormous, but just getting to a place where every phone call didn't come directly to me was a big move.

It's Hard to Let Go

Even when we can figure out a way to get out from under the total responsibility of caregiving, it is often hard for our minds to let go. Most of us caregivers get so used to the total dependence of another human being (or three) on us, that it's second nature to be in fight or flight mode at all times, without even being aware of that fact. That is dangerous for our health.

When I did take that one trip, I arranged for my sister, even though she was 50 miles away, to be the point person in an emergency. I also lined up in-town friends. Then I did my best to forget the needs of others and enjoy this trip with my friend. I still caught myself worrying, but I made an effort to let go, hard as it was. They would be okay. I'd done what I could. I knew it didn't help a soul for me to sit and worry, and it would negate any good the trip could do me.

Other's Will Judge

Recently, I heard from a spousal caregiver who had planned a two week cruise. She was exhausted from several years of caring for her husband. She found a good assisted living center near their home who could care for her husband while she was gone. She lined up friends to help out. Yet some people thought she was a terrible person for taking the cruise when her husband couldn't go along. The guilt was eating her up to the point she nearly canceled her adventure.

We talked about it. I reminded her that her doctor told her she needed a rest. She needed to get away from caregiving or she could die before her husband did. Then what would happen to him?

She went on the cruise. She enjoyed it and came back refreshed. Did she "forget" she was a caregiver? No. But she made an effort to have a life outside of caregiving. When she returned, she was happy to spend time with her husband and he was delighted to see her. However, he was so happy with assisted living that he decided to remain at the center, rather than return home. Thus, the woman made a difficult transition without even knowing it. This transition may have extended her own life.

Small Steps Toward Self-Care

Most of us will not be taking a cruise any time soon. However, taking baby steps toward self-care by getting respite help is not an indulgence. It should be looked at as a necessary part of your caregiving life.

Where to Start?

If your loved ones are in your home or their own, you may want to start by just accepting some help from friends. Often friends will say, "Let us know if you need help." Most of us will then answer, "Thanks, but it's all under control."

  • Well, don't say that. And don't wait for an offer. Ask a friend of your own or a friend of the care receiver if they could sit with your loved one for an hour this week while you get your hair done or take a walk in the park.
  • Next, contact your faith community and see if there are any people who are willing to sit for an hour, or an evening, so you can get out on your own. You could also try Senior Companions through your Retired Senior Volunteer Program. Senior Companions are healthy, senior volunteers who get a stipend from the government to sit with elders and give respite to caregivers.
  • Next, look into in-home care from a care agency. You can line up blocks of time. If your elder has a long-term care policy, see if they pay part of the cost for in-home help. In-home caregivers can provide companionship for the elder as well as practical help.
  • Look into adult day care. Many seniors love these programs and the peer interaction they provide.
  • See about assisted living. Or is it time for a nursing home? Is the type of care you are giving requiring so much nursing care that your elder may not be safe with only you there? At any rate, start looking in case the need comes to this.

Back to 24/7. Even if you do get help, if you don't mentally let go, you won't rest. Every care agency needs someone to call in an emergency. Find a family member or friend to be the point person for a few hours at a time, so you aren't on constant phone alert. Make a deal that during this time, only for the gravest emergency are you to be called. Then do something to get away.

If you find a backup person, but still can't let go, you may want to see a counselor to help you learn to do so. If you don't care for yourself in some way, your depression or other health issues could leave your care receiver without your care for good. That's a bad deal all around.